Lumbar spinal stenosis is a relatively common condition in older adults with an estimated incidence of 1 in every 1000 adults over 65 years old. Age related changes in the spine lead to increased weight bearing across the posterior elements of the spine, arthritic changes in spinal joints, and decreased cross sectional area in the...
The old saying that you can’t unring a bell is true in imaging for musculoskeletal conditions. Most patients cannot unsee their MRI results despite improvements in their symptoms and activity level with Physical Therapy treatments. Once terms such as bulging or degeneration have been utilized to describe their spines they never regain full confidence in...
Distance runners are a frequently injured group of athletes with up to 90% reporting a running related injury requiring time off from training or competition. Authors report low back pain is one of the most common sites of pain likely secondary to underlying core and hip weakness. Runners repeatedly land with 2-6 x times their...
Degenerative Disc Disease (DDD) is a commonly utilized “diagnostic” term given to patients frequently after neck and low back MRIs. It is hard to think of a more uninformed and harmful diagnosis in musculoskeletal medicine than DDD. Initially utilized to describe age related changes in the spinal structures secondary to aging, DDD continues to induce...
Direct access to Physical Therapy services was first written into a state’s law (Nebraska) in the 1950s and since has been shown in the literature to be safe, effective, and less costly than seeing a physician first for musculoskeletal pain. Due in part to its’ cost effectiveness large organizations including fortune 500 companies and the...
The black and white areas of health care are easy to navigate but the grey areas separate the novice from the experienced clinician. Uncertainty is part of health care and often clinicians make absolute statements in order to make themselves more comfortable in the grey areas of practice. In Physical Therapy, statements including “do not...
Healthcare demonstrates significant swings of the pendulum in examination and treatment trends. Thankfully the medical evidence helps balance these swings allowing us to come to a more appropriate balance in clinical practice. Unfortunately, unchecked bias in a clinician, such as confirmation bias, can lead to missed diagnoses and inappropriate treatments. In Physical Therapy, this can...
Early access to Physical Therapy services (direct access) has been previously shown to reduce a patient’s cost of care by up to $1500. In addition to its’ cost savings, direct access to Physical Therapy treatment has been shown to be a safe and effective short and long term treatment plan for patients with musculoskeletal pain....
Low back pain, along with death and taxes, remains one of the certainties of life. This condition affects over 90% of Americans and is often benign, but painful, in nature. Currently spending on low back pain is over 100 billion dollars a year and much of this spending can be attributed to unnecessary and unwarranted...
Low back pain remains the most common musculoskeletal diagnosis seen by primary care providers including Physical Therapists. While the majority of cases of low back pain are not serious in nature symptoms tend to be recurrent and can become chronic (> 3 months) if left untreated. As low back pain progresses from acute to chronic...