Generalized Therapy vs. Spine-Specialized
| What does this mean? | Manual
Therapy | FAQ
Patients will be connected with a spine therapist
who has advanced training in spine specialized techniques — one of the
most well-respected spine therapy methods in the country. The physicians of Quincy Spine Center have skills and techniques that are specifically
oriented at relieving back and neck pain.
To come to a definitive conclusion regarding its proven
benefit, injection therapy needs to undergo further testing. Some experts
theorize that there may be some placebo effect associated with the
relief that accompanies an injection. In any case, when a patient gains
relief from an injection, it reinforces a physician's desire to use
that treatment again.
The only way to permanently relieve pain involves changing the
physiology of the back by using exercise to make it stronger,
more flexible and resistant to injury. While a general physical
therapist may spend weeks attempting to mask pain using heat,
ice or ultrasound, research has shown that using these passive
treatments is not the best way to return someone to activity efficiently.
This general physical therapist often sees a wide variety of patients
each day who suffer problems related to sore elbows, knees or
shoulders. General physical therapists typically have a very limited
understanding of the best ways to treat specific types of back
problems. At best, they may have taken a couple courses on therapy
for a back or neck injury
On the other hand, a spine-specialized therapist’s
primary goal is to enable the patient to perform a customized
home exercise program as early as their first visit. The therapist’s
second goal is to make the patient independent of therapy within
a short period of time.
Instead of receiving a general treatment approach, at Quincy Spine Center, your
therapist specializes in treating back and neck pain. These therapists
have advanced, hands-on skills that can help relieve your pain and get
your injured muscles, tissues and spinal structures moving again. Instead
of a single school of thought, patients can access specialists with
a variety of skills who can match the best treatments to your particular
Manual therapy relates to the use of a therapist’s hands
to achieve pain relief. By using specific techniques, the spine
therapist can relieve pain through hands-on movements applied
to vertebrae and soft tissue areas. This is achieved not passively,
with a modality such as ice or heat, but through actively moving
the joints and tissues. Spine-specialized therapy can involve
techniques taught by schools including McKenzie, Paris, Ola Grimsby,
Cyriax and the Maitland therapy school in Australia.
A manual therapist’s background typically begins
with physical therapy training, followed by advanced education in spine
that sets them apart from general physical therapists. This specialized
education can be within a host of manual therapy philosophies, each
involving unique pain-relieving techniques that help patients return
to function as quickly as possible. Regardless of the particular school
of thought, the best spine therapists avoid the use of passive modalities,
which do not provide permanent relief.
Q. What makes Quincy Spine Center physical therapy different?
A. Just as the trend in medicine
is for physicians to subspecialize in knees, or arm, or joint replacement,
the exact same thing is happening in the area of physical therapy. That’s
good news for patients.
Just as the first step for a physician is to receive his
MD degree, the first step for a physical therapist is to become a licensed
physical therapist. Most orthopedic centers and therapy clinics will
have licensed physical therapists who split their time among patients
with knee pain, hip problems, shoulder pain, hand problems, ankle problems
and foot problems.
Experts have found, however, that back and neck problems
can be stubborn to treat and may not respond to general techniques learned
in therapy school. Worse, what often happens is that when generalized
therapy fails to relieve symptoms, the patient has to resort to spine
A. At other clinics with
general therapists, you may have laid on a table, while someone put
hot packs or ice on your back. Or your therapy may have included other
passive things like ultrasound. Or you may have had a massage. The insurance
companies who pay for back care have done extensive research on things
that relieve back pain — for the long term — and they now
have policies that eliminate payment to clinics doing “palliative
care.” The word “palliative” means something that
feels good, but doesn’t cure anything.
So while a massage or hot pack may feel good, it doesn’t
provide any lasting change to the soft tissues in your back or neck.
The effect on your symptoms is temporary, and in a sense, worthless
because it doesn’t last, and your pain will return.
Nationally, the best spine treatment clinics avoid passive
things like hot packs, ice and massage. Instead, spine specialized clinics
emphasize things that strengthen the back, make it more flexible and
resistant to injury. In other words, Quincy Spine Center emphasizes specialized
spine techniques, stretches and exercises that will help you
recover from injury without having to resort to surgery.
A. Spine specialized exercises are
based on Directional Preference. We help each patient to discover a
direction or movement that improves mobility or function to relieve
symptoms. This might be an extension movement, flexion of the trunk,
rotation of the trunk, retraction or some combination of movements.
Once a directional preference is found, then to we have to discover
the optimal load and effort required to achieve the best results.
A. The second aspect of the spine specialized exercises involves the concept of “centralization” of pain.
Using these spine specialized techniques, a therapist can help a patient that
has pain radiating down a leg to the knee area, to reduce the pain symptom
so it no longer goes as far down the leg, and over time shrinks and
“centralizes” the pain until it eventually disappears.
Some patients with pain radiating
from the neck into the arm, and from the back into the leg, can respond
very well to these exercises and stretches that centralize and ultimately
relieve the pain completely.
It is important to note, however,
that any time you have symptoms that involve radiating pain or numbness
into a leg or arm, consider these serious emergency symptoms that need
to be seen by a spine surgeon or spine physiatrist to determine if they
are worsening, or if they can be managed with therapy. If you ignore
these symptoms, such symptoms can cause permanent nerve damage. Another
emergency symptom is any loss of control or bowel or bladder.
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