Tag Archives: Chiropractor

Getting Healthcare While On a Budget

How can you get healthcare if you’re on a tight budget? The first thing to realize is that you are talking about your health. Don’t fool around if you think something is serious.

I know how you feel. I was in the same situation for the first 10 years of my marriage. You worry that you or your family could get sick because you can’t afford to take them to the doctor, and going to the emergency room would destroy you financially. In this kind of situation people are looking for ways that they can make their dollars go farther.

Part I – Prevention

The first way to spend less is PREVENTION. Eating right and exercise costs no more than eating poorly and doing nothing. Go for a walk, eat a carrot, don’t buy soda, wash your hands, know your blood pressure. Chiropractic is also an excellent way to keep in prime condition. If you can keep your body in good condition or improve it you are better able to avoid illness and recover quicker from injury.

apple pillsIf you can’t prevent it from happening and sometimes we can’t; the next best thing is to catch it early and keep it from getting worse. Many people just ignore symptoms and put off that doctors visit thinking that they’ll probably get better on their own. The reality is if you head things off early you’ll prevent the bigger things down the road. To use a dental example, a filling is much cheaper than a root canal. Don’t put off those relatively cheap preventative checkups. They are probably the cheapest office visits and if they identify something early you’ll spend much less than you would if you wait.

With chiropractic the longer you wait to come in the more visits it will take to get you back into good condition.  When our joints aren’t moving they can slip into a degenerative cycle.  So that pain in the neck, if not taken care of, could turn into a pain down the arm and back as well.

I’m not saying you should see a doctor for every little thing,  but if it’s not getting better on it’s own or it’s getting worse don’t wait weeks before getting help.  Tune in next time for part II of this discussion…

Symptom of the Week – Whiplash

I’ve covered this topic a little bit here and there with other posts, but I thought that it is such a common theme that it deserves it’s own title.  Whiplash is essentially just rapid acceleration and deceleration of your head and neck. This kind of motion can happen in sports, or in play but is most commonly associated with car accidents.

Whiplash is named for the motion of a whip.  When the base of a whip is moved properly it only has to move a very slight amount yet the tip of that whip can reach beyond the speed of sound producing the crack that you hear.  In whiplash accidents the spine acts as the whip and the head is the end of that whip.  When the head moves in this uncontrolled manner, tendons muscles and ligaments (the soft tissues supporting the spine) are often injured as well as the joints themselves.  These injuries can cause unbalanced weaknesses and spasms.  Though at first you may feel fine, over the next days and weeks these imbalances cause increasing strain on your neck, back and head.  Symptoms can even develop weeks after the incident.  These symptoms are usually headaches, and achy stiffness in your back, neck and or shoulders.  However your doctor will want to rule out any serious neurological problems as well.

With whiplash the pain is usually the reason that patients come in for care.  The pain is usually only a small symptom compared to the whole.  When you visit your chiropractor after a car accident you may have already been to the Emergency Room and had x-ray’s taken.  Your chiropractor will likely want to see those films and may even take more of his own.  You will be able to see on the X-ray films a straightening of the cervical spine.  This is very predictable with these types of injuries. The joints have been moved out of place, and the muscle spasms will hold them there.  When your spine is missing it’s normal curve it is unable to absorb shock in the way it was designed, and the reduced range of motion can become chronic.  The sooner you begin treatment the better the outcome you are likely to have.

For more on what to expect at a chiropractic visit in the case of whiplash click here.

Child Car Seat Safety

As a chiropractor public safety is very important to me.  I relate to and understand what car accidents can do to people.  Seat belts are a major cause of whiplash in my opinion, but I’d rather treat a person for whiplash than have to attend their funeral, and so I support the use of seat belts.  Our cars have many safety features designed into them.  It is important that we use them properly so that we are safer for using them.

A few summers ago Utah’s legislature updated it’s car seat laws.  My daughter was very disappointed.  She was getting ready to move out of her booster seat to a regular seat belt.  She was so excited.  But then she had to grow an extra inch or two or wait a few more months.

The basics of the new law are this; any child under the age of 8 unless 4’9″ or taller must be in a child safety seat appropriate for their age/size.  I wish that this kind of thing didn’t require a law.  Every child is precious and should be protected.  I know that every person is different, and some children might not need the seat, but if you have to make a rule then the line has to be drawn somewhere.  Sometimes these lines are arbitrary and sometimes they are based on actual research.

Motor vehicle accidents are the leading cause of death for children in the USA.  Proper restraints cut that risk by 60%.  To make sure you are using them properly, there are many resources; this IIHS site even has video, or the Utah Safety Council.  If you’re not sure how to buckle your kids properly bring them in.  I’d be happy to go over the manufacturers recommendations and walk you through a checklist.  Also, I know that most police stations will have an officer that will check your installation.  The Orem Police Station had an officer check our car seats and explain how to properly buckle up our children.  Call your local police station to find out if they have a similar program.

For adults it is important to use the safety features designed into your car as well.  Adjusting your headrest properly will reduce the effect of whiplash if you get in an accident.  Also, wearing your seat belt at your hips rather than your waist reduces abdominal or back injury.

Make sure that you and your children are as safe as can be in your cars.  Please buckle up.

Sciatica

Our Symptom of the Week this week.

Many people have sciatica, you may have heard someone say, “my sciatica is acting up.”  Sciatica is actually a description of the symptoms experienced when the sciatic nerve or it’s roots become irritated.

Sciatic NerveIt is a group of sciatic pain syndromes.  Sciatica is kind of the Thoracic Outlet Syndrome of the lower limbs.  The tingling, numbness or pain can go from your low back all the way down the leg, or it can be fairly mild and just be in your back.

Your sciatic nerve is actually a large bundle of nerves from your low back that travels through your pelvis, out through the sciatic notch and between the piriformis muscle and the other deep hip rotating muscles.  When this nerve bundle becomes irritated or “pinched” pain ensues and can be present any where the nerve goes.

Sciatic Pain

Sciatic Pain

The actual diagnosis of Sciatica would mean that the nerves are “pinched’ at the nerve root specifically due to a spinal condition.  Degeneration, disc herniation, joint dysfunction, inflammation, etc. may cause this.  However the nerve can be “pinched” in places other than the spine.  Though they are technically termed pseudo sciatica there is nothing pseudo about the pain.  The only real difference is where the nerve gets irritated.

Piriformis Syndrome can cause similar symptoms to sciatica because the same kind of thing is happening.  The sciatic nerve travels through the muscles, if they are abnormally tight then the nerve can become “pinched” and cause sciatica.

Sacroiliac Joint Pain is another diagnosis that can cause pain similar to sciatica.  Though the nerve does not actually pass through the sacroiliac (SI) joint it does travel close enough that problems in this area may affect the nerve.  Problems in the SI joint its self can also cause symptoms that mimic sciatica in that there can be pain all the way down the leg.

The cause of your sciatic pain is very important because it dictates how it should be treated.  Your chiropractor is trained to correctly diagnose and treat the causes of these painful syndromes.  Many treatments may be effectively utilized by your chiropractor, from manipulation to decompression to physiotherapy and exercises.  You can do many things at home to help to.

Piriformis Stretch

Piriformis Stretch

Piriformis stretches are useful, and even if the symptoms are not due to your piriformis it may be tight and adding to the problem.  Talk to your chiropractor if you are having sciatica.

Headaches – An Informative Post

There are many different types of headaches, but of all the people with headaches out there 90% of them have cervicogenic (tension) headaches.  These are headaches caused by a poorly functioning neck.  These are usually described as tightness, stiffness, or a pressure.

There are other kinds of headaches, migraines for example are periodic, severe, throbbing headaches that usually last more than a few hours, but less than a day.  They can make the sufferer sensitive to light and sound, and cause nausea even vomiting.  Migraines affect women more often than men.  Migraines are commonly heard of and talked about because of their severity, but are much more rare than cervicogenic headaches.

Billions of dollars are spent on headaches each year in the United States.  Headaches are a major cause of lost productivity and time off work.  One of the top reasons for seeking treatment, headaches are big money for drug companies, and big losses to businesses.

People can end up with a headache from stress, a car accident, whiplash, or any kind of trauma.  Headaches can occur a day or even weeks after the initial injury due to the cumulative nature of those kinds of injuries.  Many people think their headaches come on for no reason at all, but if they think back they will remember an accident, increased stress, playing to hard on the weekend, or something a few days ago.

Treatment for headaches traditionally has been over the counter analgesics and NSAIDS, and even stronger medications for more severe symptoms.  These medications can cause serious side effects, and recent studies indicate that we as a country may be over using these to the extent that thousands of people have serious complications every year from these relatively safe drugs.  Many times these pain medications do not work, and can even cause what is termed “analgesic rebound headaches.”

Chiropractic has a great success rate with treating headaches.  It has been found to be better at providing pain relief (with less side effects) and reducing frequency than medication.  Chiropractic addresses the root cause rather than just the symptoms.  When treating your headaches your chiropractor (which could be me if you’re in Utah) should be addressing 3 major things: First reducing the pain, second improving neck function overall, and third proper strengthening of the neck to reduce future risk of re-injury.  While chiropractic is particularly good at resolving cervicogenic headaches it has also been shown to be effective with some types of migraines, and other headaches.

If you are experiencing headaches, don’t reach for that Aspirin bottle.  Reach for the phone and contact your chiropractor.  You will receive better, safer relief, and have less chance of recurrence.

When Should I Go To A Chiropractor?

skeleton

The primary thing that you should see a doctor of chiropractic for instead of a medical doctor is joint dysfunction, sometimes chiropractors will call this “subluxation.” The problem is the same with either term. “What is that?” Medical doctors and chiropractors use different terms so I’ll try to list some of the more common diagnoses terms and explain why and how a DC should be preferred over an MD for those conditions.

Back pain of any kind. I say this, knowing that there are causes of back pain that a chiropractor cannot treat. They should be a first line provider when it comes to back pain. The advantage of seeing a chiropractor first for back pain is that it is their expertise. They have had more class and clinical hours studying and treating the back than the average MD. So, even if they can’t treat it, they are better equipped to diagnose and refer to the right person. They can also treat most back pain generators. Even the studies with the worst outcomes show that chiropractic is at least as good as standard medical treatments (most show better results) for low back pain with higher patient satisfaction, and lower risk. The second reason to see a chiropractor is cost.  A full treatment plan with a chiropractor will cost about the same as the initial MRI at a hospital ER.

If you’ve been in a car accident, after visiting the ER, and in the absence of life threatening findings there you should proceed to your chiropractor. The ER doctors will often say something along the lines of well we can’t find anything on our tests, it looks like you have a little (fill in the blank…whiplash, sprain/strain, pulled muscles, bruising, etc…). They will usually send you home with a prescription for some pain medication. They don’t deny the pain or the injury, they just don’t have any medication to treat these injuries. These injuries are what chiropractors deal with. Like with MDs, DCs cannot cure a sprain or a strain, but they can improve healing time, and reduce pain without the risk/side effects that medication has.

Pregnancy back and muscle aches. This statement is not intended to negate medical monitoring of a pregnancy. Chiropractors should not be substituting for an OB/Gyn if that is the care you choose. With pregnancy however most medications are out, due to possible harm to the baby. In this circumstance you want your treatments to be as conservative as possible. Again, that is a chiropractors realm, conservative care.

Headaches are one of those areas that are middle of the road. Most headaches are just tension headaches, and chiropractic has a very high success rate treating them. The problem is most people don’t go to their doctor for the average tension headache, they go for chronic headaches, migraines, cluster headaches, etc… With these I wouldn’t say one was better than the other. Because the cause of headaches vary so much you could start either place. The big advantage that I would give chiropractic in this case is that it is more conservative, and they won’t start with drugs. If you aren’t seeing some results with a chiropractor within 2 weeks I would recommend looking into other things, and for that matter the chiropractor should be looking to refer you about that time.

Difficulty moving, such as when you bend down and can’t stand back up, or you can’t turn your head properly to back up your car. Stiffness or soreness is also something to go see a chiropractor about. Basically anytime you have a mechanical problem be it muscles, bones, or joint structures head to your chiropractor.

Repetative stress injuries, whether they be work related, sports related, performance related, or what ever. RSI’s are something that I’ve discussed in depth previously. See here for the start of the discussion series.

I’m sure that I’ve missed many, and I hope that my chiropractic friends will correct me with comments to this post, but I hope this is a good starting point for those of you who are looking for a way to judge who you should go see.

A chiropractor can be a primary care provider and at times are. You should be able to go see your chiropractor for any reason, and he should be able to help you either through chiropractic treatment or by referring you on to the person who you should see. However, if there is a medical doctor around you would save time by skipping the chiropractor and going straight to the MD if you have a fever, bowel and bladder problems, you are oozing fluids, or have cancer. Those are things chiropractors don’t usually deal with.

Scoliosis

Human-Spine-Picture 2

“Normal” Spine – side view and from the back.

The spine normally has curves that help it to absorb shock. These normal curves can be seen when looking at your spine from the side. It curves back in the neck, forward in the area of the shoulders and ribs, then back again in the low back and then forward at your pelvis. When looking from the front or back there should be no curve in a “normal” spine.

Scoliosis is rated by the size or degree of the curve. The greater the degree the worse the curve. Anything less than 10 degrees is not usually noticed and for an actual diagnosis doctors usually don’t give you one unless the degree is greater than 20.  Your spine will usually stop growing at about age 18-24 and so does the degree of scoliosis unless you are sedentary and spinal degeneration can increase the angle

Scoliosis is an abnormal lateral curvature of the spine. it is not a disease just as having a small nose is not a disease, but it can predispose you to problems, just like a small nose may make it harder to breath or may cause you to be more likely to have certain nasal problems.

There are a few methods that are used to treat scoliosis.  There is bracing which while most research is inconclusive one recent study shows a decrease in the degree of curvature, but does not address functional improvement in the individual’s quality of life and can have negative impacts on the ribcage. Braces had recently begun to be abandoned as a useful treatment, but new research may change that. Surgery is effective at improving quality of life in some patients, but only in extreme cases and the risks are severe.

Physical Therapy is a treatment option that does emphasize function. It focuses on helping your body to cope with the strain that the scoliosis places on it through exercise and stretching for motion. This is a great start. The treatment with the best outcomes that I’ve seen for scoliosis is chiropractic. Chiropractors can prescribe braces if needed, they also do the physiotherapy work with a patient, but they also focus on joint mobility. The research for chiropractic does show show moderate corrections of 5-10 degrees with chiropractic adjustments. There are cases where chiropractors have seen complete correction, but those are the rare cases most get only moderate improvement. While sometimes the spine cannot be lined up perfectly chiropractors can help it to function better in what ever shape it’s in.  

If you have scoliosis you will always be more predisposed to certain injuries, but that’s just a good excuse to take better care of yourself than most people, and that’s not a bad thing.

More Research on the Topic Here

Is Chiropractic Safe?

This is a controversial question, though I’m not sure why. The short answer is, yes, it is safe. The easiest way to tell is to look at malpractice insurance premiums. Insurance companies don’t mess with risk. They charge an arm and a leg if they think you are a risk. Can anyone say preexisting condition? The average premiums for different professions will tell you who has risk of problems, and does not. Here let me show you some numbers (source):

Approximate Malpractice Insurance Premiums

OB/Gyn
$120,000
General Surgeon
$75,000
Internal Medicine
$20,000
Family Practice
$15,000
Chiropractors
$2000-4000

In fact through out many studies proper chiropractic treatment has not been shown to cause anything more than short term soreness at the site of treatment.

Now here’s where it gets controversial. And people may say, wait a minute studies have shown more than that. It’s true there have been rare serious problems seen after chiropractic treatments. The problem is that they are so rare that research has not been able to prove a causal link to chiropractic, or to rule it out. In fact the most recent and complete study showed that the biggest risk is no greater visiting a chiropractor than visiting a medical doctor (second source). These problems are so rare that it is nearly impossible to prove one way or the other.The big one that you’ll hear about is stroke, and the risk is estimated (due to lack of concrete evidence) to be somewhere between 1 in a million to 1 in 5 million. You can see how difficult it would be to do a study with 1 million chiropractic neck pain patients, let alone 5 million. In contrast, the mechanism of treatment seems like it could cause stroke in a predisposed patient, because in those predisposed people, simply turning your head to look at something could cause a stroke. Unfortunately there are no known tests to determine if a patient is at risk.

OK, so let’s put them out there. The possible risks of chiropractic treatment include, bruising, muscle strain, undefined soreness, headache, bone fracture, stroke. Now let’s put them in perspective. You are at least 5 times more likely to be killed by a freak asteroid falling on you than you are to have a stroke after seeing a chiropractor. Now how many people do you know that have been hit by asteroids? Bone fracture is another one of those rare things, and again will probably only happen when someone is predisposed. A person with osteoporosis, or suspected to possibly have osteoporosis, should not be adjusted with a full force method. This is why I usually leave this side effect out of the list when talking about proper chiropractic treatment. As for the headaches, soreness, and bruising, this kind of stuff will usually occur when a patient is unable to relax and the doctor uses a lot of force to get by that problem. It can occur in probably 30% of patients, because sometimes it is necessary to get the joint moving even knowing that the patient is unable to relax. This is something that should be discussed with the patient, and normally the soreness is less than 24 hours.

The last thing that I will say is that you should always bring negative effects to the attention of your chiropractor. Even if they are not caused by the doctor himself he should be aware of them, so that if they are serious he can take care of them or get you to an ER if needed. Some of the serious things to report are; intense pain, dizziness, vertigo, slurring of speech, vision changes, weakness, tingling, or numbness. They may be nothing, but you should let your doctor determine that.

Does My Insurance Cover Chiropractic?

This question brings on a rant in me. Here I go…

First of all let me lay out the basic premise of insurance. It is a group of people pooling their resources so that in the event that some rare bad thing happens they can cope with it. Until that bad thing happens those resources can be invested and earn money. This situation applies well to fire insurance, because not everyone’s house burns down. Accidents happen though, and if your house were to burn down, or wash away it would be a major loss, so insurance is a good plan in case of fire, flood, hurricane, etc… You pay someone to manage that situation. You are covered if the unthinkable happens and a job is created. That is a great idea, and system. The same thing works for

car insurance, and many other things. Even with life insurance the company is unlikely to have to pay out until they’ve had enough time to make a profit on the investment. And the premiums reflect that.You only pay $25-100 a month for most types of insurance, and the insurance man can still make money.

Insurance works because it protects you for something that is “unlikely” to happen. This is why health insurance cannot work. Everyone needs health care (even the healthy 25 year old should be getting regular checkups). The insurance companies are paying out all the time. It can only work if most of the people don’t use it. That puts the insurance company in the position of trying to either pay doctors less or get customers not to use the service that they have paid for. With chiropractic it’s even more difficult because back pain is a common, not rare, occurrence.  Insurance companies only make money  if you pay for the coverage and don’t need it or if they charge more money than the actual chiropractic care costs.

With health insurance, premiums can easily be as much or more than your mortgage/rent payment. And most people just pay it. Insurance companies have made is so that they don’t want to use the benefits because they have to pay their co-pay out of pocket and meet their deductible.

As far as insurance and chiropractic goes. I accept most insurance plans. Some I don’t because they’re ridiculous. When my patient has a $35 co-pay on top of his premium, and their treatment may only cost $45 it is cheaper for them to just pay out of pocket. That’s what I recommend for most people. Some people have really good insurance and I do accept those.

I prefer people pay out of pocket for many reasons. First, it is often cheaper for them. Second, I don’t have to ask permission from someone who isn’t even involved to do a procedure, because it may not be covered. Third, I don’t have to pay a collections agent to go get half the money promised by the insurance company. And lastly I don’t have to bill the patient again when the insurance says that they will only pay part of the bill.

So, the answer to the question is yes your insurance company will probably cover chiropractic, but if it doesn’t don’t worry about it, you’re probably getting the better deal. If the unthinkable does happen to you, such as being in a car accident, then the real insurance will cover your chiropractic care anyway, and they don’t make you pay a co-pay.

Take good care of your self. I’ll be here if you need me.

More Help for Weak Posture – Exercises

The biggest mistake people make when trying to improve their posture is forgetting to strengthen postural muscles.  They just sit up straight then after about 20 min they’re back to slouching because their muscles cannot maintain it.  I have some exercises that I’ve used for years to strengthen posture.  Here are some of the exercises that I recommend.  Here are some others that I’ve presented in a prior post. Give them a try and see how your posture improves.

Chin Tucks (For Anterior Head Postures)

Chin Tucks Full

  1. Looking forward retract your chin straight back, not down. You can use your hand to push it back if needed.
  2. Hold in that position for 5-10 seconds.
  3. Bring your chin strait forward and then back as before holding again for 5-10 seconds.
  4. This exercise can be overdone and you will feel a little sore the next morning if you do, so perform these chin retractions no more than about 5 times a day with 10 reps each time.

Shoulder Retraction (For Rounded Shoulder Postures)Shoulder Protraction-Retraction

  1. With your arms out in front of you retract just your shoulders back and down bringing the shoulder blades together.
  2. Keeping your shoulders back and down pull your elbows back in a slow rowing motion.
  3. Still keeping your shoulders back and down bring your elbows back to a straight position.
  4. Then return your shoulders to a forward position and repeat.
  5. This exercise is more mental than physical. It is designed to remind your brain to use these lower muscles to stabilize your upper back.

These exercises are for informational purposes and are not intended to be a substitute for examination, diagnosis and treatment by your physician chiropractic or otherwise.