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  • snc1226


Everyone wants a magic pill or a cool new stretch that takes away all of their pain with little to no effort. Myself included

taking pain medication
pain pill

trust me, I think about it every day! Unfortunately, we live in a world with very few absolutes but this is one of them. You absolutely cannot be a passive recipient of care and expect anything more than temporary relief. Even if I was able to come up with that magic pill, I don’t think Big Pharma would like it very much. If they break the bank while their products kill over 100k+ people each year and we all act like it is perfectly normal.. you get the point.

Rather than come here and complain about how terrible our healthcare system is I want to share a story.

A patient walks into the doctor's office complaining of low back pain that started 2 weeks ago. Doctor prescribes low dose pain killer and muscle relaxer prn. 2 weeks later pain is worse and is now in the hips so the patient returns. Doctor orders x-rays and bumps the painkiller dosage but tells the patient to start yoga to help her core strength.

X-rays show minimal arthritis, disc degeneration, and a grade 1 spondylosthesis and pain has continued.

The next step is an MRI and Physical Therapy for core strength and hip stretching of course.

Physical Therapy assessment
PT examination

MRI findings show nothing new so PT is continued and the patient is started on a steroid pack.

Steroid seems to help, patient bumps his exercise routine up because he feels so good. After a week the steroid is over and his symptoms begin to return except now the back doesn’t hurt as bad but the hips are worse.

Well golly g doc, why don’t we order imaging of the hips, silly you!

Not much shows up there so it’s probably bursitis. Keeps up with PT.

imaging of hip bones

Patient continues PT even though symptoms are worsening because no pain no gain!

At the next doctors appointment, he reports that his legs have been giving out on him when he stands up.

Long story short the patient gets a surgical consult where he is told that he will need a 2-level fusion to stabilize the spine where the spondylosthesis is. And because the patient has already tried conservative care there is no need to try any further.

Doesn’t this story sound ridiculous? Maybe not because it happens all of the time.

The ridiculous part is that what started out as slight low back pain was allowed to progress to that point. Had the patient seen the proper healthcare provider to start with they could have been back to a pain-free life with no surgery. They would also now possess the knowledge and ability to continue to progress in their own health and wellness.

So, who is the right person?

First of all, it should be someone that is well-versed in how the human body should move. They should be free of the influence of other healthcare providers. They should have little to no relationship with insurance companies. They should be accessible outside of your appointment time in case of questions/concerns. Maybe a Doctor of Physical Therapy that is certified in MDT would be a great place to start!

Not everyone is going to respond well to conservative care BUT the majority of pain can be resolved steadily with the right plan of action. Also, EVERYONE should absolutely fight like hell to stay off of that operating table. Don’t put your future in the hands of anyone that jumps to surgical intervention(some extreme instances do exist that require emergency surgery but this term is used much too loosely!). They do not have your best interest in mind.

If you happen to be one of those that are unable to resolve your pains conservatively please do yourself the service of demanding a referral to Physical Therapy post-operatively. It is very common knowledge, especially within healthcare, that one operation is likely to lead to another down the road. Do not allow yourself to end up in the same situation. Find someone that can provide you with a plan of action to avoid this statistic.

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