why-you-shouldnt-see-a-physical-therapist

Why You Shouldn’t See a Physical Therapist!

In the not so distant past…

The scene was set: A-ARON, a young, intelligent, and honestly not-so-graceful college student races to his first biology exam.

He is fully ready to take on the wretched coffee-stained fangs of his professor. But this requires him to traverse through hallways of outdated interior decoration, past droves of other zombie-like students, making it a veritable nightmare obstacle course!

To make it to his solitary confinement (the classroom where the students are quarantined before exam time), he must run at full-speed. Little does he realize, someone has spilled their coffee and failed to clean up after themselves. A-ARON slides along the linoleum floor like Will Ferrell in Blades of Glory.

A-ARON immediately feels his back seize up as he carefully extracts himself from the spill.

A-ARON
Image source: https://www.rrrather.com/view/107749

A-ARON thinks to himself, “Of all the times in the world, why now?”  A hellacious conundrum has been bestowed upon poor A-ARON, who now experiences low back pain for the first time..

What should A-ARON do now???

What-Now
Image source: http://imgur.com/gallery/zeLNA9h

A-ARON is able to make it through the bio test by the skin of his teeth. Now, he is able to solely work on what to do about his low back pain.

A-ARON slowly trudges over to the college library, sits at a computer, opens up google search and types in those dreaded words “low back pain”
Thousands upon thousands of results pop up. One website page really catches his eye, making him look at it in an extremely quizzical manner.

Image result for quizzical look image
Image source: https://whativegan.wordpress.com/2013/05/30/what-i-dont-wear-leather-or-fur/

A-ARON thinks to himself, “OMG…NO way am I seeing a physical therapist”

You know why? Because the website, called fakemednews.com reads, “Why You Shouldn’t See a Physical Therapist.” It asserts the following claims:

  • Physical therapists do not have some form of direct access in all 50 states 1
  • Physical therapists receive their education from the local mall at a significantly lower tuition 2
  • Physical therapists do not help people eliminate or reduce an individual’s pain, move better, and/or improve function/participation in society 3
  • Lower back and other joint surgeries are inexpensive 4
  • Physical therapists cannot help with low back pain without imaging 5
  • Chiropractors are the only clinicians who know how to manipulate the spine to help reduce low back pain 6
  • Opioids do not lead to addiction, and are the only treatment modality efficacious in treating low back pain 7
  • Physical therapists are not professionals, and act like a glorified fusion of a personal trainer and a massage therapist 8
  • Going to see a physical therapist costs too much!!! 9
  • It is better stay in bed and rest when you have low back pain, rather than move and go see a physical therapist 10, 11
  • Going for imaging, such as an x-ray, can help improve symptoms of low back pain in most cases 12
  • Stringent adherence to wearing a back brace will help resolve low back pain 13, 14
  • Findings on MRI can show why a person experiences low back pain accurately 15, 16
  • Treating low back pain does NOT take a multidisciplinary approach, and only orthopedic physicians are able to treat these individuals 17, 18
  • It is more cost effective to delay going to a physical therapist for acute low back pain 19, 20

After perusing www.fakemednews.com for awhile, A-ARON continues to tinker online, looking at many back-cracking compilations on YouTube, and Instagramming a photo of himself hunched over in pain, ” #BackPain #IsThisRealLife?#ImGoingtoRestHereForAwhile #Help #BatmanAintGotNothingOnThis #Prayer.

He is not feeling optimistic about physical therapy at all. But he also knows that it’s an era of fake news and professional turf wars. So he isn’t ready to write off PT just yet.

A-ARON remembers that his friend in Australia, De-Nice, just went through the same issue some months ago. He decides to give her a ring and ask what can be done for this situation.
de-nice
Image source: http://he.memegenerator.net/instance/64930855/key-and-peele-substitute-teacher-de-nice-you-mean-denise
De-Nice sets A-ARON straight. She tells him that she was originally prescribed opiates for her low back pain, but she found a local physiotherapist (mate!), and the physio helped her understand how to safely return to her normal activities. She tossed her opiates into the trash and never looked back.

Luckily, in today’s era of fake news, A-ARON is savvy enough to do his homework and spot questionable information. But if someone doesn’t know a De-Nice, they could easily be sucked into the notion that PTs are a bunch of uneducated quacks. True, there are good PTs and bad PTs. But isn’t trying the least invasive form of treatment the best plan?

A-ARON follows De-Nice’s advice and sees a physical therapist. He asks local friends for recommendations, and – on De-Nice’s recommendation – calls several clinics to ask about whether they use outdated treatment techniques, such as e-stim.

A-ARON is now fully pain-free. And, more importantly, he spreads the word to the general public that physical therapy is a great first option for acute back pain. And as for fakemednews.com? Well, it’s going to pump out all sorts of false information about PTs, because that’s just how it’s gonna roll.

Why shouldn’t you see a physical therapist? Because you’ve been misinformed.

It’s up to us, as physical therapists, to dispel the falsehoods about our profession, without overstating what we can actually provide. The more we all get involved with public outreach, elevating our profession, and collaborating with other fields, the better patients, PTs, and the overall healthcare team will be.

Written References/Resources

  1. http://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/DirectAccessbyState.pdf
  2. http://www.apta.org/PTEducation/Overview/,
  3. Penrod JD et al. Journal of the American Geriatrics Society Physical Therapy and Mobility 2 and 6 Months After Hip Fracture   Volume 52, Issue 7, pages 1114–1120, July 2004
  4.  

  5. Flynn TW, Britt S, Chou R. (2011 Nov) Appropriate Use of Diagnostic aging in Low Back Pain: A reminder that unnecessary imaging may do as much harm as good. JOSPT 41 (11). 838-846. http://www.apta.org/StateIssues/Manipulation/
  6. Zgierska, A., Wallace, M. L., Burzinski, C. A., Cox, J., & Backonja, M. (2014). Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial. Journal of Opioid Management, 10(5), 323–335. http://doi.org/10.5055/jom.2014.0222
  7. http://www.apta.org/PTCareers/RoleofaPT/
  8. Childs, J.D. et al (2015) Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. [Online] Available from: http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0830-3 [Accessed 8 February 2017].  “An award winning study in 2015, demonstrated substantial potential for lowered costs, and reduced healthcare utilization for patients who received, and adhered to physical therapy for low back pain
  9. http://www.nytimes.com/1997/10/14/science/personal-health-after-a-back-injury-exercise-smooths-the-road-to-recovery.html
  10. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010 Jun 16;(6):CD007612. doi: 10.1002/14651858.CD007612.pub2.
  11. https://well.blogs.nytimes.com/2009/02/06/scans-for-back-pain-ineffective/comment-page-5/?_r=0
  12. Walsh, N. E., & Schwartz, R. K. (1990). The influence of prophylactic orthoses on abdominal strength and low back injury in the workplace. American journal of physical medicine & rehabilitation, 69(5), 245-250.
  13. Willner, S. (1985). Effect of a rigid brace on back pain. Acta orthopaedica Scandinavica, 56(1), 40-42.
  14. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.
  15. Kjaer, P., Leboeuf-Yde, C., Korsholm, L., Sorensen, J. S., & Bendix, T. (2005). Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine, 30(10), 1173-1180.
  16. Guzmán, J., Esmail, R., Karjalainen, K., Malmivaara, A., Irvin, E., & Bombardier, C. (2001). Multidisciplinary rehabilitation for chronic low back pain: systematic review. Bmj, 322(7301), 1511-1516.
  17. Koes, B. W., van Tulder, M., Lin, C. W. C., Macedo, L. G., McAuley, J., & Maher, C. (2010). An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal, 19(12), 2075-2094.
  18. Childs, J. D., Fritz, J. M., Wu, S. S., Flynn, T. W., Wainner, R. S., Robertson, E. K., … & George, S. Z. (2015). Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC health services research, 15(1), 150.
  19. Gellhorn, A. C., Chan, L., Martin, B., & Friedly, J. (2012). Management patterns in acute low back pain: the role of physical therapy. Spine, 37(9), 775.

 

About Dustin Passigli

Dustin Passigli
Dustin Passigli is a recent graduate (May 2015) of Long Island University-Brooklyn. Dustin is currently working at Profitness Physical Therapy, an orthopedic manual therapy clinic, in downtown Brooklyn as well performing duties as an adjunct lab instructor for Anatomy courses in the physical therapy department at LIU-Brooklyn.

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