Tag Archives: RSI

When Should I Go To A Chiropractor?

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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.

RSIs & Chiropractic Treatment

Chiropractors should treat RSIs by trying to address as many factors as possible.

A doctor of chiropractic will usually focus on structure and function of the muscles and joints stressing that improper motions can cause strain, inflammation, and stiffness. He will usually address the improper motion with chiropractic manipulative therapy (see previous post on what an adjustment does). In addition to manipulation, a chiropractor may give you exercises to help retrain your mind, muscles, and joints in proper motion.

There are many things that another person cannot do for you to improve your health, but a good doctor should attempt to address them. He should try to educate you regarding proper preventative exercises and proper ergonomics. He may refer you to a physical therapist if major retraining is needed. He may consult or refer you to a movement specialist such as an instructor in the Alexander technique or the Feldenkrais method. Both of these will help you learn how to perform your tasks properly whether it is playing a musical instrument or typing at your computer.

Your doctor should also educate you on how often and what to do to take breaks. Wrist Extensor StretchHe should be able to show you stretches to relieve pressure, and even provide documentation to your employer that will allow you proper breaks, and may, if implemented, improve productivity across his company. As an employer you could bring a chiropractor in to give these instructions to all of your employees this may even improve workers compensation rates.

Your doctor should also ask about the rest of your life. Chiropractors are well trained as health care providers, though they specialize in manipulation. They should be able to help you with an exercise routine, diet, and general health, or at least refer to someone who can. Your diet is important. A chiropractor, without additional training is not a nutritionist, but can give you some general advice, or even identify possible problems with your diet. The same goes for exercise and overall health.

As a chiropractor and massage therapist I work with musicians who often have RSIs. I work in cooperation with their trainers, medical doctors, physical therapists, and anyone else that I feel can help them. I believe that your care is the most important thing in my practice, and if I don’t already know a provider that meets your needs then I need to meet a new colleague.

Cold Laser Therapy and de Quervain’s

People have been asking lately about laser therapy, so I thought I’d explain it a little and sneak in a quick condition at the same time.

De Quervain’s is the name for tenosynovitis of the thumb extender and abductor muscles.  Which is to say the tendons that move your thumb hurt at the wrist because inflammation isn’t allowing them to move properly.  It is more common in women, but anyone doing repetitive motions with their thumb such as typing, cashiering, mechanics, etc. is susceptible.  If you have it you may notice a “squeaky thumb,” pain when moving your thumb and decreased grip strength.  In my experience this condition doesn’t usually go away on it’s own.  Similar to carpal tunnel syndrome it just keeps coming back unless you receive proper care.

Many things are done for treatment of this condition.  Chiropractic manipulation and massage of the area are beneficial as well as reducing use.  You’ll likely need to talk with your employer about decreasing or changing your duties for a time while you heal.  There are also many electrical modalities that are beneficial for de Quervain’s.

That’s where the Cold Laser comes in.  Cold Laser is called many names but it is all the same thing, particular light waves that have been found to increase cellular metabolism.  In essence when exposed to these wavelengths of light your cells heal faster, and hurt less.  That’s a good thing.

LLLTIt’s an odd sort of treatment because you normally don’t feel anything at the time.  Kind of like magic with good research behind it.  We just put this wand with a laser or LEDs on the injured area and hold it there for a few moments with the light on.  The reason I bring Low Level Laser Therapy (LLLT) up with this condition is the relief time.  Generally speaking my patients are able to notice effects of LLLT within the first day, but I had a patient with de Quervain’s who claimed instantaneous relief with LLLT.  It was amazing to me and worth reporting to you.

So, if you have pain at your wrist from thumb movement visit your chiropractor and ask them about Cold Laser Treatment.