Well, let's set things straight right now. Pain is not arbitrary. It is not floating in the air waiting to befall an unfortunate individual. Pain is the body's mechanism for identifying that a tissue is in distress. The key to good diagnostics is being able to establish which tissue is causing the distress signal. What I have been able to do with my evaluations is determine that every cause has specific symptoms and every symptom is created by a specific cause. By understanding the individual's symptoms and then looking at things like a mechanism of injury, range of motion of related joints, muscle tests, functional tests and palpation trying to establish which tissue is actually creating the pain, I am able to establish the cause of pain.
If a patient came to see me and I believed the cause of pain was a structural element like arthritis, a torn rotator cuff, a torn ligament, a fracture bone, the answer would be clear and concise, get surgery tomorrow. Not in a few days, weeks or months. If surgery is required to resolve the pain, then get the surgery and address the post-surgical symptoms after that and the person will be good as new.
If the cause is found to be muscular, however, I don't care how many substandard treatments the individual receives, surgery shouldn't be an option. Approximately 90 percent of the cases I have treated, the cause was muscular. Through aggressive strength training, the pain was resolved and the person returned to full functional capacity. In a few cases, I established that the cause required surgery. The individuals had the surgery and I simply treated them for post-surgical symptoms and they returned to normal function.
The facts are clear, functional pain is caused by one of two issues, structural abnormalities or muscle weaknesses or imbalances. If the cause is structural, the answer is easy--get surgery and resolve the pain. If the cause is muscular, the only mechanism for resolving pain is aggressive, targeted strength training. When people begin to see this as the only real truth about the causes and treatments of pain, they will be able to sift through the nonsense that is the medical establishment's dependence on diagnostics tests that have never been proven to correlate the cause of pain with the symptoms.
I suggest to anyone who reads my column, if you are still in pain after getting a variety of treatments addressing a cause that was only established by the results of diagnostic tests, end this process now. Recognize that the problem isn't you. Your case is not as unusual or difficult as you may think. The problem is with those who are supposed to be in the position of identifying the cause of your pain. If someone is not trying to understand your symptoms, they will not be able to understand the cause.
