Have you failed multiple treatments and still suffering from pain?
Do you find yourself asking, “Why is nothing fixing my pain?”
Many people go through “standard” healthcare and find themselves still having the same pain as when they started. They fail months of therapy, fail injections, get unwanted diagnostic imaging, try “outside the box” treatments, or they tell me the most common result:
…..It worked at first but then my pain came back!
Well we have the answer! Here are 5 common reasons why patients fail treatment and why the treatment may not have worked.
1. Wrong Diagnosis
The correct diagnosis is essential to receive the right treatment. It is specific. For example, if you have an infection, they need to take blood work or a sample to identify what the infection is exactly. Once this is identified, then you are given a specific antibiotic that has been proven to kill that specific infection, bacteria, etc. Not all antibiotics will kill all bacteria (ex. MRSA is resistant to many antibiotics). This goes the same for your low back, shoulder, or heel pain.
How many of you go to the doctor complaining of low back pain and come out with a diagnosis of low back pain? You already knew that! Then you are treated with some sort of medication or injection that treats your symptoms. Here, take this magical pill, your pain goes away, and you get treated with “cookie cutter” book approach. This may work for some peoples pain but not for everyone. Most LBP won’t and it frequently returns. LBP is really a generic diagnosis but it does tell you specifics: is it a disc problem, is it sciatica, is it a facet problem, is it pain from the pelvis joint (sacroiliac joint), or is it referred pain from a kidney, hip, etc. The right diagnosis will dictate the right treatment and this will lead to the proper treatment.
2. Treatment was chasing the pain and not addressing the cause of the pain
Think about this: some sort of problem or impairment = cause of injury = pain = I can’t do my activity/task/sport. The pain is the affect of the injury. If you just treat your pain (ex. with medications, injections, creams, etc) then the cause of the pain is still there! This is why many injuries or pains return. Because they missed the actual cause of the pain.
Here is a great quote from Dr. Mark Hyman and Dr. Mark Liponis book Ultra-Prevention that sums it up well:
Think about it. When the smoke alarm goes off, you don’t go upstairs and unplug it to stop the beeping. But that’s what most medications usually do – they stop the alarm. They cover up symptoms, but they don’t help you find out where the fire is.
The real question is WHAT started the fire or, WHAT truly caused your pain and, WHY do you have pain? Do not just treat your pain and “slap a band aid on” to cover it up! Address the cause and other factors that led you to your symptoms, resolving your pain and making sure it never comes back.
3. Did not modify activity
An example of this is a patient complaining of neck at work due to the ergonomics of their desk and work station. They come in for treatment and respond well. They leave feeling great but every time they return to work their symptoms and pain return. I could treat them every day for the rest of their life and make them feel better, but as soon as they return to work and sit at the desk that is not properly adjusted for them, their pain will always return. You have to change the desk to get the proper ergonomics to address the cause and keep the pain from returning.
Runner’s and many jobs that require repetitive activities also experience this. An injured body part or tissue will go through the normal inflammatory process and healing process. But if they activity that is causing the pain and injury is continued over and over and over again, you will never give that injured tissue a chance to heel and get past the inflammatory stage. It is like picking the scab from a cut every day and hoping that it heals.
If the activity is causing your pain, you have to alter the activity to allow healing or modify it to stop causing your pain
4. Unproven Treatments were performed
I love it when patients tell me that they already tried physical therapy and it did not work. Then I say ” well, what did they do?”. They say ” massage, ultrasound, the electrode thing (e-stim), heat or cold packs, and exercise. The exercises made it worse but the electrode thing made it better. I tried PT for 8 weeks and it did not help!” Most of those interventions do not have proven evidence that they are effective in treating many injuries or causes of pain. My question for them is “after 3 weeks of treatment with no benefit or change in symptoms, why did you continue the same treatment and expect a different outcome to happen when it did work for the prior 3 weeks?…..” They usually just look at me with a confused faced or just say “the doctor told me too”. Also, if you are still getting treatments for the same problems for 6+ months and you still have the same symptoms that keep coming back…… your treatment is not working!
Here is a FUN FACT for you: If your treatment is not making a change to your pain or symptoms in 2-3 weeks, move on to something else. Its not going to work.
5. You won’t let yourself get better
What? Is this correct? Yes it is. Some people will never get better, because they will never let themselves get better. Some may not be in the right mind set to decrease their pain. Some people just will not rest and they never give their body a chance to heal. Some people do not put themselves in the correct circumstance to receive the best care, to get the best outcome in the fewest visits. Some people just hopes that the pain will go away and they never take control or ownership of their pain. Some people even blame other people for their pain that have no cause or influence on their actual injury. There are many cases that we can go over with this cases.
Nowofdays, with health care reform coming, I try to educate my patients to ask questions before their treatment to make sure you giving your self the opportunity and knowledge to receive the best care, giving you the best outcome:
If you are dealing with an injury or pain that is not going away, schedule your evaluation today and solve the problem that is causing your pain!
Here is a patient testimonial that has failed months of prior treatment:
I went to Dr. Ron as a result of having severe pain in both of my Achilles. My ortho told me that my choice was to have surgery or get a cortisone injection. I wasn’t crazy about either of those options. The surgery had a 50% chance of working, and the injections would only be temporary. I had been an avid boot camper with an active lifestyle. My injury was now preventing me from working out but more importantly it was keeping from enjoying time with my family. I was fortunate to meet Dr. Ron before I had to make the decision for surgery or injections. He said that most in these cases you can often get completely better with the right physical therapy. I initially thought he was full of it but I figured what do I have to lose. I thought there was no way he would be able to help me. I went in for an evaluation, and was completely surprised. He ran me through a series of movements, and mobility tests and came to the conclusion that he could help me. Still skeptical I said “Really?” He said yes “I can have you pain free in 3-4 visits.” He was able to do my first treatment that day, and within 2 days was noticeably better and by the fourth visit I was pain free. What was different about Pursuit Physical Therapy and Ron Miller was the attention to detail and the willingness to spend the time to actually treat me. There were not any distractions, they were not rushing people in and out, I actually was treated like a person rather than a number. Dr. Ron Miller actually invested himself in my care. I am now able to do all of the activities I was before. I no longer have to grimace every time I take a step out of bed in the morning, And most importantly I didn’t have to have surgery or injections to mask the problem. Thank you Dr. Ron Miller you ROCK!!
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