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What's Chiropractic & What do Chiropractors Do? (article taken from: American Chiropractic Association link: http://acatoday.com/level2_css.cfm?T1ID=13&T2ID=61 ) Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.  Doctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling. The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.” The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.  Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours. In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. When other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition. Doctors of chiropractic may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate. Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other members of the health care team. Some Common Conditions We Treat by David Lee, DC These are some of the more common conditions we see in our office. I'll be brief and to the point as possible so that you don't have to read an entire textbook to have a general understanding of the conditions. These are examples of common conditions only - if you have pain it is best advised to get a thorough examination at our office to rule out any complications & arrive at the correct diagnosis/treatment plan for your case. If finances are a problem, we can offer you a free consultation to do a brief subjective history of your complaint to see if we can help you. Back Pain - To understand this condition, we need to know: What type of pain is it - Is it dull or sharp? Is the pain in the low back, mid back between the shoulder blades or is it farther down at the base of the tailbone around the two dimples above the butt? Is the pain constant or does it come and go depending on activity? Does the pain wake yo  u up at night? Do certain movements make the pain worse such as bending a certain direction, sitting or walking? What makes the pain better other than rest? Is the pain worse in the morning or the afternoon? Is there any numbness or tingling down the legs or butt? Is there any weakness? How severe is the pain - is it extremely painful to the point of no return or is it tolerable but annoying?Pain with numbness and tingling requires more extensive testing and imaging to diagnose the problem. Prolonged numbness and tingling (radiculopathy) is never considered to be normal in any part of the body - unless you're constantly banging your elbow to set a new world record on how long you can keep the funny bone going! Numbness and tingling is usually caused by a nerve impingement somewhere along the nerve originating from the spine to the area where you feel the sensation. Some of these cases can be due to disc degeneration where the disc shrinks with age producing arthritis, disc bulges, herniated discs, decreased joint space causing more intense pressure. It may also be caused by muscles such as the piriformis muscle that entraps the nerve causing numbness and tingling to the knee called sciatica. Full orthopedic/neurological and imaging testing is recommended to identify the problem. Pain without numbness and tingling can be due to spinal joint inflammation (facet syndrome), muscle/ligament tears, posture, joint irritation, increased or decreased lumbar curve, spinal adhesions. Spinal curves are important! Many are familiar with the stereotype 'beer belly' physique that causes an increased curvature in the lower spine causing muscles to be overworked. When muscles are overworked or fatigued, they tighten and may spasm to protect the area. Those muscles must be strengthened or opposing muscles such as the hamstrings must be strengthened to reduce the excessive lumbar curvature of the spine. If the spine can't support the weight, the muscles have to compensate to do the work - and if they are not strong enough, you're in pain.  Previous injuries such as high school football, ballet or some skydiving accident where your parachute didnt open and you managed to survive, always seem to have an effect on people as they get older. We know for a fact that certain injuries greatly accelerate the degeneration in the spine within several years causing arthritis and disc degeneration resulting in chronic back pain. Other injuries seem to deposit scar tissue and adhesions in muscles that limit the range of motion causing re-occuring back pain. Treatment would greatly depend on the diagnosis but generally speaking, soft tissue treatment on tight/spasmic muscles with stretching will help reduce the amount of pain and tension plus increase mobililty. Chiropractic adjustments help mobilize the spine, break down adhesions and mechanically correct structural problems allowing for better movement and less restrictions. Physiotherapy is usually required to strengthen and stabilize muscle groups so that muscles can handle the load. Headaches - Headaches are medically grouped into several categories depending on the symptoms, how they happen and what areas they affect the most. The most common one is the tension headache where neck stiffness  and soreness due to poor work ergonomics cause a throbbing, band like headache around the temples of the head. Migraines are also a common problem. Migraines are classified into two types which are classic or non classical Migraines. The type you have depends on the 'aura' or signs that occur or trigger a migraine. These can be food items, sensitivity to lights, double vision etc. Other forms of headaches include cluster headaches which may be described as sharp pains behind the eye going to the back of the head as well as sinus headaches which produce tearing and a runny nose plus gets worse upon head movement. Clinically, headaches seem to overlap in symptoms which makes diagnosing the different types very difficult.Treatment: For some headache & migraine sufferers, chiropractic adjustments and massage therapy seem to help. In certain cases, the occipital muscles (muscles at the base of the skull at the back of the head) tighten and spasm, resulting in neck stiffness and possibly triggering headaches. This is especially true for tension & cluster headache sufferers where massaging the occipital muscles and adjusting the occiput may relieve the tension. Neck Pain - Some causes of neck pain can be due to trauma, posture or degeneration. Traumatic causes of neck pain include sports injuries, car accidents and recreational activities. Some of these injuries may cause ligament and muscle tears with the possibility of damaging a disc - provided there are no fractures. This condition is commonly referred to as whiplash, which results in muscle spasms and possible chronic neck pains after the initial conditions have gone away.  Neck disc degeneration is greatly increased with age after trauma. Pain patterns may include numbness and tingling down the arms to the hands & wrists. Many people confuse carpal tunnel with neck radiating pain, but carpal tunnel is often found in the wrist & hand while neck radiculopathy occurs in both hands and arms. Bulging or herniated discs may also produce similar symptoms. The most common cause of neck pain we see in our clinic is due to poor posture and work ergonomics which is especially true for most white collar workers that have to sit in front of computers for most of their day. Looking down at computer screens for prolonged periods of time cause great strain on the neck muscles. Your head is not light! Having to hold a bowling ball all day will fatigue even the strongest of muscles which cause stiffness and soreness producing a condition called ' Forward Head Posture ' or ' Anterior Head Carriage '. Headaches, Neck, Mid-back pain and Jaw grinding/clicking (TMJ) are common symptoms of this condition which gets progressively worse over time if posture is not corrected. Treatment for some of these conditions involve Chiropractic adjustments in the back and neck to increase movement and decrease restrictions followed by aggressive physiotherapy and rehabilitation to strip. stretch & strengthen muscle groups that are in spasm. In the case of posture, the midback and occipital muscles must be strengthened to pull the head back away from a forward position so that we balance the head on top of our bodies and thereby relaxing the neck muscles. Shoulder / Rotator Cuff - Here's a common case that sometimes baffles the best of minds. Rotator Cuff injuries can be troublesome because most people tend to need to use their arms all day. Shoulder injuries encompass a broad range of conditions such as tendonitis, bursitis, ligament & muscle tears, and dislocations to name a few. Severe rotator cuff injuries in which a person can't move their arm past a certain position or exhibits weakness require extensive orthopedic testing to determine which muscle groups or structures are affected along  with x-ray or MRI. Traumatic injuries are usually the culprit for these conditions but sometimes shoulder injuries happen with no identifiable trauma. We've had many cases of people waking up unable to move their arm or exhibit severe restricted range of motion producing pain - and they don't remember doing anything. Such cases of frozen shoulders or muscle tears require extensive and aggressive physiotherapy.Treatment: For a majority of inflammation and muscle/ligament injuries, intensive physiotherapy is recommended which includes therapeutic ultrasound to break down scar tissue and adhesions and promote increased blow flow. The newest treatment in physiotherapy is the Cold Laser ( www.microlightlaser.com ) which promotes a dramatic increase in healing for some patients. Massage therapy utilizing deep stripping and stretching techniqes are needed to reduce pain and increase range of motion in addition to breaking down adhesions. If a ligament or muscle is partially torn, extensive rehabilitation involving supervised exercises need to be done to restore the strength and motion. There are a very limited number of Chiropractic adjustments for the shoulder and I personally don't recommend these for acute cases, however adjustments in the neck and mid back between the shoulder blades help facilitate mobility and decrease tension. We usually co-treat most severe cases with a pain management specialist or orthopedic surgeon. Knee Pain & Foot Pain - We see alot of athletes or weekend warriors with knee pain, shin splints & foot arch pain. For people that jog or begin to jog, we commonly see knee pain due to tight ilio-tibial bands, which are the muscles to the outside of the thigh. When these bands of muscle tissue become too tight, they pull the knee cap to the outside as you bend causing clicking and grinding of the knee resulting in inflammation. This condition is known as patellar-femoral tracking dysfunction and is associated  with chondromalacia patella (which is the wearing down of the inner surface of the knee cap). Knee pain could also be caused by trauma in which case a torn meniscus or ligament may be present. Extensive orthopedic testing is required to find out which ligament or meniscus is damaged and an MRI or orthopedic consultation may be required. Foot pain in general may be due to a number of things including loss of the natural arch, tendonitis such as plantarfascitis (muscle/tendon on the bottom of the foot), ligament sprain etc. Your feet may require orthotics to evenly balance the weight of your body and restore the arch in the foot. Treatments: Usually with knee and foot issues, we provide extensive physiotherapy treatments encompassing therapeutic ultrasound to break adhesions and decrease inflammation, cold laser therapy to speed up healing, and stripping & stretching of tight muscle groups to restore mobility and relieve tension. Strengthening exercises are required on antagonistic muscles to provide the stability and strength required for normal function. When it comes to ankle sprains, wobble board exercises must be done to restore function or it may chronically re-occur. Chiropractic adjustments to the sacro-iliac joints and feet have also been very effective in restoring range of motion. These are just some common conditions we see in our office. There are so many conditions that chiropractic can help with including optimizing athletic performance. Please know that anyone seeking help will always be welcomed in our office regardless of financial stature. Sincerely, David Lee, DC Owner, ChiroHealthQuest Chiropractic Group Chiropractic Research
“Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.” – Journal of Manipulative and Physiological Therapeutics, Nyiendo et al. (2000), In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care. -- British Medical Journal, Korthals-de Bos et al. (2003) “Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically important differences in pain and disability improvement were found for chronic patients.” – Journal of Manipulative and Physiological Therapeutics, Haas et al. (2005)
“In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group (general practitioner). Manual therapy scored better than physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care.” – Annals of Internal Medicine, Hoving et al. (2002) “Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.” -- Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001) -- Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995) Cost Effectiveness “Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.” – Journal of Manipulative and Physiological Therapeutics, Haas et al. (2005) “Chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care. Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks.” -- American Journal of Public Health, Hertzman-Miller et al. (2002) “Chiropractic is the largest, most regulated, and best recognized of the complementary and alternative medicine (CAM) professions. CAM patient surveys show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high. There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades.” – Annals of Internal Medicine, Meeker and Haldeman (2002) |
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Numerous studies have shown that chiropractic treatment is both safe and effective.