Chronic & Persistent Pain
By Dr. Jesse Riley, MS DC
Chronic and persistent pain isn’t just scary – it’s perplexing.
You don’t know how long the excruciating pain will linger: weeks, months, or years? We have to use our bodies every day, and our normal activities become exhausting obstacles. What’s worse, in the greater Denver and Jefferson County area everyone has activities they would love to get back to – whether it’s climbing, running, or just going on a walk with your child (human or furry).
Not knowing how long your daily activities are limited is depressing. What’s even worse is it always seems like no one can understand what you’re saying to the point that maybe you even feel like you’re imagining it all. If you think this is just you, watch this video and share a laugh with someone.
And that’s the main problem with chronic pain: when it limits your activity and disposition, it interferes with your identity or even how to convey how you feel.
Many of us proudly occupy roles such as a parent, partner, or caretaker. We choose to take care of others, and ourselves, every day because it’s what we love to do. When our everyday activities become challenging or even impossible, our limitations affect our psyche. Without the ability to perform even mundane tasks like getting up from a seat, walking up or down the stairs, or trying to catch your little one running around the store, we’re not fully participating in life the way we want to. This can obviously have an effect on everyone around you too and perhaps they even start to treat you differently.
As isolating as chronic and persistent pain can be, you should know you’re not alone.
In fact, many people experience this everyday:
The good news is you don’t have to silently suffer anymore.
At Modern Movement Clinic, we know what it feels like to suffer from persistent pain. In fact, we see clients every day for this. To save you more time in your recovery, here are the first five questions clients ask us that will spare you the confusion that comes with chronic pain.
This page covers the first five questions every client with chronic pain asks us:
- How can I interpret my pain?
- How can I change the way I think about pain?
- How can I take immediate steps NOW for my persistent pain?
- How can I form a long-term plan for conquering chronic pain?
- What can I expect from my first Chiropractic visit?
How Can I Interpret My Pain?
A lot of different emotions come along with pain: confusion, hurt, anger, disappointment, anxiety, and hopelessness. Although these emotions can be a part of the recovery process, they also make it hard to discern what’s going on.
The good news is your pain can be outsmarted if you slow down and listen to what your body and mind are telling you. As we keep having our pain linger around, we often to go in this cycle of thinking about it every second to “I just hurt all the time” and not paying much attention. Listening to your body is a process that’s improved through trial and error. Together, we can learn to listen for the individual signals that YOUR body is communicating. Think of it as being able to know exactly what your friend or partner means when they text you “Okay…”.
To slow down, follow these three keys to recovery: identify painful movements, identify pain-free movements, and how to make sense of it all.
- What enhances my chronic pain? Identifying painful movement or activity.
Your clinician needs to know what movements or activities are painful so that they can help chart the route to your recovery.
The first step any good clinician or therapist will take you through is a movement assessment. Sometimes you know that “when I do this, it hurts.” Other times, there are many motions that elicit pain. You might think that you hurt 24/7 but the next section will help elucidate things to make pain more definitive and specific.
The movement assessment helps us identify where we feel pain, and when. Even better and in addition to that, we are gonna talk A LOT.
The more information we have, the faster we can put together the story of what movements and activities might be limited or modified for the time being to allow the body to calm down and thus allow us a longer leash to do things.
The initial assessment consists of the client replicating different scenarios that involve movement in different ways. Think of this as two friends sitting over coffee who haven’t caught up in a long time. We realize you’ve likely been to multiple practitioners and been told a lot of stuff, been suggested a lot of treatments (whether by them or friends/family), and maybe even told: “it’s all in your head”. We need to get all that out on the table along with your personal thoughts on all of this in addition to a movement assessment.
When we test these movements, we can pinpoint which motions might be causing a disconnect whether in thoughts about your pain or possibly keeping pain around. Beyond assessing movement, educating you on movement and building confidence is part of the recipe as well.
Differentiating painful movements are what gives us a larger picture of the overall situation.
Taking a holistic view of your specific circumstances is what typically separates traditional clinicians or therapists from modern practitioners. For modern practitioners, we know anatomy rarely ever dictates pain. There is often acute trauma (such as broken bones, lacerations, etc.) or an overuse/underuse in some fashion that underlies pain. We also know, however, that bodies are extremely strong and resilient often healing themselves on even the most gruesome occasions. Humans are highly adaptable and robust, attaining amazing feats of strength and you’re no different.
Understanding painful movements, along with your story, is an important step to learning about how we will chart your path to recovery together.
- What feels okay with your chronic and persistent pain? Identifying pain-free movements.
Focusing on what movements feel okay is JUST as important as identifying what feels painful.
We use clues from your movement assessment to get an idea of what movements do not cause a threat or threats that are tolerable right now. Know that as time moves on, your movement portfolio will get bigger and you’ll be able to do more activities with far less pain.
With the information of what motions feel okay, we’ll make a plan to get you back moving or find something that brings you joy. Think of it like we are expanding your appetite as maybe initially brussel sprouts look off-putting, and once you find out how great they are fried, you’ll learn to try them in other things.
Starting with movements that feel okay, you’ll slowly regain your ability to do your everyday tasks. We’ll add special modifications customized to you to increase your activities even more. With the ability to move more, you’ll rebuild your confidence, step-by-step.
Confidence is key!
- Making sense of everything
Now that we have a clearer picture of the source of your pain, what movements are limited, and what movements feel okay, it’s time to put the puzzle pieces together.
Through extensive continuing education and current research (something else your practitioner should be keen on), pain has been found to be much more like an alarm system for your body, NOT A DAMAGE INDICATOR. We want to make that evidently clear because we’ve all watched someone crash or get into an accident and you feel that pain. Watch this other funny video to illustrate how wild pain can really bee (misspelling intended) with a prank on people thinking the person has live bees in an elevator.
Think of your pain as a smoke alarm, instead.
A smoke alarm is incredibly helpful for alerting you to a potential fire, but if you’ve ever cooked in an apartment, you know the alarm can also be touchy. If we push our body into a state of what the brain perceives as a threat or past a threshold, the alarm bells may be ringing loudly and often. This is not only annoying, but also confusing. Therefore, we want to modify or avoid irritating movements right now. Remember this takes thought, so slow things down.
For now, limit motions that hurt and do more of what feels good.
No, it’s not rocket science, but it will make a huge impact on your recovery. When we talk about the movement that feels “good,” this doesn’t mean that the excerises make you feel like you’re on a tropical vacation. But, if the motion feels doable then do more of it. This is especially true if you feel like everything hurts. What hurts the least? It’s okay to feel a little because right now the body’s alarm system is off anyways. If your smoke alarm was touchy, we wouldn’t just NOT COOK and eat, right? This may start as something like walking around your block or simply just getting up every hour of sitting and dancing to your favorite song.
Moving more in a supported way will get you back on track in no time.
Movement assessments are so important because this information can’t be gleaned from an X-ray or just touch, but honestly neither can a good conversation around what you’re going through. Your story tells us which direction to go in. You’ll also read below why X-rays or MRIs don’t always need to be something we need initially and are often times unreliable.
Instead, take the first steps by assessing your movement with a professional.
How Can I Change the Way I Think About Pain?
We often have a lot of reasons why we think a certain way about our pain. Commonly, these come from experiences we had as kids watching our parents or guardians dealing with pain, our past experiences we have had with injury and how Doctors or the medical system have worked with us, or even just what we see on mainstream media and how they communicate pain to us.
This can have such a huge impact on our outlook and how we deal with our pain. Many times, as unfortunate as it may be, the message comes across as volatile, harsh, inflammatory, and confusing. This can leave us feeling a lot of emotions that aren’t ever really addressed by whatever clinician you work with leaving you feeling shameful, confused, and isolated. They use terms like “degenerated” or “bone on bone” and may use an image of yours to try to illustrate their point creating the narrative that “you’re weak and fragile”. This is fear-mongering and their only point of doing this is to get you to a state of despair that the only answer you can see is handing over thousands of dollars for them to simply do the same treatment every single time.
It’s imperative that you break yourself away from therapists and Doctors who use inflammatory language or even don’t take the time to help educate and provide options.
Work with a therapist uses more constructive and optimistic language. You can read much more about the power of words in this paper here. Working at Modern Movement Clinic, we take the time to explain how things like degeneration are actually normal age-related changes and how if we didn’t have our bodies adapt to the stresses we applied to these areas, we would be in more trouble!
This can be easier said than done right? After all, you just met us and what makes you think we know any more than the people you currently trust with your pain? You may be on day 60 or day 600 of this painful episode, but no matter how long this has gone one, you don’t deserve feeling the negative thoughts along with the anxiety or depression associated with this.
Movement optimism along with constructive education helps break away some of these “thought viruses” that come with your pain. Maybe you’ve had a coach or parent (or even partner) in the past that constantly provides negative feedback with no constructive criticism. This leaves you feeling scared to do anything for the fear of freedom of curiosity and choice. We know you’re smart enough and that all you need is a little affirmation and guidance to work through whatever pains you go through.
We will talk about this later but this is why we say “we don’t fix anyone but we help facilitate their own recovery” as this leaves you feeling a sense of self-efficacy and that you can conquer anything. Let’s read on to see how we can do that.
How Can I Take Immediate Steps NOW For My Chronic & Persistent Pain?
Do I Need An MRI For My (Insert Area) Pain?
Turning to imaging, through X-ray or MRI’s, is often our first instinct.
The inclination to go straight to imaging is common, but more often than not you don’t need to spend the time and money. In fact, getting an image scan first can often INHIBIT your progress as the report offers little explanation to understand what’s important. Reports with too much information and too little explanation can lead us down the WebMd rabbit hole and to further confusion.
There’s actually a lot of more studies coming out (seen here and here) that actually shows that image findings can be found in asymptomatic individuals with low back pain quite often and cartilage lesions found in the knee of soccer players yet 13% to 37% of these players with imaged meniscus injuries were completely asymptomatic, meaning showing no signs of pain.
Let’s be more clear. You are not your image results. This is why mindset is so important with chronic and persistent pain.
Valid reasons for getting image scanning would be if you’re experiencing any red flags mentioned above or if we do not see any improvements in your treatment. In this case, you will likely take an X-ray before an MRI.
Okay So What Can I Do About My Chronic Pain?
Summed up in two words: keep moving.
People commonly want to stop and rest when experiencing pain. Although rest is relaxing, new research says rest is less beneficial than if we just kept moving on with life. After all, this is just a speed bump. We’re slowed down but it doesn’t mean we won’t get to where we want to be, a pain-free life in some form or fashion. Massage therapy, dry needling, soft tissue, and adjustments or mobilizations are a nice addition to the therapeutic experience for some, but the most reliable therapy is activity and exercise.
That being said, we often have worked with people who actually have a negative response to soft tissue massage or dry needling and can make pain flare up. If this is you, don’t worry, you’re not weird and nothing is wrong with you, and you shouldn’t feel bad about that ever. Remember, pain is an alarm system and yours is just top of the class with a drawbridge, a moat, and armed guards.
To act in your recovery now, start by moving and making a plan.
How Can I Form A Long-Term Plan For Conquering Chronic Pain?
We’re glad you asked!
Having a long-term plan will be your biggest asset in recovery.
Consider the following questions to make a personalized plan that will work for your lifestyle.
Setting a Goal
Your goals must align with you personally. We often make goals that don’t relate to who we are or what we care about. Instead, create goals that are realistic and have personal meaning to you.
For example, instead of the blanket goal of “I want to get rid of my pain,” think along the lines of “I want to go on walks with my kids comfortably” or “I want to be strong and be a good support for my family.” It’s simple, it’s got meaning, and it’s personalized to you and your needs and wants.
Where Are You At Now? – Current Fitness
Your activity level should be on par with where you are fitness-wise. That way, the pace of progress you see is a level you feel comfortable with. If you have never been active before, that’s okay! You may just need more consideration to think through what reasonable expectations look like.
Modern Movement Clinic always keeps your needs and abilities in mind while pushing you towards progress.
Where Are You At In Life? – Personal Situation
Life gets crazy, doesn’t it? Maybe you’re a new parent. Maybe you have a new job that is a bit more demanding. Maybe you’re taking care of your partner or a loved one. Everyone has their own specific situation that we consider.
This doesn’t mean that you’re not prioritizing your own health. We just need to find out when that should be and what it looks like.
Consistency – Can’t Water Your Lawn With a Bucket
The biggest myth in any rehabilitation program? That progress requires 120% effort, all the time.
On the other hand, you can’t put in 0% effort and expect results. However, consistency is the single most important factor in reaching pain-free progress.
Lighter and less aggressive exercises more frequently are much better than heavy and aggressive exercises a couple of times a week. Good consistent input yields good consistent output.
Remember the pain alarm? Remember how doing good movement makes the alarm calm down? Imagine doing it consistently during the days and weeks. (Cue mind-blowing gifs)
Like the heading says, and like people of Denver and the mountain west know, you can’t expect a green lawn by slinging water out of a bucket into the backyard. Consistency is key.
Control – What We All Want Out of This
When we experience any pain that’s lasted for as long as it has, we can feel like we’ve lost control.
Feeling like you’ve lost control in your life makes you feel like your efforts don’t matter. Apathy towards your pain is the OPPOSITE of what we want. Instead, buckle in. You’re in the driver’s seat here and you get to control the acceleration and ETA most of the time.
Being aware of your recovery and progress gives you a higher success rate. Seeing progress encourages you to continue forward and maintain consistency.
Outcomes – Don’t Expect Easy Street
Any good plan has pitfalls. Some pitfalls we anticipate and others we may not see coming at all. We often expect because we follow the program that a positive response will result 100 times out of 100. Have you ever studied for a test and STILL did bad? Just me? Okay.
No, I’m not saying you must be physically active 24/7 for the rest of your life. But a mindset of setting goals of moving, self-efficacy, and consistency does make the work more sustainable. You may even start to notice other positive benefits in your life as a result.
Sometimes people believe that rehab from an injury should be a progressive upward slope. Injuries and pain are tough. Everybody responds differently and at different rates. We all come from different backgrounds and experiences with pain and injury which can manifest in recovery. However, by having a plan in place, we do create more control in the face of the uncontrollable.
What I Do Need To Do Now?
If you’ve gone this far, don’t quit now! (That’s a joke and motivation at the same time!) But it obviously means you care. I care too. The first thing is making sure you stay active. Whether you are an athlete or not, you don’t need to be sidelined. Wherever your pain is, we can do alternative exercises that can have these areas work in different ways.
You would get this from an assessment at Modern Movement Clinic and any other good movement therapist who practices with an evidence-based approach in the greater Denver and Jefferson County area. You may be a runner, skier, hiker, or just a weekend warrior but that doesn’t mean you need to put your activity to a halt. Movement is medicine.
Other Miscellaneous Questions
Active vs. Passive Therapy – Did I Say We Had to Move?
I like massages, vibration guns, heat, mobilizations, adjustments, and dry needling just as much as the next person.
We call this type of treatment passive care.
When you perform different therapeutic techniques to yourself, meaning moving in some capacity, we call this active care. A lot of research actually shows you recover faster when this is part of the plan. The adage “If you give a man a fish, you feed him for a day. If you teach a man to fish, you feed him for a lifetime” takes full shape here.
At Modern Movement Clinic, you have options.
Sometimes we need to manage the acute pain while also knowing that movement is medicine. Why not have both? Exercise and movement yield the best long-term results and you guessed it, give you control.
Should I Be Stretching My Chronic Pain Away? – What If I Said No?
Stretching for recovery is one of those ideas that has persisted for decades.
However, as more research comes to light, we have found that stretching out the area of pain can potentially inhibit progress.
It all comes down to “why do we feel like we need to stretch?” Most of the time, clients feel a need to stretch “because it feels tight.” But what if your tightness is a reaction from the body as opposed to a symptom?
Remember our conversation about the body’s alarm system?
The nervous system is kicking in here and sending you different messages. In this case, the nervous system makes the area “tight” to protect the area since it feels under threat. Oftentimes, when we stretch this actually makes the nervous system tighten up MORE.
At the Modern Movement Clinic, we commonly suggest simple movements that are pain-free or very minimal in pain that help let the nervous system know that we don’t have to have a “helicopter parent” overseeing everything.
The easiest way to answer this for yourself is if you have been doing stretching already, what effect would you say it has had on your pain? If you feel it has progressively helped, great, and continue to do it. If you feel it hurts or hasn’t made any noticeable progress, cut it out!
What About Massage Or Cool Gadgets? – I’m Hip, Too!
In short, absolutely!
My answer to these things is “if it feels good and you don’t notice any repercussions…go for it!” Sometimes relaxing by getting something like this is the step you need to move out of the pain phase.
Foam rollers, vibration guns, cupping, performance tape…it’s all fine and we say use it if you see benefits. Many have their theory of what it is doing but they are all just modifying the sensation of pain and that is it. Although these should not be viewed as a long-term solution to the problem and don’t address the problem in how it likely manifested, they have benefits that many people see every day.
To Ice Or to Heat, That Is the Question!
We get the question, “Should I use ice or heat for my pain?” all the time, and for good reason. The RICE (rest, ice, compression, elevation) principle has been around for years and it’s just easy, right?
At Modern Movement Clinic, we know that the evidence has shown that ice doesn’t help in the way that we previously thought. In fact, the creator of the RICE method has publicly addressed his theory to say as much. We suggest using what feels best to you.
For example, in Dr. Jesse’s personal experience with pains he’s had (yes, he’s human), he enjoys heat more so than cold because he PERSONALLY feels like it relaxes his body more.
If it helps, use it. If you don’t see a benefit, you don’t need to continue to do it. If it makes matters worse, look elsewhere.
In the end, use what works as there are no rules to this, just guidelines.
Signs To See Medical Specialists That Aren’t Physical Therapists or Chiropractors
Chronic pain isn’t ALWAYS caused by a mechanical event. Chances are, however, you have already covered this part but we always like to make sure we cover our bases.
Pain can stem from an underlying cause. However, this scenario is very unlikely. As in, only 1% of cases. The other 99% of cases fall under the non-emergency category and rehab is the best initial step. This is when you would see a movement therapist like at Modern Movement Clinic.
However, for the 1% of those with an atypical case, we want to make sure you don’t ignore the signs to get the help you need.
If you are experiencing any of the symptoms below, you should seek out further medical advice, such as the Emergency Room, a medical specialist, or your General Practitioner depending on the situation.
History of Cancer
History of Vascular Disease
Unexplained Weight Loss
Consistent and Ongoing Infection or Fever
Prolonged Use of Steroids or Any Drugs That Inhibit the Immune System
Significant Trauma (Accident or Trauma Recently)
Prone to Fractures (Osteoporosis or Osteopenia)
Loss of Bladder or Bowel
Numbness and Tingling In the Groin Area (Saddle-Like Paresthesia)
Numbness and Tingling In Your Arms (Especially If Upper And Lower Body)
Major And Noticeably Motor Weakness In Lower Extremities (Hard Picking Up Legs or Drop Foot)
Limited Spinal Range of Motion (All/Majority Directions Supremely Limited)
Neurologic Findings Persist Beyond One Month
Visual & Auditory Disturbances
Severe or Unexplained Headaches
Trouble With Balance & Coordination
Chest Pain, Unusual Swelling, or Shortness of Breath
What to Expect From Your First Visit (And Practitioner)
Whether you work with Modern Movement Clinic in-person, online (oh yeah, we can do that, too), or with another therapist, make sure the first part of your recovery comes from working with a licensed healthcare professional.
Not your gym buddy, Jim, not your parents, and not your athletic sibling that you still resent but won’t admit it …unless any of them are licensed healthcare professionals who have trained and passed examinations to do so.
Many other professionals in the health and wellness industry are great additions to helping some areas of your chronic pain, but they are not trained to make clinical assessments and diagnoses as this is out of their scope of practice.
Let’s see what else your examination and experience look like with a practitioner from Modern Movement Clinic.
Don’t Wear Your Sunday’s Best (Unless It’s Athleisure)
If you’re coming to Modern Movement Clinic, whether an online consultation or a live visit in our Denver-based clinic, you’re going to more.
We get that sometimes you might be coming from work or going to work, but to get the answers you seek, we need to see how you move. Bring a change of clothes if you’re coming from another activity. Dress in comfortable clothing that allows for freedom of movement.
Are You A “Fashionably Late” Person? Read This Then
We’ve all been there, right? Traffic hits, weather turns, kids are screaming bloody murder, and inevitably time speeds up. It happens!
However, we recommend that you leave 10 minutes earlier than what the navigation says on your phone if it is your first visit. This ensures you find our location without being rushed when we sit down to chat.
This can take away from the emotional component of your pain and limit our ability to get the entire picture of what is causing your pain.
The first visit lasts around 90 minutes unless indicated by the practitioner. Corresponding visits will be based on the time you and the practitioner agree upon.
We’re Pretty Modern – Doing Things Digitally
We want to remove as many complications as possible for you.
We have an online booking option that allows you to take control of your recovery from the comfort of your home. Your payment is taken care of online through our scheduling app, your exercises are all digital, and a recap of your session emailed to us after you finish.
After all, it is the 21st century and your rehab and performance should reflect your needs today.
We’re Here For You. Not Our Egos.
Finding the right healthcare provider can be hard as it sets the tone for your recovery process. Some things to look for are listed below:
- Does Physical Testing – clinical and physical examination is paramount as it relates to what your goals are. It takes time and analysis to do this. You shouldn’t be rushed in and out of the space. We don’t use special gadgets and gizmos to do the analysis unless it is needed and even then, they shouldn’t be regarded as cure-alls but as an adjunct. All that glitters is not gold quite often.
- Focuses On You – at the Modern Movement Clinic in the Denver, Colorado area, you’re not a number. You’re not even a deductible. If you come here, you are a priority. What matters to you in your recovery? That’s our priority, too! Did we just become best friends?! Now let’s get you better so we can go do karate in the garage.
- Lets You Have Independence – we like you moving and being your best self. We realize some people have an easier time with that than others do and that’s okay! We aren’t pushy at Modern Movement Clinic. You have options. Sometimes options can be confusing, so we always make time to talk with you about your options so you’re well-informed about what option fits best for you.
- Grows With Your Goals – things can change in a recovery plan, and you want someone who can change with you. When you improve, you don’t want to be doing the same things right? BOOOORRRRIIIINNNGGG. At the Modern Movement Clinic, we are constantly tweaking, progressing, and altering movements to fit your needs and goals.
What Kind of Questions Should Be Asked During the Exam For Your Chronic & Persistent Pain?
During a history, we are creating the story that surrounds your challenges, getting more background information, and asking you things you may have not considered yet. Together, these help you inform your own goals.
Here are some types of questions that should be asked in your history:
- Where is your pain located?
- When did this start?
- Is this something that is constantly present, or comes and goes?
- What does the pain feel like? Not just physically but emotionally and mentally
- Does this change with activity?
- What does your pain scale look like?
- Are there any medications or interventions you do now that make it better? What about things that make it worse?
- Do you have any numbness, tingling, or weakness of the area or other areas corresponding with your pain?
- What’s been your experience with this pain thus far? Have you already seen anyone for this?
- How is this chronic pain inhibiting your day?
- What is this pain taking away from you right now?
- If you had no pain at all right now, what would you be doing differently?
- Do you have any short and long-term goals after reading those last two questions?
Whether it is getting back to playing the piano, hitting a PR in the Colfax Marathon, or simply catching your littlest one running around the house, our goals for recovery should reflect where we are. We all need to have these types of questions discussed to set the best and most successful plan. You’ll find that at Modern Movement Clinic.
You might be thinking at this point “Okay Doc…you sound like you know your stuff. What’s next?”
What’s next is letting all this sink in.
Modern Movement Clinic is a cash-based practice that prides itself on how efficient, well-read, and communicative we are with who we work with. Notice we said ‘with’ and not ‘on’. You’re not a patient. You’re our client and with that comes a working relationship.
The time you spend with us is exactly that, with us. If you booked with Dr. Jesse Riley, your time is spent with Dr. Jesse Riley. That’s a rare thing in clinics today and quite honestly what separates insurance-based clinics from cash-based clinics. Don’t read that the wrong way. The insurance-based clinic is trying to make ends meet by commonly having a higher volume of people at one time but the system itself needs a “modernizing” of its own. That’s for another post though.
In any recovery plan, there will be ups and downs, but when working with someone like a movement therapist and chiropractor at Modern Movement Clinic for your chronic pain, know those downs will come with a little motivation, a little advice, and a lot of movement to get us out of that and moving back towards our goals.
We see cases of people having chronic and persitent pain for days, weeks, months, and even years. For as long as it goes on, don’t let this dictate that will take as long to eliminate it. At Modern Movement Clinic, you’ll gain the empowerment to know you can control this, enlightenment to know what your body is telling you, and education to carry with you moving forward.
We’re only a few clicks or a phone call away and we appreciate your consideration.
***Content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition.***