My days working as a physical therapist are usually spent working with people who already know what’s wrong, what happened, and what they need help with; that being said, sometimes a patient requires a diagnosis from me, as they may not know why they have pain, or limited range of movement, or any number of symptoms.
Much like other healthcare professionals, I don’t always have the answers. Sometimes, people are just hurt because they hurt, and that’s it. However, if someone comes to me needing a diagnosis, I will always do my best to identify their condition or injury, and then develop a treatment plan afterwards.
Step 1: Evaluation
The beginning of diagnosis starts with an evaluation. This process typically begins with a thorough evaluation of the patient’s medical history, symptoms, and physical examination.
During the evaluation, the physical therapist will ask the patient about their current symptoms, including the location and severity of pain, any limitations in movement or function, and any previous injuries or surgeries. The therapist will also examine the patient’s posture, range of motion, muscle strength, and joint mobility (depending on the needs and concerns of the patient).
Based on this information, the therapist will make a preliminary diagnosis–what they believe to be the most probable cause for the problems the patient is having. This, obviously, will vary from patient to patient, but here’s an example. A patient comes in knowing they hurt their knee playing sports, so the therapist tests the range of motion, sees that it is far less than the non-injured knee, learns that the patient’s pain is primarily occurring during lateral movements and along the interior of the knee, and gives the preliminary diagnosis that the problem is a strained ACL.
If finding a diagnosis proves to be difficult, or if the patient or therapist wants more information, then tools like MRIs, CAT scans, and X-rays can be used in order to provide all parties with more information.
Step 2: Treatment Plan
Treatment plans may include exercises, stretches, and manual therapy techniques to improve range of motion and strength, as well as modalities such as heat or cold therapy, ultrasound, and electrical stimulation to reduce pain and inflammation.
A treatment plan could work in one of two ways: ideally, the treatment plan helps resolve the pain and limitations the injury has caused, or, less ideally, the treatment plan could fail in some way, revealing that the injury may be different than initially assumed.
The therapist will also work with the patient to set goals for their treatment, such as improving their ability to walk or climb stairs, or returning to a sport or other activity. The therapist will then monitor the patient’s progress and adjust the treatment plan as needed to help the patient reach their goals.
Physical therapy diagnosis and treatment can be used to address a wide range of conditions and injuries, including:
- Musculoskeletal conditions such as low back pain, neck pain, osteoarthritis, and rheumatoid arthritis
- Neurological conditions such as stroke, spinal cord injury, and multiple sclerosis
- Cardiopulmonary conditions such as chronic obstructive pulmonary disease (COPD) and heart failure
- Pediatric conditions such as cerebral palsy, developmental delay, and musculoskeletal injuries
- Other conditions such as lymphedema, and fibromyalgia.
The diagnosis from a physical therapist can also help with the work of other healthcare professionals, such as physicians, nurses, and occupational therapists, to provide comprehensive care for patients. A diagnosis and treatment plan may even include education and training for patients and their families to help them manage their condition at home.
Step 3: Give it Time
A diagnosis is proven correct over time. Medical training helps physical therapists and other healthcare professionals provide diagnoses, but they can be wrong. That makes it seems like a diagnosis is just a guess, but in reality, it is simply that an injury, especially when it comes to sports injuries, is usually a combination of factors. Injuries or conditions can be more than what they initially seem, which is why diagnosis and treatment are progressively changing and updating.
When working with a physical therapist, it is important to work with a qualified, licensed physical therapist who has the training and experience needed to provide safe and effective treatment. A friend or family member who is a physical therapist can help, but sometimes they may not have the time or information necessary to really provide a diagnosis.
