What this Middletown office treats

Start with the exam, not the label

Most people arrive with a name already attached to the problem — sciatica, a pinched nerve, a slipped disc, tension headaches. Sometimes the name is right. Often it is a description that has hardened into a diagnosis somewhere between a website and a relative’s opinion, and the actual driver is a joint, a nerve root, or a muscle nobody has examined yet.

That is why every case at Middletown starts the same way regardless of what you came in calling it: history, orthopedic and neurological testing, measured range of motion, and a hands-on exam. It takes 60 to 90 minutes and it decides everything that follows. Two people with identical complaints can leave with completely different plans, and one of them may leave with a referral instead of a plan.

A short list belongs in an emergency department rather than here, today rather than at a future appointment: loss of bowel or bladder control, numbness through the saddle area, progressive weakness in an arm or leg, the worst headache of your life, or severe pain following a significant crash or fall. If any of that describes you, stop reading and get seen.