I have written this mini-case study based on a combination of individuals that I’ve seen and I’ve added some details which are typical of joint pain. I regularly see people with low back pain and many only decide to seek Chiropractic care after a number of years.
The sections in bold outline what I and my chiropractic colleagues at Lushington Chiropractic would do as part of working up someone’s case. Essentially with all our new guests we run through a triage assessment which consists of taking a medical history, carrying out an appropriate physical examination and if necessary x-rays in order to reach a diagnosis. We then take time to explain our findings and the potential care options to the guest.
Please also note I use the term “guest” instead of “patient” because I believe that customer care and a genuine personal touch is at the heart of all that I do. I appreciate the people I see are patients and I am responsible for their clinical care as I am their Doctor of Chiropractic. I never forget my clinical, ethical and moral responsibility to the people who see me. However, I also remember that the people who see me are people and not just a “case” or a “diagnosis”.
My fictional new guest presented to Lushington Chiropractic with a 3 month history of worsening foot pain. This guest had never previously suffered with a foot or ankle problem and prior to this had been very fit and active walking her dog 3 times a day. She was not aware of anything that may have caused the problem and had not noticed any swelling or redness.
My initial new guest consultation at Lushington Chiropractic is an hour long appointment. In this time I aim to get to the root of the problem, find out whether Chiropractic treatment is the best course of treatment for you and what other alternatives may suit you.
After I have taken the history and are happy that I’ve found out as much information as possible, I usually have a diagnosis in mind. However, I always do examination to find out exactly what’s going on and to rule out any more serious conditions whilst I confirm our diagnosis.
With this guest and all others I start my examination with looking at their posture. Quite often you’ll find clues about their problem when looking at how a person stands. Next, I will observe how the person is using the problem area, so will ask them to do a number of movements to see if there are any limitations. However, as the foot and ankle is dependent on the movement of the knee, hip, pelvis and spine it would also be relevant for me to examine these other areas to ensure that they are not playing a part in the problem.
Following this, I’ll ask the guest to take a seat and will perform a number of neuro-orthopaedic tests, these are objective tests which will help me to determine whether there’s any damage or injury in the area. An example of two of these tests is mortons compression test which assesses whether compression of the bones can cause irritation of the plantar nerve in the foot or windlass test which assesses the ability of the fascia to stretch under the sole of the foot.
I use pin prick sensation, vibration sensation, muscle strength and reflexes to help examine the nervous system, this enables me see if there is a compromise in the nerve supply. All of these tests later on will allow me to have an objective marker to see how much improvements are being made with treatments.
At the end of the examination I will have a good idea of what your condition is. I will then give you a brief synopsis of my findings and will also explain what the next steps will be for you. If you decide to see me at Lushington then I hope you’ll feel welcome and cared for, as a guest of the practice.