Chiropractor, your regular doctor or physical therapy for lower back pain: Whom should you visit first? When you visit your doctor, there is a good chance they will recommend physical therapy, since they were introduced to this mode of care for many physical problems when they were interning. There is a growing trend for primary doctors to refer to chiropractors first, especially after they had their own episode of lower back pain. This past week, a familiar face entered the office; someone who has not visited us in at least 10 years. ” Since I last saw you I have not had any problems until I retired a year and 1/2 ago.” She stated that after she retired, her legs, back and other parts of her body began to hurt. She visited her primary doctor who first suggested she can try some therapy which was done for months and did not relieve her pain as the therapy itself worsened her pain. She mentioned her old chiropractor but her doctor then suggested pain management which had her on the path to becoming addicted to narcotics which have been recently in the news lately as more people unwittingly become addicted (read about the problem at the VA here). Thousands of dollars spent on ineffective and questionable care, she finally suggested to her doctor that she would like to go back to the chiropractor she saw years ago. The doctor agreed. She felt improved after the first visit, found out her foot problems were causing her back problems and finally had an understanding of what the pain was; a problem with her body mechanics. She is still not able to understand why these other specialists did not understand why she hurt, but wanted to treat where she hurt. She finally understood that the reasons you hurt can be quite different than the areas that are hurting. Why did our approach work better? When most patients visit their doctor or therapist, they look at the problem from the point of view of their own professional bias, something all doctors have. In our office, we looked at it as purely a mechanical problem and was able to show it to her in a way she could understand it. We offer mechanical solutions to retrain, restore function and get you back to health quickly. Patients should be wary of solutions for pain that are expensive, and are purely aimed at an area of pain. Often, problems in the feet can cause problems in the back, neck and shoulders, so looking at where it hurts is simply wrong, unless there was a traumatic injury that makes you suspect an injury at that part of the body. By looking at the problem correctly, a good mechanical solution may include the following; 1. Inserts for your shoes (foot orthotics help level the pelvis and improve the way your body works from the ground up). 2. Myofascial Release or ART (a style of fascial release) or instrument assisted soft tissue treatment. Since the myofascia (connective tissue surrounding the muscles and organ systems in the body)in response to how we bear weight against the ground, fascial release can help restructure the way the body works more effectively than any other method. 3. Exercises – only done after provocative tests show the body can handle an additional loading. Often, patients are referred for therapy to an area that is malfunctioning, with the result being more pain. The area must be tested first to see if it is capable of handling additional force. 4. Manipulation by a licensed chiropractor, both to the spine and the extremities, for ultimate mechanical function of the body. Please feel free to leave comments. We appreciate your opinions.