What Happens in the Initial Appointment

I’m going to take you through what happens at your first appointment so you know what to expect.

The first thing I do is ask you about the history of your pain or injury.

I don’t have you fill out forms, I talk to you and take notes.

The questions I ask are somewhat different depending on the part of the body where you have pain.

This may take anywhere from 15 to 30 minutes, depending on the complexity of your pain and injury history and what you have to say.

For example, a lower back history will likely take longer than a shoulder or elbow history.

We take our time to make sure everything you say to me is clear.

Then, I do an assessment.

Lower back pain is experienced by at least 50 million people each year in the United States alone.

My own severe back pain when I was a teenager is what led me into this field.

Back pain is often a debilitating, terrible experience.

But it can also be just annoying and limiting.

I’ve treated hundreds of clients who’ve been in back pain for many years.

The greatest satisfaction comes when those clients are no longer in pain.

Your personal privacy is very important to me.

For most assessments, like your shoulder, elbow, or foot, you leave your clothes on.

For some assessments, such as the lower back or the knee, you partially disrobe.

All clients leave their underwear on, and female clients always wear a hospital gown that unties and opens in the back.

During the assessment portion, I do a series of physical tests of your muscles, tendons, ligaments, nerves, and joints to determine exactly what’s injured and causing your pain.

Some tests are active. That means I might ask you to lift your arm

 or turn your head to the side.

Then there are passive tests,

meaning I move your head or arm while you do nothing.

These tests let me assess your joints and ligaments,  – The ligaments hold your joints together

Then, I do resistance tests. During these, I ask you to push your arm, leg, or foot against my hand.

These tests let me test your muscles, nerves, and tendons. Tendons attach your muscles to your bones.

In this series of tests, I look for pain or discomfort and assess your strength.

If any of these tests cause discomfort, they help me pinpoint which part of your body is injured.

There are physical tests for almost every pain and injury in the body.

If together, we figure out what is injured, the prospects for a successful treatment are very good.

In most cases, by this time, I have a good idea of what’s injured and causing your pain.

Now, I move to the next step, injury verification.

This means checking if my assessment is correct by locating and putting my finger on the exact spot where the injury is.

For example, there are several likely injuries to the shoulder, and gently touching the injured muscle, tendon or ligament will cause slight discomfort.

In the neck, there are multiple likely injured spots, and we check each one.

In the lower back, there are many ligaments, nerves, and several muscles that might be causing the pain.

The positive tests tell me where to look, and when I find it, you’ll know – because it reproduces the discomfort you’ve been experiencing.

Then, we sit down again and discuss it.

I explain the source of your pain, show you drawings of what’s injured, and talk about the treatment options.

Whether my work can help you or if you need some other type of treatment.

You ask as many questions as you like until you understand.

Treatment usually means two visits a week for a while, depending on the problem.

If you have a long-standing injury or multiple injuries in different parts of your body, then the treatment will likely take longer.

Some injuries take a few weeks to treat, and others take several months.

It depends on the number of injuries and your healing capacity.

If I can’t figure out what it was, I don’t charge you for the appointment and refer you to someone else.

If you live far from the Boston area and it was a virtual appointment, we follow the same procedure except that you have your therapist or another person there that I can direct to help me with the assessment testing procedures.

If the appointment was virtual, I instruct your local therapist on the treatment if that have the necessary skills.

I hope that gives you a good idea of what the initial appointment process is like.

If you have any questions please give me a call.