Physical Therapy IS Part of Integrative Medicine
By John Woolf, PT, MS, AT, COMT
Integrative medicine has become more popular because of the frustration many patients are experiencing with a “traditional Western medicine” model. An increased use of complementary and alternative medicine (CAM) by many Americans has supported the notion that surgery and prescription drugs are not the only answer to all problems.
“Integrative” medicine incorporates healing remedies and techniques with a view of the whole person to create a healing response. An example would be using herbal supplements in addition to or in place of traditional medications, or understanding that unmanaged stress plays a large role in health and wellbeing.
Manual medicine or manual therapy is part of an integrative medicine approach. One who is trained in manual medicine should first provide the patient who has pain with a diagnosis. An accurate diagnosis is an essential part of the process.
All too often providers provide customers with treatment techniques, but fail to provide an accurate diagnosis. Without an accurate diagnosis, you may be getting treatment for the wrong problem.
A truly integrative manual therapy provider would provide two types of diagnoses:
Structural Diagnosis: This is a diagnosis based on the structure or issue causing the pain. This also called a pathoanatomic approach, because it considers “the thing” that is creating the pain signal. An example of this would be a patient with back pain. We would would diagnose the Pain Generator (the thing that is causing the pain signal) with a thorough history and a thorough examination.
Functional Diagnosis: This is a diagnosis based on the functional movement of your muscles and joints. This functional examination allows us to identify the ways in which your body is not allowing your structure to heal.
One diagnosis without the other is often inadequate and creates poor results. Here is another example.
Imagine that you took your car to the mechanic and he told you that you had worn tires and recommended that you replaced the tires. However, you just replaced the tires one year ago and you were expecting to get 4 years from these tires!!
You would likely choose to replace the tires. However, you should be wondering why you only got one year of use from the tires!
There are many reasons for premature wear of tires that includes poor alignment, wheel imbalance and improper air pressure. These are issues that could be fixed and add more miles to each set of tires.
The body is similar in this way. You have parts (structures) that can hurt and not work well. Think of the surgeons as the mechanics that replace the parts. Think of the physical therapist as the “tune-up” mechanic. The surgeon replaces the tires and the physical therapist ensures proper “wheel balance”.
We use our hands and our exercise prescriptions to help you “tune-up” your machine. And the results are fantastic! Your parts last longer!!
In summary, if you have pain, something is responsible for the pain. Go to someone who can help you diagnose what
is causing the pain: a physical therapist. And, there are likely functional imbalances contributing to the problem. Get to a physical therapist that can diagnose both the Structure and the Function. This will enable you to get the most for your time and money spent! Physical Therapy IS integrative medicine!
Teaching at the University of Arizona's world renowned Integrative Medicine Program is quite an honor. John Woolf, PT teaches students and resident physicians about the science and application of manual medicine. If you have questions, please contact him at firstname.lastname@example.org.