Part 2 of 2 in a series about self-management of injuries vs management by a medical professional.
In the last installment of this series, I went over techniques you can use to manage injuries on your own. You can find it here. In this article, I’ll go over when to seek medical attention from a professional and what that might entail.
There are two general situations where it’s worth seeking outside help: first, when you’ve tried conservative self-management techniques and they’ve failed; second, when your injury is too significant to manage on your own.
In the first situation, there’s the assumption that you’ve given a realistic try at self-management: changing your ergonomics, resting, using ice or heat if appropriate, stretching, strengthening, etc. Generally, 2 weeks of giving it a genuine and consistent effort at self-management is enough to know if it’s working or not. If, after that two weeks, you’re not seeing significant improvement, it’s time to seek outside help.
There are a variety of medical professionals that may be the appropriate choice, depending on your injury. In general, your best bets will be a physical therapist, an occupational therapist, or a doctor. Let’s look at the role each of them play.
A doctor can proscribe you medications, order medical imaging, and refer you to other medical professionals. In some situations, your insurance may require that a doctor provide a referral before they’ll cover physical therapy. In the United States, almost all states offer the ability to see a physical therapist without a referral from a doctor. For a full list of state regulations, click the linked image below.
A physical therapist cannot order medications or medical imaging, but can use clinical tests and mobility assessments to determine a diagnosis. If you’re in the United States, you can find a physical therapist near you here.
An occupational therapist also cannot order medications or medical imaging, but may be appropriate for certain types of injuries. Both physical and occupational therapists can become Certified Hand Therapists, or therapists who specialize in hand and arm injuries. In the United States, you can find a Certified Hand Therapist near you here.
Your exact therapy process will differ depending on your therapist and your injury, but could involved strengthening, range of motion, manual therapies like mobilization or manipulation, modalities like ultrasound or laser, and electrical stimulation, among others. It’s important to note that most of your recovery will depend on your investment–that is, how much time you put in outside of your scheduled therapy sessions with the home exercises you’re provided with.
The second scenario I suggested at the start of this article involved injuries that are too significant for self-management. How do you identify an injury like that?
One class of injury that would immediately require professional attention is a severe, acute injury–think along the lines of a broken bone or substantial sprain. These are the kinds of injuries that are significant enough that without medical management, the risk of inadequate, incomplete, or poor healing is high.
Another class of injury that would require professional attention is a long-term or chronic injury. At that point, in addition to having built up significant physiological issues, there’s a psychological component to address as well. Over time, our bodies become more sensitive to pain, not less sensitive; we also develop disordered thoughts that affect how we perceive our pain. A good physical or occupational therapist can help manage both the physical and the mental components of pain while also addressing the root causes.
One important thing to keep in mind when it comes to professional rehabilitation of injuries: it won’t always be comfortable. There will be times when it will be downright painful. Make sure you communicate with your therapist about how you’re responding to therapy (i.e. don’t tell them you feel great when you feel like you’re stalling), but recognize that as you’re teaching your body new patterns to move in and fixing old faults, there’s going to be a not-entirely-comfortable learning curve. That doesn’t mean it’s not working, but make sure your therapist is aware.
To recap: when it’s a severe, acute injury, when it’s been chronic and unmanaged, or if you’ve tried self-management and it’s failed, that’s when it’s time to seek out a medical professional. Different medical professionals provide different kinds of care; what’s best for you will vary based on your injury.