What actually happens at your first visit at Endura (the honest version)

Most clinic websites describe the first visit in a way that sounds reassuring but doesn’t tell you much. “We’ll do a thorough assessment.” “We’ll discuss your goals.” “You’re in great hands.”

This is the actual walkthrough.

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Before you arrive

Book the first visit online or call Dr. Devon if you prefer to talk first. The booking workflow collects the information needed before you arrive so the 50 minutes can stay focused on assessment, treatment, and the first plan.

If you’ve had recent imaging (X-ray, MRI, CT), bring it. If you have a referral letter from your GP, bring that too — though it’s not required. If you’ve tried other treatment, it helps to know what you did and how it responded.

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The assessment — the first part of 50 minutes

The College of Chiropractors of Ontario’s standards of practice require a thorough initial assessment for any new patient presenting with a musculoskeletal complaint. At Endura, the assessment is designed not just to meet that standard but to answer a specific question: what structure is actually failing, and why?

“Dr. Devon Savarimuthu, DC, CSCS, says: ‘The most important thing I can do in the first visit is be honest. If your case needs imaging before we start, I’ll tell you. If your case is outside my scope, I’ll tell you that too.’”

The assessment has four components:

1. History This is a structured conversation, not a form. Where is the pain? When did it start? What makes it worse? What makes it better? What have you tried? The pattern of your pain — time of day, loading context, activities that provoke or relieve it — often tells the structural story before any physical test is done.

2. Movement screening I watch you move through basic functional patterns: how you hinge, how you squat, how you rotate. This isn’t about flexibility. It’s about where load goes in your body when you move. The hip that doesn’t extend. The thoracic spine that doesn’t rotate. These compensations show up in movement before they show up in pain.

3. Physical tests Specific tests help compare possible contributors and reproduce the patient’s familiar task. For lower-back pain, that may include lumbar movement, hip movement, neurological findings, strength, and load tolerance. For neck or hip pain, the tests change with the history and red-flag screen. The goal is a defensible working diagnosis, not false certainty from one test.

4. Neurological screening Is the nervous system involved? Are there signs of disc herniation, nerve root compression, or cord involvement that would change the treatment approach or indicate a need for imaging? This screening catches the cases that need a referral before treatment begins.

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What a written plan actually looks like

After the assessment, you get two things clearly before you leave:

A working diagnosis — what the findings suggest, what remains uncertain, what has been ruled out, and which baseline task or measure will test whether the plan is working.

A treatment plan — what to do now, what care should test, and when the visit schedule should change. The plan is clear enough to question and review.

You will also know what should change first and when the plan needs to be reviewed.

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Treatment begins in the same appointment

When it is clinically appropriate and safe, treatment begins after the assessment in that same visit. That may include joint work, soft-tissue care, exercise, or an immediate change to the load or positions aggravating the problem.

If imaging, medical referral, or another step should come first, I will say that plainly instead of treating for the sake of filling the appointment.

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Progress reviews — and what they mean

Follow-up care has regular progress reviews. At each meaningful decision point, I tell you whether the plan should continue, change, or stop:

1. We’re on track. The structural pattern is responding. Keep going.
2. The plan needs adjusting. Something in the initial diagnosis was incomplete or the response is different than expected. We revise.
3. Your case needs something beyond what I do. This might mean imaging, a referral to a specialist, or a different type of care. I’ll tell you clearly, and I’ll help you find the right next step.

The review exists because care frequency should not run on autopilot. The plan can continue, change, step down, or refer elsewhere.

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What happens if you’re not a fit

The Endura Method works best for patients who want to understand the problem, begin treatment, and do the work between visits. Visits can be closer together during an injury and spread out as capacity returns.

It’s not the right fit for everyone. If your case needs something I don’t do — chronic systemic pain, complex psychological contributors, active fracture or recent surgical hardware — I’ll tell you that on the call before you come in, or at the assessment if it becomes clear then.

Referring someone out when it’s the right call isn’t a failure. It’s the whole point of having a proper assessment.

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Related reading

• The Endura Method
• First visit
• Lower back pain treatment at Endura

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Ready to start?

Book the first visit, or call (647) 951-5841 to speak with Dr. Devon.

→ About the Endura Method

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Dr. Devon Savarimuthu, DC, CSCS practises at Endura Chiropractic, 3440 Yonge St, Lawrence Park, Toronto. Entrance on Deloraine Ave. Free street parking.