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The Manual Touch Physical Therapy

Whole Body Approach

Reclaim movement, function and life
For information, call: 847-541-7600
or email: info@themanualtouch.com
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When Should I See a Physical Therapist?

June 3, 2020 By Denise Schwartz Leave a Comment

I am one of those fortunate people who does not have lower back pain.  Of course, over my lifetime I’ve had a few moments of lower back pain, more specifically, SI (sacroiliac joint) pain, which I was able to take care of quickly.  The SI joint is located at the top of your buttocks where the sacrum and ilium (pelvic bone) come together.

Four years ago on a Monday, I headed out for a run. Much to my surprise, I noticed some left SI pain.  Hmmm, I thought, how did that happen? I don’t remember straining myself the past few days. As the running didn’t make it worse, I continued my run.

On Tuesday, I noticed the pain increasing and lasting through the day.

By Wednesday night, the constant, dull, achy pain had begun to spread around my left hip into my lower abdomen, preventing me from sleeping, as I could not find a comfortable position to sleep in.

Thursday morning, I called my friend, Janet, to treat my back.  Janet is an excellent physical therapist and we often swap treatments when needed. We can almost always make each other feel better, but not this time – the pain did not shift or change.  

By Thursday evening, I told my husband that I needed to go to the ER.

My Emergency Room Experience

The pain was constant, I was not able to find any position to alleviate the pain, and most importantly the pain was not “reproducible”.  Meaning, no specific movement or position made the pain worse or better.

We went to the emergency room and I told the staff that my pain was not reproducible so it was not musculoskeletal.  They proceeded to work me up for a kidney stone. I had blood work, a CT scan and even an offer of morphine.  I turned down the morphine but gladly accepted Vicodin.  All the tests were negative, so at 2:30 a.m. the doctor said it must be musculoskeletal and sent me home. I was too wiped out to argue.  

Over the next few days the pain became more manageable and I could even sleep.

The following Tuesday, 8 days after first experiencing the back pain, I scratched my back and felt a rash.  I had shingles!  Apparently, on rare occasions you can have pain before the shingles rash appears, making the ability to diagnose the symptoms difficult.

How is my story relevant to physical therapy?  

I knew my pain was not coming from the musculoskeletal system (muscles, bones, ligaments, tendons, etc) because it was not reproducible, meaning there was nothing specific I could do to make the symptoms worse or better. If your pain isn’t reproducible, traditional physical therapy will not help and you should seek out medical care instead.** However, there are many issues that call for a visit to your physical therapist, as explained below.

When should you be evaluated by a physical therapist?  

If you have any of the following issues, it’s worth calling your physical therapist to get an appointment as soon as possible:

  • Specific activities or movements cause pain (“reproducible”)
  • Recent surgery of any joint: shoulder, hip, knee, ankle, foot
  • Balance issues
  • A recent fall
  • A recent injury such as an ankle or knee sprain
  • Shoulder or elbow pain when reaching, dressing, washing, sleeping
  • Back or neck pain
  • Inability to sleep because of pain
  • Abdominal pain that is “reproducible”
  • Difficulty walking because of pain or balance
  • Difficulty functioning because of pain
  • Numbness or tingling in your legs or arms
  • Pain after workout/exercise that persists for more than 3 days

A physical therapy evaluation will determine if your symptoms are reproducible and, if so, how physical therapy can help.  We will ask you questions such as:

What movements cause you pain? 

Does pain wake you up? 

Which is worse – sitting or standing? 

Do specific activities make your pain worse such as doing your hair? Putting dishes away? Squatting? Rolling over in bed?

What is the biggest mistake people make when they are in pain?

The biggest mistake you can make is to ignore your pain, or think you can just rest and it will go away.  While a short period of rest may be appropriate, ignoring the pain is often a recipe for pain to become chronic, more difficult to treat, and you may develop other issues while compensating for the original issue. 

If you’re experiencing any of the issues described above, we’d be happy to evaluate you and provide you with a personalized physical therapy plan. Give us a call anytime!

** For shingles, I have found non-traditional therapies, such as acupuncture or Integrative Manual Therapy, can be a helpful addition to your medical management.

Filed Under: Back, Neck, & Sciatica Pain, Chronic Pain, Health & Wellness Tagged With: lower back pain, musculoskeletal system, Reproducible pain, Shingles

About Denise Schwartz

Denise Schwartz, PT, IMT, C is the owner of The Manual Touch Physical Therapy. For over 30 years, she has been helping patients reduce pain and improve quality of life using a whole body approach. Denise specializes in chronic pain, spinal conditions, running/triathlon injuries and prevention, balance/vestibular disorders, functional exercise, kinesiotaping, and various non-traditional and traditional & manual therapies. Contact Denise at denise@themanualtouch.com

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On the occasion of my 69th birthday, I celebrated with a special, extended workout that included a set of 10 pull-ups and several other body-weight exercises. But the most important and most appreciated dimension of my body on that day and all others was the pain-free freedom of movement I enjoyed, the product of an exercise focus on flexibility, stretching, balance and core strength. The great change in my workouts came when I approached Denise Schwartz at The Manual Touch in Wheeling to reh… Read more
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Denise is an excellent physical therapist. I was referred to her by another therapist, and I’ll be sticking with Denise Schwartz, now. I didn’t know if it would go well, or not but I actually look forward to this physical therapy process with her, after only two sessions. This is the best my elbow has felt in a year. Denise ‘gets it,’ if you will. You tell her your situation, she truly understands the problem, gets to work, and starts fixing the problem. She has, in fact, exercised herself…so… Read more
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I’m very excited because I’m getting stronger, more stable when I’m walking, and more flexible.  Yesterday, for the first time in several years, I was able to travel by train downtown and visit the Art Institute.  There was lots of walking and sitting, activities which previously caused me to be in pain for several days afterwards.  But today, I’m just a little sore.  I feel I’ve made very good progress in feeling better, stronger and feel less pain.
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I met Denise at a local yoga studio and she became instrumental when it comes to coping with all my aches and pains. She has a holistic approach to physical therapy which many other practitioners seem to lack. I’ve done physical therapy before and a pain in the shoulder would be treated with strengthening the muscles around it. It never worked because shoulder pain can actually originate in other places – like hip stiffness caused by bad posture, shoes, soft chairs, etc. She really cares and edu… Read more
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I’m a pediatric physical therapist and I was taking a yoga teacher training.  My left shoulder and neck were getting progressively tighter and eventually pain was keeping me up at night.  I knew I wanted treatment from a very knowledgeable PT with good manual skills and someone who excelled at evaluating postural and functional issues.  Denise is that person and she corrected my biomechanics with exercises and manual therapy.  There are only a few PT’s that possess skills like Denise.  … Read more
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I am a pediatric  physical  therapist  who  (unsuccessfully) tried to treat my own shoulder pain for more than 1 year.  By the time I started PT with Denise, my pain was significantly impacting both my personal and professional life. After 2 visits with Denise, the pain lessened and my function improved.  After 8 visits, I was nearly painfree.  Denise and I continue to work together to improve my overall movement and muscle strength.  My body feels better than it has in years.  I hav… Read more
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I had recurring back and knee issues and thought I wouldn’t be able to race triathlons again.  Denise gave me exercises and encouraged me to sign up to compete. I was able to complete the triathlon and had my fastest run split in years.”  
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I complained to my family doctors about severe pain in lower back.  He recommended use The Manual Touch.  I followed Denise’s recommendation and started physical exercises for my lower back.  Also I am wearing abdominal binder which improved my strength and pain in lower back decreased from 6-7/10 to 3-4, which is give my normal life back.  Thank you very much
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Before PT:  I had difficulty in walking due primarily to knee pain and was dependent on a cane and/or walker and had no confidence with either aid. After PT:  With the expertise of Denise as my physical therapist, I was guided and taught a series of exercises to increase my mobility of the lower extremities.  She was able to accurately determine the course of treatment. Denise instilled in me the importance of a continuing daily routine of exercises to decrease stiffness and increase my … Read more
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Our Mission


We believe all body systems and mental/emotional health are connected. We take a whole body approach to discover why patients are not healing and what were the initial causes of their current symptoms. 

Our mission is to use this whole body approach to help patients heal and overcome pain and limitations, resulting in improved quality of life. We also aim to promote wellness in our communities through ongoing education. 
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Testimonials

On the occasion of my 69th birthday, I celebrated with a special, extended workout that included a set of 10 pull-ups and several other body-weight exercises. But the most important and most appreciated dimension of my body on that day and all others… Read more
Denise is an excellent physical therapist. I was referred to her by another therapist, and I’ll be sticking with Denise Schwartz, now. I didn’t know if it would go well, or not but I actually look forward to this physical therapy process with her, af… Read more
I’m very excited because I’m getting stronger, more stable when I’m walking, and more flexible.  Yesterday, for the first time in several years, I was able to travel by train downtown and visit the Art Institute.  There was lots of walking an… Read more
I met Denise at a local yoga studio and she became instrumental when it comes to coping with all my aches and pains. She has a holistic approach to physical therapy which many other practitioners seem to lack. I’ve done physical therapy before and … Read more
I’m a pediatric physical therapist and I was taking a yoga teacher training.  My left shoulder and neck were getting progressively tighter and eventually pain was keeping me up at night.  I knew I wanted treatment from a very knowledgeable PT wit… Read more
I am a pediatric  physical  therapist  who  (unsuccessfully) tried to treat my own shoulder pain for more than 1 year.  By the time I started PT with Denise, my pain was significantly impacting both my personal and professional life. After 2 … Read more
I had recurring back and knee issues and thought I wouldn’t be able to race triathlons again.  Denise gave me exercises and encouraged me to sign up to compete. I was able to complete the triathlon and had my fastest run split in years.”  … Read more
I complained to my family doctors about severe pain in lower back.  He recommended use The Manual Touch.  I followed Denise’s recommendation and started physical exercises for my lower back.  Also I am wearing abdominal binder which improved my … Read more
When I started to work with Denise I had shoulder and lower back pain.  She taught me various exercises along with posture that resulted in significant reduction in the pain.  Also, significantly improved my balance.  Her massage therapy greatly r… Read more
Before PT:  I had difficulty in walking due primarily to knee pain and was dependent on a cane and/or walker and had no confidence with either aid. After PT:  With the expertise of Denise as my physical therapist, I was guided and taught a series… Read more
Read More

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