MISDIAGNOSIS OF MUSCULOSKELETAL PAIN

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MISDIAGNOSIS OF MUSCULOSKELETAL PAIN
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Misdiagnosis remains one of the most catastrophic
and costly of medical errors. An improper
musculoskeletal diagnosis leads to a domino
effect of wrong treatments, prolonged pain,
potential inappropriate surgeries, chronic
symptoms, and disability. Uncovering the true
cause of symptoms is critical and should be the
primary focus of all clinicians. Unfortunately,
there is minimal to no research on misdiagnosis
of musculoskeletal disorders. When someone has
muscle or joint pain, they are often diagnosed
based on their MRI findings or the location of
their symptoms. An MRI shows a clear picture of
deep underlying structures. But a picture cannot
differentiate painful from non-painful tissues.
Similar to taking a picture of the motherboard in
your cell phone the image may show water damage
or no damage at all, but a photo will not tell
you if your phone is working correctly. 
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Only by using your phone can you determine if it
works. This is the same for our muscles and
joints. An MRI may show damage and imperfections,
but many of these findings are natural
age-related changes. Just like grey hair and
wrinkles occur as we age, they do not cause pain.
Unfortunately, changes found on an MRI are often
automatically blamed for the cause of pain. But
in reality, many MRI findings, such as a
herniated disc or torn rotator cuff, are
asymptomatic and not the actual cause of
symptoms! (More than 50 of rotator cuff tears
are asymptomatic. 60 of disc bulges are
asymptomatic, instead, they are often natural
changes that happen as we age.Recent research
has found that 43.5 of isolated extremity
symptoms originate from the spine. When you have
pain in a joint, such as your shoulder, knee, or
wrist, without any neck/back symptoms, you have a
43.5 chance that your pain comes from a problem
within your back! Uncovering the root cause of
symptoms is critical and leads to improved
outcomes.
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Typically, pain in and around our joints is taken
at face value, and the painful joint is diagnosed
as the causative factor, but symptoms may be
referred from the spine. If your shoulder hurts,
you take for granted you have a shoulder problem,
but research has found over a 40 likelihood that
the problem originates in the spine. Getting an
MRI before a thorough mechanical assessment may
increase your risk of being MISDIAGNOSED because
it is easy to blame the first thing we see. When
pain of spinal origin is misinterpreted as a
local problem, it can initiate a cascade of
inappropriate care.  There is ample research on
the management of shoulder, elbow, wrist, hip,
knee, and ankle disorders but minimal on the
prevalence of symptoms referred from the
spine. The spine can refer pain, numbness,
tingling, weakness, and muscle spasms in the arms
and legs. Understanding the root cause of
symptoms is critical for proper treatment.
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• Potential Reasons for misdiagnosis of
  musculoskeletal disorders
• Most clinicians DO NOT rule out the spine.
• 2. Reliance on MRIs without understanding normal
  age-related changes.
• 3. Lack of time to go through a thorough physical
  examination.
• 4. Lack of research, teaching, and discussion
  about the
• importance of clearing the spine.
• 5. Specialized physicians that only treat one and
  often do not evaluate/treat outside of their
  joint specialty.

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Virtual physical therapists

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