Tag Archives: treatment

Healthcare On A Budget – Part III Conservative Care

Get CONSERVATIVE CARE FIRST. It’s cheaper. There are almost always more than one way to treat any given condition, and some of them will not work.  That’s just the nature of healthcare.

Conservative treatment means that you use the best tool to get the job done with the least amount of risk. The most obvious example is if you have low back pain, the most conservative treatment is to stay active but take it easy. Or you could go to a surgeon to get an MRI and multiple other test to determine if the back pain is surgical. That seems kind of ridiculous.  It’s easy to see when you use extreme examples like that. It may not be so easy when comparing things like chiropractic adjustments to prescription medication.

If you were to walk through the levels of care and note the risk involved it may become clear. Let’s use the same example of back pain. Chances are in a day or so you’ll be back to normal if you just stay as active as you can but take it easy. That has very little physical risk, but does cost you a sick day or two. Hot packs and massage cost a little more and have a little more risk.

If the problem is not improving with the most conservative option move up the chain. You should be examined by a doctor. The least expensive physician with the most training in musculoskeletal conditions is a chiropractor. Chiropractic has little more risk than a massage and does not introduce foreign chemicals, needles or a scalpel into your body. The cost of chiropractic is limited to what happens while you are in the office, there is no additional charge for medication. When you leave the office you feel better. You don’t have to go to the pharmacy and pay more so that you might be able to mask the symptoms.

Generally speaking cost is relative to risk. Food for thought: the cheapest back surgery is going to be about $50,000 that’s over 1200 chiropractic visits in my office. How long would it take you to use that many visits?

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.

Utah Spinal Care

USClogo2I’m back in Utah.  I have decided that rather than opening up my own private practice that I would instead work at an already established practice.  I am now the primary treating doctor at Utah Spinal Care.  Utah Spinal Care is a family practice office in Sandy Utah just up the road from Rio Tinto Stadium and the South Towne Expo Center.  We are located at 880 E 9400 S Sandy, UT 84094.  For directions, maps, pricing, etc.  please visit the website or our Facebook page.  Come visit us and pass the word along.  If you or anyone you know is in need of some Spinal Care give us a call to set up an appointment at 801-523-0073.

What is E-Stim?

Patients often wonder what the modalities that we use are doing to their body.  While we are training a new assistant in our office I thought I would take the time to write this down for their benefit and answer some questions that I get from patients here on the blog.

IFC, TENS, Electrical Stimulation

Usually referred to as “electric stim” it goes by many other names and there are different types and reasons for using this modality.  (Feel free to add uses to the comments)  The primary use of this tool in our office is for muscle relaxation and pain relief.

To start four conducting pads are placed around the treatment area.  The intensity is then increased slowly allowing the current to flow through you to the opposite pads.  This causes kind of a numb or tingly feeling in the area.  IFCThe treatment improves healing in the area, causes the muscles to relax, releases chemical pain relievers and temporarily confuses the nervous system so that it is not able to transmit pain signals as well.  In essence you get temporary pain relief and improved healing.  While some people like to show how tough they are, more is not always better.  We will usually try to find a setting that is comfortable, even pleasant, for you.

If done before, it allows the adjustment to be more comfortable for the patient.  Because the muscles are relaxed it can make it easier for the chiropractor to do the actual adjustment and decrease the risk of muscle strain.  It also has been shown to improve recovery times.

There are possible negative effects from this treatment.  They are rare and minimal.  Some people may be allergic to the adhesive in the pads and the skin may become irritated or develop a rash.  If a pad comes loose during a treatment (most machines are designed to shut off if this happens) the electricity may arc and give you a little jolt, kind of like licking a 9-volt battery or even a minor electrical burn.

E-stim should never be used with an electrical implant such as a pace maker, over the heart or the front of the neck.  You should not use e-stim over known cancer or infection, as it may increase the growth (not good).  Lastly because the risks are just not known it is not recommended to use during pregnancy.

What a Chiropractor Can Not Do

A chiropractor doesn’t directly treat pneumonia, cancer, or chicken pox.  That doesn’t mean that he won’t recognize them when he sees them though.  This week in our clinic we had a patient come back with thanks for being the ones who finally caught his tumors.  This particular patient is a military veteran who has been having major problems for years.  He is constantly seeing multiple doctors and specialists.  He had been having leg pain for quite some time no one had really taken a look at it for what ever reason.  He has serious conditions, and so they may have been more focused on those.  What ever the reason it had not been addressed when he came in to Align Rehab and Wellness (Dr Duncan’s home) for treatment of his spine he mentioned the issue.  A history and X-ray was taken, only to show tumors in both the femur and the tibia.

While chiropractors often provide symptomatic relief for some types of cancer we don’t treat tumors directly.  This patient was appropriately referred so that further testing, more specific diagnosis, and treatment could occur.  Fortunately for the patient these tumors turned out to be benign, however he was surprised and happy that it was his chiropractor that discovered them.

Chiropractors receive extensive training in diagnosis.  Often more than medical doctors.  This training is not provided because our scope of practice includes the treatment of all conditions, but it does enable us to be primary care physicians able to recognize problems.  This is a benefit to the entire community and specifically to other health care providers.  It enables the problems to be found sooner by extending the eyes and ears of well trained professionals.  This patient and thousands of others every year are grateful to their chiropractor for recognizing something that they couldn’t even treat.

As a chiropractor it is nice to know, what I can not do.

What to Expect at a Chiropractic Visit

OK, pressing forward on these last questions (feel free to submit more)…

You can expect that your first visit will be longer than usual visits, at least an hour.  You have paper work to fill out, then I take a full history and perform a thorough examination.  We may need to take x-rays look at MRI or other reports from previous physicians.

Getting adjusted should take only a few minutes.  If electrical or other physiotherapy modalities are indicated they can take from 2-15 minutes each.  Then there is also massage.  If it is indicated, I can prescribe 15 min or half hour sessions.  Once we have an idea what the problem is, treatment is usually pretty quick.  Followup visits may only be as little as 15 minutes for everything.

During the initial interview and at any time during treatment I take time to answer any questions you may have.  I try to explain things in a way that anyone can understand it so I use a lot of analogies.  I sometimes use too many.

Treatments may produce mild discomfort, but should not produce pain.  If at anytime anything makes you uncomfortable or you experience additional symptoms; speak up, and let me know.  Some symptoms may be a sign of more severe issues, and keeping symptoms or discomfort from your doctor will never improve things and could delay needed treatment.

Local fees for chiropractic vary.  My time of service fee is $40 for an office visit.  If you are not paying at the time of service I have to charge for individual treatments and they vary in price depending on the treatments.

As far as the number of visits every patient is different.  I’ve addressed this issue beforeProfessional performers are looking to maximize that performance and may want to come in weekly or more often.  Patients who have had a trauma may need to be seen 3 times a week for a while.  Some patients come in 2 or 3 times and then not again until they have a new injury. Pregnant patients will often present with an issue that is resolved and then come regularly after until the baby comes.  Some patients just really enjoy being healthy and want to stay that way.  They sometimes schedule a month out, even if they don’t need it, but just in case.

So… Come on in.