Who do I see when my "back goes out"?
Should I see a physiotherapist, chiropractor, osteopath, myotherapist or a masseur?
Well here is my perspective as a physiotherapist.
Physiotherapists are university trained professionals with a minimum of four years undergraduate training. Their focus is on the musculo-skeletal system and they work closely with local general practitioners to provide a health service. Most physiotherapists in private practice go on to post graduate training and specialize in the management of spinal pain and sports injuries.
The physiotherapy philosophy in the management of back and neck pain is to settle initially the acute severe, symptoms and then to address the long term management so as to prevent further episodes of pain.
In the acute phase we use massage, mobilisation, manipulation, exercise and bracing to help settle the symptoms. Importantly we give advice to ensure that the condition does not get worse. When the symptoms have settled we prescribe a long term self management program which includes core strengthening exercise, posture and lifting advice. In short we aim to settle the symptoms as quickly as possible and then encourage self management.
Dependence on the therapist is discouraged. There is no evidence that supports long term or maintenance treatment of your spine by a therapist. Often I see patients who have been attending an alternative therapist on a weekly basis for months and sometime years. This type of therapist dependence should be discouraged as it is of little benefit. Treatment should be goal orientated. Ensure that you discuss your progress and treatment plan with your therapist and if you are not getting results question why.
Remember long term treatment is expensive, does not improve your ability to look after your own back and is of little benefit.