Doing a proper examination with a new patient is of the upmost importance. It not only shows where the patient’s pain/problem is but it shows the location of the origin of the pain/problem and contributing factors.
For example, the patient may be complaining of posterior leg pain but orthopedic and neurological testing will show at what spinal nerve level does that leg pain originates from.
What muscles are weak or in spasm? For example, is the nerve being compressed by a spastic piriformis as the nerve travels down the buttock or is a weak piriformis or gluteus maximus allowing for instability in the lumbo-sacral or sacro-illiac joints.
What is the history of this patient? A proper examination includes the filling out of an intake form which includes history of past injuries and current health problems.
Has this patient had a history of ankle injuries which may have affected their gait and caused compensation in the pelvis, hips or torso of the patient? Did that compensation set the patient up for problems down the road.
Does this patient have problems like acid reflux or breathing problems where the diaphragm is not working properly and therefore causing over-compensation in the abdominal muscles which support the low back or over-compensation in the neck muscles contributing to neck pain.
Does this patient have a history of hypertension; then a taking of the patient’s blood pressure is part of their examination. Are there white spots on their nails or do they bruise easily; patient may need certain supplements to improve oxygen flow/wound healing and cut down on chronic inflammation.
Does the patient have problems with urination or gout; these problems may show up as an energy blockage in the kidney meridian and the psoas muscles which is linked in applied kinesiology to the kidney meridian. Stimulation of acu-points on the kidney meridian may affect the psoas; part of which is located in the front of the lumbar spine and an imbalance can contribute to low back pain.
For more on use of applied kinesiology in a chiropractic examination; please see https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/
Range of motion testing shows not only what movements are painful but it is also important as it gives a clue of what muscles may be involved. Range of motion after treatment is a quick test of how the patient is doing.
A proper examination (and following treatments) also requires that the patient is either wearing an examination gown (women) or down to their underwear (men). This enables me as the doctor to rule out anatomical problems such as a swollen ankle or knee as contributing to the patient’s complaint.
The doctor can also rule out health problems that cause pain that need to be referred out. For example an established patient came in complaining of posterior pelvic pain and since she was in an examination gown, I noted a rash. The rash was herpes zoster and she needed to be referred out as well as needing nutritional advice and an adjustment. If she was still wearing street clothes as in many chiropractic practices, I would have not known the “real” cause of her pain.
The above examination takes time and is geared for a chiropractic and applied kinesiology practice not for a quickie fifteen minute /3x a week practice. . Unfortunately a lot of chiropractors do not do a complete examination which I deduce when new patients who have previously seen another chiropractor ask me when I enter the examination room if they should lay face down. No I say, I need to do an examination first.
If you are interested in a comprehensive examination and treatment, please free to contact me at firstname.lastname@example.org or call me at 212-431-3724.
© 2015-Dr. Vittoria Repetto
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