It would be nice if a doctor could stop and explain everything he is doing and examining while he was in the process of doing the examination. Unfortunately in this day and age when a doctor may be seeing dozens of patients a day he may not have time, or take the time, to do so.
We’re lawyers, not physicians or doctors, but after having read thousands of pages of medical records here’s an educated guess as to what the doctor is doing. Damage to the sciatic nerve, the main nerve exiting the spinal column in the low back and going down the legs, will often result in certain abnormalities which a doctor can spot while doing a physical examination. These include weakness when bending the knee, loss of the ability to rotate your foot up or down (thus walking on your toes or heels), loss of reflexes to the knee and ankle, difficulty bending forward or backward at the waist, and pain when lifting your straightened leg up off the exam table.
In this situation what the doctor is looking for is objective evidence to confirm or supplement your subjective reports of an injury and subsequent pain.
The goal of physical therapy, or PT, is to improve your movement, improve your physical functioning, and reduce pain. It is not a stall that a doctor necessarily insists on prior to a surgery – although it may seem like it some times.
Why is that? A lot of injuries can be repaired with physical therapy. It’s non-invasive, and although it can cause some temporary pain and swelling, and is effective in some situations. Many people are cured with physical therapy and are quite happy. Some injuries, though, require much more. It’s pretty common, however, that your doctor will order PT prior to recommending surgery. If you’re one of the lucky ones whose problems are solved with PT then you’re good with this. If you’re one of the ones who requires surgery… well PT can be frustrating because you feel like it’s a waste of time. In most situations there isn’t any harm in trying the conservative approach first but it can be frustrating.
Following a surgery PT is often necessary to help rebuild your strength and prepare you for a return to work. And while PT often hurts during and afterwards you’ll likely hear your therapist explain that there is a difference between “hurt” and “harm.” As irritating as that is when you hurt… it’s true.
