Tell your doctor to go pound sand.

So, you have some pain and you go see your PCP or some other person. 

They perform some half-assed assessment of the injury in question and suggest taking some medication and checking back in 4-6 weeks.

Really? That is the best they can offer?

Maybe you will get an x-ray (which really only looks at the bones). Usually they are negative or you have arthritis. News flash. At some point, we will all have arthritis.

Arthritis is not a diagnosis and it is not a death sentence. You can function just fine (for the most part) with arthritis. 

Yup. Definitely arthritis. And maybe a touch of something else you will need meds for.

No disrespect for these health care professionals, but their evaluations skills are average at best. And, they often do not have the time to truly evaluate someone even if their skills are not subpar.

And, treating pain with meds only attempts to deal with your symptoms. It DOES NOT deal with the underlying problem that is causing the pain.

Failure to fix this 'problem' means your symptoms will never, completely, go away.

You can try the meds if your pain is bad and you need some relief. But, instead of waiting 4-6 weeks, why not ask for a referral to see a Physical Therapist or other qualified clinician right away?

Yes, Physical Therapists can pretty much do it all. Except prescribe meds, but who wants that headache anyway. See what I did there?

A lot of bad can happen in 4-6 weeks when you are in pain.

If you have an acute injury and the pain lasts for say, 6 weeks. Over time, your brain develops pathways for this pain. So, when other things start going wrong (like increased stress or other things wrong in your life), the brain will revisit the old pain pathways to make you change your behaviors. This can be a main contributor to chronic pain.

This is the brains way of trying to communicate with you and trying to get your attention. 

So, after an ankle injury, for example, you have swelling and pain and as a result impaired or altered proprioception and mechanics. You forgo any quality therapy and after 6 weeks, scar tissue builds. This can lead to joint tightness. As the joint tightens, the brain continues to receive impaired somatosensory input. 

The sooner we catch the problem, the sooner we can fix the problem.

You fix the problem and the symptoms go away. How sweet is that?

I see too many patients/clients that have had chronic pain that was mismanaged for too long so the person suffered. The treatment was focused on chasing and treating symptoms, not fixing the problem(s).

Always advocate for yourself and ask to see a PT or other qualified clinician.

And, remember that you can choose who you want to see. Just because your doctor has PT in the same building or typically refers to someone they know does not mean you have to go there.

Be more like Bill.

Just so you know, it is becoming less common to get an MRI without going through some Physical Therapy. X-rays used to be given out like lollipops, everybody gets one. But even they are not ordered right away.

I have another post I am working on regarding the efficacy of imaging and just know that imaging's ability to diagnosis without a thorough evaluation is very poor.

Not good.

Unreliable. 

Always advocate for yourself and if the care you are being provided is not up to par, do not accept that as your fate. 

And once you find good clinicians, in any area, do not let them go. They are hard to find. 

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Until next time,

Dr. Tom