Your Irvine Chiropractor Blog
Comparing the Risks: Spinal Manipulation versus Back Surgery
While most people seeking medical care for back or neck pain recognize that they may have treatment options (often including chiropractic care and surgery), many do not understand the potential benefits and risks associated with those choices. Patients who ask family, friends or coworkers for advice all too often hear secondhand stories about healthcare “miracles” or “nightmares” experienced by a friend’s uncle, a wife’s boss or a father’s golfing buddy. The clinical facts—on the other hand—are often less accessible to the average person and tend to leave a smaller impression. However, for those who want a broader perspective on their treatment options, there are several high-quality research resources available. The American Journal of Medicine and Spine (among others) have featured information on the risks involved with surgery and spinal manipulation.
Headline: Both Surgery and Manipulation Present Risks
Patients who are suffering with neck pain and considering both surgery and chiropractic treatment should be aware of the risks and discuss them openly with their healthcare providers.
In the case of any surgery, there may be serious complications from anesthesia, excessive bleeding, blood clots that lead to pulmonary embolism and infection. These general risks are added to the more specific risks of surgery on the spine. These may include a dural tear (the dura surrounds the spinal cord and a tear can cause leaking of cerebrospinal fluid), spinal cord injury and persistent or increased pain from an unsuccessful procedure.
Spinal manipulation may also cause dangerous complications. Spinal manipulation has been associated with disc herniation, cauda equina syndrome (pain, weakness or loss of bladder and bowel function) and vertebrobasilar accident (a tear in a major artery of the neck). These complications can be just as serious as the complications associated with surgery.
If similarly severe complications may result from either course of treatment, how can a patient weigh the risk of each option? Managing risk isn’t just about understanding “worst-case”-type scenarios, it’s also about understanding how likely these and other complications are to occur. This is where some additional research findings can help.
How Frequently Do Serious Complications Actually Occur?
In April 2010, the journal Spine (published by Lippincott Williams & Wilkins) included an article that summarized the incidence of adverse events in spinal surgery based on the authors’ review and analysis of the existing literature. They found complication rates for spinal surgery ranging from 5% to 19%. Similarly, the American Journal of Medicine in 2002 published the results of a study that examined the incidence of serious adverse events for spinal manipulation. By comparison, researchers involved in that work reported complication rates ranging from one out of every 400,000 manipulations to one out of every two million.
So now we can see that the risk of a serious adverse event from spinal manipulation is extremely low relative to the risk posed by surgery. That’s one reason that the Mayo Clinic and many other reliable healthcare organizations around the world consider spinal manipulation very safe when performed by someone trained and licensed to provide this type of chiropractic care.
Whenever we talk about risk, it’s always important to remember that almost everything we do can be ‘associated’ with some type of adverse event. Driving a car, handling scissors, and even eating dinner can all lead to serious complications. The best way to handle these risks, including the risks of spinal manipulation, is to understand them and keep them in perspective. Healthcare providers are uniquely qualified to help you do that. If you or someone you care about is interested in chiropractic care—including its potential benefits and risks—please call our office to make an appointment.
References
Dekutoski, MD, M. B., Norvell, PhD, D. C., Dettori, PhD, J. R., Fehlings, MD, PhD, FRCSC, FACS, M.G., & Chapman, MD, J. R. (2010). Surgeon Perceptions and Reported Complications in Spine Surgery. Spine, 35(9S). Retrieved August 31, 2011, from http://www.medscape.com/viewarticle/721611
Staff, M. C. (n.d.). Chiropractic adjustment: Risks – MayoClinic.com. Mayo Clinic. Retrieved August 31, 2011, from http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107/DSECTION=risks
Stevinson, MS, C., & Ernst, MD, PhD, E. (2002). Risks Associated With Spinal Manipulation. The American Journal of Medicine, 112(7), 566-571. Retrieved August 31, 2011, from http://www.sciencedirect.com/science/article/pii/S0002934302010689
Tags: degenerative disc disease, disc bulge, DRX9000 Spinal Decompression, herniated disc, low back pain, low back surgery, neck pain, neck surgery, Sciatica
How Many Adjustments Will I Need?
The short answer to this question is, “It depends.”
For example, the number of recommended adjustments may depend on why you sought chiropractic care in the first place. Were you concerned with pain, or recovery from an injury, or did you seek care to promote your overall health and wellness? The national average when dealing with pain and injury is 20 to 22 adjustments per patient, per injury. When the initial pain or injury has been relieved and treatment moves more into the area of general wellness care and health maintenance, the number of adjustments is almost always a partnership between the chiropractor and the patients. They work together to determine overall goals and set up an appropriate treatment schedule.
Many patients find relief in their first visit and see considerable progress within a week or two of regular visits, and regular adjustments can become less necessary as your body stabilizes. Of course, this varies from patient to patient, depending on the nature of the injury and the stage of treatment they are in. In the first or acute stage, when the patient has first consulted a chiropractor, the primary goal may be to relieve pain and increase mobility, so several adjustments a week may be required to accomplish this.
However, the scar tissue and postural imbalance that can build up around spinal injuries can take some time to heal completely, so there may be a reconstructive or healing phase of treatment. This stage seeks to improve the strength and flexibility of soft tissue surrounding the area of the original injury. During this phase there are commonly fewer adjustments – from once a week to once a month. At first the patient may find in nearly every visit that their spine has slipped back out of adjustment and requires correction. When the spine starts holding its adjustments, however, treatment can be reduced to a check-up every few months.
The number of recommended adjustments may also vary depending on the nature of the services provided by the individual chiropractor. Some treatment approaches seek to correct problems in a few sessions, while others take a more long-term approach, constantly evaluating the patient’s progress and changing the treatment regimen accordingly to not just heal the immediate injury but develop a more healthy spine and lifestyle. Chiropractic care is to some extent an art form; there are many ways to adjust the spine, and many ways to determine whether the adjustment has been successful. This can depend on the chiropractor’s personal style, where they were educated, their experience, and many other factors.
To some extent the determination of how many adjustments you will need depends on you, your personal goals, and how much you want to benefit from chiropractic care. Some patients seek only resolution of pain or discomfort from an injury, and are not as interested in long-term therapies to improve their spinal and general health. Others choose to pursue treatment because they recognize the importance of maintaining a healthy spine, to prevent future injuries and increase their quality of life.
Resources:
http://www.ehow.com/video_4397485_how-many-chiropractic-visits-do.html
http://www.demosschiropractic.com/chiropractic-fidelity.cfm
http://www.oliverspecific.com/chiropractor/how-many-chiropractic-adjustments-do-i-need-part-2/
http://www.back2harmony.com/faqs_treatment.html#howmany
http://www.creatingwellnessdr.com/chiropractic-adjustments.php
Tags: Chiropractic, chiropractic adjustment, chiropractic careWhat Should I Expect at my Chiropractic Appointment?
During your initial visit, you will be provided with a few registration and medical history forms by the office staff. Then the chiropractor will typically ask further questions about your health history and about your current problem or condition, such as:
- If you are experiencing pain, where is it located and when did you first notice it?
- Does the pain or discomfort seem to be the result of a recent injury or activity, or has it existed for some time?
- Are there activities or circumstances that make it better?
- Are there activities or circumstances that make it worse?
You may also be asked about any pre-existing medical conditions or prior injuries, your family’s medical history, and other treatments you have received from health care providers. Once completed, your chiropractor then will carry out a thorough chiropractic examination, with a special emphasis on the spine. In addition to general tests such as blood pressure, respiration, reflexes, and pulse, the examination may include certain tests to assess the range of motion of the injured or painful body part, muscle tone and strength, and neurological integrity. Additional diagnostic studies such as X-rays or laboratory tests may be performed or recommended.
The medical history, physical examination and diagnostic tests all help to determine a specific diagnosis. The chiropractor will explain the diagnosed condition to you and determine if it is likely respond well to chiropractic care. If so, the chiropractor will explain the proposed chiropractic treatment plan or other treatments to you and the anticipated length that the treatment should take. Both short- and long-term goals for your treatment will be discussed, and additional therapies may be recommended for future visits, such as:
- Application of heat or cold to affected areas.
- Massage and stretching.
- Modalities to speed healing of soft tissues and improve pain control, such as electrical stimulation and traction.
- Rehabilitative and general exercise to improve muscle balance, strength, and coordination.
- Lifestyle counseling about healthy eating and weight loss.
Many chiropractors begin treatment during your first visit, although some may wait until the next appointment to perform the first adjustment. During a typical adjustment, you will be placed in various specific positions while your chiropractor treats the affected areas. For example, you may be asked to lie face down on a padded table specifically designed for chiropractic adjustments. Chiropractors then use their hands to apply a controlled, quick force to a joint, which extends it beyond its usual range of motion. The goal of this maneuver is to increase the range and quality of motion in the area being treated and to aid in restoring health. You may hear cracking or popping sounds as your chiropractor manipulates your joints during the treatment session. This is similar to cracking one’s knuckles, and there are rarely any feelings of pain or discomfort.
As your course of treatment continues, your chiropractor will evaluate your progress, to see how much your treatments are helping, and may adjust the recommended treatment regimen accordingly.
Resources:
http://www.spine-health.com/treatment/chiropractic/what-expect-first-chiropractic-consultation
http://www.ctchiro.com/FAQ.php
http://nccam.nih.gov/health/chiropractic/introduction.htm
http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107/DSECTION=what%2Dyou%2Dcan%2Dexpect
http://www.mychiro.com/chiropractic.htm
http://www.pazdelchiropractic.net/index.php?option=com_content&view=article&id=10
Tags: Chiropractic, chiropractic adjustment, chiropractic careCan a Chiropractor Prescribe Medication?
Doctors of Chiropractic are not licensed to write medical prescriptions or perform surgery in the United States. They rely instead on a variety of manual treatments, including spinal manipulation and mobilization, which are designed and selected to improve function and alleviate pain for their patients. The chiropractic field is based on treatment with as little use of medication as possible, and is defined by the National Chiropractic Association as ideally a “drug-free, non-surgical science.”
That said, most chiropractors recommend that their patients have a primary care physician, and they recognize the efficacy of medications to relieve extreme pain and other conditions. If medication is needed, many chiropractors work closely with their patients’ primary care physicians to determine which medicines may be needed to reduce pain or speed the healing process. If chiropractors are also licensed in a field such as homeopathy or naturopathy, they may recommend those types of remedies, or provide general nutritional counseling. Their ability to do this depends on regulations that vary widely from state to state in the U.S.
One state, New Mexico, has recently passed legislation that allows some chiropractors to prescribe medicines. This legislation was considered valuable to the public because the state contains many areas of low population in which the only medical professionals available are chiropractors. After completing a standardized course, these Advanced Practice chiropractors are allowed to prescribe medicines from a strictly regulated formulary. This program has provided access to these medicines to many residents of New Mexico who would otherwise have had to travel several hours to see a medical doctor. Whether this approach will be taken in other states is yet to be seen.
In many cases, chiropractic care is all the therapy that is needed to treat common problems such as lower back pain. Chiropractors are trained in how to perform the manipulations that correct these problems. However, if the problems are more serious or if concurrent conditions are present, chiropractic care may be complemented by other medical treatment. We certainly urge you to consult with your primary care provider in such cases, and to rely on their specialized training to determine if medication is needed.
Resources:
http://www.acatoday.org/content_css.cfm?CID=2205
http://www.spine-health.com/treatment/chiropractic
http://willistonchiropractic.com/about-chiropractic/
Tags: Chiropractic, chiropractic education, chiropractic safety, chiropratic careDo Chiropractic Adjustments Hurt?
Chiropractic adjustments, also known as spinal manipulations, are a procedure in which a joint is moved past its usual range of motion in daily life. The purpose of chiropractic adjustment is to improve your body’s functioning and alleviate pain.
Adjustments are most commonly made to joints in your back, but also to joints of the neck or other parts of the body, such as the shoulders. You may be treated by a chiropractor in order to correct such conditions as:
- Neck, back, shoulder, arm, hand, chest, leg, or foot pain and stiffness
- Headaches
- Sciatica
- Arthritis
- Trauma, such as whiplash
- Scoliosis
- Sports injuries
- Repetitive strain disorders such as carpal tunnel syndrome
- Fibromyalgia
Moving the joint beyond its range of motion sounds painful, doesn’t it? However, the joint is not moved beyond the range of motion it is naturally designed to move in the body. You may feel pressure or mild discomfort, and the discomfort may be greater if there is significant inflammation or tension around the joint being treated. However, chiropractic adjustments should not be painful.
If you are new to chiropractic medicine, you may have a harder time relaxing during the procedure than more experienced patients. If you stiffen or resist the adjustment, you may feel some discomfort. However as you get used to the procedures you should find not only that the discomfort decreases, but that you may feel relief and a sense of well-being after the adjustment I completed.
During the procedure, you will be placed in a certain position to treat the affected areas. Usually you will be lying face down on a padded table. There may be popping or cracking noises during the adjustment, as the joint is moved. These noises are the result of the release of tiny pockets of gas during the procedure, which is completely normal. In fact, it’s the same thing that occurs when someone cracks their knuckles.
After the procedure, you may feel some soreness or aching in the muscles or spinal joints. If it occurs, this kind of discomfort usually happens within the first few hours of treatment. It should not last longer than 24 hours (and if it does, be sure to contact your chiropractor for assistance). If you like, you can place an ice pack on the affected area which should help reduce the symptoms and help you recover more quickly.
In order to be sure you have as pain-free a treatment as possible, be sure you choose a board-certified chiropractor with good patient references. An experienced, competent practitioner will be able to give you the most effective treatment possible with the least amount of discomfort.
References
Chiropractic Adjustment: What you can Expect. http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107
Reactions Following a Chiropractic Adjustment. http://www.spine-health.com/treatment/chiropractic/reactions-following-a-chiropractic-adjustment
Tags: Chiropractic, chiropractic education, chiropractic safety, chiropratic care
What is a Chiropractic Adjustment?
Chiropractic adjustments are the foundation of chiropractic treatment. Chiropractors use adjustments to correct mild vertebral subluxations, or dislocations and misalignments of the bones of the spine (vertebrae). The word “subluxation” has its origins in the Latin words “luxare” (to dislocate) and “sub” (mild). Subluxations may put pressure on or irritate nerves and blood vessels in the spine, and cause musculoskeletal pain and dysfunction.
Adjustments, also known as “spinal manipulation”, involve the use of a certain amount of controlled force, applied in a specific direction, to a joint that is not moving properly. Adjustments are usually carried out manually by the doctor, or by using an instrument. Chiropractic adjustments help return your vertebrae to their natural position and range of motion, with the goal of restoring health and normal functioning. In addition to restoring joint mobility, adjustments can also allow healing of tissue injuries involving inflammation and pain.
Before carrying out an adjustment, your chiropractic doctors will thoroughly evaluate your case through collection of a health history, physical examinations, laboratory tests, imaging (such as X-rays) and other procedures. During the adjustment procedure itself, you may be lying down on a specially designed chiropractic table. Your chiropractor will apply the adjustment in a controlled, sudden manner, pushing your joint beyond its normal range of motion.
There are over 96 individual chiropractic maneuvers your doctor may choose from for your adjustment. Factors in this decision include how much force is needed, where in the body the adjustment is needed, the position of both the chiropractor and the patient also contribute to the selection of the best type of adjustment for your particular condition.
Adjustments may be used to treat back pain, neck pain, or pain in other areas of the body such ass arms, legs, and shoulders. The procedure rarely causes pain; however if there is recent trauma or if you are new to chiropractic medicine there may be some discomfort. The popping and cracking noises that occur during adjustments are due to the release of gas bubbles between the joints, and these sounds are perfectly normal. It is a similar phenomenon as when knuckles are cracked.
In many cases, chiropractic care is all that is needed to treat a certain kind of problem, such as lower back pain. However, adjustments may be complemented by other medical treatment if concurrent conditions are present.
Resources
http://www.acatoday.org/
http://www.chiro.org/acc/What_is_Subluxation.shtml
http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107
http://www.mdguidelines.com/chiropractic-adjustments-and-manipulations
Tags: Chiropractic, chiropractic adjustment, chiropractic careDo I Really Need to Stretch?
Stretching is the part of our workout regimen many of us tend to skip. We might say it is because of lack of time, impatience or a feeling that stretching is “pointless.” However it is important that our joints are able to move in various directions with a certain degree of freedom. As our bodies age, we become stiffer and lose the flexibility we had when we were young. Chances are unless you’re a dancer or a gymnast, you’ll have lost that fluid flexibility you had as a child even in your twenties. However, it is never too late to regain enough flexibility to remain youthful and limber by training through stretching. Proper stretching allows us to continue doing our daily tasks into old age, such as reaching that high shelf, bending to pick up a dropped object, or accessing that hidden switch behind an awkward kitchen cabinet.
One reason it’s really important to stretch before working out is that we are likely to use muscles and tendons that are normally inactive. Without flexibility to those muscles, the risk of injury or of tearing those muscles and tendons when used, is higher. If stretching is done correctly before working out, it’s a good prevention against injury, and can also be used to treat injuries as well. Finally, when done properly, stretching simply feels good. It can be a great way to gently start the day or to wind down after work.
Preparing the body for exercise by warming up the muscles by stretching is easy and need not take up much of your time. This will increase the blood flow to your muscles and loosen them up allowing you to exercise without having to worry about injury or being overly sore the next day. Simply warm up the various muscle groups with slow stretches of the joints towards the end of their range of motion; this should cause the feeling of a gentle “pull” being felt in the muscles. Hold the position for up to half a minute and then alternate side or muscle groups. Not only does stretching prevent injury, but it also improves the mechanical efficiency of your body. Stretching prior to exercise means the muscles are stretched and warmed up, allowing them to undergo the full range of motion with less effort when exercising – this means the body’s overall performance is improved.
Other added benefits to stretching include improved circulation to the muscles and joints, alleviating the pains felt post-workout, and stretching can also help to improve your posture. If you find at the end of the day stiff and achy from sitting at a desk all day – try stretching. You might find that you’ll feel instantly better. Regular stretching in your shoulders and neck may help you to maintain a better posture. As a result, this may help to prevent the onset of lower back pain.
References Used:
[1] http://www.spineuniverse.com/wellness/exercise/incorporating-stretching-your-exercise-routine Accessed October 2011
[2] http://www.healthnewengland.com/newsletters/LivingWell/LW/Livewell13.pdf Accessed October 2011
Tags: Chiropractic, chiropractic care, Exercise, fitness, stretching
Why You Should Drink More Water!
Water is the elixir of life, but do we get enough of it? Many people think that substituting sodas, coffee and juice for water is enough to keep us hydrated and healthy, but nothing can beat the original and the best – water.
Our bodies are made up of 43-75% water, and it’s an essential component of our health. The wide range in percentages comes from measuring different populations ranging from newborns (~75%) to obese people (~45%), with normal adult hydration at about 57-60%.
We can survive a month without food, but we’ll die after a week without water. The body is able to absorb many nutrients and salts better thanks to water’s ability to transport these nutrients and oxygen to our body’s cells and organs. Detoxifying is vitally important to our health, since it cleans our bodies of impurities. The best way to excrete these impurities is through urine and sweat – both of which depend on our water intake. Upping your water intake may help to reduce the risk of kidney stone formation. The kidneys filter our waste products through the blood and out via urination. If the concentration of salt in our urine is high, and our water content low, this increases the risk of kidney stone formation. By drinking more water, this concentration of salts is reduced.
We are at risk of sunstroke if our bodies become dehydrated. When we sweat, this cools our body down. If dehydrated, the body cannot sweat and overheats, which can damage the body’s internal organs.
If you suffer from high blood pressure, maybe it’s your water intake that is the problem. When our bodies excrete and lose more than the optimal amount of liquid, our blood vessels constrict, which can cause our blood pressure to increase. If blood pressure is increased by a deficiency in water, this may also increase the risk of heart disease. Because the constricted blood vessels cause an increase in blood pressure, the heart works harder to compensate for the reduced volume of blood. Lower blood pressure and greater consumption of water help lower stress on the heart.
What’s more, drinking more water can help you stay younger looking. Drinking a lot of water helps keep the skin clean and fresh-looking by removing impurities through sweating. Water also helps to keep the skin hydrated, which means younger looking skin – sagging and wrinkled skin is usually a sign of dehydration. Drinking water also cuts hunger pangs and acts as a good filler. Water has zero calories, so consider trading in your sugary drinks and juices to help control your weight.
If increasing your water intake seems like a chore, why not add lemon or mint to your bottle to make it taste better? Eat more fruits rich in water such as watermelon, and try to drink water more regularly over the course of the day. Having a glass of water or water bottle near you during the day has been shown to increase water consumption without effort.
References Used
[1] http://www.jbc.org/content/203/1/359.full.pdf Accessed October 2011
[2] http://thetaoofgoodhealth.com/10-health-reasons-why-you-should-drink-more-water-4/ Accessed October 2011
[3] http://www.uihealthcare.com/topics/generalhealth/ghea5288.html Accessed 2011
Tags: Chiropractic, nutrtion
The Perfect Office Chair Makes All the Difference
For the majority of us who work in office and at desk jobs, we spend a great deal of time sitting down. While sitting for most of the day seems pretty low risk compared to other occupational hazards, sitting in the same position all the time can stress the structures of the spine, and may result in injuries to the back, neck and even the wrist. It is important to find an office chair that is ergonomically designed to support the lower back and promote good posture. An ergonomic chair cannot only prevent injury and pain in the back, but it also maximizes your function at work.
When looking for the right ergonomic chair for you, it is important to find one suited to your needs. With so many ergonomic office chairs on the market, it’s important to research them, since there is no single chair that could be labeled the “best.” There are specific features that should be considered when looking for a desk chair, such as adjustable seat height. Your feet should be flat on the floor with your thighs at a horizontal position, and your arms should be even with the height of the desk. Having an adjustable armrest is also beneficial, since users can rest their arms and relax their shoulders, which can eliminate significant tension while working. You should also look for a chair with a seat that has sufficient width and depth to support any user. While working, you should be able to sit with your back resting against the back of the chair. In addition, the back should also be adjustable in its tilt forward and backwards.
One big issue about working at a desk all day is that many chairs are not designed to support the lower back. Support for our lumbar spine, or our lower back, is very important. Our spinal curvature has an inward curve in the lumber spine, and sitting for too long without supporting it will lead to slouching and straining the structures of the lower spine. An ergonomic chair must offer lumber support and adjustment, so the user can fit the chair to the inward curve of the lower back.
Additional things to also consider are the seat material: is it comfy? An ergonomic chair with a swivel on the chair can help you reach different areas of your desk without strain.
After researching the properties of the ergonomic chairs on the market, you need to consider your specific job and what functions you need to perform. Consider your priorities and properties you need for your ergonomic chair. Once you’ve decided on the chair for you, explore stores to try the chairs out. See if they’re comfortable and meet your needs. Shop around, both online and off to make sure you get the best price and quality out there. You might also want to consider alternative ergonomic chairs, such as kneeling or saddle chairs and even the exercise ball chair.
References Used:
[1] http://www.spine-health.com/wellness/ergonomics/office-chair-ergonomic-chair-alternatives-traditional-office-chairs Accessed October 2011
[2] http://www.wikihow.com/Choose-an-Ergonomic-Office-Chair Accessed October 2011
[3] http://www.officechairadvice.com/ Accessed October 2011
Tags: Chiropractic, chiropractic care, ergonomics, healthy posture, posture, proper workstation

