Four Phrases That Make Me Cringe as a Physical Therapist

There are a few phrases that make me cringe when I hear them in the clinic. These phrases unnecessarily frighten patients. When someone is afraid of movement they become weak, stiff, and deconditioned. This will make someone’s pain worse instead of improving it. Here are four phrases that make me cringe as a physical therapist.

First Phrase that makes me cringe as a physical therapist:“Degenerative Disc Disease”

Sometimes MRI reports will say “degenerative disc disease”. When used in the context of the lumbar spine (low back), this phrase makes a normal sign of aging seem abnormal and frightening by labeling it a “disease.” Our joint capsules and intervertebral discs lose water as we age. This means that our discs are going to shrink, or ‘degenerate’ as we age. For people in their 50’s and older, this is normal wear and tear. The label of “disease” denotes that something is abnormal or wrong when it really isn’t.

Second Phrase That Makes Me Cringe: “Your Joint is Out of Place”

This is different than a traumatic incident where a joint dislocates. I am referring to when a practitioner (usually a chiropractor, but some physical therapists unfortunately say this as well) tells a patient they are popping their joint “back into place.” This is a scary thing for providers to put into patients’ heads. Imagine thinking your joint is dislocating when you move – that’s scary! When this is not actually happening, it’s inaccurate to say this to patients. This phrase REALLY makes me cringe as a physical therapist.

Number three on my cringe list: “Let’s Just Try an Injection”

Injections performed in isolation are a band-aid that only help for a limited time. Injections can be a very helpful tool to help patients get over the hump when treating a condition such as arthritis. Injections are most effective in long term pain management when performed alongside physical therapy. This is because injections mask pain but don’t address weakness, muscle tightness, etc.

Fourth phrase that makes me cringe as a physical therapist: “You probably have a pinched nerve.”

Sometimes patients have complaints of a pinching sensation in their shoulder, neck, or hip. Many of my patients worry that they have a “pinched nerve.”

I promise, it’s not a “pinched nerve.” When neural irritation (nerve issue) is present, there is usually a radiating pain, numbness, and/or tingling into an extremity. A sensation of being “pinched” in a specific spot is never a nerve problem. This is usually a muscle functioning incorrectly, muscle impingement, or some other issue. But the nerve? It’s usually not involved.

If you are told you have one of these “conditions”, please have a detailed conversation with your provider.

There you have it, a non-exhaustive list of phrases that make me cringe as a physical therapist. I cringe when I hear these phrases because as I mentioned earlier, most of the time they are unhelpful to patients. Most of my patients feel much better after gaining clarity on this information. To avoid stress and misunderstandings, It’s important to examine your situation in a greater context. Have a conversation with your provider so you can gain a better insight into what’s going on.