Physical Therapists

3 Comments

• #1 by mistify on January 24, 2010 - 4:44 am

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  No treatment has been deemed superior. Physical therapy, chiropratic care and pain management have all been determined to have equal long term outcomes. However, I think part of the problem with reseach on treatments of low back pain, is that most back pain is never properly diagnosed. Your MRI may display bulging or herniated discs, but they might be completely irrelevant to your symptoms. A thorough mechanical assessment to see what happens to your pain during certain movements is necessary to classify your pain. Once your pain has been classified into mechanical or non-mechanical and subsequently one of the further subcategories can you seek the appropriate treatment. For instance, for someone whose pain is due to a bulging disc and confirmed by mechanical assessment, massage and “stablization” exercises will usually not help…conversely, someones whose pain is due to another reason will not be helped by the same methods used to treat the bulging disc.
  To say the very least, most back pain is poorly classified (even if MRI has been done)… a thorough classification is needed to do this. This is a procedure that only a handful of PTs, DCs and MDs are credentialed to perfrom. If you have not done so already, I suggest you have a mechanical evaluation by finding a credentialed provider at: http://www.mckenziemdt.org
  Another option you might hear about is spinal decompression. This is typically performed at a chiroprators office. Many are being lured to this with the statement that it has over a “90%” effectiveness rate…however, what they do not tell people is that this is at the 90 day mark only (short term results) and only for people who have a one level problem without degenerative changes. As more levels and degeneration is involved, the numbers drop to 70%, 65%, 50%…etc…similar to physical therapy. No large long term outcome studies have been done…and I suspect it has similar results as PT and pain mangement. I’m not against it, I just think it is not being fully honest with its marketing…I have had patients who’ve gone through it (and I was seeing them for another reason) and they state they find themselves going back 1-2 times a year for further treatment.
  I would highly recommend the MDT website, and also exploring different pratcitioners within the same fields you’ve tried…there are always different treatment approaches among practicioners.

• #2 by rosieC on January 24, 2010 - 5:24 am

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  Degenerative should tell you that it is only going to get progressively worse and not better. If you have herniated and bulging discs you need to consider surgery,

• #3 by mistify on January 24, 2010 - 9:25 am

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  The best surgical approach is the best solution for many back problems. One necessary surgery is the removal of the gelatinous nucleus pulposus that extrudes from the center of a disc when it ruptures. Quick action is recommended to prevent permanent damage to the spinal cord in some cases.
  The bulge of a herniated disc can be trimmed away to eliminate pressure on the spinal cord and/or nerve roots thereby relieving the pain. This procedure has the negative side effect of weakening an already damaged disc. The entire disc can be replaced with a synthetic disc or one from a cadaver, but disc replacement can have considerable negative consequences.
  The symptoms of a thinning disc can be eliminated by locking the spacing of the vertebrae using plates and screws. In some cases two adjacent vertebrae are allowed to fuse together with transplanted bone to replace the surgically removed disc. Some of these procedures give a fairly good result, but many disastrous complication are also common.
  The program presented here is very low risk, but a complete medical diagnosis should not be delayed before starting this program. Medical conditions such as tumors and/or cancer should be ruled out by a doctor before attempting chiropractic manipulations or traction. It is therefore advisable to have a complete diagnosis performed by a medical doctor before proceeding with the program present here.