As a physical therapist, of course I am biased to answer that question with a resounding YES! The Washington Post recently published an article commenting on a research study about the costs associated with low back pain. The article titled “Oh, my aching wallet: MRI instead of physical therapy for low back pain leads to $4,793 higher price” explores the cost of an MRI versus going straight to Physical Therapy for treatment.
For many, just the words “herniated disc” strikes fear/terror in thousands if not millions of American adults. What is it about the term “herniated disc” that is so closely associated with agonizing pain. Granted, many have experienced excruciating pain due to some degree of lumbar disc injury. In reality, about 40-60% of all disc herniations are asymptomatic. In short, this means that about half of all people with herniated discs never knew that had a herniated disc. Along those same lines, the Washington Post article points out that most people over 40-50 years old have some level of benign back impairment that can be perceived as a more serious condition.
One of the several downfalls with MRI’s is that they can show varying levels of medical conditions that exist in your body that your body doesn’t recognize as problematic. The Advanced Physical Therapy Education Institute refers to this as VOMIT (victims of medical imaging technology). Basically, this study shows that while imaging (in forms of MRI or x-ray) may detect various levels of injuries throughout the body, most people never feel the pain until after made aware of an injury with the image.
In the state of Pennsylvania, physical therapists are not able to order such diagnostic tests as MRI’s and X-rays, we only assess with our eyes and our hands. With every new evaluation we see, we constantly assess how muscles and joints are moving. If we detect a muscle or joint is not moving correctly, we prescribe an exercise or apply a mobilization in an effort to help a joint move appropriately.
Beyond movement, physical therapists are assessing posture. We want to see how a patient is holding themselves throughout the day. How do they sit, how do that stand, is there something about a patient’s sleeping position that is affecting their pain.
If you do not believe that posture can affect pain symptoms, simply try keeping a pain journal. Do you see any patterns? Do you have pain after driving to work, when waking in the morning, after sitting to several hours in a board meeting or lounging on a couch watching a movie. If so, you may benefit from a visit to your physical therapist.