© 2019 by Spinal Symmetry Pty Ltd


The Acute Patient

November 23, 2017

Here at Spinal Symmetry, we see a variety of people for all sorts of issues. Ranging from check ups to see if their body is functioning at optimum capacity, to chronic old issues they may have been dealing with for a long time, or repetitive issues that present from time to time due to posture or work strains.


However, the most severe presentation we see at the clinic are people in acute pain.




An acute presentation is defined as an injury that has occurred suddenly and has only been present a short period of time and generally is much more sharp and severe in nature, which is the complete opposite to aches and soreness related to chronic issues.


Obviously there is an extensive list of issues and events that can cause acute pain presentations. So it is unachievable to be able to cover all reasons why and how we have acute pain in this article. Also, every case is very unique to the person who is experiencing the episode, so all advice covered in this article will be very generalised to give you an idea of what happens in an acute case.


The first topic to cover is the decision of when you should come in for a treatment when something happens. Again, everyone is different, but as a general rule of thumb- if you are able to walk into the clinic, even though you may not be upright or may need some assistance, then you are more than likely to be able to benefit from treatment.


This is where the practitioner will take a thorough history through extensive questioning of what has happened, examination of your body to find a reason for why this pain has started, and this will determine whether your body will be able to cope with a treatment.


If the practitioner finds any issues which are classified as ‘red flags’ you will be referred immediately out of the clinic to the GP or hospital for more testing to see why these are showing up. Red flags are signs to indicate that there may be something more sinister going on rather than just a structural issue that we can help with.



These may be signs of organs causing your pain, any hard neurological signs or symptoms, possibility of broken bones or fractures etc. Generally any unusual signs that aren’t matching with what we are finding and seeing in your body that need to be checked before it is safe to treat you. Your safety is always the first priority when treating an acute presentation.


Once we are happy that there are no red flags and that it is safe to treat the area, we will usually do some soft tissue work to the area. This is not only to start to correct the issues but also is our way of diagnosing why this is happening.



When the practitioner has assessed why things are happening they may need to adjust areas to correct the structural imbalances. This is where the biggest difference in how a treatment differs from when you are in acute pain vs chronic pain.


In acute pain your body cannot handle being adjusted the same way it is adjusted when there is a chronic condition.


Treatment can be considered a trauma to the body, it is a good trauma because it is placing a positive input in helping the body to heal. However when the body is in acute pain, the body and nervous system usually isn’t able to process this. So too much treatment or over treatment to the body can potentially have a negative effect.


The nervous system is in a hypersensitive state when you are in acute pain, so we need to do the smallest amount to make the biggest difference.



It is akin to taking a thorn out of your hand. While the thorn is in the hand it is hot and swollen and the whole area is painful, however as soon as you can take the thorn out, the whole hand will start to settle down and heal.


The Spinal Symmetry method, which is discussed in previous articles (20: Chasing the pain vs whole body Spinal Symmetry care) addresses the whole body and looks for the underlying imbalance in the hips and pelvis. This usually will be affecting your area of dysfunction and/or pain.



In an acute case this doesn’t not happen. Your background of imbalance is assessed and made note of in your file but in majority of cases it will not be addressed when you are in this acute pain. This is because your body isn’t ready to start that healing process. We need to deal with the thorn first, and then work on the background of imbalance at a later date.


So what will most likely happen once your whole body is assessed and soft tissue is performed is that the practitioner will determine the quickest way to remove the thorn and do just that.


That is usually the extent of physical treatment for that day. The practitioner will then advise how to manage your pain over the next 24-72 hours while your body heals from having the thorn removed.


In most cases it wont be an instant fix. Your body needs time to heal and this does take time. The self help advice may include; ice, heat, hot/cold showers, rest, anti inflammatories either of the natural or medicated varieties, pain relief medication, bracing, etc.




Once the acute episode has passed, and depending on the type of background of imbalance we assessed initially, you will need to return for treatment once your body has healed from the acute episode. This is so that we are able to get to the root core and correct the imbalance that potentially aggravated the acute episode in the first place.


Your practitioner will discuss with you when this treatment will be appropriate and it is this that will give your body the long term correction to reduce the likelihood of acute presentations to reoccur in the future.

The good news about acute presentations is that if we are able to treat them early enough in the episode, the body will not have had time to compensate elsewhere. Once we remove the thorn, the body will generally recover quickly.


It is usually when issues are left untreated for lengths of time that the body tries to correct itself, leading to compensations throughout the body.


This is what complicates the prognosis of your case. When an acute presentation has been left untreated, not only will the thorn need to be removed, but all the compensations will also have to changed as well. This is when multiple treatments over weeks/months are usually needed to correct all the underlying issues.


To conclude, when dealing with acute pain, the best advice would be to ring the clinic and talk to a practitioner to find out when you should come in and be assessed. They will be able to give you personal advice that will help your body and your situation, because everyone is different and all causes are different.



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