Last month, I was fortunate to be a vendor at the Kitsap Fest event at the Silverdale waterfront. I offered education on the McKenzie Method, the unique and highly effective system of assessment and treatment I use for musculoskeletal pain. Hundreds passed by my table, making it a lively and highly energetic event.

I had fascinating conversations with people from all walks of life, mainly regarding the aches and pains that keep them from the quality of life and activities they once enjoyed. The persistence of their symptoms, however, certainly wasn’t due to a lack of treatment. Most had received numerous interventions, both conservative and invasive, up to and including several surgeries.

While I often see patients who fit that demographic, I generally don’t see dozens in a single day. It was likely the repeated exposure to those people that left me pondering why chronic pain, multiple failed treatments, and even numerous operations are such a common occurrence.

While there are many possible reasons, one overlooked cause is that our medical system is set up to reimburse providers for services rendered instead of outcomes achieved. Rather than a mindset of assessment, where the provider determines which intervention is necessary ahead of time, many are content simply applying their favorite treatment. When that occurs, the treatment cart is placed before the diagnostic horse.

The unfortunate byproduct is that you can’t treat what you don’t understand.

Thankfully, systems of diagnosis and treatment for musculoskeletal pain exist that are rooted in assessment. Those methods seek to classify patients into unique subgroups based on their response to assessment and then treat them according to that classification. The result is more precise treatments and ultimately improved outcomes.

One such classification system is the McKenzie Method. Its strength is that it is a decision-making tool rather than just another technique. The assessment can reliably determine whether a patient with back, neck, or extremity pain can be classified into a McKenzie Method subgroup and effectively treated within the method. According to research, roughly 75% of patients fall into that category.

The assessment also greatly benefits those who don’t fit the criteria for a McKenzie Method classification. Those patients have been shown to be better candidates for other tests and interventions (e.g., MRIs, injections and surgery) compared to the general population of patients with musculoskeletal pain. Therefore, the assessment helps improve the selection criteria for expensive and invasive procedures at are overused in society.

When patients aren’t categorized in that way, they often fall through the cracks. They are the ones who end up passing by my Kitsap Fest table with decades of pain, multiple failed surgeries and an identity now wrapped up in their condition. After meeting those people, my first thought was that it was a shame they were never assessed. There was likely a simple answer to their problem if their providers had sought to understand their pain rather than simply applying their craft.

Dr. Jordan Duncan is from Kitsap County and writes a monthly online health column for Kitsap News Group. He is the owner of Silverdale Sport & Spine.