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Guess What? Your "Diagnosis" is Actually just a Symptom!

By: Dr. Ashley Bertorelli, PT, DPT, Founder/Owner of The Green Room PT


In Physical therapy, we often receive referrals from MDs to evaluate and treat patients with a diagnosis of “back pain,” “neck pain,” “shoulder pain,” “radiculopathy,” “sciatica,” etc.  Guess what?  These technically are not diagnoses, they are symptoms.  Think about it- if you go into your PCP and you say you have back pain and they diagnose you with back pain, you’re still not sure what caused it in the first place, what’s contributing to your pain, or exactly how you should treat it at the root cause to get it to go away and not continue avoiding activities you fear may make it worse.  There are exceptions to this, and some MDs will send you away with a specific and accurate diagnosis, but this is increasingly rare.    

Guess who can provide an accurate working diagnosis for your pain?  A skilled Doctor of Physical Therapy can!  We are considered the musculoskeletal and movement specialists of the medical world, and we are trained to have a better understanding of how all the muscles, joints, ligaments, nerves, etc. affect each other than even most of the better Orthopedic surgeons and specialists out there.  If you think about it, most Ortho’s these days specialize in one joint: the ankle, the knee, the shoulder, and they aren’t regularly evaluating and figuring out how limitations in one part of the system are affecting other parts of the system.  If you went to an Ortho MD for your hip pain, did they check your ankle mobility?  I doubt it!  If you went to them for a knee problem, did they check your hip strength or range of motion, and how that may be contributing to your knee pain?  Probably not.  (But I will bet you were offered a Cortisone shot, whether you wanted it or needed it or not!)

If you have an ache or pain and don’t want to just cover up the symptoms with pills, injections, rest, activity avoidance, or surgery, seeing a Physical Therapist is the answer to your problems!

For example: If you have back pain, we can identify which muscles are tight, which are weak, which joints are stiff, and what nerves may or may not be involved, all contributing to your specific symptoms and situation.  If you are prone to recurrent back pain a few times a year, we can evaluate you and your body, your lifestyle, etc. and help you figure out why that is happening in the first place and how to stop that pattern in its tracks.

Another example: We see a lot of patients with a diagnosis of “sciatica” (pain shooting down the back of the leg or glute) or radiculopathy (pain radiating down an arm or leg).  That again, is not a diagnosis.  “Sciatica” is a symptom of something else- it can come from a tight piriformis, a bulging or herniated disc, spinal compression, or other causes.  “Radiculopathy” can be from an impinged nerve under a very tight muscle, it may be from a disc bulge or herniation in the cervical or lumbar spine, or may even be from postural habits.  We can help you figure out the source of your sciatica or radiculopathy, and what strategies and exercises you can implement to make it go away!

But what about imaging?  There’s a time and place for imaging, but this a lot of time just muddies the waters.  There is not a person out there with a 100% clean MRI or x-ray.  Most people have degenerative changes in their spine after the age of 25, most have a disc bulge or herniation, a compressed disc, a meniscus tear, small rotator cuff tear, etc.  These are actually very common findings in asymptomatic/pain-free people!  Just because an image finds something doesn’t mean that’s the source of your pain!  And to make things even more confusing, your symptoms may not be something torn, bulged, injured, damaged, etc. at all.  It may just be inflammation from faulty movement patterns or postures.  A mechanical and movement assessment from a Physical Therapist will give you clearer and better answers about 95% more of the time than an image or two will (okay, that number is not the result of a study- just my estimate based on about 16 years of practice to-date, haha).  Imaging can be helpful to rule in or out bigger issues, and can help us rule out things of concern, and we will even recommend imaging at times.  But it definitely will not give you the whole story in >90% of cases (again, just my estimate).

So, if you’re done just covering up your symptoms with pills, shots, rest, or surgery, or if you want to understand more about how your own body works and ways you can help yourself feel better and move better (and how to stop avoiding certain exercises and activities forever out of fear of re-injury!) please see a Physical Therapist!

Our clinics accept most insurance plans, and our evaluations and treatments are always one-on-one! If you would like an evaluation at one of our clinics, send us a message on our contact page, email, or call our Troy office: 518-326-3771 or Clifton Park office: 518-280-2185 to schedule!


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