Diagnosing the reason someone hurts is a fact-finding mission first, a puzzle second and appropriate procedures to help the person feel better last. Jumping to conclusions or biasing my findings often leads to the wrong diagnosis and ineffective treatment, which is why I like to be thorough. It is all about the process of developing a diagnosis and an appropriate treatment. When I first meet a patient, I will make sure all of our paperwork is filled out and then proceed to ask them about their main complaint and previous history. It is quite common for anyone with a longstanding problem to have a disc with an MRI or a doctors report, x rays and while these are important, it is also understood that doing a good exam can be often more helpful than an MRI or an x ray. Since most of our patients are not being treated for trauma, the tests often are a history of malfunction and what you see on the test is the result years later. Many doctors will order these tests after doing a basic evaluation, however, a thorough evaluation and history provides us with the background behind why you are hurting, and gives us all the facts to help us examine you more appropriately. The worst thing we can do is only evaluate the painful area and ignore the rest of the body. This approach common in the medical world often leads to the wrong conclusion and treatment only of the symptomatic area. Often, the cause of the problem can be found elsewhere in the body had the healthcare provider holistically evaluated the patient first. Patients are often surprised by the questions asked during while taking the history since many of their former symptoms may actually why their current problem exists. In other words, your should pain may be a lower body problem, as well as your stiff neck. Your foot problem may be a core issue, or a chronic shoulder problem. You would never know this unless someone helped you connect the dots. If trauma was involved, or if you have had problems for years, an x ray may be performed in our North Brunswick office to rule out traumatic injury, wear and tear or perhaps to more fully understand the effects of an old surgery. If another pathology is suspected, an x ray can help us understand if there is a problem that requires an immediate medical referral. The good news is that this is most painful problems can be improved in our office, often during the first visit. We do not require advanced imaging or tests to treat most patients and the current medical literature actually discourages their use in most cases. Treatment is based on the mechanism behind why you hurt, and is customised to your unique needs. One of the most common things we recommend is foot orthotics. This is because many of our patients are built asymmetrically and leveling their hips with the proper shoes or inserts in their shoes can make an immediate difference in how they feel. Often, off the shelf inserts that are prescribed can reduce back and knee pain quickly. During our initial visit, we may use methods such as myofascial release to improve movement and flexibility and a spinal adjustment to further improve how you move. Patients often feel better from this procedure and improved mobility reduces inflammation and problems due to impact as well. Exercises are often given on the second visit to help improve core function and mobility. Most patients who have chronic problems may believe that their problems was just their regular stiffness or achiness, however it is true that we are biased by how we usually feel. When we hurt, patients who do not improve on their own will call us for an appointment. We do our best to help patients understand their bodies better and help them improve quickly. By evaluating and treating holistically, which also means being thorough, we look at and consider everything. If a problem is not resolving in a reasonable period of time, I will reevaluate and rethink our approprach and using active evaluation methods, work at understanding how to help the patient become free of pain, while improving how they function and feel. This approach helps many patients not only feel and function better, but they avoid future problems. A properly functioning body, nervous system and core helps protect us from future problems. We avoid one size fits all diagnosis and treatments. A patient came in today diagnosed with peroneal tendonitis in his foot and now his mid back into the shoulders were hurting. The orthopedic who diagnosed him referred him to physical therapy for the peroneal tendonitis. Our exam showed the lateral fascia on the right side of his body into his shoulder was very tight and the right foot was falling off to the side. The problem began when he stretched the right side of the leg after pickleball. The problem had nothing to do with peroneal tendonitis but over time, his right side tightened up playing pickelball. The patient was sent for rehab to his right leg with balancing exercises. He went a couple of times, experiencing exercises and stretching protocols to his right leg. This is a typical protocol based treatment regimen of someone rendering a diagnosis and another person following a protocol for what was on a prescription from the doctor. This is also segmenting care which means that if the patient did not improve, they will again see someone else. This approach rarely resolves problems, but may offer some relief. The patient who has used our office for many years returned for a second opinion. During our evaluation, the patient was unable to stand up from sitting with the weight of my hands on his shoulders. The patient is a physically fit individual. His right side was very tight from the bottom of the foot through his shoulder blades and his right foot turned in. The patient at the end of the first visit was able to plant his right foot properly, had better right ankle and foot mobility and even had shoulder blade relief as well. He was able to stand up from sitting with 10 lbs of pressure on his shoulder on each side with minimal discomfort. There was a noticible difference on how he was standing and he felt his balance had improved as well as his foot on the right side. Had he followed the orthopedics recommendation, he would have had a month of therapy to the symptomatic area and would likely have worsened. Diagnosis and treatment of many painful conditions of the lower back, legs, knees and even neck and shoulders are often interconnected, which is why a holistic full body diagnostic approach offers the best option for relief of pain and fast return to the pickelball court. Perhaps, this is why active people understand that doctors of chiropractic are their best first choice to diagnose and treat many of the conditions they experience. Certified sports chiropractors take an extra year of education to learn how to diagnose and treat many common athletic injuries. We are all different, come from different backgrounds and have all adapted differently and have different medical historys. over the years. A holistic approach is always the best approach to relief of painful feet, back hips, legs, neck shoulder and even wrists and elbow. Chiropractors are trained to evaluate and think holistically and their approach has been studied extensively and especially with lower back pain, are your best choice for many common painful problems. Our office believes the primary care approach to musculoskeletal problems is most likely to help others faster, rather than segmenting the care to others which results in more doctors visits, medications, tests and procedures. Keep it simple. Our care is focused on what makes your problem unique to you. Need help now? Book online using our request an appointment link.