When Physical Therapy Can & Can’t Help You

We recently had a new client come in for his first visit. He was struggling with back pain that was keeping him from doing his job as well as he would like, staying active with his family, traveling, and hiking.

He had seen many medical providers, including his primary care physician, an orthopedic specialist, and a spine specialist. He had tried medications, injections, and did not want to take pain medication. After years, he stood up for himself, and asked his primary care physician what else he could try, and she suggested physical therapy.

When he first came into our office, he admitted that he was a bit skeptical and unsure. He had been told that his pain was due to scoliosis, and that there might not be anything more that could be done.

What is scoliosis?

All it means is that your spine isn’t perfectly aligned. I even have scoliosis! And I don’t have pain. Turns out that many people who have scoliosis don’t have pain, and just because you have scoliosis doesn’t mean that you will have pain.

The same thing is true about alignment. Our spine is strong and resilient and meant to move! It isn’t meant to stay perfectly aligned in one position all day long. This is why research has also found that posture doesn’t cause pain. And there isn’t one best posture. Each person’s “best” posture will look different, and is variable throughout the day.

So if you have been told that your spine isn’t aligned and you keep getting adjusted, but aren’t seeing results, that could be why. Or if you have been told you have bad posture and that is why you are in pain, but changing your posture isn’t helping, that’s why.

So, if scoliosis wasn’t causing his pain, what was?

We did a movement assessment, and found that he wasn’t moving well, and was putting too much stress on certain muscles. Those back muscles weren’t strong enough to be doing so much work, so they got tight, irritated, and started giving his body the pain signal.

You see, pain doesn’t always mean that you have injured or broken anything. It is like the check engine light of a car. It’s a warning sign that a certain body part is doing too much, not enough, or that you should change HOW you are moving.

No one had ever told him this before, and he wasn’t sure what he should do. He had seen so many other medical providers and wasn’t sure if he trusted himself enough to make a good choice. He mentioned that he had heard mixed things about physical therapy. Some friends said it worked for them, and others said it didn’t work for them. So, he asked me a really good question, “Why does physical therapy work for some people and not for others?”

There are a lot of factors that can affect a person’s success with physical therapy.

The first is the clinic or physical therapist that you go to. At some clinics, providers have to see 4-5 patients an hour, so they can only spend 10-15 minutes with you. This amount of time can make it hard to find the root cause of the issue, and sometimes, only the symptoms get treated. The person will feel better initially, but months after they are done with physical therapy, their problem might return.

The other problem we hear from patients who have gone to other clinics before becoming patients with us, is that they didn’t see their PT each visit, or switched between multiple PT’s each visit. If they did not see a PT, they saw a PT assistant, or a PT aide. What usually happens is the PT writes a plan, and the assistants and aides follow it. Sometimes, patients don’t progress as fast as they could because changes aren’t being made at each visit, or you never see the same person frequently enough to really get to know you and your case.

We like to use the analogy that physical therapy is like a restaurant.

You wouldn’t ever say, “I went to restaurant and got food poisoning, so I am never going to restaurant again,” would you? No! Physical therapy is the same way. Just because you have tried it once, doesn’t mean that it won’t work for you. You might not have found the best fit for you and your case.

The therapist and the clinic aren’t the only thing that affect success, the patient also plays a HUGE roll in their treatment. We typically give patients exercises to do at home to keep them progressing even when they aren’t in the clinic. If a client doesn’t do the exercises, or isn’t honest with their PT about how often they do their exercises, or if the exercises are helping or hurting, this can make the therapist’s job a lot more difficult.

Physical therapy isn’t a magic, quick fix, and PT’s don’t fix people. The PT and the patient make up a team, like a coach and athlete relationship. Both people have to put in the work, be honest, and communicate well to see the best results.

If this sounds like you, and you aren’t sure if physical therapy will work for you, or have tried physical therapy before and haven’t seen any results, apply for one of our “Talk to a PT First” calls, to speak with one of our therapists who can help you decide if physical therapy is right for you!

About The Author

Dr. Kaitlin Herzog

Dr. Herzog attended the University of Pittsburgh, where she earned her bachelor’s degree in Exercise Science. She went on to earn her Doctor of Physical Therapy degree at Wheeling Jesuit University. Kaitlin has been an athlete for most of her life and was introduced to physical therapy when she had several sports-related injuries. She decided to become a physical therapist to help others maintain an active lifestyle while staying pain free. Kaitlin uses a hands-on approach to help people of all backgrounds optimize their movement and performance. Dr. Herzog is a record-holding competitive powerlifter, and you can find her training or competing in her spare time. She also enjoys Olympic weightlifting, CrossFit, yoga, sports, hiking, baking, crafts, traveling, and exploring Greensboro with friends.​

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