Can You Read This Scan for Me?

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[00:01:02] [SPEAKER_00]: Sign up now. I use it every day in the clinic for virtual and live visits.

[00:01:07] [SPEAKER_00]: I just speak to the patient and at the end hit Comprehend and a soap note is generated.

[00:01:11] [SPEAKER_00]: I love it and you will too.

[00:01:19] [SPEAKER_00]: Welcome back to Untold Physio Stories and one of your hosts Dr. E with Modern Manual Therapy and Edge Mobility System.

[00:01:24] [SPEAKER_00]: Andrew's not with me and I wanted to make sure I recorded at least one more episode for August.

[00:01:30] [SPEAKER_00]: Sorry, I took a couple weeks off. It's been a busy week, busy month for me.

[00:01:36] [SPEAKER_00]: Been teaching lots of live seminars. You can check that out at modmt.com slash calendar.

[00:01:41] [SPEAKER_00]: If you want to attend a live MMT seminar or hashtag manual therapy party.

[00:01:47] [SPEAKER_00]: So I had a lumbar patient who actually did rather well.

[00:01:51] [SPEAKER_00]: She had chronic leg pain radiating leg pain for several years and she finally came to see me.

[00:01:59] [SPEAKER_00]: She was referred to me by one of her friends someone else who I had podcasted about.

[00:02:04] [SPEAKER_00]: They both love to crochet or sew or knit or something like that.

[00:02:09] [SPEAKER_00]: And my ignorance always mixes all three of those up, but basically it's a prolonged sitting issue.

[00:02:15] [SPEAKER_00]: Now she responded very very well to traditional lumbar loading did a little tweaks here and there modified her chair and her seating height.

[00:02:25] [SPEAKER_00]: Made sure she got up regularly and did some lateral chain strengthening.

[00:02:31] [SPEAKER_00]: She's about 90% better for the most part after maybe two to three visits.

[00:02:36] [SPEAKER_00]: So I don't hear from her for maybe three or four weeks and then she ends up getting an MRI.

[00:02:44] [SPEAKER_00]: Now, I told her not to get to MRI but she got it anyway.

[00:02:49] [SPEAKER_00]: Then she didn't even really she got the results,

[00:02:52] [SPEAKER_00]: but she wanted her doctor to explain them to her either the radiologist or the primary or the ortho or whoever had recommended it or had prescribed it.

[00:03:03] [SPEAKER_00]: Now, the doctor said that he was too busy to do this and she needed to just schedule another visit and he wouldn't he couldn't even do it over the phone.

[00:03:13] [SPEAKER_00]: So that upset her and she basically said, hey, you know, I don't really even need treatment anymore.

[00:03:18] [SPEAKER_00]: I'm not feeling as good as I was before the MRI, but overall still feeling much better.

[00:03:26] [SPEAKER_00]: And she basically wanted to make a visit with me just to explain the results of her MRI.

[00:03:33] [SPEAKER_00]: And I said, look, I don't need the disc.

[00:03:35] [SPEAKER_00]: I don't even have any means to actually read this disc.

[00:03:39] [SPEAKER_00]: And even when I did have like a CD-ROM or something attached to my computer, I couldn't open it up anyway.

[00:03:45] [SPEAKER_00]: All I need is the report and I will explain it to you.

[00:03:49] [SPEAKER_00]: So she was really happy and I got the report and it said, you know, she had moderate to severe degeneration

[00:03:59] [SPEAKER_00]: and she had a disc protrusion on the that was radiated that was to the right L4 L5.

[00:04:08] [SPEAKER_00]: It was protruding to the right with some nerve root impingement or encroachment or whatever.

[00:04:14] [SPEAKER_00]: That's what the thought virus or words was.

[00:04:16] [SPEAKER_00]: Now, the best part about this, you know, she was obviously very worried about a lot of this language

[00:04:22] [SPEAKER_00]: that is included in the report and she didn't really have any means.

[00:04:27] [SPEAKER_00]: She didn't have anyone to really explain it to her.

[00:04:29] [SPEAKER_00]: So I was like, look, your symptoms are on your left side and all the relevant findings are on the right side.

[00:04:35] [SPEAKER_00]: So she was pretty happy about that.

[00:04:37] [SPEAKER_00]: She really didn't consider that at all.

[00:04:40] [SPEAKER_00]: And I thought that that was just great luck on my part because many times I've had people do very, very well

[00:04:47] [SPEAKER_00]: and then they get to MRI and then it's all downhill from there and they're not sure if they should get surgery or whatever.

[00:04:55] [SPEAKER_00]: So in this case, you know, there's 50-50 chance of the symptomatic side being the same side

[00:05:01] [SPEAKER_00]: as the majority of the, you know, quote unquote degenerative findings or positive findings.

[00:05:08] [SPEAKER_00]: And she left actually feeling better and, you know, continuing with her home exercises.

[00:05:12] [SPEAKER_00]: I heard from her a couple weeks later and overall she's back to doing her crocheting or knitting

[00:05:18] [SPEAKER_00]: or whatever it is that requires lots of sitting with her friend.

[00:05:23] [SPEAKER_00]: So I thought though overalls like, you know, this is something that whether it's cash based mostly cash based,

[00:05:30] [SPEAKER_00]: I think, but I mean how many times does a patient actually just need us to, you know,

[00:05:37] [SPEAKER_00]: go over the results of findings in a way that won't cause nocebo?

[00:05:44] [SPEAKER_00]: You know, I guess I'm going to have on in a week or two.

[00:05:48] [SPEAKER_00]: Dr. Lance Mabry is very big on radiology and differential diagnosis.

[00:05:55] [SPEAKER_00]: And he basically says that the majority of the, you know, thought virus kind of anti-PT,

[00:06:04] [SPEAKER_00]: pro pain science scan research is the reason why scans end up being nocebo

[00:06:11] [SPEAKER_00]: is because they are described by a non-PT who doesn't know pain science.

[00:06:17] [SPEAKER_00]: And like, oh, that kind of makes sense, you know, because the more you're into pain science,

[00:06:20] [SPEAKER_00]: like I have been for the better part of two decades, the more you think that like basically scans are all nocebo

[00:06:27] [SPEAKER_00]: when they end up being not relevant to the case.

[00:06:32] [SPEAKER_00]: But, you know, it kind of makes you hesitant to order scans at all

[00:06:36] [SPEAKER_00]: or that you would think like scans are never relevant.

[00:06:40] [SPEAKER_00]: And there's, you know, there's probably way more gray area obviously in both these things.

[00:06:43] [SPEAKER_00]: But I never really thought that the reason why all these pain science studies show that people do worse

[00:06:50] [SPEAKER_00]: after getting a scan is because it's the way that the scan is explained to them.

[00:06:55] [SPEAKER_00]: So let me know what you guys think.

[00:06:57] [SPEAKER_00]: I hope you guys have a great Labor Day weekend.

[00:07:01] [SPEAKER_00]: Also, make sure to rate Untold Physio Stories five stars wherever you listen to podcasts,

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[00:07:10] [SPEAKER_00]: And Edge Mobility System is having a Labor Day sale.

[00:07:12] [SPEAKER_00]: Also, make sure to go Edge Mobility System.

[00:07:14] [SPEAKER_00]: The coupon will be auto applied in your card.

[00:07:16] [SPEAKER_00]: You can save 15% off of anything.

[00:07:19] [SPEAKER_00]: And there's also a sale on MMT Insiders as well, 25% off.

[00:07:23] [SPEAKER_00]: Email me if you want details.

[00:07:25] [SPEAKER_00]: Have a great holiday.