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Foiled again

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  • Foiled again

    Posted by Barrett<script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,8,27,12,40,0), dfrm, tfrm, 0, 0, 0, 0)); </script> (Member # 67) on 27-09-2005 19:40<noscript>September 27, 2005 12:40 PM</noscript>:

    I have had countless conversations with a local physician, treated virtually every member of his family, several of his best friends and had come to consider him one of the very few in Cuyahoga Falls who actually had some reasonable idea of what I thought and what I did. I have treated him as well with, according to him, success.

    However, I was recently informed by another therapist that some recent cervical pain in his own system had grown considerably bothersome. He never discussed this with me but rather ordered a home cervical traction unit for his personal use. He did this after finding some self-imposed cephalic pressure provided him with temporary symptomatic relief.

    There are two issues here and several questions come to mind:

    1) Is it reasonable to assume that the pain-relieving maneuver is necessarily the therapeutic one?

    2) Does it matter which tissue is primarily involved?

    3) If brief traction provides relief, is there any reason to believe multiple applications of this force will be increasingly effective? If they are-how so?

    4) Has anyone out there ever gotten a physician (especially an orthopedist) to consider the lessons of the neurobiologic revolution-in effect, to quit “only hanging out at the joint,” as I often say?

    5) Is there any point in putting forth the effort necessary to talk to these guys? (This last one may be only rhetorical)

    Please understand I'm not complaining but only describing what I've come to see commonly. I don't expect this to change, but I'd like to see it more clearly.
    <hr> Posted by OaksPT (Member # 2776) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,8,27,14,40,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-09-2005 21:40<noscript>September 27, 2005 02:40 PM</noscript>:

    I have similar experiences where I treat the physician, the spouse the child, etc. I have been even called on a Sunday night at home, because the particular physician was in so much pain that he would have to cancel his surgeries the next day, unless I did something to "fix him".( This coming after several injections given by his nurse.)
    So as sucessful as intervention is with these physicians, pain is still the primary motivator, when that's gone, their memory fades.
    Many times I have had a surgeon tell me that the patient has to be crazy because their MRI shows hardware in the proper place. I have a good repoire with this particular physician, and gently ask him, 'What do you think your MRI would have shown last week?'. They usually tell me to kiss their @ss, and then schedule the next patient.
    You may see this clearly, but you have special glasses,
    <hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,8,27,17,49,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 28-09-2005 00:49<noscript>September 27, 2005 05:49 PM</noscript>:

    1.) In many cases pain is a necessary component of getting better, such as a total knee replacement. I think it is unlikely that someone is able to get their knee very limber by simply performing the pain relieving maneuver.
    Perhaps the timing of said pain relief is important. Again with TKA's: My patients typically state that they feel less pain and more limber when leaving, despite some of the pain felt during treatment.

    2.) I think it matters more to the extent of educating a patient what not to do. But if the pathology itself is undetectable then any recommendations that are tissue specific are guesses or 'better safe than sorry' type recommendations. Also, I'm assuming you're not meaning the distinction between neuro versus musculoskeletal types of tissue.

    3.) No. Not in my opinion or experience. Also, not according to systematic reviews.

    4.) I concur with Oaks on this point. Neuro = crazy or wimpy.

    5.) I think there is. But I've always had a thing for windmills.

    Last edited by bernard; 29-12-2005, 05:52 PM.
    Simplicity is the ultimate sophistication. L VINCI
    We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

    Everything should be made as simple as possible, but not a bit simpler.
    If you can't explain it simply, you don't understand it well enough. Albert Einstein