The Right Time For Chiropractic Treatment

Many of us experience back and neck pain. But when is it the right time to see a chiropractor for a diagnosis or treatment? And can they really help? The answer is yes.

Chiropractors have been around for a hundred years, and are licensed doctors who are required to pass a series of four national board exams and are regulated by state licensing boards. They are medical professionals who diagnose and treat musculoskeletal and nervous system disorders.

A chiropractor can use many different techniques to relieve pain, including applied pressure, massage, and hands-on manipulation (adjustment) of the vertebrae and joints. They may also order X-rays, MRI studies, and lab work. Chiropractors don�t prescribe medications, but they do recommend such things as therapeutic and rehabilitative exercises and nutritional and lifestyle counseling to help the body heal itself.

Chiropractors believe one of the main causes of back or neck pain is subluxation. Subluxation occurs when your vertebrae become misaligned. Treating subluxations can help to alleviate pain associated with a myriad of conditions, including:

• headaches
• sciatica
• trauma, such as whiplash
• scoliosis
• leg pain
• sports injuries
• bursitis and tendonitis
• fibromyalgia
• spinal arthritis (spondylosis)

Sometimes chiropractic care (eg, an adjustment) can cause mild soreness or aching but that usually resolves itself within 12 to 48 hours.

Chiropractic Tests

When you visit your chiropractor for the first time, he/she will probably ask you to perform a series of simple tests to evaluate your posture and range of motion. You may be asked to bend forward,� backward or side-to-side. The chiropractor will also check the way you walk and how your posture looks sitting down and standing up.� Other tests may include:

• Piriformis Test: The patient flexes and bends the knee while lying down.
• Straight Leg Raise: One leg at a time is raised in a locked-knee position to check the sciatic nerve and flexibility of the hamstring muscle.
• Measuring the length of each leg helps determine if there is a discrepancy in leg length or if the pelvis is out of balance.
• Hand strength (grip)
• Evaluation of reflexes and muscle testing

Sometimes you might hear a pop while the chiropractor is testing or adjusting you, which is perfectly normal. This is caused by small pockets of air or bubbles in the fluid that surrounds your joints. When joint tissues are stretched, those pockets of air �pop,� which creates the cracking sound you hear.

Diagnosis

Once the chiropractor identifies the problem, he/she can recommend treatment options, and explain how many chiropractic visits are necessary to reach an expected outcome (eg, resolution of pain). He/she may also suggest improvements to your diet and lifestyle, such as quitting smoking or increasing/modifying certain activities. A chiropractor may also recommend certain types of exercises in conjunction with chiropractic treatment to stretch and/or strengthen the back and neck.

Adjustment Techniques

A chiropractor is educated in dozens of ways to treat pain. Here is a sampling of the different techniques that may be used.

Toggle Drop � The chiropractor presses down firmly on a particular area of the spine followed by a quick and precise thrust.

Lumbar Roll � With the patient on his/her side, a quick thrust is applied to the misaligned vertebrae.

Release Work � The chiropractor uses gentle pressure with the fingertips to separate the vertebrae.

TENS (Transcutaneous electrical stimulation) � This device sends stimulating pulses across the surface of the skin and nerve strands to block pain signals along the nerves and release endorphins which are natural painkillers.

Cold/Heat Treatment � Chiropractors may alternate between ice and heat therapy to treat back or neck pain. Ice packs are used to reduce inflammation (swelling) for 15 minutes at a time. A heating pad (or other heat source) helps increase circulation and may promote faster healing.

Table Adjustments � The patient lies on a special table with a �drop piece� then a quick thrust is applied when the table drops.

Instrument Adjustments � Instead of hands-on manipulation, the patient lies on the table face down while the chiropractor uses a spring-loaded activator instrument to perform the adjustment.

Manipulation Under Anesthesia � This is performed by chiropractors certified in this technique. The treatment is performed in a hospital outpatient setting.

Keep in mind that chiropractic care is not a cure-all for your back and neck pain! However, it is considered by many to be a safe and effective way to help relieve pain and improve spinal function. Many physicians and surgeons recommend chiropractic care to their patients.

Written by Stewart G. Eidelson, MD