Recently my old bones starting to hurt at the neck. Was wondering what our fellow ozber favourite go to when this happens? Share some first hand experience?
Chiropractor or Physiotherapist, Who Do You Believe in?
Comments
so pharmacist?
Doctor
Pharmacist
Back fairy.
Witch doctor?
Who Do You Believe in?
AMUN-RA
Imhotep, though his policies are a little iffy.
and chiro will try and sell you isagenix or some other magical solution :P
And a maintenance plan! So keep going back
Of course they would, what sort of culture would they be promotion without maintenance plans? Chrio's kids need private school enrolment too!
How dare a medical professional ask you to exercise!
chiro will crack your back and you will fine for 2 months
What actually is back cracking? Is it the same as knuckle cracking, which just releases gas from the synovial fluid in the joints?
Physio would probably be better if U so the excercise and build muscle. I went chrio about 6 sessions and it sent my poor ass broke and didn't get any benefit.i had more pain after there adjustments. I do use this foam roller they sold me though.
There must be 37 chiros on the site. Oz bargainers know a waste of money when they see it.
U don't see many muscley ppl whining about sore ligaments. None I could think of lol. Even sports players.
" ppl whining about sore ligaments"
Maybe because there are no nerves or receptors in them, but there are in the muscle they are attached to.
ppl whinning about sore ligma
…hmmm
what's ligma?
" ppl whining about sore ligaments"
Maybe because there are no nerves or receptors in them, but there are in the muscle they are attached to.
Ligament tests to diagnose injuries wouldn't be painful if this was true.
Here's a test example for a MCL injury
Because weakness = pain a lot of the time.
That's because we're busy complaining about sore tendons and muscle imbalances
Neither until you have the affected area scanned or have an Ultrasound on the area.
I tried both, exercises and back manipulation, and ended up worse than when I started.
I ended up having an MRI done on the affected area and they found a tumor, now removed, and that was causing the pain.
It might be a toomah..
It's naoght a toumar!
It waas a toomaaa!
Not having ago but not everyone with back pain has a tumor
Most back pain is disc or lumber joint related
"Nothing a back crack and some isogenix cant fix" - said the chiro
As part of assessment, a trained physio (I assume maybe chiros? as well) would go through potential red flags, however, it is contraindicated by the evidence to image people if there is no clear indication of possible malignancy. Reckless imaging has done a lot more harm than good for a lot of people by the finding of incidental findings that were probably unrelated to their presentation,. resulting in a downward spiral of negative beliefs and consequently chronic pain.
It is unfortunate that professionals missed your malignancy but that shouldn't be a reason to image everyone with back pain.
that shouldn't be a reason to image everyone with back pain.
It should be if it's obvious that long-term treatment over months from a physio or a chiro isn't working. Surely they should realise that saying "See you next week, here's your bill" isn't achieving the desired outcome.
Yes, if conservative treatment has failed against sound clinical reasoning then a good PT/Chiro would have send you for further investigation, that is definitely taught in the curriculums for physiotherapy. You will get bad PT's, that is why I actually became a PT in the first place, and I agree, good ones are hard to come by. That said, and I cannot stress this enough, Imaging people straight off the bat unless properly indicated (suspecting malignancy, neurological symtoms etc) is more damaging than beneficial. There has been a big push to reduce unnecessary imaging over the last decade for this reasons.
If you want a read (systematic review) on overimaging here is a good one, one of the themes was that patients underestimate the harms of over imaging "such as radiation exposure, increased anxiety and overtreatment".
https://bmjopen.bmj.com/content/10/8/e037820Even in hospitals over imaging happens, sometimes out of fear of getting sued. Working in a hospital I have seen very unnecessary imaging happen in the ER with doctors not having any background in low back pain. Some hospitals do have physiotherapist in ER to help with this type of presentations though which is good.
@Xuaxace: As a relatively recent patient, there is very little explanation of the harms of over-imaging given to you at the time (admitted to emergency, head injury), so I'm not surprised that patients underestimate such risks. It's hard to estimate a risk that you aren't informed of.
I seem to recall an othropaedic surgeon briefly discussing the increased radiation exposure with scans….but he seemed to be talking aloud to himself to balance the risks rather than inviting my input into the process (not that I have any expertise or standing to make an informed decision).
That said, glad I was imaged as it picked up my neck fracture!
I am 2 months post shoulder surgery, first started seeing PT when presented with mild pain following a harsh accident. Went back for weeks and the pain got worse and worse. She thought it was tendonitis, but eventually got me to get an MRI. Turned out I had a labral tear, which in my case could only be fixed with surgery. Had I gotten an MRI earlier, it may have been identified as fraying, instead of a full tear where I could heal with a few months of rest. It wasn't the fault of the physio, but the apprehension from the PT and myself (given the cost) lead to a late identification. Now, I've taken the resources of further imaging, surgeons, hospital beds, my own time (6-12 months recovery) and money. If a condition doesn't improve, an MRI is a useful preventative for early onset issues so they can be managed without surgery. This is especially true for younger patients who want some longevity of their full bodily function for years to come, given that I'm in my 20's it makes me quite sad to need surgery so early. Also imaging is terribly covered by Medicare, geriatrics get more cover to fix their old and decrepit joints than those who can actually use them. You should be able to claim on an MRI referral from a physio as it's a complete waste of a Dr visit.
"Disc dessication" is a good example. It sounds (profanity) brutal but is a normal part of aging and even found in scans of healthy young people.
Chrio's are good if you want to get cracked, it leaves a similar feeling to a good massage, rush of endorphins, relaxation etc. - treats the symptoms not necessarily the cause. Technically this is a great business model though as you'll always have repeat customers.
Physios are there to treat the cause, not the symptoms and don't necessarily use massages which is why you'll leave not feeling amazing, but the exercises the give you will fix you in the long run.
Agree 100%.
On it! Chiro for relief then physio for long term fix (build muscles)
- Spot on about Physios. They assess the issue, often with MRI and x-ray so they’re sure what they’re treating. Then they’ll sometimes provide massage to relieve the discomfort but then prescribe exercise programmes to help you improve your range of movement and break up any scar tissue resulting from the initial injury. For lazy people who won’t perform the exercises at home, this can be a lengthy process. If you do the exercises, the issue will be resolved with fewer visits.
- Correct about Chios, too. They are there to provide short-term improvements, at best. Then you’ll be told that you’ll revert back to pain if you don’t keep returning. Great money spinner.
- Look at the course outlines for physio and chiropractic courses. Physio is VERY anatomy and physiology heavy (what you would hope for!). Chiro is very light on both anatomy and physiology (not good) but heavy on business practices. Sums it up.
The chiro courses are not lighter on anatomy / physiology than physiotherapy from what I gather.
I'm an Osteo student not chiro but the course is just about the same on the anatomy / phys side of things at rmit.
"rmit" - there's your problem.
sarcasm aside, most of the chiro stuff isn't backed by good quality evidence unfortunately.
i don't particularly care about that though. whatever makes the patient happy and if it's the temporary release of endorphins etc. then go ahead.
it's like how no one can say no to a good massage.
who am I to say how anyone should spend their money - and if the marketing ploys work then good for them.but the reason why i really dislike chiros: I've actually seen a few vertebral artery dissections post manipulation in my (somewhat) short career. It's not a risk free procedure unfortunately. (I've also seen acupuncturists poke right through lung parenchyma). I just would like more regulation in the alternative medicine industry and they need to be more accountable for the damage they cause - if they cause damage that is.
It's not just the alternative med field though - seen a patient post being treated by a cosmetic "surgeon" which caused multiple intraabdominal lacerations. Don't know if it's the same guy who's been on the news lately…
If you're lazy and want the chance of riding wheelchairs for life, then go with chiro!
If you want spend a lot of time to fix issue, then physiotherapist.
None of the above, but least of the list a 'back butcher' Chiropractor. See a MEDICALLY trained Doctor, a good indicator, someone that can actually prescribe medication is the level of qualifications. Then they can direct you to a physiotherapist, if it's the best course of action.
I am a bit biased (physio) but doctors are generally not the right people to ask for advice around pain management and musculoskeletal injuries. That is part of the reason why in Australia people can access Physios directly without the need to go through a doctor.
Agree totally. Any time I have ever gone to a doctor for injuries they just prescribe Ibuprofen or something with a bit of codeine if really bad, and if it continues for more than a few days tell me to see a physio. Best just buy some over the counter painkillers for short term relief and go straight to the physio.
Favourite go to: exercise. And it's free.
Only once you're in a half way decent state though. Exercising can make a mild, temporary injury into a much longer term one.
What if exercise was the cause of the problem?
correct technique at all times!
Only one of them comes with the increased risk of a stroke. And only one of them has a very weird foundation story.
That’s chiropractor, for those who aren’t sure.
No, go to some of the massage places in town and there's a high risk of a stroke (guaranteed if you say the right words apparently). Their foundation stories are often a bit iffy too.
I don't see what belief has to do with it
It is like saying do you believe in science and evidence based practice or quackery
Which unfortunately seems to apply to many things these daysOsteopath? Dry needle?
Osteopaths don't generally have an actual medical degree (if by that you mean MBBS or MD), certainly not any more than a physiotherapist does.
https://www.google.com/search?q=do+osteopaths+have+a+medical…
Ah I was misled it seems.
Still, they're studying for accreditation 4-5 years apparently.@Speckled Jim: anyone can study for 4-5 years, or even longer if they chose to fail a few courses.
and also, 4-5 years of science, or pseudoscience?
I don't have much experience with osteopaths so I'm actually quite neutral - I've just had to deal with the mess chiro's have left patients and hence I'm super skeptical about them but again I'll admit that's probably observer bias.
Still, they're studying for accreditation 4-5 years apparently.
I've played Halo for 20 years and I can tell you I am still not equipped to save the galaxy.
@Sunshines bright: they do not have a medical degree in Australia. they would get laughed out of medical school.
unfortunately a clown somewhere gave them permission to use the Dr title…
There's nobody on this list with an actual medical degree. Even a physiotherapist is paramedical at best. I don't know about osteo, but chiros are quacks that sell snake oil.
I've had great results from an osteo. In my experience they're kind of between a physio and a chiro in that they'll deal with joint misalignment with minor manipulation but only after a proper massage of the affected area to relax the muscles.
A chiro will realign joints with zero effort to relax the muscles so they'll pull your joints back out of alignment sooner or later (sometimes before you've got home in my experience).
Physios rarely manipulate to sort misalignments, they work on injuries by working on the muscles with massage and exercises. Their results take longer to achieve but they're much longer lasting. If the patient maintains the exercise programme or adapts movement to match the physio's recommendations then that can fix things more or less permanently.@banana365: You might need to do a bit of reading and research if you still think joints "misalign" and your Osteo is "aligning your joints". It is unfortunate that is what your osteo is telling you.
@Xuaxace: No additional research required, though perhaps a better use of words than "misalignment". I hadn't considered that that word was commonly used (at least in Australia) in the more "mystical woo" sense that involves chakras and other such nonsense. I'm talking about "physically not in the right place" which, in my case, was shown by both X-ray and MRI. Poorly advised/executed exercise following a shoulder subluxation resulted in one side being stronger than the other and causing a cascade of other issues.
Osteopaths do not have a medical degree and are not medically trained. If the practitioner you visit is representing themselves as such and they're not also a Medical practitioner, they're breaking the law.
@Sunshines bright: All of this relates to the USA. Osteopaths in Australia do not follow this pathway, do not have comparable training, are not employable in hospitals nor can they prescribe medications or refer for surgery. They are registered alternative health practitioners that are limited by their scope of practise.
Now, that's not to say it doesn't work for you, it may well, and that's great. I'm happy whenever anyone can find relief from their pain regardless of what title that person has. But let's not try to fool others as to the breadth of their qualifications.
@downbythecreek: I read the same thing on line. Even in the US, osteopaths appear to be somewhat (a LOT) less than a fully qualified MD).
@grr1701: I don't believe they are less qualified. A Physician that holds a Doctor of Osteopathic Medicine from the USA can certainly register as a medical practitioner in Australia.
I don't know whether they can register as an 'Osteopath' here though, but I doubt many come here to practise in that field.
@Sunshines bright: Please stop spreading incorrect information. You didn't need to copy and paste it from above.
Physio. Chiros are just bone and joint poppers. I'm pretty sure you need a degree to be a physio, but you need a Udemy course to be a chiro…
Physio is a HARD 4-5 year degree.
Chiro is 5 years too.
Length of time doesn't dictate competency.
Length of time doesn't dictate difficulty either
It is if you rub it like that
The psysio's i've been to have been useless, they ask where it hurts and stick electrodes on that spot, leave you alone for 20 minutes and come back …
A proper physio would do better, but to remove all doubt, pay the extra and go see a sports physio, the ones that sporty people use, they don't just try to remove paid, they try to restore full function (but old may be difficult to fix)
If your physio is sticking electrodes on a spot i don't think you're going to a physio.
Yes he is. Some "passive" physios use dry needling, TENS (electrodes) as well as massage.
"Active" physios go through everything with you (history etc) and work out and go through exercises with you.
If you follow the exercises they do give some relief generally but never expect miracles. Been there done that.
I'd never go to a Chiro again they actually made my problem much worse by not knowing the real cause (well, to be fair no-one did not me or doctor) and I ended up having to have a c6/7 decompression surgery. Looks great on airport X-Rays though - get pulled up a lot when travelling overseas.
There's evidence TENS works for pain relief but it is short lived.
NEMS (preferably through needles but pads also work) has evidence behind it for muscle strengthening + relaxation under CERTAIN protocols.
If someone absolutely can't engage the muscles without pain on their own, there is a time and a place for it.
Unfortunately some do use dry needling and TENS machines, if they deem it appropriate, I’d choose to go to a different physio if they did that, I think.
The psysio's i've been to have been useless, they ask where it hurts and stick electrodes on that spot, leave you alone for 20 minutes and come back …
Avoid any place like this as they might start with heat packs for 20mins, face to face for 20mins and electrodes for 20mins. Then a bill for 60min of time.
This is done by physio practices so they can see 2-3 patients simultaneously.
Sounds like a lazy physio.
Like I said above, there's a time and a place for tens / nems but they should be using that downtime to draw you up rehabilitative exercises or educate you not leave the damn room lol.
lol what, what kind of physio did you go to? I've never ever heard of that. Been to multiple physios.
Of course they will ask you to localize the pain and under what conditions, that's part of diagnosis. They will then try and be a bit more hands on to test their hypothesis, and once confirmed help you out in how to manage it.
Most physios I've been to are great. People just don't realize that muscle and joint issues don't get fixed overnight. They take time and effort (exercises) to right themselves.
But a chiropractor is a doctor!!!!! /sarcasm tag
One of them is a psuedoscience, easy choice.
https://www.youtube.com/watch?v=tj7twH8h7LE