We tell you exactly how we escalate.
Asynchronous care is only responsible if it knows its limits. Here is the actual logic Allostatic uses to keep you safe — not a black box.
The guardian principle
Don't over-escalate — but never miss a true emergency. Allostatic tunes for recall first (catch every emergency), then precision (avoid crying wolf).
Emergencies — care now
4 patternsIf any of these appear, Allostatic stops intake and directs you to 911 or the nearest emergency department. No asynchronous management.
Cauda equina syndrome
Spinal cord / nerve-root compression- New trouble starting or controlling urination, or leaking
- Numbness in the groin or 'saddle' area
- New weakness in both legs
- Loss of bowel control
Allostatic does: Immediate direction to emergency care. No async management.
Cardiac / vascular event
Heart attack, aortic involvement- Chest pain or pressure, especially with arm/jaw/back radiation
- Pain with shortness of breath, sweating, or nausea
- Sudden tearing back or chest pain
Allostatic does: Stop intake; call 911 / emergency services now.
Stroke / cervical artery
Vertebrobasilar insufficiency, stroke- Face drooping, arm weakness, slurred speech
- Sudden severe headache unlike any before
- Dizziness with double vision, drop attacks, or difficulty swallowing
Allostatic does: Immediate emergency direction; FAST guidance surfaced.
Mental health crisis
Suicidal ideation / self-harm- Thoughts of self-harm or suicide
- Feeling hopeless or that others would be better off
Allostatic does: 988 Suicide & Crisis Lifeline surfaced; warm human escalation.
Urgent — be seen today
5 patternsThese need a same-day, in-person evaluation before any movement plan. Allostatic routes you and notifies a clinician.
Deep vein thrombosis
Blood clot- Calf swelling, warmth, redness — usually one leg
- Tenderness deep in the calf
- Recent surgery, long travel, or immobilization
Allostatic does: Urgent same-day medical evaluation directed; no exercise loading.
Possible fracture
Bone fracture- Significant trauma or fall
- Unable to bear weight or use the limb
- Point tenderness over bone, deformity, or rapid swelling
Allostatic does: Directed to urgent in-person medical care for imaging.
Systemic infection
Spinal/joint infection, sepsis- Fever, chills, or night sweats with the pain
- Hot, red, swollen joint
- Feeling generally unwell, recent IV drug use or immune compromise
Allostatic does: Urgent medical work-up directed before any movement plan.
Cancer screen
Malignancy / metastatic disease- Unexplained weight loss
- History of cancer with new deep, constant pain
- Night pain not relieved by position change
- Age over 50 with first-time unexplained back pain
Allostatic does: Referred to a physician for work-up; not managed as routine MSK.
Progressive neurological deficit
Nerve / cord compromise- Worsening weakness, numbness, or clumsiness over days
- Dropping objects or tripping more often
- Changes in both hands or both feet
Allostatic does: Urgent referral to a physician for evaluation.
What Allostatic is — and isn't.
Allostatic is
- A licensed virtual physical therapy practice for movement, MSK, and longevity
- AI intake with a doctor of physical therapy in the loop
- Able to refer you to a physician or specialist when something needs one
- A safe first stop for most aches, injuries, and recovery questions
Allostatic is not
- An emergency service — call 911 for emergencies
- A prescriber of medication — physical therapists don't prescribe
- A pediatric service (18+ for now)
- A replacement for in-person care when an exam or imaging is required
Allostatic's AI provides triage support and history-taking; it does not make a diagnosis on its own. Every clinical decision, plan, and referral is made and owned by a licensed doctor of physical therapy exercising independent professional judgment. The triage screening described here is decision support, not a regulated diagnostic device.