Navigating Your Path to Wellness: Physical Therapy in Decatur, GA

 If you’re looking for physical therapy for your neck or back problem, consider us. We don’t do extremity physical therapy, but we do specialize in the neck and back. Dr. Castanet has 37 years of experience, 18 years in orthopedics, physical medicine and physical therapy, and 5 years in a neurosurgical practice. During that time the quality of physical therapy for all conditions has improved tremendously. But neck and back problems remain a frequent source of frustration for patients and therapists.

The common methods of treatment include passive modalities, ergonomic instruction, and exercises. But these approaches often fail to sufficiently improve pain caused by herniated discs and pinched nerves. For these kinds of problems many patients need a specialized approach not readily available to therapists. Let’s examine why. Disc herniations are a common cause of difficult and intractable neck and back pain. The reason disc problems are so common and difficult is as follows: There are 24 spinal discs between all your vertebrae. They are tough, fibrous, connective tissue and a lot of physical demands are placed upon them. This is especially true in the neck and lower back because these two areas are highly mobile.

The discs are very strong when they are subjected to pure axial loads, i.e. straight up and down the spine, IF the spine is in a neutral position, without any bending or turning, whatsoever. But that is not how we load our spines. We spend our days, activities, and nights bending, twisting, and turning in all manner of directions while we impose these loads. And we don’t think much of the way in which we are imposing these loads, until we feel pain. The net effect of all these demands is that, starting from childhood, we get microscopic tears to these tough, fibrous discs, and they don’t heal entirely.

These tears aggregate in the discs in which we place the greatest physical demands. Over time, these increasing tears allow the inner part of the disc to migrate through the tears, until the disc herniates out and pinches a nerve. In the early phase of this process, i.e. the inner disc, you don’t feel pain because there are no pain fibers in the inner part of the disc. But once the tears accumulate, and affect the outer layers of the disc, you feel back pain. This usually gets better on its own until it gets worse. Eventually, the herniated or bulging disc can pinch a nerve in your neck or low back.

This can cause pain wherever your nerve goes, e.g. your arm or leg. During this slowly, progressive process the pain in your neck can move from your neck into your shoulder blade or between your shoulder blades. In fact, this is usual, and it is missed, diagnostically, by many therapists. 95% of the time, if you feel pain in your shoulder blade it is caused by a neck problem. And the problem is almost always what we call a disc/osteophyte complex, i.e. a combination of disc herniation and arthritis in your neck. Similarly, in the lower back, it is usual for back pain to progress into your buttock, then thigh, and leg. This pain is often misdiagnosed as piriformis syndrome. Why? Because the piriformis muscle is in your buttock, but it is one of many muscles in your buttock. And, if piriformis syndrome exists, a hypothesis that remains unproven, it is much less common than back and buttock pain caused by a herniated disc.

Do misdiagnoses matter? When it comes to the spine and its treatment, diagnoses are sometimes provisional, and subject to change. Most causes of spinal pain are benign, even when the pain is severe. But if the diagnosis is correct, and the treatment appropriate, then improvement must begin quickly, or the diagnosis should be reconsidered.

This means that patients should not be wasting lots of time and money doing treatment that is not getting them better. When the diagnostician/doctor, and the treater/therapist are not the same person, it is ideal for them to be in close communication, so that the patient is being evaluated, treated, and re-evaluated quickly. I think that getting treated for six weeks and not improving quickly, is usually a waste of the patient’s time and money, and can result in needless physical pain.

In my clinic, I am the doctor, diagnostician, and treater, so not a single session of treatment is done without a re-assessment of progress and decision about the need for further diagnostic testing. And the patient is involved in every decision about their treatment and diagnostic testing. Getting back to the issue of neck and back treatment, as I said, disc problems are driving spinal pain. Disc problems cause joint and nerve problems, and these three pain generators are the cause of 98% of spinal pain.

The spinal pain reflects the slowly, progressive, degenerative compression of the spine. And the most effective redress for this compression is to decompress the spine, to reverse it. Are we talking about reversing the compression to age 15? No. We are talking about decompressing your spine a few millimeters to give it relief that lasts longer than any other non-surgical treatment we have so far.

In practice since 1987, and having participated in the treatment of more than 40,000 patients, I can tell you that the non-surgical spinal decompression treatment that I do, is the most effective treatment I’ve ever seen and used for patients. It gets patients better, faster, and more lastingly than any other treatment for spinal pain. 

If you’re looking for physical therapy in decatur ga, or physical therapy decatur ga I recommend you call my office at 404-558-4015.