The initial exam takes approximately one hour. Included in the initial exam is a thorough and complete history of the patient's main complaint, secondary complaints, lifestyle, past medical history etc, a comprehensive physical exam, and a treatment.
A good patient history gives a picture of the overall health of the patient, and gives important information needed to properly diagnose and treat a patient, and as well identifies any other condition that might slow or complicate recovery.
A physical exam will follow and include many different assessments of the primary area of injury including, neurological, orthopedic, postural, joint, and muscular testing. While testing the primary area of injury, other areas of the body may also be tested, due to the fact that the body works as a whole unit, not as single parts, including many types of muscle connections, pain referral patterns, overall functional movements, etc. Common examples include treating the shoulders for headache sufferers, or giving hip strengthening exercises for certain types of knee pain, especially in runners.
When the history and physical exam findings are explained to the patient and both Doctor and patient have decided on a treatment plan, the treatment may take anywhere from 10-30 minutes and consist of any or a combination of the following: Stretching and/or strengthening/rehabilitation exercises, Active and Passive Soft tissue therapy (myofascial release, muscle energy techniques, etc) Spinal Manipulation/mobilization Extremity Joint Manipulation/mobilization, Modalities (IFC, TENS, Russian Stim), or Needle or Electro-acupuncture. At the end of the treatment, exercises or instructions may be given to the patient to ensure proper recovery and to inform the patient of certain movements or activities that might make their issue worse. In general, what the patient does on their own time is usually just as important as the actual treatment. Proper home care will ensure a higher rate of success with reaching the patients goals while improving long-term outcomes.