A thorough assessment is required.
This involves the history (eg. mechanism of injury, aggravating and easing activies, location of symptoms etc), the location of symptoms and specific questions to determine the nature of the problem.
At this point usually the clinician has a good idea of the likely diagnosis, but the physical examination (testing movement, strength, pain, reflexes etc) helps to confirm the liklihood of the diagnosis being correct.
Sometimes further tests or investigations are required (such as MRI,CT or bone scan) but this is commonly only with significant trauma (eg car accident or heavy sporting collision to rule out broken bones, significant structural damage) or when patients are failing to rapidly respond to treatment as expected.
As a McKenzie specialised practitioner, I also assess the affect of repeated movements and/or sustained positions and determine their effect on both the symptoms and physical signs (eg blocked movements or movements that produce pain). The advantage of this McKenzie Assessment is that repeated movements provide more information that single movements, and can often help to identify the problem when the presentaiton is complex. This McKenzie assessment process has been shown to be as reliable as MRI investigation for many problems (eg neck and low back disc problems). This can be cheaper and get to the crux of the problem fast.
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