If you’ve tried physical therapy or chiropractic in the past and did not get satisfactory relief, does that mean that neither is effective for your condition? The answer is a resounding no! There are a number of reasons for this including: misdiagnosis, improper staging of the injury, lack of treatment flexibility, and lack of treatment synergy.
Misdiagnosis? You might say, “I have a herniated disc at L5/S1 seen on MRI.” You likely concluded that this must be the source of your pain. Your doctor may have told you so. There are times when the patient is correct and the pain-generator is the disc. There are other times when, in spite of the prevalence of a disc herniation, the pain is coming from another structure. Furthermore, if the pain is coming from the disc, there could be underlying factors that are the primary problem causing a secondary disc condition. A recent study illuminated this confusing point by demonstrating that over 50% of adults without pain had a bulging and/or herniated disc on MRI. It’s complicated, and you need to be sure that the subtleties of your condition have been thoroughly evaluated. Did your physical therapist have ongoing dialogue with the prescribing physician? Did the physical therapist proceed with a disc protocol without any nuanced thinking about your specific condition because he received a prescription for a herniated L5/S1 disc? Did your chiropractor diagnose your condition with these complexities in mind, or did they label your condition a “subluxation” or “slipped disc?” If you were misdiagnosed, it’s very likely that your treatment was not the treatment of choice.
Regardless of your diagnosis, your treatment should always evolve. Whether you have a muscular strain or a bulging disc, the treatment should match the stage of the injury. Acute, sub-acute, and chronic stages of injuries require different forms of treatment because the physiological components of each stage are unique. These physiological components include, but are not limited to: inflammation, pain, loss of range of motion, loss of strength, loss of stability, and loss of function. Various physical therapy modalities, rehabilitative exercises, and chiropractic manipulative therapies are targeted for these injury components. Did your treatment evolve? Did you get the same treatment each visit? If so, was there a reason it did not change?
Did you go to a facility that specialized in one form of treatment at the expense of considering other treatment forms for you specific condition? There are a multitude of excellent physical therapy and chiropractic techniques including: McKenzie, Rolfing, Active Release, Gonstead, Flexion-Distraction, Activator, Spinal Decompression, and many others. If you went to a provider with a rigid mentality regarding which treatment option is best, it is very likely that your condition was fit into a paradigm favoring their preferred form of treatment. Does it make sense that at some clinics everyone gets the same treatment? If there’s only one “tool in the toolbelt,” which tool will be used?
There have been studies comparing the effectiveness of exercise, chiropractic manipulation, patient education, medications, and massage. All have demonstrated some benefit to those with back pain, but what about combinations of these treatments? You may have tried one or more of these options. If you tried several forms of treatment, were they used with the intention of correcting a specific component of your injury? Any one form of treatment by itself is, in most cases, insufficient. A combination of therapies, each with a known purpose, creates a powerful synergistic effect that far exceeds what any individual therapy could do.
At Complete Health & Chiropractic Center, we believe that there is a most efficient way to treat each individual. First, the chiropractors and physical therapists work together to get the correct diagnosis. Often this process involves your family doctor, orthopedist, or other specialist. Once the correct diagnosis has been made, a customized treatment plan is created that may include a number of physical therapy and/or chiropractic modalities and techniques. As treatment progresses and your condition changes, your treatment accordingly evolves. This process requires knowledge and experience. It also requires thoughtfulness and preciseness in order to make the process successful. “Cookie Cutter” approaches do not work. If physical therapy or chiropractic failed in the past, it may be because the providers did not account for the subtle complexities of your injury or condition.
