In many unspecialized clinics, a physician will see the patient, perform an examination, and then refer the back pain sufferer to a physical therapy clinic all the way across town. This general "evaluate and treat" prescription for physical therapy is all-too-common. Often, a general physical therapist will start from scratch by forming their own evaluation and assessment without knowing what the original physician found out through diagnostic tests.
This general physical therapist often sees a wide variety of problems every day, such as patients with sore elbows, knees and sore shoulders. In most cases, this general therapist has a very limited understanding of how to treat specific types of back problems. At best, a general physical therapist has taken a couple courses on how to perform therapy for a back or neck injury.
A general physical therapist may also rely too heavily on passive "modalities," such as ice, heat or ultrasound, to treat back pain. This may not be a good choice, as research has shown that using these passive treatments is NOT the best way to return someone to activity efficiently.
How our spine center differs
Instead of sending a patient across town, they will be able to come directly into our rehab department. They will also be connected with a spine-specialized therapist who has advanced training in spine. Rather than starting from scratch, this therapist works off of information gleaned from the previous physician's evaluation, picking up where they left off.
What does this mean for you?
Instead of receiving a general treatment approach, your therapist is specialized in the treatment of back and neck pain. Our therapists have advanced, hands-on skills that can help relieve your pain and get your injured muscles, tissues and spinal structures moving again. Instead of a single school of thought, you get the benefit of being treated by a specialist with a variety of skills who can choose the ones that best match your particular problem.
Q. What makes SpineTeamSpokane physical therapy different?
A. Just as the trend in medicine is for physicians to subspecialize in knees, or arm, or joint replacement, the exact same thing is happening in the area of physical therapy. That's good news for patients.
Just as the first step for a physician is to receive his MD degree, the first step for a physical therapist is to become a licensed physical therapist. Most orthopedic centers and therapy clinics will have licensed physical therapists who split their time among patients with knee pain, hip problems, shoulder pain, hand problems, ankle problems and foot problems.
Experts have found, however, that back and neck problems can be stubborn to treat and may not respond to general techniques learned in therapy school. Worse, what often happens is that when generalized therapy fails to relieve symptoms, the patient has to resort to spine surgery.
Consequently, those therapists who spend 100% of their time with spine patients learn early on that they need advanced training to help patients recover from back and neck pain nonsurgically. The better the spine training, the more often the back or neck pain sufferer will be able to recover without having to resort to spine surgery.
Spine Team Spokane physical therapy, in addition to other techniques, uses the McKenzie method of spine therapy, which is regarded worldwide as one of the most effective, spine-specialized therapy techniques.
Q. What is the McKenzie Method?
A. The McKenzie Method was developed about 40 years ago by a New Zealand therapist who observed that back and neck pain symptoms could be relieved through special stretches and movements. Over the years, the technique has evolved to include a systemized approach designed to help many people with back and neck pain symptoms recover without the need for surgery.
Therapists who want to learn the McKenzie Method attend special courses and take a credentialing exam that documents they are proficient in these special techniques. If they pass a series of rigorous exams that include Parts A, B, C, D and E, they become McKenzie-certified therapists, and can put the initials MDT” after their name.
The McKenzie Method (also known as Mechanical Diagnosis and Treatment or MDT) enables the McKenzie-trained spine therapist to use a “system” of evaluations and movements with the patient. Through this approach, the McKenzie therapist can assess how the patient's symptoms respond to various movements or sustained positions. If a certain movement relieves pain, this provides information to the therapist about the disc or soft tissue injury, which in turn influences the recommended therapy treatment. Said another way, the therapist helps the patient discover what specific movements begin to relieve pain, and then use additional, complementary stretches that encourage healing and relief of symptoms.
Q. What will my therapy at SpineTeamSpokane be like?
A. At other clinics, patients may lie on a table, while a therapist puts hot packs or ice on your back. Or your therapy may have included other passive things like ultrasound. Or you may have had a massage. The insurance companies who pay for back care have done extensive research on things that relieve back pain —for the long term — and they now have policies that eliminate payment to clinics doing “palliative care.” The word palliative” means something that feels good, but doesn't cure anything.
So while a massage or hot pack may feel good, it doesn't provide any lasting change to the soft tissues in your back or neck. The effect on your symptoms is temporary, and in a sense, worthless because it doesn't last, and your pain will return.
Nationally, the best spine treatment clinics avoid passive things like hot packs, ice and massage. Instead, spine specialized clinics emphasize things that strengthen the back, make it more flexible and resistant to injury. In other words, Spine Team Spokane emphasizes specialized McKenzie spine techniques, stretches and exercises that will help you recover from injury without having to resort to surgery.
At the foundation of McKenzie, for example, is the philosophy of helping the patient to take responsibility for their own health. We will show you the special exercises that are customized for you. By using this customized series of stretches, you have the resources you need back at home to control your back or neck pain symptoms long term.
Q. How do McKenzie exercises work?
A. McKenzie exercises are based on Directional Preference. We help each patient to discover a direction or movement that improves mobility or function to relieve symptoms. This might be an extension movement, flexion of the trunk, rotation of the trunk, retraction or some combination of movements. Once a directional preference is found, then to we have to discover the optimal load and effort required to achieve the best results.
Q. Will my leg or arm pain go away using this method or will I need surgery?
A. The second aspect of the McKenzie Method involves the concept of centralization” of pain. Using these McKenzie techniques, a therapist can help a patient that has pain radiating down a leg to the knee area, to reduce the pain symptom so it no longer goes as far down the leg, and over time shrinks and “centralizes” the pain until it eventually disappears.
Some patients with pain radiating from the neck into the arm, and from the back into the leg, can respond very well to these exercises and stretches that centralize and ultimately relieve the pain completely.
It is important to note, however, that any time you have symptoms that involve radiating pain or numbness into a leg or arm, consider these serious emergency symptoms that need to be seen by one of our spine specialists to determine if they are worsening, or if they can be managed with therapy. If you ignore these symptoms, such symptoms can cause permanent nerve damage. Another emergency symptom is any loss of control or bowel or bladder, which needs to be addressed within 48 hours to avoid permanent paralysis of the nerves that control your bowel and bladder. If you have any of these red flag symptoms, you need to see a spine specialistwithin 48 hours.