As a physical therapist for over 18 years, who specializes in the diagnosis and treatment of pain, I have seen just about everything. It has become increasingly clear that one of the main inhibitors to people getting their back pain resolved is the fractured nature of the health care system when it comes to treating pain.
If you have back pain, you have the option of seeing a neurologist, orthopedist, chiropractor, physical therapist, pain management physician or an acupuncturist. Each specialty claims to know what to do to resolve your symptoms.
Unfortunately, to make things worse, your diagnosis usually results from a diagnostic test, such as an MRI or x-ray. Starting with a diagnosis from one of these tests almost immediately seals your fate, because these tests have now been proven to be invalid in correlating a positive finding such as a herniated disc or stenosis to pain. And worst of all, it is up to the patient to determine what path to take. There is no coordinated effort to establish the cause of pain and treat it.
So you start off with a faulty diagnosis which then is treated by each specialist. Not one of these practitioners are in a position to even determine whether your specific symptoms are the result of a tissue that falls into their specialty or whether it is outside of their specialty. They simply treat based on generalized premises.
For instance, you were found to have a herniated disc on an MRI, the chiropractor gives you adjustments, the orthopedists give you anti-inflammatories, the neurologist gives you Cymbalta or Neurotin, the physical therapist gives you electrical stimulation or ultrasound and the acupuncturist gives you needles.
Every one of these treatments is generalized for a herniated disc. Not one of them attempted to determine whether the herniated disc is creating your pain. Whether the pain is in the mid back, lower back, close to the spine or across the back, it doesn’t matter.
This is why the existing system is failing. No coordinated ability to identify the cause of pain. This has been confirmed by a new report provided by the federal government. The report identified that 116 million American adults suffer from chronic pain. It was noted in the report that there are no stand alone courses provided for pain in medical school for any specialty.
The existing medical model is fractured when it comes to treating pain. A new specialty must be created where a person in pain begins their journey into the medical establishment. It is here where a diagnosis is developed.
Depending on what tissue is creating the pain signal determines what specialist the person is sent to. This is the most effective method of getting the correct diagnosis which will lead to the most effective treatment. At this time, this is the model that I practice. I utilize the method of diagnosing that works to determine what tissue is creating the pain signal.
This is not what I was taught in medical school. It is the system I developed immediately after finishing medical school because it was evident that medical school did not prepare me properly to diagnose or treat pain.