The healing timeline for an acute injury is anywhere from 6-12 weeks and in some cases even longer. Described as sudden onset of pain, gradual onset of pain/numbness including paresthesia (not limited to just pain/paresthesia; could include unusual or abnormal gait or position (antalgic posture) motor weakness or dysfunction, reduced ROM w/pain, etc). We use this model of care to address your skeletal, muscular, and nutritional needs to improve pain and function.
This type of care requires a sacrifice of time, effort, and finances on the part of the patient in order to obtain any marked, lasting improvement in the patient's condition. Additionally, it involves a significant commitment from our entire team of practitioners/staff.
The acute care treatment plan is designed by our providers to specifically address the patient's unique condition to facilitate the achievement of the patient’s goals when they are fully engaged. We utilize a multifaceted conservative healthcare approach that is delivered over the patient's period of healing time. This schedule of care is critical to follow and if the patient is unwilling to make the appropriate sacrifice, the clinic reserves the right to refuse treatment for non-compliance. The clinic’s goals are simply to restore/improve the patient’s functional outcome, as defined by significant improvement of the documented objective findings as they presented.
The purpose of Therapeutic Withdrawal is to determine how the patient’s condition responds to a “reduced” frequency of treatments. The patient may still be in the acute “fibrosis” repair phase and thus has not met full therapeutic benefit, in which case their treatment frequency will be altered accordingly. If the patient has met maximum therapeutic benefit and does not regress between visits within the withdrawal period, they will then be released from care.
An appropriate supportive care plan will be recommended so as to “support” the functional improvement that has been gained via the acute care phase. In an overwhelming majority of cases, it has been demonstrated that a patient’s condition does regress in time due to factors like repetitive stress (i.e. extended periods of sitting/standing, repetitive motions/actions, aggravating factors such as the use of toxins like tobacco/vape, alcohol and other illicit substances, obesity, weak core musculature, etc). Some of these factors may be out of the patient's control such as work requirements, effects of gravity, and congenital anomalies. Other “lifestyle” choices that are within the patient's control will be addressed with them so they are aware of the detrimental effects of such choices.
Chronic Care involves patients who meet a certain diagnostic/demographic population which includes but is not limited to age, biomarkers related to BMI, and blood pressure/heart rate that is not within normal limits. This patient population will also almost always have an abnormal gait, marked “structural” postural abnormalities, and marked weakness in both the axial as well as the appendicular skeletal musculature. This can be directly related to neurological deficits resulting from nerve root and/or spinal cord impingement or from deconditioning and is will most likely be both. When multiple causal factors are suspected, it is prudent to attempt to rule them both out, so as to most accurately diagnose the patient. These diagnoses will ultimately drive the treatment plan recommendations that will enable to the patient to achieve the best possible outcome.
Once a therapeutic withdrawal has been completed and an appropriate frequency of care has been determined to enable the patient to continue performing their necessary activities of daily living, they will be encouraged to continue with said treatment frequency in an effort to reduce the likelihood of a new injury/exacerbation AND prevent the patient from becoming dependant on drug therapy to manage their symptomatology. These daily activities include but are not limited to working, sleeping, remaining active in the capacity they desire, self-care, cooking/cleaning, and caring for family members.
In some cases where patients regress much quicker than anticipated, this is an indication that their condition was not fully healed and they were still in the fibrotic repair phase.
We fully recognize the difference between macro-traumatic injuries which typically occur at a “moment in time” and usually involve a high-intensity event and micro-traumatic injuries which result from our daily activities and/or sedentary lifestyles. The cause of micro-traumatic injuries is typically unknown by the patient and they commonly state, “I didn't do anything”. These injuries occur over time and are much more common than macro-traumatic injuries and the patient’s history of present illness/injury is how we differentiate between the two mechanisms of injury. The mechanism of injury, a patient's demographic information, and lifestyle/familial history, in addition to their aggravating factors, will prove to help our providers anticipate things like prognosis, healing time frame, at-home exercise recommendations, and vulnerability of potential re-injuries/relapses, etc.
