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Phases of Healing for Joint Pain

Dr. Todd takes you through the treatment plan process at Axial Spine

We don't believe in cemented treatment plans.  Our treatment frequency and duration is guided by the process by the healing process. In this post we explain those stages of healing and what it will mean for your treatment. 

First Phase: "Mechanical Diagnosis"  (2x per week)

A clear diagnosis is paramount to an effective treatment plan.  This starts at your first visit. And while it usually is confirmed within minutes of your second visit, in difficult cases it may take 3 or 4 sessions to complete.  Why? Even when we think we understand your case the first day, a trial period of at least 48 hours of doing home exercises is necessary to confirm the diagnosis.  For difficult cases it may take more than one trial period, which is why it may take 3 or 4 visits. We want to establish a clear diagnosis to build an effective treatment plan, so while in this phase our doctors will have you come into the office multiple times per week.

Second Phase: "Reduction" (2x per week)

This phase is all about eliminating pain.  This hopefully begins at your first visit, as decreasing or eliminating pain will confirm we are on the right track.  We often use the analogy that joint pain is very similar to a cut in the skin.  We are attempting to find a movement to create the same effect as a stitch would for your skin, keeping the edges of this "cut" close together so that healing takes place. Once we find that movement, it is performed repeatedly so healing can happen quickly. We will also ask you to avoid movements that will stretch, or tear, the "cut" tissue. Your doctor will want you to come in two times per week until significant reduction in pain is met. This usually occurs in just a few visits - It is fairly rare that a patient is coming in twice a week for more than two weeks.

Third Phase: "Maintenance" (1x per week)

This phase is all about time.  Once we have found the right movement to "stitch up the cut," it takes time for that cut to heal. Just like our cut analogy, pain will go away before healing is completed.  In this phase, the patient will continue the exercises at home while focusing on things like posture, protective exercises, and prevention at office visits. In healthy people, the cut will heal up in 10-14 days with the proper care. 

Fourth Phase: "Recovery of function" (1x per week)

This phase is about returning to normal daily function.  This includes regular activities such as exercising, lifting, and bending. This phase will begin as soon as a reductive load is discovered, often at the 2nd or 3rd visit. It becomes the sole focus of treatment once enough time has passed for tissue healing to have taken place. This rarely takes more than 1-2 visits.

Fifth Phase: "Prevention" (As needed)

This isn't so much a phase of treatment as it is our goal once you are done with treatment. Unfortunately, about 50% of people with an episode of back pain will experience a re-exacerbation of that pain within one year if they don't make any changes.  This can be brought down to 10% or less with 2 simple changes to day to day life.  1, continue to perform the exercises that helped heal your cut.  Think of this like brushing your teeth - try to do it twice a day, but understand you'll miss a few days, and that's ok.  2, Getting some form of regular spinal adjustments.  This is like getting your teeth cleaned. Since movement is the magic that helps joints stay healthy, getting a level of joint mobilization that is hard to achieve on your own can be incredibly helpful in decreasing recurrence. 

Our goal with treatment is to get you better as fast as possible. However, it is also our goal to get lasting relief, meaning avoiding exacerbation for years to come.  This takes understanding and planning, which means we ask our patients to come in for a few visits even after the pain is gone.  We use this time to talk about what to expect, and how to avoid falling back to square one. 

Dr. Todd Peterson, DC, Cert MDT. Dr. Todd Peterson Dr. Todd Peterson is a chiropractor and certified provider for Mechanical Diagnosis & Therapy (MDT, aka the McKenzie Method). Dr. Peterson played football at the University of Nebraska, where he was a 4 year letter winner and Academic All American. He briefly played professional football in 2009 before returning to Chiropractic School in 2010. He earned his doctor of chiropractic (DC) degree from National University of Health Sciences in 2013, graduating with Magna Cum Laude honors.

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