Diagnosis by Technology vs. Diagnosis by Exam

Does it really matter which means are utilized to determine a patient’s diagnosis? When it comes to diagnosing musculoskeletal pain, I certainly think so. The art of performing a physical exam on a patient is missing in the realm of musculoskeletal medicine. I know this because, as an experienced physical therapist, we are the only physicians who rely on extensive physical examinations to diagnose and treat the majority of physical ailments. Other physicians, such as general practitioners or orthopedic doctors, utilize MRIs and x-rays to diagnose. So, why use physical examinations? There are plenty of reasons.

What Actually Is Your Problem?

Seems like a pretty simple question to answer, right? Wrong. All too often I see patients in my office who have a hard time answering this question. Why? Often they find themselves in my office after experiencing pain for several months and after seeing multiple other physicians before me. The first thing that I usually discover is that the patient has yet to have had a comprehensive physical examination. This is what the background of their treatment usually looks like –

  • First, they saw their family physician and verbalized their pain complaint
  • The family physician prescribed pain medication and referred the patient to a specialist, usually an orthopedic surgeon
  • The specialist also listened to the patient’s complaint, maybe even performed a brief exam, and then ordered an MRI or x-rays to determine a diagnosis

That’s when I come into play. The patient arrives at my office and tells me, “I have a bone spur,” or “I have a bulging disc,” etc. To which I reply, “Yes, that is what your MRI/x-ray says, but what actually is your problem.” {cue blank and confused stare} It is amazing to me how many patients, by the time they end up in my office, have lost sight of what their original complaint was due to being so fixated on this diagnosis that has been determined by a machine.

The Art of the Physical Examination

Once the patient realizes that I am actually interested in their original complaints, they are eager to explain things further, such as:

  • When did their pain start?
  • Is there a difference in the origin of their pain vs their pain now?
  • What movements make the pain worse vs which movements ease the pain?

The physical therapists at OSPTC are trained to make a diagnosis by physical examination. We don’t send you out for an MRI or x-ray, and we certainly don’t recommend pills for your complaints. Instead, we will listen to you and examine you thoroughly as only a physical therapist in one of our offices has been trained to do.

Getting to the Root of the Problem

So, what can be determined by a physical examination? First of all, we will look for the cause of the pain by looking at how you move.

  • What is stuck?
  • What is weak?
  • Are there any restrictions in your fascia or peripheral nervous system?
  • Are there restrictions in your joint capsule or just a trigger point in your muscle belly?

Once we find the source of your pain, we will begin treatment right away. When you start to see the results of our treatment, you will rest easy knowing that not only has the problem been diagnosed, but the root of the problem has been discovered and treated as well. It will be then that you realize that diagnosis by exam is a much more efficient way to treat musculoskeletal pain than diagnosis by any machine or technology.

With four locations from Crestview to Destin, Florida, our physical therapists are trained specifically to perform extensive physical examinations to diagnose your problems as well as discover and treat the root of those problems. Orthopedic & Sports Physical Therapy Center has expertise in assessing, diagnosing, and treating the real issues that cause medical problems.  Let Orthopedic & Sports Physical Therapy Center, LLC be your first resort to treatment, rather than your last. We are dedicated to delivering quality treatment that will get you back in shape as soon as possible.