 
Overview | FAQ
One of the key features that differentiates
PacificaSpine from other clinics that treat back and neck pain is its
spine-specialized therapy department.
In many unspecialized clinics, a physician will see the
patient, perform an examination, and then refer the back pain sufferer
to a physical therapy clinic all the way across town. This general "evaluate
and treat" prescription for physical therapy is all-too-common.
Often, a general physical therapist will start from scratch by forming
their own evaluation and assessment without knowing what the original
physician found out through diagnostic tests.
This general physical therapist often sees a wide variety
of problems every day, such as patients with sore elbows, knees and
sore shoulders. In most cases, this general therapist has a very limited
understanding of how to treat specific types of back problems. At best,
a general physical therapist has taken a couple courses on how to perform
therapy for a back or neck injury.
A general physical therapist may also rely too heavily
on passive "modalities," such as ice, heat or ultrasound,
to treat back pain. This may not be a good choice, as research has shown
that using these passive treatments is NOT the best way to return someone
to activity efficiently.
How our spine center differs
Instead of sending a patient across town, they will be able to come
directly into our rehab department. They will also be connected with
a spine-specialized therapist who has advanced training in spine. Rather
than starting from scratch, this therapist works off of information
gleaned from the previous physician's evaluation, picking up where they
left off.
What does this mean for you?
Instead of receiving a general treatment approach, your therapist is
specialized in the treatment of back and neck pain. Our therapists have
advanced, hands-on skills that can help relieve your pain and get your
injured muscles, tissues and spinal structures moving again. Instead
of a single school of thought, you get the benefit of being treated
by a specialist with a variety of skills who can choose the ones that
best match your particular problem.
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Frequently asked questions about therapy
at PacificaSpine
Q. What makes PacificaSpine physical therapy different?
A. Just as the trend in medicine is for physicians
to subspecialize in knees, or arm, or joint replacement, the exact same
thing is happening in the area of physical therapy. That’s good
news for patients.
Just as the first step for a physician is to receive
his MD degree, the first step for a physical therapist is to become
a licensed physical therapist. Most orthopedic centers and therapy clinics
will have licensed physical therapists who split their time among patients
with knee pain, hip problems, shoulder pain, hand problems, ankle problems
and foot problems.
Experts have found, however, that back and neck
problems can be stubborn to treat and may not respond to general techniques
learned in therapy school. Worse, what often happens is that when generalized
therapy fails to relieve symptoms, the patient has to resort to spine
surgery.
Consequently, those therapists who spend 100% of
their time with spine patients learn early on that they need advanced
training to help patients recover from back and neck pain nonsurgically.
The better the spine training, the more often the back or neck pain
sufferer will be able to recover without having to resort to spine surgery.
PacificaSpine physical therapy, in addition to other
techniques, uses the McKenzie method of spine therapy, which is regarded
worldwide as one of the most effective, spine-specialized therapy techniques.
Q. What is the McKenzie Method?
A. The McKenzie Method
was developed about 40 years ago by a New Zealand therapist who observed
that back and neck pain symptoms could be relieved through special stretches
and movements. Over the years, the technique has evolved to include
a systemized approach designed to help many people with back and neck
pain symptoms recover without the need for surgery.
Therapists who want to learn the McKenzie Method
attend special courses and take a credentialing exam that documents
they are proficient in these special techniques. If they pass a series
of rigorous exams that include Parts A, B, C, D and E, they become McKenzie-certified
therapists, and can put the initials “MDT” after their name.
The McKenzie Method (also known as Mechanical Diagnosis
and Treatment or MDT) enables the McKenzie-trained spine therapist to
use a “system” of evaluations and movements with the patient.
Through this approach, the McKenzie therapist can assess how the patient’s
symptoms respond to various movements or sustained positions. If a certain
movement relieves pain, this provides information to the therapist about
the disc or soft tissue injury, which in turn influences the recommended
therapy treatment. Said another way, the therapist helps the patient
discover what specific movements begin to relieve pain, and then use
additional, complementary stretches that encourage healing and relief
of symptoms.
Q. What will my therapy at PacificaSpine be like?
A. At other clinics,
patients may lie on a table, while a therapist puts hot packs or ice
on your back. Or your therapy may have included other passive things
like ultrasound. Or you may have had a massage. The insurance companies
who pay for back care have done extensive research on things that relieve
back pain — for the long term — and they now have policies
that eliminate payment to clinics doing “palliative care.”
The word “palliative” means something that feels good, but
doesn’t cure anything.
So while a massage or hot pack may feel good, it
doesn’t provide any lasting change to the soft tissues in your
back or neck. The effect on your symptoms is temporary, and in a sense,
worthless because it doesn’t last, and your pain will return.
Nationally, the best spine treatment clinics avoid
passive things like hot packs, ice and massage. Instead, spine specialized
clinics emphasize things that strengthen the back, make it more flexible
and resistant to injury. In other words, PacificaSpine emphasizes specialized
McKenzie spine techniques, stretches and exercises that will help you
recover from injury without having to resort to surgery.
At the foundation of McKenzie, for example, is the
philosophy of helping the patient to take responsibility for their own
health. We will show you the special exercises that are customized for
you. By using this customized series of stretches, you have the resources
you need back at home to control your back or neck pain symptoms long
term.
Q. How do McKenzie exercises work?
A. McKenzie exercises
are based on Directional Preference. We help each patient to discover
a direction or movement that improves mobility or function to relieve
symptoms. This might be an extension movement, flexion of the trunk,
rotation of the trunk, retraction or some combination of movements.
Once a directional preference is found, then to we have to discover
the optimal load and effort required to achieve the best results.
Q. Will my leg or arm pain go away using this method
or will I need surgery?
A. The second aspect
of the McKenzie Method involves the concept of “centralization”
of pain. Using these McKenzie techniques, a therapist can help a patient
that has pain radiating down a leg to the knee area, to reduce the pain
symptom so it no longer goes as far down the leg, and over time shrinks
and “centralizes” the pain until it eventually disappears.
Some patients with pain radiating from the neck
into the arm, and from the back into the leg, can respond very well
to these exercises and stretches that centralize and ultimately relieve
the pain completely.
It is important to note, however, that any time you
have symptoms that involve radiating pain or numbness into a leg or
arm, consider these serious emergency symptoms that need to be seen
by a spine surgeon or spine physiatrist to determine if they are worsening,
or if they can be managed with therapy. If you ignore these symptoms,
such symptoms can cause permanent nerve damage. Another emergency symptom
is any loss of control or bowel or bladder, which needs to be addressed
within 48 hours to avoid permanent paralysis of the nerves that control
your bowel and bladder. If you have any of these red flag symptoms,
you need to see a spine specialist, such as a spine surgeon or physical
medicine physician, within 48 hours.
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