Proper Back Pain Care Doesn’t Always Bring Relief

Yes, it’s true, proper care does not guarantee you will be out of pain, but it can direct your care in the proper direction.
You have a bout of low back pain, you want relief and you don’t know what to do. Many people who experience low back pain want to find the quickest avenue to acquire the proper care.
The lack of understanding about one’s pain experience can have individuals make hasty decisions, so this article advocates ensuring you take the time to get to know your particular problems well. During the evaluative process in physical therapy, the physical therapist interviews you to find out how positions and/or movements influence your symptoms.
You might have heard some say, “We don’t treat symptoms; we treat the origin.” This is a very misleading statement because this would have low back pain be placed into the same category as the common cold.
In-fact, the effects movements and positions have upon ones symptoms provides important information about the symptom generator (the tissue origin of pain and how gravity influences it).
Studies show, for example, that if you have pain in your leg from your back, procedures which centralize those symptoms (brings the pain up higher in the leg and preferably into the low back and out of the leg), your rehabilitative potential is quite good.
Healthcare/medical providers can argue about the potential origin of the pain, but the studies show a good prognosis regardless of the tissue at fault (e.g., disc, spinal joint).
What you tell your physical therapist will provide important information in determining the cause of your pain and how it is affected by gravitational force.
The pain could have come on via a traumatic event (e.g., motor vehicle accident), by bending in one direction too much or improperly, sitting too long, standing too long, lifting too much weight, etc.., the list goes on. Your input provides information which sheds light on the likely mechanism of injury and directs treatment.
The physical therapist can than correlate his examination findings to determine the appropriate direction of treatment. It is important to note that the success of treatment is always dependent upon the status of the injured tissues.
While we at Professional Physical Therapy & Rehabilitation, PC boast a huge success rate with our spinal pain patients, and our practice has grown significantly as a result. Not everyone will respond as desired or even as expected, even when genuinely keeping to good postural and body mechanic principals.
Some of you have read my articles about spinal decompression and the ATM2 machine, a device for which no one in the area has the experience we do in its use.
One note to make is that spinal decompression (aka spinal traction) is used for the same exact reason in every medical/healthcare facility that has the device. It’s a great option, as is the ATM2, which is and has always been paid for by your insurance, along with other methods of treatment.
These are wonderful options for a variety of back pain problems, but they are not the only options. Every treatment does not help everyone; hence, why we at Professional Physical Therapy & Rehabilitation, PC also utilize a variety of treatment approaches.
Despite the numerous available treatment options, again, not everyone will respond as desired. However, such an experience helps direct ensuing care for one’s particular problem.
Most readers are used to medical and/or healthcare providers touting how great their treatments are. In an endeavor to provide a public service, I offer the readers an example of a case when treatment does not help with pain.
First, there is a lot to learn from conditions which are non-responsive and if any medical and/or healthcare practitioner states they never had someone who hasn’t responded well, run away as quickly as possible. Everyone is subject to the integrity of one’s injury.
For example, I recently had a patient attend our facility, and she was actually coming in to treat for her knee, along with her low back. She entered the facility maintaining a forward inclined posture; she was avoiding standing straight and she was avoiding backward bending.
She had been standing like this for some time, even though her pain level had settled down. However, following the application of procedures which required assuming the erect position and moving toward the backward bending position, pain returned with a vengeance later on that evening.
This is an important finding which is sometimes a necessary reaction which enables the physical therapist to note the nature of the condition and to properly direct the patients care. Sometimes this reaction is just plain unavoidable no matter the treatment provided.
Some conditions are just that sensitive. In some cases patients who are very persistent can eventually do well as the inflammatory process fades; others who are less tolerant of such a reaction can be directed to other medical professionals, such as MDs, for medication and/or injections as seen needed.
This is one of the most difficult concepts for some people to understand, as they come for care with complaints of pain, yet their pain worsens. Every medical and/or healthcare provider is at the mercy of the integrity of the damage, so there are certainly going to be cases which are more difficult than others.
Inflammation will often resolve over the ensuing days, regardless of what treatment is provided. During the resolution process, anyone can look like a hero when applying non-stressful gentle treatments to the low back as the pain subsides by natural processes.
However, unless the aforementioned person is satisfied with maintaining a forward bent posture for perhaps a long time into the future, something needs to be done to obtain the proper direction for treatment.
With regard to the above case, the patient returned for another visit; extra caution was taken to minimize the potential for exacerbation, however, the same thing occurred once again. This was certainly a cue to refer the patient for orthopedic consult to either acquire other anti-inflammatory medications and to receive further diagnostic studies (e.g., MRI).
Injections may also follow as inflammatory chemical pain clouds the problem and until it resolves sufficiently, it will be difficult to progress such a patient.
By the way, over the 20 years of my experience, I have had numerous patients try so-called alternative and/or natural anti-inflammatories, and I have to say anecdotally, that they have yet to have shown positive results of shortening the inflammatory phase beyond natural resolution.
Here is a clear case that needs to be referred for further diagnostic testing with a potential need for surgery, often based upon the patient’s pain tolerance and severity of the prevailing injury. An important thing to note is that when you do receive care for back and/or neck pain, ensure the spine itself is assessed first and foremost.
There are some practitioners who are evaluating and treating soft tissues before they examine the spine itself, hence, working from the outside inward instead of inside outward which is imperative to receiving proper care.
At Professional Physical Therapy & Rehabilitation, we do our best to help those in pain heal from their musculoskeletal condition and we also help direct care when ones condition is not suitable for any form of care.
Procedures which do not exacerbate the problem are OK if they involve stress reduction (e.g., gentle massage), however, this will not affect the actual problem that exists.
We offer numerous methods of care and unlimited treatment session time so one might be here anywhere from one to three-plus hours, based upon need and/or patient motivation and/or tolerance. The extra time has really made a difference for so many people. The extra time also avails for a healing social and amiable atmosphere.
We just plain have fun here; so it’s great to laugh, even when you’re in pain. If you have musculoskeletal pain anywhere in your body; if you have balance deficits; if you desire a fun friendly atmosphere where you will not be rushed in and out within a set time frame, and you want the best care possible; look no further.
Our patients become like family. See videos of real patient treatments, read and listen to our many testimonials on the Testimonial page of our web site, www.ProPTRehab.com. There is simply no place better to receive your physical rehabilitative care.
Professional Physical Therapy & Rehabilitation, PC; is located at 650 Town Bank Road; N. Cape May. Call (609) 884-9800.
— Dr. Mitchell Hackerman