Does Everyone Need to See a Chiropractor?

When people first find out I'm a chiropractor, there are two common responses.  First, is that they have been to a chiropractor and want me to "crack" their back or neck for them, often implying I should do it right there in the restaurant or wherever we may be.  Second are people who say, "I don't need to see a chiropractor.  I don't have back pain."  Should people who don't have pain go see a chiropractor?

It wasn't all that long ago that people only saw medical doctors when they were sick.  They only consulted a dentist when they had a tooth ache.  I'm old enough to remember those days.  The idea of consulting a health professional for prevention of problems is a fairly recent phenomenon.  Most of our society now sees the logic in seeing an MD, dentist, or optometrist before problems arise for either prevention or early treatment.  Using the same logic, it also makes sense to see a chiropractor before back pain, neck pain or headaches become problems.

Since every person has a spine, everyone has the potential to develop spinal problems.  Statistically, 80% of Canadians will experience back pain over the course of their lifetime.  For many of those people it will be debilitating; interfering with their ability to work or perform activities of daily living.  But the effects of spinal problems are not limited to pain.  Abnormal function of spinal joints results in irritation to adjacent spinal nerves.  This produces alteration of nerve function through the entire path of that particular spinal nerve.  The result can be health problems distant from the spine itself.  A person can suffer detrimental effects of spinal problems without actually having pain in their spine.

Chiropractors use the term, Vertebral Subluxation, to describe abnormally functioning spinal joints with associated nerve irritation.  It may or may not be accompanied by pain.  Chiropractors are uniquely trained to detect and correct Vertebral Subluxations.  Like most conditions, Vertebral Subluxations can be most effectively treated when they are detected early.  Once abnormal spinal joint function becomes chronic, associated muscles adapt patterns where they are either too tight or too lax.  The ligaments of the joints are weakened.  Blood supply to the joints is altered as well.  It's also significant that chronically irritated spinal nerves heal very slowly.  Consequently detecting and correcting Vertebral Subluxations early, even before there is associated pain, makes a lot of sense.  Seeing a chiropractor when you don't have back pain, neck pain or headaches is as logical as seeing a medical doctor when you aren't sick or a dentist when you don't have a toothache or an optometrist when you can see well.  

If you are the type of person that only consults a health professional when they have an obvious problem, you likely won't grasp the logic of seeing a chiropractor when you don't have pain in your back, neck or head.  But that doesn't mean that you don't have spinal problems.  Waiting until you have pain can result in much more damage to the tissues and prolonged treatment.  As well when treatment is delayed the outcomes are often much less desirable.

As always whether you choose to see a chiropractor when you don't have pain is up to you.  But the logical approach is to get checked and assure your spine is working as well as it can so you don't end up with debilitating or chronic spinal problems.  Regular chiropractic adjustments should be part of your healthy lifestyle.

5 EASY STEPS TO BECOME UNHEALTHY IN 2013

If your New Year's Resolution is to become less healthy this year, I have 5 easy steps for you to take to reach your goal.

1. Inactivity – Lack of physical activity will result in increased risks of circulation problems, heart disease, diabetes, digestive problems, sleep disturbances, muscle wasting, joint problems and mental health issues. It's not just physical activity you want to avoid but mental stimulation as well. Being a couch potato in front of the TV might be a great place to start.  This will minimize both your physical and mental activity levels.
2. Poor Nutrition – Eat as much as you can of whatever looks good and tastes good. Go for high sugar, deep fried, highly salted, high calorie, processed and genetically modified foods.  Avoid natural foods, especially fresh vegetables (green = bad) and fruit.  Consuming large quantities of alcohol will also deplete your nutritional reserves.  Without essential building blocks the body is unable to repair itself and all its systems gradually breakdown.
3. Poor Supplementation – Don't take any supplements.  Rely on the nutrient deficient foods you choose (see #2) to supply what your body needs, even though these foods don't have what the body needs.  Even more detrimental to your health is to take supplements that your body can't absorb or that are in forms that the body can't utilize. Choose low quality supplements that contain toxins and fillers. This is sure to stress the body chemically.
4. Stress Response – Prolonged stress has been shown to be a causative factor in 8 of the 10 most costly illnesses. This includes cardiovascular disease, some cancers, gastrointestinal disorders, respiratory problems, spinal conditions, as well as mental health conditions.  So don't develop mechanisms to reduce your stress levels. Let your stresses eat away at you both mentally and physically.
5. Nerve Interference – Don't worry about using proper body mechanics. Ignore aches, pains and stiffness in your spine.  A poorly working spine affects the nervous system, which is the master control of the entire body.   It only takes as much pressure on a spinal nerve as the weight of a dime to reduce the function of that nerve by 60%. Then every tissue that nerve goes to will be compromised. Be sure not have any chiropractic adjustments to correct vertebral subluxations and reduce nerve irritation in the spine.

I don't know which of these steps will cause the greatest deterioration in your health, but be assured that if you do all 5 of them you will definitely go downhill this year. It doesn't get any easier than that!  Going downhill is always the easy path.

But perhaps becoming unhealthy isn't really your resolution for 2013.  Do you instead want to get healthier? Then you will want to do the opposite of the things I've listed. Increase your physical and mental activity, improve your nutrition, take high quality supplements, control your stress levels, and reduce nerve interference with chiropractic care.  As chiropractors we can help you become healthier this year.

Massage Therapy

To say I was over due for a good massage was an understatement.  I usually have a therapeutic massage every 3 - 4 weeks.  It had been almost 8 weeks.  When I go that long been massages, the experience is not usually real pleasant.  My muscles tighten up too much over that length of time.  It is easier on both me and the therapist when I get massaged regularly.  The massage therapists at Powers & Jans Centre don't usually have mercy on me either, so I try to avoid neglecting my massages.

There are good reasons to get a massage regularly.  Therapeutic massage produces a host of beneficial effects in the body.  These include improving flexibility, muscle tone, blood flow, and lymphatic drainage.  This helps promote soft tissue healing.  Massage helps to increase dopamine and serotonin levels in the body enhancing a person's sense of well being.  The immune system is also stimulated.  Massage is also extremely beneficial in stress reduction.

As chiropractors we find that therapeutic massage works very complementary to our chiropractic adjustments.  We regularly coordinate massages and adjustments for a variety of conditions including headaches, neck pain, back pain, and sprains/strains.  Shoulder, arm, hip, knee and leg problems also benefit from combined treatments.


From my personal stand point, I function better when I get a therapeutic massage on a regular basis.  Not only are my muscles less tense, but my overall motion is improved.  As part of an overall strategy to maintain health, all of the benefits listed above are important.  Having a healthy lifestyle involves putting together many pieces, all of which lead to the end result of health.  No one thing will make us healthy.  Therapeutic massage can be a very valuable component of a healthy lifestyle.  It certainly is for me.


Even though I regret that it was so long between massages, Amanda was kind to me.  There were a few areas that were quite sore as she worked on them but I felt so much better when she was done.  I promise Amanda, I won't go so long between massages again. 

Vomiting

Here's a question for you: If you throw up, does that mean your body is sick or healthy?  Think about it.

Let's look at this a little more closely.  Say you and your friends went out to a not so fabulous restaurant and ate some potato salad that wasn't properly stored.  Later that night all of you get stomach cramps.  What's the best thing for your body to do?  Throw the bad food back up; get rid of it, right?

What should your body do if the digestive tract is overrun by a pathogenic bacteria or virus?  How about if you lose track of how many beer you've consumed and the alcohol in your system is becoming toxic?  The best response for your body in both these scenarios is to vomit.  That's the healthiest reaction for the body.  A healthy body expels toxin substances from the upper digestive tract by vomiting.  Even though you may not feel perky, the body is not sick.  It is protecting you from becoming sick.

Too often we look at symptoms as being the problem rather than looking for the cause of the symptoms.  Just suppressing symptoms can be dangerous.  What if you stopped the vomiting in the situations mentioned and the toxins remained in the body?  Far more serious damage would occur. 

Back pain, neck pain, headaches, fatigue, sleeplessness, numbness, weakness; they are all just symptoms.  What is causing the symptoms?  That's what chiropractors try to find.   Our primary job is to find vertebral subluxations that are interfering with the proper functioning of the nervous system.  A variety of symptoms, not just pain, can occur when the nervous system is not working optimally.  The key is to look to the cause of the symptoms and not just mask the symptoms.  Just like inhibiting vomiting can be dangerous, covering up or numbing any symptom can also produce greater problems.


Symptoms, like vomiting, are a healthy body's signals to you that there is a problem.  You need to fix the cause rather than eliminate the symptoms.

Quack, Quack

Growing up I remember my older brother referring to the local chiropractor as the "Town Quack".  The term quack can be defined as someone who fraudulently pretends to have a medical skill.  This has often been used to describe chiropractors.  Chiropractors did not pretend to be medical doctors or possess the same skills as a medical doctor, rather we have developed our own particular skill set.  Chiropractors were seen as being unscientific and the chiropractic approach was labelled unorthodox.  Even though countless people were helped with chiropractic care, chiropractic was ridiculed and chiropractors labelled as quacks.

There has been a significant shift in attitudes in the past two decades as science has caught up to what chiropractors have observed clinically for a long time.  Independent researchers and policy makers are acknowledging the benefits of the unique chiropractic approach.  For the great majority of patients with both acute and chronic low back pain, neck pain, and cervicogenic headaches spinal manipulation (chiropractic adjustments) is recommended by authoritative groups who establish treatment guidelines in both Europe and North America.  These include the UK Evidence Report (2010), Joint Clinical Practice Guidelines from the American College of Physicians and the American Pain Society (2007), European Back Pain Guidelines (2004), Bone and Joint Decade Neck Pain Task Force (2006), and Evidence-Based Practice Center at Duke University (2001).  As recently as May of this year the British Medical Journal was arguing that primary care for patients with back pain and musculoskeletal problems should be transferred from general practitioners to chiropractors, osteopaths, and physiotherapists.

The reason for the wide acceptance of the chiropractic approach is that there is now a great abundance of research showing that chiropractic adjustments are amongst the most effective treatments available for neck pain, back pain, cervicogenic headaches, and other musculoskeletal conditions.  More of what we do as chiropractors is validated every year.   More of what we do still needs to proven.  But just because something is not scientifically validated doesn't mean it should be discontinued.

Even as chiropractic struggles to prove itself, much of what we consider to be scientifically accepted medical procedures actually remain unproven.  The Office of Technology Assessment, a branch of the United States Congress, with the help of an advisory board of eminent university faculty, has published a report with the conclusion that, " . . . only 10 to 20 percent of all procedures currently used in medical practice have been shown to be efficacious by controlled trial."  The British Medical Journal puts give the figure 15%. Therefore, 80% to 90% of medical procedures routinely performed are unproven.  Should all these procedures be discontinued until they are scientifically validated?  Probably not and neither should chiropractic procedures.  The very nature of scientific analysis and the vagaries of the human body may mean some very effective procedures may never be scientifically validated.

Only rabid sensationalist continue to call chiropractors quacks.  The term still doesn't apply because we are not medical doctors and we don't pretend to do medical procedures.  We practice chiropractic; a scientifically validated branch of the healing arts.

Auto Accidents

Summer, winter, spring, fall - there are auto accidents in every season.  The amount of damage done to occupants can be great even when little damage is done to the vehicle.  The human neck is particularly vulnerable in a motor vehicle accident but the low back, shoulders, jaw and knees are also commonly hurt.  When symptoms occur immediately, it can be a sign of significant injury, but often it can be several days before symptoms appear.  Even with a large amount of soft tissue damage, symptoms may not be severe initially.

To understand how damage occurs in an accident, basic physics needs to be considered.  The force from the mass of the impacting vehicles is transferred to the occupants who are of considerably less mass.  The result is a tremendous amount of stress on the soft tissues, particularly in the spine.  The head which weighs about the same as a 10 pin bowling ball is whipped backward, forward, or sideways depending on the location of the impact.  The term whiplash is used to describe these forceful, sudden motions.  The tissues of the neck are not nearly strong enough to withstand the forces from even a minor accident.  Damage is usually not limited to the neck.  The entire spine is usually affected and the extremities may be as well.

Because of the extensive damage, correcting the injuries can take a considerable length of time.  Chiropractic adjustments, low level laser therapy, therapeutic massage, nutritional supplementation, and exercise programs may all need to be employed to get proper healing of the injured tissues.  The sooner treatment can be started after the injuries occur, the better the results usually are.  Delayed or untreated injuries will heal with scar tissue which is less elastic and less functional than the original tissue.  This can result in accelerated degeneration and increased susceptibility to future injury.  Many chronic conditions can result from improperly treated whiplash injuries.  I can't tell you how many times patients have told me they wished they had looked after their injuries better following auto accidents that had occurred years earlier.  These people have come to realize too late that not properly rehabilitating the accident related spinal injuries has resulted in ongoing health issues.

In Alberta, only chiropractors and physiotherapists are authorized to establish treatment plans for injuries sustained in motor vehicle accidents.  This is because insurance companies recognize that physical treatment is far more effective than drug therapy or rest for the type of soft tissue injury incurred in auto accidents.  The insurance industry in conjunction with the government and health care providers has established a very streamlined system to assure accident victims received proper care.  All persons involved in an accident, regardless of who is at fault, are pre-approved to receive 10 or 21 treatments from recognized practitioners after assessment and recommendation by a chiropractor or physiotherapist.  Obviously I'm biased, but I think you should consult a chiropractor first.  I say this because we are the only profession specifically trained to find and adjust subtle spinal joint injuries called vertebral subluxations.  Unless the subluxations are corrected the spine cannot function properly.  Without a well functioning spine, a person cannot be healthy.

If you, or someone you know has been in a motor vehicle accident,  get your spine checked by a chiropractor as soon as possible.  The sooner treatment can begin the better the prognosis.

Stampede Time

The annual Medicine Hat Exhibition & Stampede is now going on.  It's the time of year when all things western are celebrated.  Living in Medicine Hat, it's hard not to be involved at least to some extent because ranching has historically and remains a big part of the economy of the area.  We have a large number of ranchers as patients in the office.  Although it's dangerous to generalize, but I'm going to state with confidence that as a group ranchers are wonderful people.  Their connection to the land, to their community, and to their roots helps them to develop great character traits.  

Work on the ranch can be physically demanding, involving heavy lifting as well as riding and wrangling.  I'd like to share a case of a rancher patient.  Todd (not his real name) came to our office with a complaint of low back and pain in both hips that had been persistent for the previous year.  The pain was constant and interfered with his sleep as well as making his work nearly impossible to do.  Riding his horse had become shear agony.  This was a serious situation for this 32 year old man!  No work, no pay when you are a self employed rancher.  Todd also had been experiencing headaches daily for the previous 5 years.  He discounted the severity of the headaches, but his wife insisted they were also interfering significantly with his life.

The exam we performed  showed several vertebral subluxations in Todd's spine.  We adjusted him using Activator Methods protocols.  After his first adjustment he experienced significant relief and was able to ride again. Even though he lives 2 1/2 hours from our office, he was desperate to get better and took the time necessary to come for treatment.   After the second adjustment he was able to lift light weight again and the headaches were very intermittent and mild.  After the fourth visit to our office Todd was pain free; no headaches, no back or hip pain.  He was pleased with the way his back now felt, but was ecstatic about how great it was to have no headaches.  Once the headaches had gone he realized how much they had been affecting him.


I don't necessarily like to relate cases where the results are nearly miraculous, but there is something very significant about Todd's case that can be a lesson for all of us.

One of the advantages of working on someone who rides horses regularly is that they usually have great core strength.  This is a real asset when rehabilitating the spine.  Strong core muscles are essential to support the spine.  Ranchers tend to respond very well to chiropractic care for this reason.  Many of the work activities, not to mention rodeoing,  can be hard on their backs, their strong core muscles help them recover quickly when they do injure themselves.
 
From my observations working with ranchers for many years now, their strong core muscles really protect their spines.  For those of us who do not have the opportunity to ride horses regularly, we have to find other forms of exercise to help us.  Our office can certainly provide you with some good core exercises.  Sorry, they won't be as much fun as riding a horse.

Flat Feet

A normal foot has three arches.  When the medial arch weakens, the foot flattens out and is commonly called a flat foot.  The more correct term is that the foot is pronated.  Because the foot is the foundation of the body's posture, when the foot is pronated it results in problems throughout the body.

Without the normal, flexible arches the foot is unable to push off properly when walking.  The result is an abnormal twisting of the foot.  This sets off a chain reaction that stresses the knees, hips, and low back.  The result can be pain and dysfunction in any of these areas.  People with pronated feet also fatigue more easily, they have more problems walking and athletic performance is hampered because it takes more energy when the foot doesn't work properly.

Way back in 1988 researchers, Otman S., et al., studied a number of women with flat feet.  Those that had their feet supported with custom orthotics had improved foot mechanics over the control group.  The researchers looked at more than just foot mechanics.  Very interestingly the ladies with the orthotic corrections consumed less oxygen, had lower blood pressure and lower heart rates both during and after walking!  Their calculated energy consumption was much lower than the women who did not have correction for their pronated feet.

This is a perfect example of how interconnected the body is.  Pronated feet don't just give you sore feet.  They can be the cause of knee, hip or low back pain.  More significantly, they can cause your entire body to work less efficiently.  Loss of stamina and productivity can result.  Quality, custom orthotics can correct the foot's mechanics and help the entire body work much more effectively.

If you read my post "I Don't Have a Foot Fetish" you may recall that I look at the feet in order to determine functional leg length difference.  While looking at the feet I also look for how the patient's shoes are wearing.  There are telltale signs of foot pronation or flat feet.  This can certainly be a complicating factor in not only pain a person may be experiencing but also their overall health.  Supporting the normal arches of the foot can have a huge impact on a person's well being.

Mattresses

Getting quality sleep is a very important factor in achieving and maintaining good health.  Patients often ask for advise on purchasing a mattress.  The mattress needs to provide both comfort and support in order to be effective.  There are many good mattresses on the market and comparing them can be difficult when different brands have different features.  A knowledgable sales person is a great asset when trying to make a choice.  Certainly you will want to buy from a story that will give good service.  The cost of a mattress can look formidable but always keep in mind that you will be spending approximately one third of your life on mattresses.  That usually makes the price seem more reasonable.  Most mattresses come on sale regularly.

Consider your individual needs when shopping for a mattress.  Do you share the bed?  Do you have physical challenges, circulation problems, or a bad back?  Are you a large person who needs extra space or firmer support?

Look at the following areas when selecting a mattress:

• Size: A mattress should be large enough to accommodate not only yourself comfortably, but also your spouse if you have one.  Remember that it is normal for people to move and turn in their sleep and you don't want to distrurb one another.
• Support: A good mattress will support the body at all points while keep the spine in the same posture as when standing.  The heavier parts of the body, the hips and shoulders, should sink into the mattress enough to keep the spine in its normal alignment.  Too much or too little support and the spine will be contorted.  This can result in disturbed sleep and morning stiffness.
• Comfort: There should be a cushion on top that embraces the body and the surface should be breathable.  Natural fibres breath the best.  
• Durability: Look for materials that have know lasting quality.  Buy the best mattress you can afford  so you can have years of comfortable sleep.
• Construction: Metal coils provide the best long term support.  The greater the coil count in relation to surface area the more support and durability.  These coils may be concentrated more in the areas where there is more weight.  Connecting coils can reduce motion transfer.
• Warranty: The longer the warranty, usually the higher the quality of the mattress.  Never buy a mattress with less than 10 years warranty.  Keep in mind that the warranty is not necessarily an indication of how long the mattress will last.  It's there to protect you against flaws and defects.

Test the mattress.  Trying laying in all your usual sleep positions.  Make sure your partner is on the mattress at the same time doing the same thing.  Are you both comfortable?  Can you move without disturbing each other?  Sit at the edge of the mattress.  Does it support your weight or does it sag?  Take your time to do a mattress test.  Remember mattresses are a major purchase and can have either a positive or negative impact on your health over the life of the mattress.

Chiropractic vs Medicine for Low Back Pain

Many people consult chiropractors for their back pain only after they have tried everything else.  Researchers are now telling us this is the backwards approach to looking after acute low back pain.  A December 2010 research paper published in The Spine Journal compared medical care and chiropractic care for acute low back pain.  


You can read the abstract of the research paper by clicking the link above, but I will summarize the findings for you.  Acute low back patients where divided into two groups.  The first received "usual" medical care which consisted of a variety of treatments including medications, massage therapy, and physiotherapy.  The second group received chiropractic care for a period of 4 weeks.  The participants were evaluated for both pain and function in their lower backs at 8, 16, and 24 weeks after starting care.  Significantly, after 16 weeks 78% of the people in the medical care group were still taking narcotic analgesic medications.  They also had much poorer scores on the function of the low back.  That is the ability to perform normal daily activities.  At the 24 week mark, both groups had improved pain scores but the medical group showed no improvement whatsoever in back function.  The chiropractic group had significant function improvement.  Please note that chiropractic care was discontinued after 4 weeks while medical care was carried on throughout the study.


The authors of this study also specifically noted that "spinal manipulative therapy" (I prefer the term adjustment; see my 23/04/2011 post) is only effective when performed by chiropractors.  It is not effective when given by osteopaths, physicians, physiotherapists or other practitioners.


The data in this study shows that chiropractic care is astoundingly superior to medical care in improving the ability of people with acute low back pain to return to normal activities.  Although not specifically mentioned in the study, we can extrapolate that by delaying chiropractic care people under medical care will have a much more difficult time to returning to normal function.  They will suffer unnecessarily and the direct and indirect costs will be much higher.  The wise thing for people with low back pain is to consult a chiropractor first not last.