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.

A PEBBLE IN YOUR SHOE

I've heard stories of monks who would deliberately put a pebble in their shoe so they would constantly be reminded of the suffering of Christ. A pebble in one's shoe is certainly an irritation. The pebble is felt on every step and the foot soon becomes irritated to the point that even when resting the foot is sore. It becomes impossible to step properly on that foot. Soon the knee, hip and low back become sore as the body compensates for the foot that isn't working properly. Even the mind is affected. Where does your mind go with every step you take? To the pebble of course. You just can't wait for the opportunity to take your shoe off and get rid of that pebble. The pebble doesn’t have to be very big either.  I can't imagine deliberately putting one in my shoe!

Even though a pebble in your shoe is a small thing, it can affect your entire body.  There is another even smaller thing that can affect your body.  That is a vertebral subluxation.  A vertebral subluxation is when there is a loss of proper motion between the joints of the spine which is accompanied by nerve dysfunction.  There is usually associated swelling and muscle spasms as well.  Pain may or may not be present, but there will be loss of function whereever the associated nerves travel.  A vertebral subluxation is such a small, subtle lesion that it takes a great deal of training and practice to accurately detect it.  Finding and correcting vertebral subluxations is what chiropractors specialize in.

Physical, emotional or chemical stresses can all cause vertebral subluxations.  Once a vertebral subluxation is present it is much like a pebble in a shoe.  It is a constant irritation to the body.   Even though no pain may be present when the subluxation first occurs, the longer it exists the more severe the associated problems will be.  Initially there may only be stiffness.  Later muscles will spasm.  Pain may occur early in the process or may never be part of the symptoms.  Common symptoms include back pain, neck pain, headaches, pain in the arms or legs, numbness, tingling, and weakness.  Even the internal organs can be affected when the nerves going to them are not functioning properly.

Chiropractors are specially trained in the detection and correction of vertebral subluxations.  The only solution for a pebble in a shoe is to remove the pebble.  The only solution for a vertebral subluxation is to restore normal spinal joint and nerve function with specific chiropractic adjustments.

Injured

A short time ago I injured my right shoulder.  Just like most injuries patients present with, I really don't know what I did to cause the problem.  I can speculate about why the pain came, but it was most likely the result of an accumulation of several things.  One morning I woke up with discomfort in the shoulder.  It eased as I did my normal morning activities.  Shortly after noon, the pain returned and by evening I knew there was definitely some damage.  My sleep was quite disturbed that night and by the next morning the pain was more severe and my ability to use the right arm was restricted.

The things I did to heal the shoulder were:

1. Start treating the injury as soon I realized that the shoulder was injured.  The longer the time between injury and rehabilitation the longer treatment takes and the poorer the outcome will be.
2. Ice to reduce inflammation and improve circulation.  I also used BioFreeze when using real ice was inconvenient.
3. Stretching to tolerance to maintain joint mobility and function.  Motion is necessary for healing.  It assists both circulation and nerve function.
4. Chiropractic adjustments to the shoulder to normalize joint position and motion.  This helps the joint to heal faster and stronger.
5. Chiropractic adjustments to the spine to assure there is no interference to the nerves going to the muscles, tendons, and ligaments of the shoulder.
6. Low level laser therapy to increase the healing energy of the cells.  This speeds the healing process.  Laser improves circulation and normalizes nerve function.  Not only do injuries heal faster but they also heal stronger when treated with laser.
7. Proteolitic enzymes to reduce inflammation.
8. Therapeutic massage to improve circulation and break down adhesions in the injured tissues.  Massage also improves muscles balance to normalize the mobility of the injured joint.
9. Nutritional supplements including calcium, magnesium, vitamins C & E, glucosamine sulfate, chondroitin sulfate, and omega 3s to assure proper nutrients for healing.
10. Return to mobility and strengthening exercises as soon as possible to rehabilitate the injured joint.

This approach was very successful for me.  Within a week I was pain free and back to my normal activities including shoulder exercises.  When the pain is gone healing is still a long way from complete.  That's the nature of soft tissue injuries.  I know that even though I am feeling good, I still need to continue with adjustments, laser, massage and exercise to assure the best possible healing.  Did I need to do each of the items listed?  Perhaps not, but I want to have the best healing possible so I don't have problems with this shoulder in the future. 

Perhaps you have an injury.  The approach I took to heal my shoulder injury will be effective for virtually all bodily injuries.  Following the same basic procedure will help you to heal most efficiently and effectively.

Arthritis

"Oh, it's just my arthritis acting up."  Just my arthritis?  "My doctor told me that I have back pain because I have arthritis and I just need to live with it."  Live with the pain?  "It's nothing serious, just some arthritis."  Nothing serious?  "I was told I have arthritis in my muscles."  Now that's an impossibility!

I've heard each of these statements and similar ones many, many times.  They indicate a lack of understanding of what arthritis is.  By definition, arthritis is inflammation in a joint.  There are about 100 kinds of arthritis and each type has a different cause.  Different types of arthritis need to be treated differently and the long term effects are different.

The most common type of arthritis is degenerative arthritis also called osteoarthritis or degenerative joint disease.  When people talk about arthritis, this is usually the type they are referring to.  Although degenerative arthritis is found more frequently as people age, it can be found in younger people as well.  It is not a direct consequence of age, because not everyone develops it.  It may be present in only one joint or in many joints.

I prefer the term degenerative arthritis because it is the most descriptive of what is happening.  At some point in time the joint was injured.  This may have been a single incident trauma, but more commonly it's due to small repetitive injuries.  These repetitive injures may have only caused minor discomfort at the time, but the cumulative effect is significant damage to the joint.  Injured joints become inflamed, hence the term arthritis.  If injuries are not properly rehabilitated degeneration will result.  The pain is usually worse with activity but the most common symptom is stiffness.

Although there is no cure for degenerative arthritis, symptoms can be controlled and further degeneration stopped.  Joints are meant to move, however degenerating joints move abnormally.  Restoring as much normal motion as possible significantly reduces symptoms of stiffness and pain while halting the progressive degeneration.  Chiropractic adjustments are very effective at normalizing joint mobility.  The Activator Methods adjustments use in our office are non-traumatic and gentle.  Exercise to tolerance enhances the effects of the adjustments.  Chiropractic adjustments also assure that there are no vertebral subluxations interfering with nerve supply to the affected joints.

Low level laser therapy is also a very effective tool for helping sufferers of degenerative arthritis.  Near infrared laser light stimulates cells to heal.  Inflammation is reduced, circulation improved, and nerve signals normalized by the painless laser therapy.

A number of nutritional supplement have also been shown to be helpful.  These include: glucosamine sulfate, chondroitin sulfate, MSM, ASU, devils claw, boron, boswellia, bromelain, niacin, SAMe, tumeric, and willow bark,  NSAID drugs have been shown to only moderately improve the symptoms of degenerative arthritis and only when used for short periods of time.  There can be significant side effects from these drugs.

People with degeneration arthritis in weight bearing joints should try to be diligent in not carrying extra weight.  A sedentary lifestyle can also aggravate degenerative arthritis.  Blood sugar needs to be controlled to reduce inflammation and prevent further degeneration.

  

Pain in the Neck

Do you suffer from a pain in the neck?  I'm not referring to your neighbour, child, spouse or parent (bad joke, forgive me), but to a physical pain in the upper part of your spine.  The pain may be an ache, a stab, a burn, a throb or a shock.  It can be an annoyance or debilitating.  Regardless of the nature of the symptoms you are experiencing, neck pain shouldn't be ignored.  Pain is your body's signal that something is wrong.  Ignoring the pain is like ignoring a warning light on the dash of your car.  Ignore either your body's signals or your car's signals and there can be long term consequences.  (It's okay to ignore other people who are being a pain in the neck).

There can be many causes of neck pain, some quite serious.  The most common cause is a vertebral subluxation.  This is a condition where the joints of the spine lose their proper motion and the nerves next to joints become irritated.  There is associated damage to the surrounding muscles and ligaments along with swelling.  The pain can be localized in the neck or can travel into the arms, upper back and chest.  Subluxations in the neck are a frequent cause of headaches.

Chiropractors are specifically trained to find vertebral subluxations and correct them with spinal adjustments.  We are the only profession with this specific training.  Should the neck pain be caused by something other that a subluxation, we are also trained to determine other problems.  If there is a more serious condition, that is beyond our expertise, we will refer you for appropriate care.

If vertebral subluxations are not corrected, they can lead to accelerated joint degeneration, muscle atrophy, chronic pain, loss of mobility, and nerve degeneration.  These are not things any of us want to experience.  At our office we use Activator Methods to correct subluxations.  This is a very specific and comfortable procedure which restores normal joint function allowing healing of all the associated tissues.  During correction pain is usually the first thing to disappear.  Getting rid of the pain in the neck is the starting point.  Rehabilitating the muscles, ligaments and nerves can take much longer.  We will assist you through the entire process if you desire.  At our office it is always the patient's choice on how they proceed with their chiropractic care.

Don't ignore neck pain, or any other pain.  Pain is your body's way of telling you to do something.

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.

When the Pain's Gone

Everyone's excited when pain they've been experiencing goes away.  That's because pain is such a powerful force in our lives.  But the reality is that pain is not a very good indicator of how healthy or unhealthy we are.  When we have a problem pain is usually the last symptom to appear.  It can also be the first thing to disappear when correcting a problem.

Vertebral subluxations in the spine involve muscles, ligaments and nerves.  The inflammatory response to these tissues being injured is usually what produces pain in the spine.  Although irritation on the nerves can also produce pain.  With specific spinal adjustments, the inflammation associated with spinal injuries often subsides very quickly.  The pain goes away.  At this point however the job of rehabilitating the spine is only partly done. 

Muscles, ligaments and nerves take time to heal; often a very long time.  They must also be retrained to do their jobs properly.  Only through the re-establishment of normal joint motion, by spinal adjustments, can the tissues begin to work properly.  Exercise and nutrition are also vital to successful healing.  Until the muscles, ligaments and nerves are fully healed and retrained, they are susceptible to re-injury.

I'm exited for my patients when their pain goes away, because that is usually their goal when they first come to see me.  However, I also know that the job of correcting their spine is only just beginning.  The patient is always in charge of deciding how far they want to take their care.

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.

Pain is the Great Motivator

The one symptom that brings more people to our office, more than all the others put together, is pain.  Pain is the motivator that gets people to schedule an appointment.  Pain pushes them into their cars to get to our office.  Pain is the factor that forces them to do something about their situation.  If we are honest with ourselves, pain is the motivator for most of the significant changes we make in our lives.

Other than in traumatic circumstances, when we have physical problems pain is usually not the first symptom to appear.  Stiffness, numbness, weakness, restlessness, fatigue, or swelling may come before pain.  In heart conditions digestive problems, shortness of breath or fatigue will usually precede chest pain.  Constipation, diarrhea, bloating, or food sensitivities often come before abdominal pain when a person has digestive system problems.  Pain is the body's most powerful way to get our attention.  The loudest alarm is saved for last.  If we ignore all the more subtle symptoms, the body will give us pain we cannot ignore.  Pain gets our attention and persists until we do something to help the situation.  It is designed to motivate us into action.

Emotional pain can be as great a motivator as physical pain.  It is the tough situations in life that cause us to reflect and decide to do things differently; to take a new path.  A health crisis for ourselves or someone we deeply care about can motivate us to change our lifestyle for the better.  A financial crisis can cause us to re-evaluate our spending and saving methods.  A family crisis can help us to see our own shortcomings and to appreciate the value of those around us.   Without the emotional pain, seldom do we make any significant changes to our lives.

Pain is not the problem, rather it is given to us to tell us there is a problem.  Its purpose is to motivate us to make changes.  Sadly, pain is too often seen as the problem.  We try to numb the pain, block the pain, or ignore the pain without finding out why the pain is there.  By doing these things we miss the opportunity to fix the cause of the pain.  When the physical or emotional cause is not corrected, the pain just keeps coming back.  It's simply the body's loudest alarm to get our attention and motivate us to make some changes.

There's a familiar saying, "Don't waste the pain."  Don't ignore it or block it.  Use it to determine the cause and then make changes that will improve who you are physically and emotionally.  Correct the cause and the pain doesn't have to come back.  Chiropractic is about finding the cause of the pain and correcting it.

It's Dangerous to Feel Good

Most people are motivated to come to our office because of pain.  They have pain in their head or their neck or their back or their shoulder or their leg or somewhere.  Pain is the driving force at this point in their lives.

If we've determined we can help a person and they start receiving chiropractic adjustments, pain often begins to subside fairly quickly.  The improvement of course is dependent upon the precise nature of their condition, how long it's been there, and their overall ability to heal.  As pain levels become more tolerable for the person, I'm usually compelled to give them "The Lecture".  They've entered the danger period.

"The Lecture" is pretty brief:  When we have problems, pain is usually the last thing to come and it's the first thing to going in rehabilitation.  The pain reduction is a sign that irritation is coming off the nerves.  It does not mean that the other soft tissues, muscles and ligaments are healed.  That takes time and until they are healed the problem and the pain can return very readily.  People have often put off doing any number of activities due to the pain and are anxious to return to them.  They need to keep in mind that doing too much too soon can be dangerous.  When rehabilitating injuries it's important to use the area, but not abuse it.  That's always a fine line.

The goal of chiropractic care is to help people to be healthy.  Health is the ability to do the things in life that we both need and want to do.  The road back to health can be an up and down process.  Try to make it more ups than downs by learning to use but not overuse injured body parts.  When the pain subsides, remember it's dangerous to feel good.