Reason 5 - Our guarantee.
We have heard this story so often it makes me feel a little ill. I have been seeing my (insert one of chiro, physio, osteo, masseur, etc) once a week for 6 months - and it seems to help for a day or so.
This is not helping. It is treating the symptoms, and because it is not getting at the underlying cause it is ultimately ineffective, expensive, and treatment without an endpoint.
Our guarantee has 2 parts. The aim is to minimise the risk of treating people who either don't have a neck problem relating to their head pain, or not continuing to treat people who are getting no more than short term relief.
Firstly we don't book everyone that calls for an appointment. We conduct a phone interview lasting approximately 10-15 minutes seeking information that may save you the time and money of an initial consult. Some people from the phone interview will be referred back to their GP or specialist for further investigation or referred back to their local health professional (Physio/Chiro/Osteo) for follow up.
Those that are accepted will then book an initial assessment. Here we look for clear signs that your neck is related to your condition. By very selectively and precisely stressing the joints in the top of the neck we look to temporarily reproduce the area of your usual symptoms (i.e. push pain up into your head behind the eye). If we can reproduce these symptoms we sustain the pressure and look for the referred pain to ease after 30-40 seconds.
If this "reproduction and resolution" of familiar symptoms occurs (and it does in approx. 80% of initial assessments) we accept the person into the initial treatment block.
If we cannot reproduce familiar symptoms, or we can but they do not subside then it is unlikely the treatment we use will be effective, so rather than try and convince you to get a treatment that will ultimately provide short term or no relief and little else, we set ourselves apart from the crowd and decide not to treat you.
Secondly, if you are accepted into the initial treatment block, then we expect there to be significant changes in your condition within 2-3 weeks. That is not to say that you will be "cured" in 2 weeks. If we get to the end of the second treatment week after the initial assessment, and there is no sign of significant change we stop.This is a protection for the 10% of cases who start treatment, and their condition does not respond preventing the cycle described above of "endless" treatment programs with no goals. This number is relatively low, indicating over 90% of people respond. The reason for such a high success rate is due in part to screening out 20% from the initial assessment, but unfortunately there are some whose necks will not respond to treatment in the long term - we will not continue to treat if you are not improving.
We would love to be able to help everyone, and we would love everyone to respond well to treatment. The reality is that only 80% have treatable problems related to their neck, and approximately 90% of these will respond to treatment. The difference is we are upfront about these numbers, and open about every step of the process to minimise the risk of receiving treatment that is ultimately not effective.
The improvement in the first few weeks is why this clinic can effectively run outreach services to regional areas. Those that do respond, respond quickly and are able to manage with self treatment soon thereafter.
Roger O'Toole is the Director and Senior Clinician of the Melbourne Headache Clinic and has over 10 years experience as a physiotherapist.