It’s normal to have many questions when you first explore the health benefits of chiropractic care. Here are some answers to the most common questions that chiropractors are asked.
Treating your musculoskeletal and nervous system
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 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 interventionsto 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.
What should you expect on your first visit?
Expect the first visit to take an hour or longer. We’ll take a complete medical history and identify problem areas, perform neurological tests, take X-rays or look at MRIs if we have to. We need to know things such as patient history, high blood pressure or hypercholesterol problems.
After reviewing your medical history, your chiropractor will discuss your general health with you and conduct a thorough physical examination, including orthopedic and neurological evaluations. The session might include a review of past X-rays or you may be asked to have new ones taken.
The course of treatment will probably include a series of adjustments to help realign your spine, neck, or other problem areas. The chiropractor may ask you to lie down on a padded massage-type table for spinal adjustments or you may be seated on a stool or in a special chair that provides access to your back. You may be treated fully clothed or asked to undress and wear a hospital gown. Before doing any manipulation, the chiropractor should explain exactly what the process involves.
Typically, chiropractic is performed using very little force, although techniques vary. As the chiropractor applies pressure to your spine, you may hear (and feel) a popping sound, like a knuckle cracking. You should not feel any serious discomfort from the adjustment, however. If you do, it is important to let the chiropractor know immediately. Many patients find the experience relaxing. Most describe feeling less pain, reduced tension, and more flexibility in the areas that were adjusted.
An initial visit usually lasts at least an hour. Subsequent visits may only take 5 to 15 minutes. Sometimes one session with a chiropractor is all that is required to relieve pain. An average course of treatment for an acute problem involves three to five visits a week for two weeks. Chiropractors generally have working relationships with M.D.s and physiotherapists. Chiropractors will refer you to a medical specialist — often an internist, orthopedist or a neurologist — if your condition persists and further testing or treatment appears necessary.
Improving sports performance through Chiropractic
Spinal and peripheral joint injuries can restrict range of motion, reduce strength, slow flexes, shorten endurance, and decrease performance. Chiropractic care of these types of injuries has become increasingly popular. Professional sports teams, Olympic trainers, and competitive athletes are employing chiropractic doctors because they demand results.
Chiropractic care helps restore function to spinal and peripheral joints that are fixated and not moving properly. Besides helping to relieve pain, chiropractic care can also help reduce inflammation. Muscles, tendons and ligaments depend on upon proper joint movement for peak performance. Injuries to these tissues can reduce range of motion, decrease blood supply, and literary “take you out of the game.”
Normalizing joint function helps speed the healing of these soft tissues and reduce the deconditioning effect of being on the sidelines.
An aerobic exercise program or a plan of brisk walking or swimming can improve muscle tone and help you recover from sprains, strains, and other activity-restricting health problems.
Whether you are a tri-athlete, play golf, tennis, cycle/swim, and run or even bowl, the best treatment for sports injuries is prevention. Ask Doctor Armitage for a care plan based on your age, condition, and health objectives. Find out how chiropractic care can help restore your health, improve your performance, and increase your competitive edge.
Active Care for more complete recovery
Without some form of active care or rehabilitation, recovery from an injury or a long standing spinal problem can take longer to achieve. Overlooking the importance of improved range of motion and muscle strengthening can result in a relapse, with your original health problem returning again and again.
Chiropractic rehabilitation involves the restoration of proper joint function of the spine or extremities, and the coordination and strengthening of support muscles and soft tissues. This will usually involve specific spinal or other joint adjustments, combined with a program of proprioceptive (body position awareness) and strengthening exercises, resistance training, and exercises to improved muscle tone.
Some patients receive a set of simple exercises or “maneuvers” they can do at home. Other types of injuries will require the use of specialized equipment to isolate and strengthen specific anatomical regions.
Ask Dr. Armitage for ways you can speed the healing process and strengthen the supporting soft tissues of your spine and body through specialized active rehabilitation.
The tragic result of uncorrected trauma
Collisions that occur during sporting events, slips, falls or automobile crashes can all have a damaging effect on your neck and back. These “types” of collision-related injuries are often called a “whiplash.”
The resulting instability of the spine and soft tissues can contribute to headaches, dizziness, blurred vision, pain in the shoulders, arms and hands, reduced ability to turn and bend, and low back problems. As the body attempts to adapt, symptoms may not appear until weeks or even months later.
The chiropractic approach to these types of injuries is to use specific chiropractic adjustments to help normalize spinal function. After a thorough case history, examinations and x-rays (if needed), the doctor will recommend a series of visits to help restore proper motion and position of spinal bones. If caught early enough, pain and inflammation can be reduced and the formation of excessive scar tissue can often be taken care of quickly.
Consult Dr. Armitage to reduce your chances of dependency on pain medication, enduring constant whiplash-related headaches or falling victim to early degenerative spinal conditions as result of undetected or incompletely treated biomechanical conditions associated with whiplash or whiplash like injuries.
There are many types of Headaches
One of the most common causes of headaches is the biomechanical malfunction of spinal bones (vertebra) and the muscles in the neck and upper back (Cervicogenic or Muscle Tension Headaches).
When vertebra and muscles of the spine lose their normal position or motion, sensitive nerves and blood vessels to the head can be affected. When spinal nerves and related tissues are overworked, stretched or irritated, they can produce throbbing headaches. Aspirin and medications may cover up these warning signs, but do not correct the underlying structural and biomechanical cause.
Many people experience correction and relief through Dr. Armitage’s chiropractic care.
If an examination reveals reduced range of motion, loss of normal spinal curves, or mechanical restrictions, chiropractic care should be considered. After a complete explanation you’ll receive a care program designed for your unique spinal problem.
Specific chiropractic adjustments can help correct spinal joint dysfunction created by the various chemical, emotional and physical stresses in our lives.
Many patients report almost immediate headache relief. Others find the correction of their condition takes longer because their spinal problem has existed undetected for many years. Every patient responds differently. Benefit from the drug-free results millions have enjoyed by consulting a chiropractic doctor.
Three primary categories of lower pack pain
In the assessment of lower back pain, differential diagnosis utilizing a “triage” concept of classifying low back injuries into one of three categories helps to guide your chiropractor. These include:
Non-specific: mechanical back pain in the lumbar spine (most common type of presentation). Sciatica: when the nerve root in the low back is pinched or compressed causing a referral of pain, weakness or altered sensation down the leg, past the knee. Potentially serious: tumor, infection, fracture, major neurological problem (caudiaequina), local open wound or burn, prolonged bleeding (hemophilia), artificial joint implant problems, pacemaker problems, joint infection.
With a diagnosis of potentially serious injuries, chiropractic manipulation is typically avoided over the relevant anatomy, although it may not be ruled out on other anatomical regions.
Lower back pain symptoms are typically described by chiropractors on the following scale:
Acute (symptoms lasting less than 6 weeks) Sub acute (symptoms lasting between 6 and 12 weeks) Chronic (symptoms lasting for 12 weeks or more) Recurrent/flare up (symptoms are similar to original symptoms and return sporadically or as result of exacerbating circumstances). (17)
These lower back pain symptoms may be further broken down as mild, moderate or severe in pain intensity and debility.
Chiropractic Treatment Plan for Lower Back Pain
Goal setting for the chiropractic treatment plan is driven by the patient’s pain and disability issues and activity intolerance. Patient education with the guidance of the chiropractor is important to reduce anxiety levels that often accompany intense low back pain. The guidelines recommend chiropractic care 3–5 visits/week over 1–2 weeks.
If no demonstrable improvement is noted, the compliance and sincerity of the patient should be evaluated and the risk factors that may prolong recovery identified followed by discharge, referral to another chiropractor, or the initiation of a different treatment approach at 3–5 visits/week for 2 weeks. (18)
Consistent among all guidelines of low back pain treatment is the prevention of chronicity. The use of active care (care that is patient-driven such as exercise, activity modification, ergonomic modifications, etc.) is emphasized to accomplish this goal.
16 and 17 — Globe G, Morris C, Whalen W et al. Chiropractic Management of Low Back Disorders.
18 — Bigos S, Bowyer O, Braen G et al (1994) Acute low back problems in adults.
A variety of common disc problems
A Disc does not slip. Since spinal discs have a very poor blood supply, they also depend upon the circulation of joint fluids to bring in nutrients and expel waste. If a spinal joint loses its normal motion and this pumping action is impaired, the health of the disc deteriorates. Like a wet sponge, a healthy disc is flexible. A dry sponge is hard stuff, and can crack easily. This is how many disc problems begin.
Because of the way each disc is attached to the vertebra above and below it, a disc cannot “slip” as is commonly thought, However, trauma or injury to the spine can cause discs to bulge, herniate, or worse, rupture. This can be quite painful, putting pressure on the spinal cord and nerve roots, often interfering with their function.
The chiropractic approach to disc problems is to help restore better motion and position to the spinal joints. Besides reducing disc bulging, better spinal function helps decrease pain and inflammation so the slow process of healing the surrounding soft tissues can begin.
While results cannot be guaranteed, many patients have avoided needless surgery or a dependency on pain pills by choosing conservative chiropractic care.
The most common disc injury is a small crack or micro tear in the tough, outer cartilage material of the disc called annular fibers. These small tears result in the production of inflammation causing pain and muscle spasm. It is the accumulation of these small tears (with recurrent episodes of back and neck pain, sometimes noted as only morning or post activity stiffness) that begin the progression of degenerative disc disease (See Desiccated disc).
The soft jelly like material in the middle of the disc pushes to one side, forward or backward because of the weakened or torn annular fibers of the disc and swelling occurs. The nucleus is still contained within the tough outer fibres of the disc, but can still cause pressure and painful symptoms.
The soft jelly like material from the nucleus in the middle of the disc ruptures through the tears in the tough, inner fibres of the annulus and extends to the outer edge, or beyond the normal limits of the disc.
Prolapsed or Sequestrated Disc
A piece of disc material separates away and becomes a fragment or a free-floating piece.
As part of the healing process, your body begins to replace the torn and damaged fibers and cells of the disc with scar tissue. The production of scar tissue is stimulated by the inflammatory response. This is the same inflammation that stimulates stiffness, pain and muscle spasms. As a cumulative result of multiple episodes of minor injury OR an over production of inflammation, the scar tissue becomes layered and thickened. The scar tissue causes the disc to loose its ability to maintain its fluid content. As this degeneration occurs, the disc and vertebra of your spine begin to have the roughened or worn down appearance seen on spinal X-Rays, CT or MRI scans (known as osteoarthritis).
We do have X-ray facilities on site. Not all cases need to have X-Rays and it is decided on a case by case basis by you and your chiropractor after having discussed the clinical reasoning with you. As health care professionals that focus on the structural and functional integrity of your body, X-rays (or other available imaging like CT or MRI scans) enable your chiropractor to assess potential key points of structural stress that help to identify areas of joint dysfunction in your spine and other joints. X-rays or other types of imaging for the spine and joints may also help to identify and manage any potential problematic areas of your skeleton, joints and soft tissue that may otherwise go unnoticed until they become more severe and difficult to deal with (e.g.: early stage disc degeneration and arthritis). With a more precise and thorough diagnosis of your condition, positive treatment outcomes are better achieved.
It is also important to be able to identify any congenital (born with) anomalies in the vertebrae or spine (e.g.: scoliosis) and joints (abnormal bone growth), as well as any serious pathology such as cancer, tumors, infections, fractures, & bone diseases that would require the modification of, or could be a contraindication to chiropractic treatment. Moreover, conditions such as the ones just mentioned are not always apparent or obvious with just a consultation and physical examination. If your X-rays show any signs of disease or pathology that is not a chiropractic problem, you will be referred to the appropriate health care professional.
If you have current films from another doctor we are happy to request and review them. Some patients that have been established as chiropractic patients for years prior may not need new x-rays taken.