Nobody else does this because it is really hard.
I get this question about once a week from a patient who is getting better and previously failed with physical therapy, failed with chiropractic treatments, and was thinking about surgery. The answer is because this level of diagnosis and treatment takes a lot of work, and it is really hard.
Your doctor needs to embrace the complexity of the human body.
The first challenge is to look at injuries objectively. Every technique system and even school takes the vastly complex human body and tries to simplify it into one variable. If you are a chiropractor, that means adjusting, if you are a physical therapist that means stretching and strengthening, if you are a medical doctor that means medication and surgery.
Your doctor will only find what he or she has been trained to find.
Looking at musculoskeletal problems objectively is absolutely necessary to figure out a patient's problem. It is difficult because it means that I need to look for problems in patients that I wasn't taught to find. I pride myself on establishing a complete and accurate diagnosis for every one of my patients. That part is mentally challenging, but what goes on in my office is also physically challenging. The main reason I am able to fix problems for patients who have been to other healthcare providers, is because I specialize in finding and fixing muscle adhesion.
Manual Therapy is a skill.
Treating adhesion is physically exhausting because it is a skill. The ability to feel an adhesion takes a ton of training and breaking down adhesion takes even more work. You have to learn the right tests to figure out which muscle is the problem. Then you have to feel that muscle which usually is deep to other muscles and many times very small. Once you feel the muscle you need to find the adhesion in that muscle. Then comes the most challenging part, creating tension against the adhesion at the right depth while the patient's body moves.
This is different, this is better.
This is not, "Rub where it hurts." This is not, "Stretch what feels tight." This is not, "Crack where it hurts." This is not, "Do these three exercises for low back pain." This is detail specific diagnosis and treatment. And that is why this works when other things do not. It is hard, humbling work, but it is worth it. Most providers do not want to put in the work and that is why nobody else does this.