Why most hip, knee, and lower back pain must be evaluated and treated as one condition.

During her initial evaluation, she said that her lower back is tight and achy and her neck is always tight.  Chiropractors had helped her for years but hers retired at the pandemic’s beginning.  Upon further questioning her knees and hips, she said walking down the stairs was a problem and soft surfaces felt better when walking on her knees which continued to become more painful over the years.

When I evaluated her, she was having marked difficulty with balance, had problems squatting due to lower back pain and overall tightness in her legs and she had flat feet that were asymmetrical.   She said that after all these years, nobody had ever looked at her feet.

Cleveland Clinic reports that nearly 800,000 knee replacements are performed yearly in the U.S. The rates of hip replacements according to WebMD continue to skyrocket.

People who have knee or hip problems often experience lower back pain as their first symptom.  Most medical physicians who see these patients first have only 140 hours in musculoskeletal training for family practice and are primarily trained to evaluate the part that is painful rather than the patient.  They are also trained to refer to orthopedics who also evaluate the part or refer to therapists who treat the part.

We are the sum of our parts.   A foot affects an ankle which affects the knee which affects the hip and then the lower back.   The opposite side will compensate and so will our upper body.  This is consistent throughout anyone who walks upright and is even seen in animals that walk on all fours.  Think of dominoes as one that will affect the next one.

If you would like to see this for yourself, visit any park and watch people walk. You will never see an ankle or knee or lower back walking around but you will see people who have knees, ankles, and lower backs.  This is the reason that you may miss the obvious cause of a knee, or hip, or back problem by evaluating the part rather than the person. You will also begin to understand that different people are shaped and move differently which is why one-size-fits-all methods don’t and why care must be personalized to be effective.

Knee and hip replacements are at epidemic proportions, and meniscus surgeries have not improved how our knees function or feel and may actually lead us to permanent damage years later due to recent studies concerning the meniscus and how it works.  How is it that experienced physicians and most of the healthcare system continue to fail miserably and make sure your parts last as long as you do?

A growing case for chiropractors as the primary care providers for the musculoskeletal system.

Chiropractic sports physicians are trained to look at how you move and function holistically.  This is probably why chiropractors who are at athletic events often have a line of participants waiting to see them.  Athletes know it’s the chiropractor who will increase their chances of continuing to participate, avoid further injury or improve their performance.

The motion of the human body is holistic; chiropractors are taught to evaluate patients holistically.  Rather than segmenting care, chiropractors will take a holistic history, and perform an exam of the patient including evaluation of the part, how it moves and functions, and then all the other articulations that are involved with it.  Once they understand the mechanics behind the dysfunction, treatment is often rendered on the same day. This applies to most chronic or long-standing conditions.  For acute conditions due to trauma, chiropractors will take an x-ray if needed and refer out to the appropriate provider.

This adds to the efficiency of the care.   Our office also uses treat test treat which is an evaluation system to test how the treatment worked that visit improving the efficiency of care.   This is preferred to the old way of making a working diagnosis and performing the same protocols on everyone regardless of their history or mechanical build which is common with today’s physical therapy regimens.  This assures that the treatment is customized to the patient’s needs.

It is also important to note that chiropractic sports physicians are a one-stop-shop for most mechanical conditions of the foot, knee, hip, and lower back as well as the rest of the musculoskeletal system. This is preferable to the specialist-for-everything approach which is expensive, inefficient, and often ineffective in resolving many musculoskeletal system problems that may improve markedly using a simple approach.

Since chiropractors are physician-level providers, they rarely require a referral and can change treatment when necessary without needing someone else’s permission, improving the efficiency of care.

Is healthcare that complicated or has the system made it that way to suit their needs, not yours? 

Patients in pain often will make poor decisions based on fear.  The idea of seeing the doctor, and waiting for the test to see what the problem is rarely works for non-traumatic lower back, knee, and foot problems.  The Annals of Internal Medicine in their report “The New Guidelines for lower back pain”  confirmed that the problem of lower back pain has to do with motion and chiropractors routinely use a number of the methods they listed while avoiding drugs and surgeries which should only be a last resort.

Anyone who suffers from knee, hip, and back problems should read the book Cheating Mother Nature, what you need to know to beat chronic pain.  The book written 12 years ago is quite relevant today, as most patients have little understanding of why they hurt.   Often, simple explanations as are included in this book will empower patients to make better choices regarding how and why pain exists and how to find the providers most able to help them.

Years ago, you went to a doctor and they may use all other knowledge to help you find a solution to your problem.  Years later, a specialist for everything has resulted in more tests, more procedures, higher costs, and some improvements in how we age.   More people are taking more medications than ever before and musculoskeletal problems are still a huge blind spot for most medical providers who refer these cases out. The public still doesn’t fully understand that medical providers don’t have the tools and knowledge to properly treat mechanical problems conservatively, resulting in referrals and additional costs that are often avoidable.  While it is true that there is a movement within those professions to improve the training, medical providers are still not required to take a minimum number of continuing education in the diagnosis and treatment of the musculoskeletal system yet.

Chiropractic sports physicians have this training and spend their days evaluating and treating these conditions.   A chiropractor may recommend foot orthotics, manipulation of the affected area, myofascial release to improve how you move, and corrective exercises, often all in one session.   Cost-wise, many insurance carriers do offer chiropractic care and even without coverage, chiropractors are a cost-effective solution that can have a marked effect on helping you age with less pain and fewer injuries.

A hands-on approach is what is required for most painful problems in the lower body. Often patients will visit with one or two major complaints and leave with four or five problems resolved during the same period.  This is likely why chiropractors have such high levels of satisfaction from publications such as Men’s Health or Consumer Reports when compared to other types of musculoskeletal providers, while United Healthcare has saved millions of dollars by using chiropractors.

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