Most soft tissue injuries to the back and neck do not require surgery. Surgeries are normally only appropriate if there is a disc problem, such as a disc that is ruptured or very badly swollen and impinging on a nerve root coming from the spinal cord. Not all of these conditions require surgery to treat effectively. The overwhelming majority of soft tissue back and neck injuries do not require surgery.
In cases where surgical intervention is not recommended, a medical physician is normally performing a diagnostic role. The diagnosis may speculate on precisely what is happening anatomically. However, it is often very difficult to come to a precise and accurate determination as to what is happening physically.
Because of that, the diagnosis is often indefinite or ambiguous because of a lack of definitive information that can be obtained by a simple examination of the patient and nothing more. Medical physicians normally do not actually do anything for persons with soft tissue injuries other than the prescribe medications, or recommend physical therapy, chiropractic or acupuncture (which I refer to as “hands-on modalities”).
One thing that is frustrating is that a person who has a soft tissue neck or back injury may continue with prolonged symptoms with a diagnosis that is indefinite long after the patient last saw a doctor. An “indefinite” diagnosis is one in which there is no pin pointing of the injury; there are no broken bones or other abnormalities that could be identified as the source of the symptoms.
So how do we end up with an indefinite diagnosis? When a soft tissue injury occurs, there can be damage to the soft tissue that is not visible on X-rays, MRI’s or Cat Scans. The damage is sometimes microscopic. However, when the damage heals it leaves behind scar tissue. The scar tissue can result in stiffness and be the source of pain. There is really nothing that can be done to correct the problem.
There may have only been a few visits to the doctor, who has not recommended any hands-on modalities. Claims under these circumstances have limited value, but the patient continues to experiences symptoms. Hands-on modalities can enhance the value of the claim. Chiropractors, for instance, actually adjust the spinal column. They touch the person injured every time that the person comes in for treatment, which could be as often as three times a week. It is common for physical therapists and massage therapist to touch the area of injury also.
When this hands-on therapy occurs, the persons performing it can often feel abnormalities in the soft tissues. An example would be muscle splinting, which is where there is an involuntary contraction of a muscle or muscles; this is involuntary muscular guarding to protect the area of injury. There are other things going on that can only be detected by the health care profession actually applying their hands to the area of injury, and perhaps massaging or manipulating it.
It could be that the medical physician that sees the patient one or two times will detect muscle splinting. However, something else happens when the patient has hands-on modalities. With hands-on modalities, the patient usually has treatment on a periodic basis over a period of weeks or months. The patient may be treated two or three times per week or more. Each time, the health care professional is feeling the area of injury and documenting what they are finding based on touch, and the progress of the healing.
There are times when this hands-on health care professional will conclude that the area of injury is not healing to a return of the previously normal condition of the area of injury. They may conclude that the injury is permanent. They may have other opinions based on their extensive hands-on treatment that better explain the injury and its attendant problems.
When the treatment is concluded, there is frequently a clear, written record of the treatment over a long period of time, and the existence of any problems that never resolved. The record of the hands-on treatment then provides objective verification of the full extent of the symptoms and whether those symptoms resolved satisfactorily.
The hands-on treater will frequently offer explanations concerning the symptoms and the failure of the symptoms to fully resolve. When this type of information is available for a claim, the value of the claim is greatly enhanced as compared to a record of a couple of visits to a doctor and an accompanying indefinite diagnosis. The indefinite diagnosis does not provide much if any objective verification of the injury.
The hands-on record of treatment provides that objective verification. Further the extensive documented record of hands-on stands as evidence that the injury was a real problem for the patient that took time to resolve and was not just some passing, temporary issue of little conseuqence.
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