Many people that experience chronic pain have seen multiple practitioners over many years without lasting relief. They often feel better for 1 or 2 days, but then their same symptoms return time and time again. Sometimes they never feel even a bit of relief from symptomatic treatment, but that’s what most insurance companies allow for, so that’s what they get. For example, if their symptoms are in their shoulder, the practitioners are usually pretty restricted to only being able to treat in the shoulder and upper body areas. If the practitioner spends time treating the patient down in the pelvic or leg area, they will not get reimbursed for that time. This kind of treatment was all that I knew when I was first starting out as a PT. We had to document and describe every single treatment that we did and we had to pick just the right codes to make sure our billing was correct and that we would get reimbursed from the insurance company for our treatment. We had to make sure that we weren’t treating anything else besides what we had specifically coded for or we could be audited. It was a nerve wracking process and at times, I was seeing over 30 patients in a day. I had to think about all of those things for every single patient. I was focused much more on documenting and coding correctly than I was able to focus on being creative and finding the source of each individual’s pain. This all changed when I had finally had enough of not being able to give every patient my best and I decided to open my own practice that was not in-network with insurance companies. I was now able to treat my patients as a whole person, not just their symptoms.
Every person has a completely different story and our current medical system often treats people with protocols and only utilized practices that have been validated by research. I really like the thought behind “evidence-based practice” but sometimes there are treatments that cannot be researched objectively because they are so completely different for each person. Also, the best treatment tends to be a mix of many different modalities and practitioners – no one can do it all! In my opinion, the best treatment for chronic pain is finding a team of practitioners with different specialties that work together and communicate while keeping the patient at the center of their focus. I am so blessed to have become part of an amazing team of practitioners that are all striving to do their absolute best for our patients. We are all considered to have unique specialties, but in reality what we do should not be considered unique, it should be the norm! We are all patient-centered and holistic practitioners that recognize that the body does not work as individual pieces and parts, it works as a whole. Our patients are not just their physical bodies, they are emotional, social and loving beings that often need much more than just physical treatment. All of the practitioners on my team know that our patients often have a history of trauma which can be anywhere along the spectrum from a minor athletic injury to severe abuse. Trauma doesn’t always have to be a huge event in someone’s life – it can be repetitive work trauma or repetitive poor postures. It can even be a sprained ankle at the age of 15 that has caused a shift in a patient’s body and may start showing symptoms in their low back or shoulder when they are 40 years old! All of the practitioners on my team listen to the patient and take note of their symptoms, but we are also very open to following what the patient’s body is telling us as well, which can often lead to places that no one would have ever suspected were involved. This is why we often have success where other treatments have failed. We do not have protocols and we do not know what we are going to do when the patient walks into our office. Every day is different and we treat what the patient and their body is telling us on that day. I feel truly blessed to be able to listen to my patients and listen to their body and let them lead me to what will work best for them. It’s a complete 180 from what our current US medical system looks like, but I am hopeful that more people will start to find myself and other like-minded practitioners so that they can get the best treatment for their whole self.
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What is the difference between symptomatic treatment and holistic treatment? I’ll return to the example of shoulder pain – often if a person has shoulder pain they get symptomatic treatment for their shoulder and possibly their chest, upper back and neck. These are all great areas to treat, but what if we just stop there? For many patients, that might completely resolve their pain, and that is wonderful! But for our patients with chronic pain who have already had those areas treated by many different practitioners but have not had the results they are hoping for, what next? They are often told that there is nothing more that can be done or that it is “in their head” and they need to see a psychologist. My heart absolutely breaks for these patients. To be told that chronic pain is “in your head” is completely invalidating and leaves patients feeling like they might be crazy and that no one believes them. I have many psychologists on my team and I think that they are wonderful and definitely a big part of healing for many people, but we can’t tell people with physical pain that all they need is psychology – it is not treating the person as a whole. This is why I believe that a team approach with holistic treatment is the best for people with chronic pain – they need practitioners that can work with them as a whole person – physically, mentally and emotionally. They also need practitioners that are willing to look outside of their symptoms to see if anything else could be contributing. Almost all of my patients with chronic shoulder pain have impairments in their cranium (head), neck, mid-back, low back, pelvis and hips. Some of them even have impairments in their legs, feet and toes that once addressed, often help their shoulder pain to resolve. I know it sounds crazy, but when you hear the saying “everything is connected,” it is so true!
In conclusion, my advice to people suffering with chronic pain is to look outside of the normal medical system. Initially, the out-of-pocket costs might seem daunting, but most practitioners that work outside of the insurance-restricted medical system will spend much more time with you, will listen to you and your body, and will often provide you with pain relief that you may not have found previously. They may also have a team of practitioners that can encompass every aspect of your healing and keep you at the center of their communication and treatment. In the end, the out-of-pocket costs may even be less than the co-pays and deductibles that you have paid in the past and your outcomes will likely be much better.
For further questions, or to schedule an appointment, please email Dr. Lisa Wilcox at DrLisa@SolsticePhysicalTherapy.com, call (720) 369-7738 or contact through her website at www.SolsticePhysicalTherapy.com.
**This is not to be considered medical advice, please contact a physical therapist or other healthcare professional for more information. All content on lisawilcoxpt.com is created for informational purposes only and is not to be taken as medical advice, treatment or diagnosis.