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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 Pain & Sciatica, Chronic Pain, Health & Wellness, Physical Therapy 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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Denise gave me confidence that she knew what was wrong and what to do about it, and under her care I quickly felt better and am now on the road to better fitness. She has a feel for what’s causing what, and is good technically and also good at making you feel cared for.
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Denise has worked on areas of severe pain and has diminished them to a tolerable level.
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The physical therapy I received at The Manual Touch PT helped reduce my sciatica pain to a manageable level in just a few sessions.  The exercises I was given strengthened and trained my muscles to prevent further back problems allowing me to return to playing basketball.
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I needed help.  Denise and the manual touch provided the best customized, targeted therapy I could have found.  She put my torn knee back together, straightened my back, worked with me to regain the mobility I’d lost due to a neck injury, even had me doing dance steps I’d not done in 60 years.  I didn’t think I could do this; she showed me I could.
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I can honestly say that Denise was the first physical therapist to listen to my story.   She has demonstrated more patience and compassion than any other therapist that I’ve ever met. For the past 8 years, I have been symptomatic with Ehlers Danlos Syndrome (EDS), a rare genetic condition which affects the connective tissue throughout my body. As a result of this disorder I deal with ongoing severe acute and chronic pain and a variety of other rare overlapping conditions such as thoracic outl… Read more
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I had constant neck pain from a car accident 2 years ago.  I went through PT somewhere else without any good results.  I then was recommended to come to The Manual Touch PT. At my first appointment I could tell that Denise was able to get right to the point of my problems.  After numerous therapy sessions I felt such a relief of my constant pain.  It is better now, I can sleep better and use less pain medication.  My goal is to avoid surgery and I feel hopeful that will be possible.
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Denise Schwartz at Manual Touch is a marvelous diagnostician and therapist. During the past few years, I’ve sought out Denise’s care for various physical limitations. I am continually amazed by her ability to determine my discomfort’s cause as well as by the effectiveness of the exercises she recommends to ease my pain. She also knows how to best manipulate my aching joints to bring relief. I can whole-heartedly recommend Denise because she is a skilled, proficient, compassionate professional. … Read more
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I saw Denise for ongoing heal pain as well as an athletic back pain injury. My back pain is gone and my heal pain (which I’ve had for several years) is significantly better so that it doesn’t interfere with activity. The exercises Denise gave me have strengthened my core and will prevent future injuries. Not only that, she provides personalized and attentive treatment the entire visit (much more personalized care than traditional PT centers). I highly recommend Denise!
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Excellent, professional assessment and treatment for an older woman who’s had lots of failed therapy. Kind and compassionate and caring! Thanks.
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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 reduced the sensitivity to pressure that was caused by my open-heart surgery.
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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

Denise gave me confidence that she knew what was wrong and what to do about it, and under her care I quickly felt better and am now on the road to better fitness. She has a feel for what’s causing what, and is good technically and also good at making… Read more
Denise has worked on areas of severe pain and has diminished them to a tolerable level.
The physical therapy I received at The Manual Touch PT helped reduce my sciatica pain to a manageable level in just a few sessions.  The exercises I was given strengthened and trained my muscles to prevent further back problems allowing me to return… Read more
I needed help.  Denise and the manual touch provided the best customized, targeted therapy I could have found.  She put my torn knee back together, straightened my back, worked with me to regain the mobility I’d lost due to a neck injury, even ha… Read more
I can honestly say that Denise was the first physical therapist to listen to my story.   She has demonstrated more patience and compassion than any other therapist that I’ve ever met. For the past 8 years, I have been symptomatic with Ehlers Danlo… Read more
I had constant neck pain from a car accident 2 years ago.  I went through PT somewhere else without any good results.  I then was recommended to come to The Manual Touch PT. At my first appointment I could tell that Denise was able to get right … Read more
Denise Schwartz at Manual Touch is a marvelous diagnostician and therapist. During the past few years, I’ve sought out Denise’s care for various physical limitations. I am continually amazed by her ability to determine my discomfort’s cause as well a… Read more
I saw Denise for ongoing heal pain as well as an athletic back pain injury. My back pain is gone and my heal pain (which I’ve had for several years) is significantly better so that it doesn’t interfere with activity. The exercises Denise gave me have… Read more
Excellent, professional assessment and treatment for an older woman who’s had lots of failed therapy. Kind and compassionate and caring! Thanks.
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
Read More

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