I recently took Dr. Michael Fink’s course on MedBridge, Medical Screening and Differential Diagnosis – Systems Based Approach. This provided me 6 contact hours of medical screening and review of specific systems, which goes beyond the minimal necessary to fulfill my continuing education needs. I embrace my role as a Direct Access practitioner. Not only […]

With the evidence clearly indicating positive benefits from early use of physical therapy to decrease costs for musculoskeletal conditions, it continues to astound me when individuals get injured on the job and worker’s compensation fights against having physical therapy. I am sure every reader of this blog has a story to go along with the following: Chief Complaint: […]

Before reading the objective findings below, make sure you read the subjective history taking in Part 1 here of this differential diagnosis case. Observation: Slouched posture. Decreased lumbar lordosis. Gait: Stiff leg, wide-based gait pattern with very little knee flexion and hip extension. Tenderness: Generalized tenderness in lower lumbar spine and SIJ with no particular […]

Looking for feedback on this case.  Questions will be provided at end of blog post below case. Script: Lumbar Disc Herniation. Medical History: (I am listing the “Yes” remarks from intake form): -Positive for arthritis -Positive for sleeping difficulties – She smokes 1/2 pack a day and 4 packs a week – She doesn’t work out […]

Quick case here. I have a current 31 year old female patient who is seeking my care for shoulder pain following a work injury.  She arrived to our clinic the other day with excruciating left flank pain. Subjective: She says she started having left low back pain that morning but very mild.  However, when she […]

This is a VERY powerful case report.  Read on to see how osteopractic intervention set the bar higher in physical therapy results. Initial Evaluation Subjective History: 42 y/o female presents with neck and arm pain.  It started when she was lifting heavy objects at work and at home due to circumstances of moving some things.  Her […]

Therapeutic pain science educated has sky-rocketed in the past few years.  Even though the concepts have been around for quite some time, it seems to have found a place among on-line discussions, continuing education courses and a slew of YouTube videos since my graduate studies. I have become quite fond of the information myself and continuing […]

I was recently evaluating a patient for low back pain who within the last 6 months had PT at another location for same condition. I asked him what type of procedures were performed to assist in his recovery.  I tend to do this in general to get an idea of what works and what doesn’t […]

I recently had this case: Subjective History: 87 y/o female presents with right elbow pain.  It has going on 2 years or more.  She has had all of the injections should could have in the right elbow (at 3), and now she is told the elbow pain is from the neck.  She has also tried […]

I recently had this case: Subjective: 44 y/o female presents with neck pain.  It started coming on a few weeks ago (no known reason) but really got really bad yesterday (again no known reason).  She sought PCP office for a consult, who did x-ray (she is unsure results yet) and prescribed Prednisone & Skelaxin (but […]


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