Why a Shoulder MRI Often Isn’t That Useful

MRIs Of Both Painful And Non-Painful Shoulders Are Similar,
Which Questions The Usefulness Of These Tests

Shoulder pain is the third most common musculoskeletal condition, as up to 67% of individuals will experience it at least once in their lifetime. When pain in the shoulder occurs, the traditional approach is to identify its source through diagnostic testing and then treat the injury appropriately. MRI scans are frequently used during this process because they provide highly detailed images of shoulder structures, but more recently, some experts have questioned whether these tests are helpful or even necessary.

The primary reason is that abnormal findings from MRIs do not always correlate with pain, and some patients with no signs of pain display so-called “abnormal” MRI results. This has led researchers to take a closer look at MRIs of individuals both with and without shoulder pain to help determine the reliability of these tests when making a diagnosis or treatment decisions.

Comparing both shoulders in patients with pain in one shoulder

One study took a unique approach by comparing MRI scans of both shoulders in patients with shoulder pain in only one shoulder. For the study, 123 individuals with chronic shoulder pain for an average of three years were recruited and accepted to participate. The average age of participants was 39.4 years, with 15 individuals being aged 60 years or older. All patients underwent an MRI of both shoulders, and two healthcare professionals—a radiologist and a shoulder surgeon—interpreted the findings from these scans independently.

Results showed there was a high prevalence of structural abnormalities in both shoulders of these patients. For example, the radiologist identified complications with the rotator cuff and one of the major shoulder joints in both shoulders for about 90% of patients, while the surgeon found these issues in about 75% of patients. In addition, no significant differences were detected in the prevalence of abnormal MRI findings between the painful and non-painful shoulder, except for one type of injury.

The source of your pain may be something else

These findings suggest that MRI results may not always indicate the source of pain in many patients with shoulder pain, since abnormal findings were also found to be very common in shoulders with no symptoms. Therefore, despite the frequent use of MRI for shoulder pain, it may not be the most effective way to diagnose these injuries. Of particular concern is that focusing exclusively on MRI findings can lead to costly and risky interventions like surgery being performed unnecessarily, even if the pain is not related to these findings.

Try conservative, natural care first

Physical therapists, on the other hand, treat most cases of shoulder pain from the first visit and rarely order MRIs unless it’s deemed completely necessary. This saves patients time and money, which allows them to start their path towards improvement immediately rather than being held back by MRI findings that may not truly reveal the reason behind their shoulder pain. So if you’re dealing with shoulder pain, we strongly recommend seeing a physical therapist at Bacci & Glinn Physical Therapy before having an MRI.

Call us today at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to schedule an appointment.

Orthotics Prescribed By A Physical Therapist May Be A Simple Strategy For Foot Pain

The way that your feet connect with the ground has a major impact on how you walk or run and if you’ll experience pain when doing so. The feet are the foundation when walking or running, and if they strike the ground incorrectly during these activities, it can start a chain reaction that leads to problems elsewhere in the body. To address potential problems like foot and ankle pain, orthotics may be recommended to alter the way your foot contacts the ground and correct any imbalances that might be interfering with your stride.

Foot orthotics are molded pieces of rubber, leather, plastic, or synthetic materials that can be inserted into many types of shoes and then worn normally. They are available in various lengths, sizes, and styles, and range from over-the-counter to fully customizable, giving individuals a wide range of options to choose from. The main purpose of orthotics is to support and stabilize the feet by correcting any imbalances in each foot and more evenly distributing one’s bodyweight.

Orthotics Can Benefit Many that are in Pain

Orthotics are usually prescribed for people who are already suffering from foot and/or leg pain, but they may also be recommended to prevent problems from occurring down the line. Two of the more common conditions addressed with orthotics are plantar fasciitis and Achilles tendinitis:

Plantar fasciitis occurs when the plantar fascia ligament—which connects the back of the heel to the front of the toes—becomes inflamed or irritated, leading to a stabbing or jabbing pain over the arch and under the heel of the foot
Achilles tendinitis is inflammation of the Achilles tendon, which connects the calf muscles to the back of the heel and allows you to stand on your toes when walking, running, or jumping; this leads to pain, stiffness, and/or swelling at the back of the heel or directly above it

For some patients, orthotics can help to address issues with foot shape—like flat feet or high arches—that may be responsible for plantar fasciitis and other foot-related issues. Orthotics may also be recommended for conditions like shin splints, knee pain, back pain, bunions, hammertoe, and calluses, as well as for individuals who are older, overweight, or have diabetes.

Expert advice on orthotics from our physical therapists
If you’re thinking about giving orthotics a try, the physical therapists at Bacci & Glinn Physical Therapy can help you navigate this process. One of the biggest challenges patients face is choosing the right type of orthotic for their foot type, since there is an abundance of options to choose from. But our physical therapists can evaluate your foot type, gait, and whether you’re dealing with any foot or heel pain, and then recommend the best type of orthotic, which are usually categorized into the following three groups:

Heel cups
- The smallest and simplest type of orthotic
- Can be easily inserted into most types of shoes
- Made of gel, silicone, or plastic
- Can alleviate pain from plantar fasciitis, Achilles tendinitis, and other conditions by absorbing shock and reducing tension on painful structures
Orthotic insoles
- Provide arch support and cushioning for some or all of the foot
- Ideal for correcting foot shape issues like flat feet or high arches, which may be contributing to heel pain
- Available in full length, 2/3 length, or 1/2 length sizes
- Can be customized or purchased over the counter
- Worn during the day
Night splints
- Treat heel pain related to plantar fasciitis throughout the night
- Hold the foot and toes back so the calf muscles, Achilles tendon, and plantar fascia are kept slightly stretched
- Simple and effective way to alleviate heel pain that strikes in the morning with the first steps of the day
- Available in a boot style cast, sleep supports, and sock style supports

For additional guidance on selecting the right foot orthotic, contact:

Bacci & Glinn Physical Therapy today at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to schedule an appointment.

Lymphedema Treatment in Visalia

If you are searching for lymphedema treatment in Visalia or lymphedema specialist in Visalia, we can help. Read more below about how we can help you manage lymphedema.

We are lymphedema specialists here in Visalia & Hanford

Some patients may not be aware that physical therapy can treat far more than your average ankle sprain or episode of back pain, and may be surprised to hear the full extent of conditions it’s effective for, including conditions like lymphedema.

Lymphedema involves the lymphatic system, which is part of both the circulatory system and immune system. It plays a crucial role in both systems by collecting and filtering lymph fluids from tissues throughout the body and returning it to the bloodstream.

If the lymphatic system is damaged and fluid can longer drain normally, the result is lymphedema, which is swelling from the accumulation of excessive fluid in the tissues. Lymphedema may occur due to a hereditary disorder, but in most cases, it results from surgery and/or radiation from various cancers, particularly melanoma and breast, prostate, head, and neck cancers. Lymph nodes are frequently removed to assess the aggressiveness of cancer and whether it has spread to other parts of the body, while radiation can produce scar tissue that also blocks lymphatic organs from properly processing lymph fluids.

Swelling from lymphedema can develop in many regions of the body, but occurs most commonly in the arms and legs. Other symptoms of lymphedema include skin feeling tighter or thicker in affected regions, as well as pain, weakness, or heaviness in these areas, which can make it difficult to move certain joints—like the wrist or ankle—as easily as usual. The onset of lymphedema can also vary widely, occurring immediately after surgery or trauma in some patients and not for years later in others.

Physical therapists can help control your swelling and improve your mobility

Since lymphedema affects one’s ability to move normally, physical therapy should be considered a first-line treatment because it is perfectly suited to address these impairments and help patients regain their physical function. Although all physical therapists can treat lymphedema, certified lymphedema therapists undergo specific training for this condition and use the most up-to-date and evidence-based practices in their treatment plans. At Bacci & Glinn Physical Therapy, our certified lymphedema therapists can treat lymphedema with a variety of interventions, and a typical treatment program will include the following:

Compression therapy: involves wearing a garment or bandage that applies pressure to the affected area and increases the flow of lymph fluid; these garments are to be worn several days per week
Manual lymphatic drainage: this manual (or hands-on) technique helps to move lymph fluid in the appropriate direction to optimize reabsorption by the lymph nodes and reduce swelling
Decongestive lymphedema therapy: this technique, which is considered the primary treatment for moderate-to-severe lymphedema, involves several components (eg stretching compression, exercises, skin care, and self-care) that are intended to mobilize lymph fluid and reduce swelling
Personalized exercise program: regular exercise is also key because it promotes lymph drainage while also increasing the strength and flexibility of joints affected by lymphedema
Skin care: therapists will closely monitor the skin and recommend appropriate treatments to help patients avoid dangerous infections

If you’re dealing with limitations that may be related to lymphedema, the certified lymphedema therapists at Bacci & Glinn Physical Therapy can help.

Contact us at 559-733-2478 (Visalia) or 559-582-1027 (Hanford) to schedule an appointment today.

Best Lower Back Pain Treatment in Visalia – It’s Prevention and It May Extend Your Life

Preventing lower back pain my extend your life. But, if you are experiencing lumbar pain, and are looking for the best back pain treatment in Visalia, we can help.

More on Prevention and Longevity

Low back pain is incredibly common. About one-half of all working Americans will experience symptoms at least once every year, and roughly 31 million are affected by it at any given point in time.

So if you consider yourself part of this group, you have plenty of company.

Dealing with low back pain can be troublesome and place a strain on everyday life. Typical movements like bending over to pick something off the ground or twisting your torso when looking to the side might suddenly give you pause and make you less mobile in the process. This is one of the main reasons low back pain is also one of the leading causes for missed work due to disability.

Anyone Can Experience Lower Back Pain

Low back pain is most prevalent in individuals between the ages of 30-60, which is mainly due to the aging process. Anyone can get low back pain and it can develop for a variety of reasons, but there are certain factors that are believed to increase one’s chances. These risk factors include older age, poor physical fitness, a sedentary lifestyle, being overweight, diseases like arthritis and cancer, occupations that strain the back, smoking, depression, and anxiety.

Fortunately, most cases of low back pain will resolve on their own in a short period of time, but up to 10% of individuals will go on to develop chronic low back pain when it lasts for more than three months. When the condition becomes chronic, it can have an even more significant impact on quality of life, and it also becomes more difficult to treat.

According to Scientists, Here’s Why You Want to Avoid Chronic Back Pain

According to a recent review, having chronic back pain may reduce one’s life expectancy as well.

For the review, researchers performed a systematic search for published studies that evaluated the impact of low back pain on the risk for death (mortality) in patients. This search led to 11 studies being included in the review, which included data on more than 80,000 patients who were monitored for 5–23 years. Results showed that mild back pain did not have any long-term associations with mortality and is therefore unlikely to impact the length of one’s life. However, patients with chronic back were found to have a modestly higher mortality risk compared to those who didn’t have back pain.

Address Lower Back Pain Quickly with One of the Best Lower Back Pain Treatment Options in Visalia or Hanford

These findings suggest that over time, chronic low back pain may reduce one’s life expectancy through various mechanisms, such as greater disability, reduced quality of life, and physical inactivity. Therefore, it stands to reason that addressing low back pain early and preventing it from progressing to the chronic stage may improve an individual’s quality of life and extend their lifespan.

One of the safest and most effective ways to alleviate low back pain is through a course of physical therapy, which is based on personalized treatment programs that teach patients various exercises and movement-based techniques that reduce pain and increase function.

Don’t Let Pain Get In Your Way – We Can Help

To learn more about what we can do for your low back pain, contact Bacci & Glinn Physical Therapy today:

559-733-2478 (Visalia)

559-582-1027 (Hanford)

Peripheral Neuropathy Treatment in Visalia – Why You Might Consider Laser Therapy

If you are searching for peripheral neuropathy treatment in Visalia or Hanford, this article is for you. Why? Because we have a specialized treatment that most other clinics don’t offer…deep tissue laser therapy.

How Peripheral Neuropathy Can Occur with Diabetes

Diabetes affects more than 34 million Americans, and it’s one of the leading causes of death and disability in the nation. The disease occurs when the body either doesn’t produce enough insulin—a hormone that allows the body to use glucose for energy—or the cells in the body fail to recognize the insulin that’s present. Both type 1 and type 2 diabetes lead to similar symptoms, which include increased thirst and hunger, extreme fatigue, blurry vision, and increased urination.

But about 50% of individuals with diabetes will also experience a condition called diabetic peripheral neuropathy. This complication is the result of poor circulation throughout the body and can lead to pain, tingling, and numbness, as well as decreased balance and proprioception. These impairments often cause patients to have an abnormal gait (how a person walks) and increase the risk for falls in older adults.

Peripheral Neuropathy Can’t Be Cured But There Is Some Hope

Unfortunately, peripheral neuropathy can’t be reversed, but physical therapy is an effective strategy that can help by retraining sensory receptors in the legs to compensate for these changes. By addressing these impairments, physical therapy can improve balance and function, and reduce fall risk as a result.

Some physical therapists also use laser therapy to treat diabetic peripheral neuropathy. This non-invasive intervention sends wavelengths of laser energy to painful areas and leads to changes at the cellular level, with the goal of alleviating pain and increasing function. These lasers gently pass through the body without breaking the skin or causing any discomfort, and the risk for side effects after treatment is therefore very low.

Recently Published Study Supports the Use of Laser Therapy

The benefits of laser therapy for diabetic peripheral neuropathy were highlighted in a study published in 2019. For the study, 20 patients with painful diabetic neuropathy were randomly assigned to receive either deep tissue laser therapy or a sham (fake) laser therapy treatment for 12 weeks. Results showed that the patients who underwent the real laser therapy experienced significantly greater reductions in pain compared to those who underwent the fake laser treatment in all pain evaluations.

In addition, patients in the real laser therapy group reported significant improvements in quality-of-life measurements and significantly faster times in a test that assesses speed in task that involves standing from a chair and walking a short distance.

These findings suggest that laser therapy is an effective intervention for managing pain and improving quality of life in patients with diabetic peripheral neuropathy.

We caution readers to understand that this is a pilot study. The results of this research are encouraging, but more research is necessary. Nevertheless, if you’ve exhausted most of your options, we’re willing to see if it laser therapy will work for you.

We offer Treatment is Not Currently Available at Most Physical Therapy Practices

We offer this laser therapy treatment in Visalia at Bacci & Glinn Physical Therapy for diabetic peripheral neuropathy and a variety of other conditions.

Therefore, we encourage you to contact us today at:

559-733-2478 (Visalia) or 559-582-1027 (Hanford) to learn more or schedule an appointment for any pain you may be experiencing.

Click here to visit our contact page for more details.

Achilles Tendinitis Treatment in Visalia

Achilles Tendinitis (AKA Achilles Tendinosis) Is A Common Injury That Responds Well To Physical Therapy

If you’re searching for Achilles tendinitis treatment in Visalia, we can help. Conservative physical therapy care including laser therapy treatment, and the appropriate stretching and loading of the healing tendon can reduce your pain.

The Achilles tendon sees a lot of action. This thick band of tissue—which connects the calf muscle to the heel bone—allows you to point and push off your toes, so it’s utilized every time you walk, run, jump, and get on your tip toes. These types of activities are part of everyday life and they keep the Achilles tendon busy, which is one of the main reasons why it’s also vulnerable to injury.

Achilles Tendinopathy is Common – Here’s Why

As the largest and strongest tendon in the body, the Achilles tendon can withstand loads of up to 2,000 pounds when running. This durability is necessary because of how frequently the tendon is used, but as with every other structure of the body, it has limits. When pushed too far, one of the most likely results is Achilles tendinitis.

Achilles tendinitis is a common injury that is seen most frequently in runners and other athletes. For runners, the condition usually stems from doing lots of speed training or uphill running, or after suddenly increasing the intensity or duration of runs without taking enough time off to recover. This constant strain can cause small micro-tears in the Achilles tendon and lead to inflammation, which is the telltale sign of tendinitis.

Patients with Achilles tendinitis usually notice heel pain that comes on gradually as a mild ache in the back of the leg or above the heel after a run, which may get worse after long runs, sprinting, or climbing stairs. Tenderness and soreness may also occur, particularly in the morning. As a result, running and performing many daily activities often becomes more difficult due to these symptoms.

Our Physical therapists can effectively address Achilles Tendinitis (acute injury) Tendinosis (chronic problem) based on the current best clinical evidence

For patients affected by Achilles tendinitis, physical therapy is generally regarded as the best available treatment to help them recover. Physical therapists are movement experts trained to identify any underlying issues, behaviors, or habits that are contributing to each patient’s symptoms. From there, therapists create personalized treatment programs that address these limitations and teach patients how to make the necessary changes to avoid future problems. A physical therapy program for Achilles tendinitis will typically consist of the following:

Calf-strengthening exercises: according to recent research and the latest guidelines, a combination of eccentric and concentric strengthening exercises are effective for treating Achilles tendinitis, and both are frequently used in treatment programs
- “Concentric” means a muscle shortens while doing work, while “eccentric” is the opposite of this, in which a muscle lengthens; heel drops and heel raises are great example that involves both types, as standing up on your tiptoes is concentric because it shortens the calf muscle, while lowering yourself down from tiptoes is an eccentric exercise because it lengthens the calf muscle
Manual therapy: these are hands-on techniques administered by the physical therapist that include massage, manipulation, and mobilization, which improve mobility and function, and alleviate symptoms
Stretching exercises: the physical therapist will usually guide the patient on how to stretch tight muscles in order to improve flexibility and range of motion; patients, in turn, can perform these exercises on their own at home
Pain-relieving modalities: ice, heat, ultrasound, and other passive interventions may also be used to reduce pain and inflammation

So if you’re dealing with any painful symptoms that sound like Achilles tendinitis, you may want to consider seeing a physical therapist.

Call us today to learn more about what we can do for you or to schedule an appointment for your first visit.

Foot and Ankle Treatment in Visalia and Hanford

Searching for Foot and Ankle Treatment in Visalia or Hanford?

Physical Therapy Is The Fastest Way To Regain Your Abilities After A Foot Or Ankle Injury

Regardless of your activity level, you need your feet and ankles to work properly in order to get around. Perhaps even more so than the hips and knees, these body parts are essentially the vehicles that allow us to move and navigate the world around us.

This is why any injury to this region of the body can be seriously detrimental, as experiencing pain with each step can interfere with doing the things you love or possibly drain your motivation to engage even in basic activities. There are several injuries and conditions that can develop in the foot or ankle, and each one has the potential to slow you down. But they have something else in common as well: all of these injuries can be effectively treated with a comprehensive course of physical therapy.

Physical therapists are movement experts that guide patients through a variety of active and passive interventions that will go on to alleviate pain and help patients regain their abilities. Below, we offer a brief summary of some of the more common foot and ankle injuries and highlight key components of a typical physical therapy program for each.

Ankle Sprain & Treatment

An ankle sprain occurs any time the foot twists or rolls beyond its normal range of motion; in most cases, this happens when a player lands on another player’s foot wrong or twists their ankle when making a cutting motion in sports
A sprain means that one of the ligaments in the ankle—which connect bones to one another—has stretched too far or was torn from this force
Physical therapy highlights
- RICE (Rest, Ice, Compression, Elevation)
- Gentle stretching exercises
- Strengthening exercises
- Sport-specific training (when applicable)
- Ankle bracing

Plantar Fasciitis & Treatment

The plantar fascia is a flat band of tissue that connects your heel bone to the toes and supports the arch of your foot
Plantar fasciitis is the inflammation of this structure, and it typically results from training too hard or wearing unsupportive shoes
The main symptom is a sharp, stabbing pain at the base of the heel that’s worst during the first steps of the morning
Physical therapy highlights
- Gait assessment
- Stretching and strengthening exercises
- Foot taping, shoe orthotics, and supportive footwear
- Gait training

Achilles Tendinitis, Tendinosis, Tendinopathy & Treatment

The Achilles tendon connects your calf muscle to the back of the heel and is used when you walk, run, and jump
Achilles tendinitis occurs when this tendon gradually becomes inflamed, usually after an individual makes sudden changes to their training regimen
Symptoms include an ache in the back of the leg or above the heel that is painful after waking up and when going up or down stairs
Physical therapy highlights
- Calf-strengthening exercises
- Stretching exercises
- Manual (hands-on) therapy
- Pain-relieving modalities

Tarsal Tunnel Syndrome

The tarsal tunnel is a structure made up of bone and ligament tissue on the inside of the ankle; tendons, blood vessels, and the posterior tibial nerve run through it to serve the foot
Tarsal tunnel syndrome occurs when this nerve is compressed as a result of excessive stress on the foot and ankle
Symptoms include pain, numbness, tingling, weakness, and swelling in the ankle and foot
Physical therapy highlights
- Nerve gliding activities
- Muscle strengthening exercises
- Balance and coordination activities
- Orthotics, taping, and bracing

Jones Fracture

A Jones fracture is a break of the fifth metatarsal, which is the bone that connects your pinky toe to the rest of your foot
It results from a forceful blow to the bottom or outside of the foot, usually from landing from a jump improperly
Symptoms include pain, swelling, and discoloration on the outside of the foot, and difficulty walking or bearing weight
Physical therapy highlights
- Treatment can only begin after the fracture has healed (6-8 weeks)
- RICE (Rest, Ice, Compression, Elevation)
- Balance exercises
- Range of motion and strengthening exercises
- Gait training

Sever’s Disease

This overuse injury results from inflammation of growth plates in the heels of young athletes, usually during growth spurts, because the heel bone grows faster than the surrounding muscles, tendons, and ligaments
Sever’s disease is more common in boys than girls
Symptoms include swelling and redness in the heel, as well as discomfort and difficulty walking
Physical therapy highlights
- Activity modification
- Manual (hands-on) therapy
- Posture and functional training
- Gentle calf stretching exercises
- Passive modalities (eg, ice and electrical stimulation)

Any of these conditions has the potential to throw your routine out of synch and cause you disability and distress, but we can help.

Contact us today to schedule an appointment for any foot or ankle pain you may be dealing with, and read our next blog if you’re interested in getting a closer look at Achilles tendinitis.

Slipped Disc Treatment in Visalia

Many Herniated Discs Will Eventually Improve on Their Own…

If you are searching for slipped disc treatment in Visalia, or slipped disc treatment in Visalia, new research again has concluded that this problem (sometimes thought of a bulging disc, which is technically not correct) will resolve on its own, for most people.

Here’s More Information about Herniated or Slipped Discs

Herniated discs are a common but often misunderstood condition. For a brief anatomy lesson, your spine is made up of small bones called vertebrae, which are stacked on top of one another.

Between these vertebrae are soft, rubbery pads called intervertebral discs, which absorb shock in the spine and keep it flexible. These discs have a structure that is similar to a jelly donut, with a softer center encased in a tougher exterior. A herniated disc, also known as disc degeneration or disc bulging, occurs when the softer jelly-like substance pushes out through a crack in the exterior ring.

Although a herniated disc may lead to pain in the lower back and/or numbness and weakness in the arm(s) or leg(s), many patients don’t experience any symptoms. In fact, one study found that 80% of 50-year-olds and 96% of 80-year-olds without back pain had signs of disc degeneration on an imaging test, while 60% and 84% of the same age groups had signs of disc bulging.

Most Can and Should be Treated with Natural Physical Therapy

The majority of patients with a herniated disc who do experience symptoms can be treated with a conservative approach that usually includes various movement-based interventions delivered by a physical therapist. However, many patients go on to have surgery to “fix” the herniated disc, even if their symptoms may not stem from this finding.

This can be problematic because surgery is expensive, risky, and may not lead to the outcomes that patients expect. In addition, it’s been reported that in some cases, the portion of the disc that has protruded out will spontaneously regress back towards its original position over time. Researchers were curious how frequently this spontaneous disc regression occurred, and therefore conducted a comprehensive study called a systematic review to find out.

More severe disc herniations associated with greater chances for regression
To conduct the review, researchers performed a search for studies in which patients not treated surgically were assessed with imaging tests like an MRI or CT scan. The studies also had to include information on the incidence of regression in these patients. This search led to a total of 9 studies fitting the necessary criteria to be included in the review.

These studies included data on 361 cases of herniated discs, which are classified according to the level of severity. A bulging disc is the mildest type of herniated disc, followed by a protruded disc, an extruded disc, and finally a sequestrated disc, which is the most severe type. Results showed that discs frequently became smaller, particularly in the more severe types of herniation. Disc regression occurred in 96% of sequestrated discs, 70% of extruded discs, 41% of protruded discs, and 13% of bulging discs. In addition, 43% of the sequestrated discs went on to reach a point where the disc was no longer herniated, which was called a complete disc resolution. Most of the regression was found to occur within one year.

Slipped Disc Treatment in Visalia? Here’s the TL;DR – It Will Go Away on Its Own

These findings show that it’s possible for a herniated disc to regress or completely resolve without any surgical intervention. Although regression or resolution of a disc does not definitively indicate that the patient will also improve—just as a herniated disc does not guarantee that symptoms will occur—research suggests that outcomes are better for patients after a reduction of the herniation. Therefore, patients with back pain should be hesitant before considering surgery to address a herniated disc, since there’s a chance it may not be responsible for their symptoms and because may resolve on its own.

Instead, we encourage patients to trial a course of physical therapy for their pain. Physical therapists only order imaging tests unless it’s deemed absolutely necessary and utilize a strategy in which they treat back pain with a variety of safe, noninvasive, movement-based interventions right away.

If you have questions or need help, click here to visit our contact page.

For Natural Treatment for Herniated, Bulging, or Slipped Discs,
Call (559) 733-2478

MRI Clinics in Visalia – Do You Really Need One?

If you have neck, back, shoulder, or knee pain and you are looking for an MRI or x-ray clinic in Visalia, you may not need this expensive test…at least, not right away.

Imaging Tests for Low Back Pain
Continue to Be Used Frequently Despite Potential Risks

Diagnostic imaging tests like X-rays, MRIs, and CT scans are important tools that can help doctors more clearly understand what’s happening in the body so they can reach or confirm a diagnosis. But just because these tests are helpful does not mean that they should be used at all times, or even frequently.

Low back pain is one of the most common medical conditions, and it will affect up to 80% of individuals at some point in their life. Imaging tests are only recommended when a “red flag” is present, such as signs of nerve damage, serious underlying problems like cancer or spinal infections, unexplained weight loss, bladder or bowel issues, and abnormal reflexes. If none of these red flags are present, most guidelines state that an imaging test is not needed, since it will not usually help to identify the source of pain.

Diagnostic Tests are Simply Overused – This Means You’re Paying for Something that Might Be Unnecessary

Despite these recommendations, diagnostic tests continue to be used frequently for various reasons. Some patients with low back pain request or demand an imaging test because they are seeking a concrete diagnosis, while many medical professionals may be more likely to order a test if they have the technology in their facility. It’s not clear how many patients end up undergoing an imaging test for low back pain, so a team of researchers performed comprehensive study called a systematic review and meta-analysis to investigate.

One-third of patients who go to the emergency department receive an imaging test
Those involved in the review performed a detailed search of several medical databases for studies that included data on the use of imaging tests for patients with low back pain. This search led to 45 studies being identified that fit the necessary criteria for inclusion into the review.

The Problem is Getting Worse?

These studies showed that there were nearly 20 million unique consultations to either a primary care physician or the emergency department for low back pain. These consultations resulted in nearly 4.5 million imaging tests performed over 21 years. Further analysis of these figures revealed that there was moderate-quality evidence that one-quarter of patients who initially consulted with a primary care physician were referred to imaging, as well as high-quality evidence that about one-third of patients who went to the emergency department underwent imaging. It was also found that the use of imaging increased by 50% over the 21 years covered in these studies, despite the presence of guidelines against this practice.

Overuse of imaging tests remains a pressing and alarming issue…

The results of this review show that overuse of imaging tests remains a pressing and alarming issue. Imaging tests are not only extremely expensive—costing an average of $1,119—and expose patients to potentially harmful levels of radiation in the case of CT scans and X-rays, but they can do more harm than good for many patients. This is due to the fact that imaging tests don’t always identify the cause of patients’ pain—especially for low back pain—and often reveal “abnormalities” unrelated to the pain that may be misconstrued as a cause. As a result, many patients undergo invasive procedures like surgery that may not lead to the desired result because it does not address the source of their pain, which is usually difficult to pinpoint.

Going down this road can be avoided by seeing a physical therapist first. Physical therapists rarely refer low back pain patients to imaging tests because they understand the many risks associated with this approach. Alternatively, they treat patients with a multifaceted, movement-based program that is designed to address their symptoms according to their needs, abilities, and goals.

See Us for a Consultation First. You May Need an Expensive Test…But, You May Not!

Visit our contact page for more details or call us at (559) 733-2478.

Overuse and Repetitive Strain Injuries

Repeatedly performing certain motions can produce pain and dysfunction over time

Most injuries will fall into one of two categories: acute and overuse. Acute injuries usually result from a single, traumatic event, such as a fall, slip, or collision with another athlete or object. Some common examples of acute injuries include wrist fractures, ankle sprains, shoulder dislocations, and hamstring strains.

Overuse injuries, on the other hand, occur gradually over time rather than on the spot. They are more common than acute injuries but are also more subtle, which makes them more challenging to diagnose and treat. Overuse injuries may result from training too hard and pushing your body past its limits, or simply by moving incorrectly or with bad posture on a repeated basis. Another term used is repetitive strain injuries, which shows how repeating the same movements can result in small trauma—or microtrauma—to tendons, bones and joints. Eventually, the damage gets so bad that symptoms begin to arise, in which cases treatment is usually needed.

Here at our practice, we treat a variety of sprains & strains. Below, we offer a brief overview of the mechanisms responsible for 5 common overuse injuries:

Shoulder Impingement – Consider Physical Therapy for Shoulder Impingement Syndrome in Visalia
Shoulder impingement syndrome (SIS) is a condition that involves the rotator cuff, a group of muscles and tendons that keeps the shoulder stable. In SIS, rotator cuff tendons become compressed—or “impinged”—as they pass through a small bone on top off the shoulder blade called the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted movement and pain that occurs at rest, when moving the shoulder overhead and/or when sleeping.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. The condition can also result from an injury that compresses the structures of the shoulder—like a fall—or from frequently sleeping on your side. Sleeping in this position regularly can strain the shoulder and cause impingement over time.

Plantar Fasciitis – We Provide Effective Physical Therapy for Plantar Fasciitis in Visalia
The plantar fascia is a thick, connective band of tissue that runs across the bottom of the foot and connects the heel to the toes. It’s a tough structure designed to absorb the regular stresses that are placed on the foot, but can become damaged when these forces are excessive. When this occurs, the resulting condition is plantar fasciitis.

Plantar fasciitis is a stubborn overuse injury and the most common cause of heel pain.
It occurs most frequently in runners—especially long-distance runners—due to the repetitive strain they place on their feet. People who have flat feet or high arches, are overweight or regularly perform any other weight-bearing activity are also at increased risk. The most common symptom of plantar fasciitis is a stabbing pain near the heel that’s most noticeable upon waking up and after standing for long periods.

Carpal Tunnel Syndrome – Relief for Those Searching for Physical Therapy for Carpal Tunnel Syndrome in Visalia
The carpal tunnel is a space at the base of the palm that contains several tendons and the median nerve, which provides sensation to the fingers. If these tendons thicken or any other swelling occurs in the area, this tunnel narrows, which puts pressure on the median nerve and leads to a condition called carpal tunnel syndrome.

Carpal tunnel syndrome is extremely common, as it affects about 5% of the population.
The greatest risk factor is any task that requires repetitive hand motion, awkward hand positions, strong gripping, mechanical stress on the palms, or vibration. As a result, individuals who work on an assembly line—like manufacturing and meatpacking industries—are at the highest risk. The risk if also high in office workers. Symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm.

Golfers Elbow – Choose Physical Therapy for Golfer’s Elbow in Visalia
Golfer’s elbow is a condition that results from the repeated bending of the wrist that is necessary in a golf swing. This damages the muscles and tendons of the medial epicondyle—a piece of bone on the inside of the elbow that allows the forearm, wrist and hand to bend and move in several different ways—and eventually leads to inflammation. It is especially common in golfers because gripping or swinging clubs incorrectly or with too much force can take a toll on the structures within the elbow over time.

Common symptoms include pain, tenderness, swelling, weakened grip strength and a burning sensation on either the inside or outside of the elbow. These symptoms often develop gradually and are worsened by activities that involve the forearm, and if left unchecked, can go on to make many basic activities that require gripping or grasping a major challenge.

Lower Back Pain – Natural Physical Therapy for Back Muscle Strain in Visalia
Back pain is the most common musculoskeletal injury, and a significant number of cases are due to a strain of one or more back muscles. This condition—also known as a pulled muscle—is the result of muscle fibers tearing from being overstretched or overused, which can occur from repeatedly bending your back or using improper posture.

The most common symptom is pain in the lower back that is often most intense during the first few hours of the day. Pain also tends to get exacerbated with certain movements or positions that strain the muscles of the spine, like standing for long periods of time. Tenderness and stiffness of the spine is also likely.

Physical therapy for all types of overuse injuries
In addition to being the product of overuse or repetitive strain, another feature that all of these conditions share in common is responding to physical therapy. Our physical therapists can help by identifying the behaviors or habits that are responsible for your pain, and then recommending adjustments to your movements along with a personalized treatment program to help you move with less pain.

MRIs Of Both Painful And Non-Painful Shoulders Are Similar, Which Questions The Usefulness Of These Tests