So You Got A Cortisone Shot!….Now What?

So you got a cortisone shot.  Now what?

At least that’s the question you should ask yourself.  You see, cortisone works great at eliminating inflammation – that’s the point of the injection – but inflammation is just the result of an underlying problem.  Cortisone does nothing to fix that!  The result, as some of you may know, is having to go back multiple times for more the cortisone just to get relief.

What you may not be hearing is that while cortisone may be of benefit in pain relief in the short term, studies are now showing that patients have a worse clinical outcome when compared to patients that did absolutely nothing for their pain and injury over the course of a year.  That should be startling information for those out there that have had a cortisone injection.

If you would like to see more on this information click here.

If you are someone who is debating getting a cortisone injection, or have already had one or several, there are some very important questions that you should answer.

The most important thing being – “What is your diagnosis?”  This should be a tissue-specific diagnosis!  Tennis elbow, plantar fasciitis, and tendonitis are NOT good enough!

The next question should be, “What are you trying to accomplish by getting the injection?”  Are you looking for pain relief, or are you looking for a permanent fix?”

If you have been diagnosed with tendinitis, this may seem like a simple solution, but being that a LARGE majority of tendinitis cases are NOT inflammatory and instead degenerative, cortisone will actually make this worse, as referenced here.

This brings us back to our original question – “What is your tissue-specific diagnosis?”

If you are debating another shot, “How long do you think this one will last?

If it’s your first, the average cortisone injection will provide 6-12 week’s worth of relief.  Some are lucky enough to get more relief than that.  People who already have had one, should expect similar results as before or less.

The last question to ask yourself should be, “What do you do after this shot wears off?”

If there was a tissue-specific diagnosis, there should already be a plan in place.  If there was no plan in place it’s time to get one!  You deserve better answers, you deserve better solutions!

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At Thrive Spine and Sport, we answer your first question!  Your body does not care what technique or treatment the provider is trained in.  It simply cares, what it needs to fix the problem!  If what your body needs is not a treatment we perform, we will refer you to where you need to be.

Thrive Spine and Sport specializes in the diagnosis and treatment of overuse and sport injuries, specifically the diagnosis and treatment of adhesion.  Adhesion is one of the most common, most misdiagnosed condition in the body causing pain, inflammation, and restricted range of motion.  Most of our patients have tried numerous providers before finding relief in our office.  If you or someone you know is currently struggling with pain, we invite you to call our office to get answers to your problem today at 319-423-0925!

Chiropractic, PT, or an Educational Booklet: Which Is Better Treatment For Low Back Pain in Cedar Rapids?

Would you believe me if I told you that an educational pamphlet is just as effective as chiropractic care or physical therapy in relieving low back pain?

In 1998, a study published in the New England Journal of Medicine looked to compare the effectiveness of chiropractic, physical therapy, or an educational pamphlet for low back pain.  The conclusion of the study fueled a lively debate.  What the study found was that there was little difference in outcomes between low back pain patients treated with standard chiropractic manipulation, McKenzie exercises, or the educational booklet!  Not surprising, chiropractors and physical therapists alike were outraged from the findings.

While many previous studies done prior have shown chiropractic and physical therapy to be effective for helping with low back pain, why did this study show an educational pamphlet was just as effective?

To start, let’s look at the study design.  The patients were diagnosed with a regional diagnosis, low back pain, after pathology had been ruled out (herniation, cancer, etc.).  This would be no different than saying someone has shoulder pain.  Patients were randomly assigned to either chiropractic, physical therapy, or the educational readings.  This is where things got interesting.

Patients sent to a chiropractor were diagnosed with a sprain/strain 50% of the time, and another 30% of the chiropractic group was diagnosed with facet syndrome, or misalignments of the spine.  The same group of low back pain patients sent to the physical therapist were diagnosed with disc derangement 92% of the time.  This should raise some alarm!  The same group of randomly assigned patients sent to two different providers had significantly different diagnoses!

While it is entirely possible that the provider’s diagnoses were correct, it is highly unlikely that the difference was that dramatic.  It has often been demonstrated that nearly 70 percent of low back pain arises from 3 different sources; disc (39%), facet (15%), and Sacroiliac (SI) joint (13%).  This is where the study inherently failed.

While the study was not specific enough to sub classify low back pain patients into their respective groups, the providers themselves seemed to have classified patients based on what they can fix, not what the patient necessarily had.  McKenzie exercises have been shown to be effective in treatment of pain arising from the disc.  Likewise, chiropractic manipulation would be most effective in treating those struggling with facet and SI joint complications.

While this was not the intent of the study, this ultimately showed where modern day health care has gone wrong!  Too often, providers of any profession try to categorize patient’s problems into what they can fix, and not what the patient actually has.  It comes without saying that patient outcomes would be much higher if patients were given the treatment they need, and not the treatment the provider is certified to practice.   When providers try to fix patients by classifying them into what they can fix and not what the patient actually has, an educational pamphlet has just as much value as chiropractic and physical therapy.

Reference:

Excerpt modified from [Original DC article] by William Brady, DC. Used with permission. www.integrativediagnosis.com