Two years, four physical therapists, each doing excellent spinal evaluations. And still, Melvin had so much pain in his lower back he was in my treatment room in agony.
After a few questions, I began assessing his spinal mobility, general symptoms, pain, including pain location and behavior, and testing of strength and nerves. I didn’t find anything that the prior therapists hadn’t seen; but Melvin was there unable to function. I had concerns that the problem might go beyond the basic low back pain, so I expanded my search. Additional testing revealed he had significant difficulties with balance, mobility, and risks for dependency. In the two years he had been coming into the clinic he had never received a mobility exam. Providers had stopped looking after the spinal tests.
Sadly, function and mobility are exceedingly common misses in healthcare. We see the effect of a problem; we treat the effect. Too often the root cause is ignored. Additionally, practitioners are so pressed for time they are not able to look for the underlying cause. Medical care becomes a band-aid approach.
The US healthcare system probably isn’t going to change any time soon, so what do you do if you feel like you’re getting a “band-aid” and not having the actual cause of your problem addressed?
First, no one knows your body better than you. Second, no one knows what you want or need to be able to do. You have to educate and advocate. Be brutally honest with yourself and your provider. You don’t win any prizes for being stoic, or conversely from being dramatic. It falls upon you to accurately report any changes in your functional abilities.
- Are you less confident?
- Do you feel unsteady when you first stand up?
- Do you tend to touch the railing when going up or down the stairs?
- Are you walking less or slower than you were a decade ago? Or has it changed recently?
- Can you still do the fun things like hiking, biking, throwing-and-catching, running, lifting or climbing a tree?
In my experience, medicine isn’t looking for changes in these areas. You need to tell your providers as soon as things start to feel … “different.”
In Melvin’s case, beyond doing the expected spinal exam, I dug into his prior history and noted some concerns and potential underlying causes. He had some notable concerns including obesity and diabetes with visual changes, and a lack of sensation in his feet leading to wounds and ulcerations. My additional testing scored his foot sensation at <30%, his balance and ability to rise were just 20%, and his blood pressure plummeted when standing which had led to prior falls. These are not standard assessments that have been integrated into routine medical practice, so you need to tell your providers right away if your body isn’t keeping up with the life that you have been living or want to live.
The concept of living your best life is why we began EEI Physical Wellness Institute. We know there are missing links in healthcare. Our unique, science-based Functional Assessments (FAST, RODA and EEI&U) assess what you can do prior to any diagnosis. If we identify areas that are starting to slip, we can customize training recommendations to fit your needs. When you train to improve all areas of your function, then you’ll have an easier time doing what you love for years and decades to come.
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This is all us, no AI was used in this blog.
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