Ask questions, demand answers, and experience the difference.
Health is the single most important aspect of living a fullfilled life. So having trust issues regarding the advice you listen to and implement is not only normal, it is GOOD! Trust should be something healthcare providers earn. All of the fancy degrees and white coats in the world cannot make up for a lack of respect and empathy. Incase you haven't noticed, our healthcare system is a disaster. I truly feel horrible for anyone that has to try and navigate the nightmare that should be something that betters your life as a whole!
The reality is that you should question every answer you receive from any provider, respectfully of course. If you feel that they get defensive about being questioned, thank them for their time and find someone else that is willing to educate you. Do not let their credentials or reviews blind you to the fact that they don't care about you..
Do I think PTs are more qualified to treat spine pain patients? Absolutely, not. Unfortunately, My time in the standard healthcare model has shown me that there is not a single profession that has all the answers. That being said, there are plenty that have the wrong answers, but that is for another day. I am writing this because you as a consumer of information should not be led to think that there is only one path to feeling better. You should be given the tools and knowledge to made educated decisions about your health.
Research, as reported in The Journal of Orthopaedic & Sports Physical Therapy in 2018, found that there was no significant difference between patients who saw an MD then went to PT versus those who went directly to PT through direct access models. This is likely because our training revolves around ensuring we understand the muskuloskeletal system and how your body should respond to specific stimuli. Going to a qualified PT first helps protect you from unnecessary procedures, medications, wasted time waiting on referrals, and even surgeries. Your typical path to relief is flawed and dangerous at times
. Common Example:
You’re out doing yard work or playing with the kids and feel a twinge, but it doesn’t last so you don’t think much about it. You go in and rest on the couch, sit and eat dinner, then it’s off to bed. You wake up and feel like someone is jamming a burning sharp dagger into your back and let’s not talk about the pain shooting down the leg! The logical thing to do in this situation is to rest right? I mean isn’t that the first part of RICE?! Well, this is a pretty bad idea but who wants to move when it hurts so bad? This is where being educated on what pain actually means and what your body is trying to tell you is important.
A few days later you are still hurting so you take a day off work to see the MD. You are given pain meds and muscle relaxers and often told to rest more. Well, these band-aids are not fixing anything, so you end up back to the doc. Well, if that combo didn’t work let’s try a steroid, an x-ray or MRI, and a referral to a specialist.
You have the MRI which is miserable and EXPENSIVE if you have a high deductible plan, or no insurance and the best part is that the specialist says you have “age-appropriate findings” or even better “the spine of an 80-year-old” (at 30-40). Either way, a common next step would include neurogenic medication and stronger pain meds.
If they found something on the imaging you may even get scheduled for an injection at this phase.
Side note: Evidence has found that out of 100 non-symptomatic people off the street, 80% had at least one bulging disc
This is where PT may be introduced. If you are lucky you will end up with someone that has done a lot of post-grad education specifically for the spine.
Some people will go to PT before their injection and will be educated and helped to the point that they no longer need the injection. Others will get the injection and stop PT because the injection “fixed” their back. The first group will hopefully escape the healthcare system with a solid set of tools to help them control their pain and adjust their body mechanics. The latter group tends to need repeat injections or more invasive procedures. Eventually, they stop working as well and now you are really in for some fun. Surgery should always be used as the LAST option, do NOT let anyone operate on your SPINE until you have exhausted all other options! There is a reason it is called your CENTRAL nervous system.
To recap, if the outcomes are the same regardless of starting with PT or at the doctor, does it really matter?
Well, each step mentioned above is another expense. Whether it’s your co-pay, medication cost, injections, imaging, etc. they all cost you time and money.
So, time and money are the short answer. The other interesting finding from this same study was that a PT that utilizes evidence-based screening can accurately determine the appropriateness of Physical Therapy as a treatment for your issues. This helps ease the concerns over safety some professions note as a reason to not pass direct access.
We have safety, effectiveness, and efficiency noted as reasons you can trust a PT with your spine. Provided you determine they are well versed in spine care.
Ask questions, demand answers, and experience the difference!