Did you hear the one where…
Did you hear the one where the family doctor says to the patient that he doesn’t really believe in physical therapy? The patient then asks why he prescribed it for her in the first place and he just shrugs his shoulders and says, “Because you asked for it.”
Of course, there’s a longer story behind that “joke”. I can’t tell it or I’ll lose some hair as I remember the unfortunate contact I had with the loser doctor. Thankfully, it really is one of my very few bad doctor experiences. Right now, I’m trying to figure out the best way to treat 2 or 3 troublesome discs without surgery. It seems that going into full abdominal surgery without your back being in top shape can lead to some back trouble in recovery. Three weeks into physical therapy, my right leg went numb and has stayed that way for three weeks now. Trying to get to the person/tests/therapy to correct the problem hasn’t been easy. I’m finally 2/3 the way there; I found a good neurologist who throughly ruled out other causes and ordered an MRI which confirmed what the physical therapist and I both suspected - disc changes. Now I get to decide if I want Physical Therapy again or Physical Medicine. The neurologist also doesn’t think much of physical therapy, much to my dismay. I’ve always highly respected that field and almost went to school to become one. Instead, he is recommending the Physical Medicine and Rehabilitation department. Yet, no one can really explain to me what the difference is. Can anyone enlighten me?
TK!
PM&R is a physician specialty, like neurology, surgery, etc. Physical therapy is a non-physician ancillary/complimentary medical profession. A PT (at least in our state- yours may be different) can only practice under the orders of a physician.
As I’m sure you are aware, a PT is going to use physical modalities only, such as exercise, stretching, ultrasound, electrical stimulation, etc. A PM&R specialist may prescribe PT as a part of your treatment regimen, but may also prescribe medications, injections, or other more invasive procedures short of surgery.
As I’m also sure you are aware, the skill levels of physical therapists have a great deal of variance. This is one of the factors that make some skeptical of their effectiveness, although this argument could well be made about neurologists and family docs as well.
I think the biggest factor is that many musculoskeletal conditions are self limited, and therefore most get better and resolve without treatment. As an example, 90% of people with low back pain will report resolution within 4 weeks, regardless whether they received any treatment at all. This makes it difficult to “prove” that PT makes any difference. Therefore, there is no overwhelming scientifically compelling evidence either for or against its use for many conditions. The numbers required for such studies to be done would be enormous.
Personally, I have a great deal of faith in physical therapists…as long as they are ones I know and trust! It’s a different ballgame if I don’t know them and therefore don’t know if they know what they are doing.
I was hoping you’d comment! I’ve also appreciated and respected PT’s. The one I had this spring dismissed me until I had a more through work-up, since she couldn’t resolve the numbness issue. So, tomorrow I’ll tryout the PM&R department. I am hoping that they will be able to make some headway. Thanks for your input; it is greatly appreciated!!!
go make fun of doctors intelligence y don’t ya.Ha ha. Some doctors not have enough experience and end up making alot of mistakes