Is Google Your Healthcare Provider?
Using Google to solve your health problems is a great idea … except when it isn’t.
Ok, the Sheldon reference is a bit extreme and certainly no solution is ever 100% wrong. It is, however, a regular occurrence at our office where we hear someone has been Googling extensively or their friend who went to school for “x” diagnosed them with “Y”. I bring this up not to be dismissive about self-diagnosing, but because we understand each patient comes to the office with a particular problem and a unique set of experiences which led them to us. Unfortunately, it’s rare that phyxMe PT is the first stop on the medical merry-go-round, while the general rule is it will be the last.
Despite the massive amount of information present on the Internet and the knowledge base of other healthcare practitioners, using the same thought process over and over will ultimately lead to the same result or outcomes. If it wasn’t fixed the first time, it seems unlikely the same method of treatment will have a different result the second time, which highlights the danger of self-diagnosis and the importance of provider specialization. Each healthcare provider has their “sweet spot” or “wheel house” where they excel, their “lane” as it were.
This is true for every provider from primary care physicians, neurologists, orthopedic surgeons, chiropractors and physical therapists. I can testify one of the biggest obstacles I faced early in practice is “staying in my lane” because I wanted to help everyone. After 20 years in practice, it has become much easier because I know who can expect to get the best results with our program and who will be better served by receiving treatment with another provider.
At our office, we specialize in working with patients who are experiencing motor dysfunction, coordination and control issues. What does all that mean? Typically, the majority of most MSDs (musculoskeletal disorders) present as the following:
- Neck pain(muscular pain, radiculopathy, sclerotogenous pain, etc)
- Lower back pain (facet syndrome, sciatica, etc)
- Knee pain (e.g. Runner’s knee)
- Shoulder pain (rotator cuff problems)
These types of symptoms tend to be the most common for us because these types of symptoms occur when the body is not functioning as it should. The loss of normal structure or movement patterns leads to repetitive stress type disorders leading to the problems listed above.
Quite often, patients come to us after being referred by their primary care physician, a friend who’s received care at our office, one of the many groups of athletes we see (Cross Fitters, triathletes and runners) or the random Internet search. The danger of self-diagnosis and using popular websites such as Google or WebMD is that they list a wide range of possible problems and solutions, with the worst case-scenario usually taking the top spot. How a patient finds us often, surprisingly, determines their success at the office.
Medically managed patients may be more challenging simply because the “medical mindset” is based on using drugs or surgery to solve problems. If the problem is extremely short-term and minor, this methodology might work; unfortunately, the vast majority of these problems have been “brewing” for quite some time. Medically managed problems can be challenging because use of medications very often gives a patient a false sense of recovery when, in fact, the symptoms have only been masked temporarily.
As soon as the medications are discontinued, the problem returns and is often much worse because the underlying cause remained untreated and was causing additional wear and tear (damage) to the area as the patient resumed a full/normal activity because their body wasn’t “reporting” any problems. It can be difficult to move past the mantra, “Pain is the problem.” Managing pain, especially post-surgery, is extremely important and it’s just as important to understand where your actual baseline level of pain lies during your regular activities. More importantly, the primary goal during diagnosis is to determine the causes leading to your pain.
During the initial consultation, one of the more important questions asked is “How long have you had this problem?” Most people assume the question is directed at the particular episode that motivated them to seek help, which is certainly important, AND it’s also important to know the first time ANY problem, which resembled the current one appeared. Many times, the first neck pain or low back pain someone experienced was several months before or even several YEARS before the current event.
Another danger of self-diagnosis is that patients may discount their pain or injuries and put off going to a healthcare professional. Getting the entire picture through your patient interview, physical and orthopedic testing and imaging will give the best results. Investing time prior to determining a treatment plan is time well spent because it helps us determine exactly what’s gone wrong, exactly what it takes to fix it AND if we are the best option for you. We never take a case unless we are certain we can make a positive difference, which brings us back to the opening line.
As a healthcare provider, my job is to determine what’s causing your problem and what it will take to correct it. What I won’t do is waste any time, yours or mine. If it becomes clear a patient isn’t 100% interested in solving their problem or they seem to doubt my credibility, the best course of option is to refer that patient to another provider because the process at our office is a cooperative effort. It’s not like going to the physician where prescription is written and you only have to take some pills for a couple of weeks.
Treatment at our office typically won’t be your only responsibility. Habits from home or the gym usually play a role in your problems even if the connection isn’t entirely clear. Playing “detective” with new patients is crucial because every piece of information from the interview and exam helps shed light on what is causing your pain and the underlying problem. The danger of self-diagnosis shows itself in how frequently patients overlook symptoms or issues to fit a certain idea or theory to explain their pain. Patients are often surprised by the cause of their problem and it would never have been discovered were it not for the thoroughness of our examination process.
Preconceived notions also play a role in how a patient will progress through care. A recent example highlighted how powerful preconceived notions (and Google search information) can be for patients. A patient who had a long-standing lower back pain and had exhausted his medical treatment options came to our office for an initial exam. The exam indicated x-ray imaging was necessary to complete a diagnosis.
After completing the x-ray analysis using a specialized software program which helps determine each patient’s neutral/normal position, it became apparent the patient had a significant leg length discrepancy (one leg was congenitally shorter than the other). This imbalance lead to a severe structural shift which, over time had caused ongoing and ever increasing lower back pain in a patient who was only 25 years old. In reviewing his x-rays during his consultation, the dramatic shift (as seen below: normal on LEFT) was explained as well as the need for a lift to balance the pelvis because working to strengthen the muscles would only allow for a partial fix.
With a leg length inequality of more than 3-5 mm, the body simply can’t hold the body even as the muscles will tire out over time. The extra load and work in attempting to hold things even and neutral will also lead to irritation, inflammation, adhesions and scar tissue, if present for a long enough period of time. The patient had determined, via an Internet search, which his leg length was not real and he refused to agree to use a lift as part of his program but he was willing to participate in all of the other recommended action steps to get better. Unfortunately, in this case, I was unable to accept his case because I would not have been able to deliver the result he was expecting.
It would have been fairly straight forward to get him out of pain but, his problem would have returned and our goal of helping him achieve long-term stability and avoiding recurring bouts of lower back pain would not have been met. As much as we want to help everyone, it’s not always possible because not everyone seems to want help. The real danger of self-diagnosis is that patients will not accept care or treatment that helps them recover. However, for those who are fully invested in solving their problems, the corrective process is much simpler and even more enjoyable.
One of our patient was a high level Cross Fit athlete and Olympic Power lifter who reported frequent lower back pain and stiffness which she was willing to work through along with an “unbalanced” feeling when she was using her legs: squat, dead lifts, power cleans, etc. Upon completing her x-ray analysis, it was apparent she had a significant leg length deficit (greater than 5 mm). Placement of a lift and re-imaging demonstrated a significant improvement in her pelvic balance as seen below:
She noticed an IMMEDIATE improvement in her “balance” AND was able to PR in her squat and deadlift within 2 weeks of implementation not to mention her lower back pain got continually less noticeable until it finally dissipated entirely. Her short-term goals were met nearly immediately AND she placed 2nd in the State of Illinois power lifting championships in her weight class.
It’s also possible to see that her scoliosis which was initially 9.1 degrees reduced to 5.8 degrees simply by adding the lift and completing 2 weeks of treatment. The lift wasn’t the entire solution as additional work was needed to reduce the likelihood of curve progression to a full-blown scoliosis over time but, we were able to make a significant improvement in that as well in less than a month.
If making a patient “happy” means their treatment plan will be altered to the point of changing the outcome, we will direct them to another provider because our reputation is built on delivering the best results possible and wasting your time, money and effort doesn’t make sense for you or us. Happy patients are patients who have met their goals: getting out of pain, running longer/faster, lifting more or just feeling better on a daily basis. With 20 years of experience treating MSDs (musculoskeletal disorders), our programs are specifically designed to achieve your goals in the shortest, most efficient way possible.
If you are at the point where your problem has become persistent or it’s become a repeat offender and you don’t want to waste any more time trying to find a solution. phyxMe Physical therapy is a good place to start and dig deeper into what’s been happening with you. We are here to deliver results over the short and long-term, get you out of pain, back to doing what you need to do and enjoy doing AND helping develop a custom solution so you can keep yourself on the right track for the years ahead.