EVALUATION AND DIAGNOSIS
Many people don't realize that chiropractors have extensive training in examination and diagnosis, especially regarding musculo-skeletal and neurologic conditions. In fact we have significantly more training in orthodedics and neurology than primary care physicians. Our staff has additional extensive specialty training, even better enabling us to determine the true nature of your condition and its complexities. If the condition is not understood, the chances that it can be effectively treated are poor.
Good diagnostics is a lot like crime scene investigation. There are:
The victims are the source of the pain, the structure or tissue that is inflamed and painful, even when the source of the problem is elsewhere.
The villain is the source of the altered mechanics that places increased stress on the victim, resulting in inflammation and pain.
Although at times the source of the problem is at the site of pain, careful evaluation is necessary in order to determine whether what we call the "key link", the underlying cause lies elsewhere.
Patients are often amazed when we are able to find their sore spots without asking. We are often asked "How did you know it hurt there?". We have a pretty good idea where it's sore because we feel the lack of joint mobility, the swelling and muscular tension and fibrosis.
Unfortunately, many chiropractors are not specifically trained and experienced in detailed evaluation of joint mobility (motion palpation), or of specific muscular function. Lacking this training, many chiropractors do not have the means to determine precisely where and in what direction adjustments are needed, what muscles need to be treated and how and what exercises may be needed by the patient. As well trained as chiropractors are in orthopedic and neurologic evaluation, many consider this knowlege to be medical rather than chiropractic therefore minimizing there use of these procedures and their importance in determining what is wrong and what needs to be done.
As an exampleof the need for specific evaluation, if a chiropractor is aware of only a few possible sacroiliac joint disturbances, when in fact there are a dozen or more that may need to be adjusted, alone or in combination, optimal results may be elusive. It's hard to find what you are not looking for.
Patients often state that they have seen chiropractors who perform almost exactly the same treatment each visit and that all patients receive essentially the same treatment. Despite the fact that this does occur, even non-specific chiropractic care helps millions of patients. However, more difficult or unresponsive cases may require the provider to be very specific in their evaluation and treatment.
In many cases, not only the spine and pelvis need to be adjusted, but possibly ribs, hips, knees, feet or other areas. Muscular imbalances often need to be addressed with stretching, strengthening and massage or myofascial release in the form of Active Release Techniques® (ART). Patients almost always benefit from therapeutic exercise instruction and may need nutritional advice.
Specialized training gives us a broader view of the possible causes of the problem and more treatment options. There is a saying that if all you have is a hammer, everything is a nail. It helps to have many tools to use when needed.