Our session will be
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Personalized
Our initial sessions will be dedicated to assessing your current wellness and creating a personalized plan to fit your unique needs and goals.
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Targeted
Everyone has pain points when it comes to achieving full body wellness. I’ll work closely with you to help identify and overcome your triggers.
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Integrative
Since achieving wellness is more than just exercise and diet, I’ll be guiding you toward other helpful practices such as mindfulness training, aromatherapy, and more.
How you’ll feel
more confident and clearheaded with increased energy and deeper sleep
BOOK YOUR FREE CONSULTATION.
Comprehensive wellness assessment
Personalized nutrition, mindfulness, and exercise plan to help you reach your goals
Unlimited guidance and support via email
Helpful tools, tips, and tricks for navigating your unique obstacles
FAQs
Most of the clinical guidelines I read suggest analgesics and Physical Therapy for Non-Specific back pain. What is wrong with this approach?
Unfortunately, there is a lot to discuss regarding “non specific” back pain, treatment guidelines, and Physical Therapy for spine. This strikes right at some of the main causes of both the ongoing back pain and opioid epidemics. I will cover the problem with “Non Specific” Back pain separately in a moment. With regards to clinical guidelines and Physical Therapy, recent literature shows worsened outcomes for measurements of disability, hospitalization, opioid use, and surgery due to following these pathways. Please don’t think I am bashing Physical Therapy. I recommend it often for hip and shoulder. I will use it in spine but only after making an accurate diagnosis and addressing biomechanical issues at the vertebral level.
From the abstract:
”Opioid use is an indicator of the efficacy of care for low back pain. All physical therapy modalities realize no lowering of opiate use, while the addition of active and passive care increases use by 90%. Longer physical therapy care increases the use of opiates, spinal injections, MD specialty care, and hospitalizations. Chiropractic care reduces the use of opioids by 55%, with patient satisfaction of 96%, while decreasing disability by 313% compared to physical therapy.”
“Despite the outcomes in the evidence, most of our healthcare systems and the providers they influence still list physical therapy as the cornerstone to treating low back pain, costing hundreds of billions annually.”, “the evidence in the literature strongly suggests that to help eradicate the low back pain epidemic and reduce the use and costs of opioids, chiropractic should be the first provider.”
Ok so what about non-specific back pain?
Part of the root of the problem in our current management of back pain is insufficient diagnosis. We live in a world of cause and effect. Nonspecific back pain is simply incompletely diagnosed back pain. I may have to use a code which suggests unspecified low back pain but that is simply a function of the ICD not containing an appropriate code to identify the actual pain generator. All back pain has a cause. It is usually discernable by examination and then should guide appropriate intervention. If it is not diagnosed at this level, the interventions performed will be less specific and the intervention will be less successful. This is a significant factor in our current failure as a whole in health care to adequately address back pain.
What If my patient may have a more serious condition such as a herniation or worse?
This is exactly where my specialty training is most relevant. I specialize in the Diagnosis and Management of Spine and Spine Related Disorders while specializing in the Treatment of Mechanical Spine Disorders. I am thoroughly versed in appropriate diagnosis and triage of spine and spine related pain. In the following publication I outline a case of Osteomyelitis/Discitis that presented to my clinic after seeing both her Primary Care Practitioner as well as being admitted to the hospital and undergoing 3 days of testing all without receiving the proper diagnosis or treatment.
Doesn’t low back pain usually resolve on its own?
This oft repeated fallacy comes from a 1966 study (Dillane et al Acute back syndrome: A study from general practice. BMJ 1966:2:82-84) that never actually collected any natural history data. The study collected only care seeking data extracted from scheduling logs of general practitioners in the UK. When patients with low back pain did not return it was assumed by the researchers that the participants had recovered. It has been reported in multiple subsequent studies that indeed patients do quit seeking the care of their primary care physician 90% of the time within 3 months but longitudinal studies have shown that only a small percentage are recovered at 3 months and the majority continue to have pain and associated disability at 1 year. Donelson et al 2012 states “Collectively, our findings, and those of other studies, indicate that it may be inaccurate to characterize LBP as having an excellent prognosis. Recurrences are frequent and are often progressively worse over time. Recovery from acute LBP is not as favorable as is routinely portrayed. Eventually, there may be no recovery, and the underlying condition may become chronically painful. In light of these characteristics, it seems inappropriate to characterize the natural history of LBP as benign and favorable.
Are you available for a question about a specific patient’s diagnosis or management?
Absolutely, my mission is to improve outcomes in spine-Full Stop. I welcome a visit, a call, a question, or a referral. My cell phone is available to all practitioners whether I am seeing a patient of yours or not. Contact my staff who will then put us in touch.
When I refer a patient what is the process?
A simple call or fax to my office with details is all that is required. We will appoint your patient, examine, diagnose, and plan treatment if indicated. You will receive an Evaluation and Management report within a few days outlining our findings and recommended treatment. If their is a need for further diagnostics these will be ordered and performed unless this patients insurance requires your involvement. If Outside specialist referral is indicated we will contact you prior for your preferences. If any stat referral is required this will be made and we will immediately contact you as well. It is our goal to make the referral process as easy as possible and exceed your exp