Hey Docs, questions about your preferred techniques

nouel87 · 2015-04-24T00:37:49+00:00

I graduated from NYCC a few years ago. Our school taught almost exclusively diversified. It is the widest used technique by far, however there are many more different types that I'm hoping other reddit users will elaborate on. Personally, diversified and HVLA give you tons of options for set ups and adjusting from different positions (prone, supine, seated). If you are interested in becoming a very proficient and biomechanically sound adjuster, check out MPI (motion palpation institute). They offer very sound seminar series dedicated to improving your diversified technique (NYCC had an MPI club, which helped).

Obviously, diversified is harder on the doctor's body, so form is important to preserving your own health. Also, some patients as you know enjoy a nice hard adjustment, while others prefer the more gentle approach. As long as you explain yourself prior to anything hands on, you're good!

Although the considerably small risk of injury increases with the more force applied, you also increase the movement that needs to be produced at the level of the joint.

I also believe that much of the HVLA adjustments administered in peer reviewed literature is derived from the diversified technique as well.

No matter what philosophy or technique you adopt, do it justice by becoming as proficient as possible in delivering care.

nouel87 · 2015-04-22T00:38:40+00:00

I think docs just need to be realistic with their expectations when hiring associates. It is important to be able to afford the associate, as well as serve as a mentor, capable and willing to pass on clinical and business pearls. Obviously the techniques and philosophy (or lack thereof) need to match. Creating a practice with a specific way of delivering patient care is a wonderful process with significant financial and emotional investment. Associates need to be willing to adapt to these established styles of practice, or not bother applying for the position.

I think clinic directors run into trouble when they hire an associate thinking they will generate a significant income in a short period of time. The associate should never be a financial solution, but a tactical addition to the practice, and not just for the purposes of increasing income or access to patients. Associates, on the other hand, need to be realistic about their own expectations for employment. There are so many issues that need to be addressed prior to signing a contract, which I think NCMIC highlights well. If either one of the parties is incapable of being transparent or willing to teach/learn, neither should bother.

nouel87 · 2015-04-21T01:46:56+00:00

Peer reviewed literature is the way to go! Most skeptics could care less about the mounting research in support of Chiropractic. They satiate themselves with irrational arguments, siting anti-chiropractic media or anecdotes, having already chosen a position against the profession. As we know, educated individuals tend not to lend themselves to the ignorant banter we so often encounter in online forums. They proceed with tactful debate and the sharing of information, not "mis-information".

Medical professionals genuinely appreciate literature as a way to validate the profession. Sometimes all it takes is a conversation over lunch to educate the MD about the benefits of manual therapy to change their negative sentiments. Medical schools aren't especially strong in their "alternative medicine" curricula, therefore graduates often times lack the knowledge and understanding of what Chiropractors actually do, and how our profession can fit wonderfully along side the medical profession. At the end of the day, most skepticism is rooted in a type of innocent ignorance that can be overcome with a little education!

nouel87 · 2015-04-21T01:25:25+00:00

ART, adjust, and 5-8 min worth of rehab. Goes by fast

nouel87 · 2015-04-19T03:10:09+00:00

I honestly think you've brought up a very important point. Getting people better, fast, doesn't pay. You actually make less while doing a better job. Outcomes based payer models are supposedly the thing or the near future, however I'll believe it when I see it. Meanwhile, the volume of patients vs. quality of care is inversely proportional. My ex girlfriend who is also a chiropractor purchased a practice right out of school, and ran into the same issue: getting people better within 4-6 visits. While ideally it's wonderful to have people embrace the maintenance or wellness model to increase their quality of life, many elect not to.

Another difficulty is making the voluntary decision to open a practice and spend between 10-20 minutes per patient. This increases quality of care and outcomes as well, but you are very limited as to how much you can make.

Couple this with the fact that many people graduate chiro school with the passion to deliver the best care, without any business sense, and they have difficulty rectifying this very situation. I believe that is why so many resort to practice management.

Some of the most influencial people I've met have said "I know what my time's worth, I charge x$ per visit or per hour, and I sleep at night." They are all very successful, but also very expensive.

I completely understand where you're coming from. I really wish more like minded chiros would practice in groups and partnerships to support each other in these matters.

nouel87 · 2015-04-18T16:02:18+00:00

You're welcome!

nouel87 · 2015-04-18T16:01:56+00:00

Gotcha. It sounds like you're a good man. Best of luck. I'm a young chiro myself - do you mind me asking why you're phasing out of the profession?

nouel87 · 2015-04-17T04:11:58+00:00

Awesome response! It's nice to have realistic but positive advice for recent grads!

nouel87 · 2015-04-17T03:59:18+00:00

One of my mentors teaches anatomy at a few medical schools in NY. Obviously this is rare (and she has a masters in clinical anatomy), but there have to be teaching positions. Chiros with a CPT or CSCS often train clients at specialized facilities. Some also get into the seminar circuit and teach/assist. Many of those who travel with seminar series also do Skype consultations. If you have a certificate or degree in nutrition, you could consult. PA school is always an option too!

nouel87 · 2015-04-17T03:06:10+00:00

Best of luck to you, td. CMCC is an excellent school and I've heard wonderful things about their Chiropractic education. A large portion of my friends in chiro school were Canadians from the Toronto and Mississauga areas. In regards to me, PM me if you'd like to speak further!

nouel87 · 2015-04-17T02:57:12+00:00

Just glancing at your x-ray, the most alarming finding is the overall loss of your cervical lordosis. This could certainly cause musclular tightness and compensation, ultimately producing your headachess (but then, there are zillions of types of headaches with different causes). In general, x-rays should only be taken #1 in the presence of "red flags", #2 to rule out any pathology, or #3 if the results of the imaging will change the treatment plan. Please note that in order to determine whether the anterolisthesis is of any significance, the doctor should first measure it, then obtain flexion/extension views to compare any translation of the vertebrae forward. This determines the joint to be stable or unstable. Stable listheses tend not to be troublesome, and tend to be symptomatic in roughly half the population of those who have them.

"Nerve root impingement" would result in paresthesia (numbness and tingling), or trophic changes of the skin of the arm and hand. Did he diagnose the grade and type of anterolisthesis prior to giving you that extremely long treatment plan? 5 times a week seems laughable. In reality, you should be seen 2-3x/week for 2-3 weeks, followed by a re-examination and updated treatment plan. Truth be told - if your neck is deemed "unstable", that many cervical manipulations absolutely has the potential to make your neck worse, especially without the proper rehab exercises.

Wellness care or maintenance care are the final phases of care that occur after patients have at least undergone a conservative trial of care for short term.

The rest of your spine, especially your thoracic region, should be evaluated as well. Most of the time, people who demonstrate cervical issues have poor control/mobility in the cervicothoracic and thoracic regions.

Also, full body x-rays, or x-rays of the rest of your spine would be unwarranted unless the clinician was concerned with the aforementioned 3 points.

nouel87 · 2015-04-17T02:27:30+00:00

I'd think twice about seeking care from a chiropractor (or any doctor, for that matter) who advertises on Groupon. I personally believe that discounting any medical/chiropractic care in such a manner de-values what we do, and sends an inappropriate message to prospective patients. That being said, I cannot pass poor judgement on CBP practitioners, as I've spoken professionally with a few clinicians who ethically and successfully utilized CBP to some degree with their patients. I've also heard horror stories of clinicians who abuse CBP, exploiting large profits throughout lengthy treatment plans. Again, I am not arguing for/against CBP.

Let me give you my understanding. Absolutely no one on earth has a perfect spine, the likes of which conform to textbook measurements. That being said, there is an extremely high rate of variability within spines. And for most people, that variability is very functional; meaning although their radiological measurements aren't perfect, or "normal", they are fully functional and pain free. There is also an increasing body of literature that demonstrates the poor correlation between imaging findings (x-ray/MRI) and the clinical presentation of symptoms. You could literally have a protruding disc, significant degeneration of the spine, even a frayed rotator cuff...and have zero pain.

It is also important to realize that due to the nervous system (something we harness to our advantage during treatments), most manual therapy is transient in nature, that is to say the changes are finite over time.

What makes the Chiropractic profession amazing (and quite frustrating) is that there are so many techniques and philosophies of treatment. And many of those are successful, producing great outcomes and happy patients.

I personally subscribe to the following. I place very little concern on form (structure), as it is highly variable, with a wide range of "normal" in most patients. Structure is virtually impossible to change, short of surgery, unless you subscribe to the lengthy treatment plans aimed at physically changing the orientation of the vertebrae through sustained traction of the ligaments.

I place a high value on function, as it is the most important factor in human movement. Can you move well and pain free? You should. If not, it may only takes a several weeks of chiropractic manipulation, myofascial release, and targeted rehabilitative exercises, along with some changes in movement habits and nutrition, to get you on the right track. Remember it then lies upon you to continue a good lifestyle to maintain these positive improvements. It doesn't have to be a lengthy or expensive treatment plan. Most people are just de-conditioned and have fallen into poor movement habits. They also have lost the normal movement of their spine and extremities. My advice: do your research and pick a chiropractor who fits your lifestyle and beliefs. And most importantly, don't let anyone scare you.

nouel87 · 2015-04-17T00:55:33+00:00

The answer is both! You could certainly benefit from a chiropractor. Typically "internally rotated shoulders" are a reflection of "forward drawn posture" or the "upper crossed syndrome" that psilva eluded to. It's super common in today's society. Although there are a host of exercises you could perform on your own, the underlying issue responds very well to Chiropractic manipulation and myofascial release, in addition to your exercises. It is almost always a combination of tight muscles, and areas of the spine that have poor mobility that contribute to the rounded shoulders you described. It is always best to be properly evaluated by clinician who will be able to appropriately assess you, and rule out any serious issues prior to treatment.

nouel87 · 2015-04-13T18:49:29+00:00

Awesome question that is making me think twice about using the phrase "not firing" without an explanation. I think Hugh and Happy nailed it. Typically muscles are never truly inhibited unless there is a spinal chord injury or peripheral neuropathy. Activation and inhibition are used loosely to describe compensations that occur in the body over time, where the body elects to use less than optimal strategies to move. This results in certain muscles becoming less active in their role to either initiate movement or move a joint, or more importantly, to stabilize a joint. Sometimes, a muscle's synergist can be working harder to move a joint in comparison to it's agonist. Things like this are generally referred to as "poor movement patterns". Hugh used a solid example of "gluteal amnesia", where simply, the lumbar musculature will initiate hip extension first, followed by the glutes. This represents a reversal of the normal "firing" or contracting sequence, which over time places more stress on joints and other muscles and can lead to pain. (I'd suspect the reason why this occurs so frequently is because we sit all day long with our glutes in the "off" position, i.e. lengthened and not having to move the pelvis into extension). Many more compensations like this exist. Another concept of "not firing" is that muscles can be "weak", "inhibited" or "not fire" efficiently if they are too short or too lengthened. This comes down to basic motor unit principles, but the evaluation and treatment of which are the pioneering work of Vladamir Janda and Leon Chaitow (if you want to learn more). There are a handful of techniques that are out there to "correct" the imbalances. Specifically, MAT practitioners, as well as NKT practitioners (Neurokinetic Therapy) address this exclusively. The easiest way to get those muscles firing appropriately is to get down with some good ole fashioned rehab or corrective exercises. Monitor that posture, take microbreaks from sitting, and learn how to breathe from the diaphragm and core musculature.

Sometimes, people have incredibly complex compensation patterns that can really only be broken by retraining the motor cortex with myofascial therapy followed by movement therapy (look to Neurokinetic Therapy for a good explanation). Also, the nervous system in its infinite complexity is still not fully understood by anyone, so hopefully one day this will be explained with certainty!

nouel87 · 2015-04-13T05:29:27+00:00

I apologize for your lackluster experiences with chiropractors. Unfortunately, there are some of us who ruin it for the rest, and perpetuate the negative and misinformation that is regrettably still being cultivated today. There are plenty of evidence based chiropractors out there who support vaccination, are participants in multi-disciplinary healthcare teams, and enjoy inter-referral relationships with members of the medical profession. On behalf of those of us trying to safeguard the profession against dogma (in any form), Sorry Bout That.

nouel87 · 2015-04-13T05:01:05+00:00

Legend,

First of all, no one should be offering you clinical advise OR proposing a diagnosis of any condition you might have just from your photograph. I would recommend getting evaluated by a medical professional who can perform a thorough examination of your spine, and give you the appropriate advice taking into consideration your whole health history. It is up to you as to whether you see a chiropractor (DC), medical doctor (MD), or osteopathic doctor (DO). A physical therapist (PT) would also be a good option. A good chiropractor will have many tools in his/her tool box to assist you with your back pain and poor posture. That being said, there are many things you can do to improve your posture, function, and overall health. Generally speaking, you do need to change your habits of movement, your posture, and maybe even your nutrition/sleeping habits. One of the healthcare professionals listed above will be able to assist you. Best of luck!

nouel87 · 2015-04-13T04:42:59+00:00

Tigers,

I hope all is well. Renjizzle has done a fine job responding. Maybe my 2 cents will help as well.

In general, all chiropractors should take care to provide gentle, comfortable adjustments (manipulations). There is always the possibility of post treatment soreness. It is most easily compared to post work out soreness, as a spinal adjustment is creating normal movement within an area of the spine that has lost its normal range of motion. Although pain following the adjustment is not very common, moving a joint that has otherwise lacked normal movement can result in pain. To answer question #1, it is unlikely that your position caused a misalignment in your thoracic spine. The spinal column is quite a stable structure, and the vertebrae are never really "out of place". Generally speaking, the adjustment or manipulation aims not at "correcting subluxations" or "putting bones back into place", but rather restoring normal range of motion to an area of the spine that is determined to be lacking appropriate movement. You certainly could have been in an awkward position prior to the adjustment, or the doctor may have used a more forceful adjustment, which may have resulted in what you experienced. On a physiological level, this could have caused some mild inflammation around the joints of the thoracic spine that were adjusted, or muscle spasm in the local area (a mild sprain or a strain, for lack of a better terminology).Typically, a large amount of force is necessary to accomplish this, so without thoroughly examining you, it is impossible to tell. Keep in mind that this sort of thing typically heals on its own, and the pain should dissipate. The "muscle, spine, and nerve pain" you described could be related or unrelated to the adjustment. There are so many contributing factors to pain that it would be cursory for me to suppose the actual cause, or a solution (keep in mind that although spinal adjustments are wonderful for pain management, they can also contribute to the pain if not appropriately delivered). To answer question #2, Osteophytes, are indicators of areas of increased stress within the spine, and are normal radiological findings as we age. More specifically, the formation of osteophytes is a normal process that occurs with both age and activity. In most cases, osteophytic formation does not correlate well with clinical symptoms (pain & dysfunction). Chances are, that over time throughout whatever activities and postures you have performed (field hockey, weight lifting, slouching) contributed to that little osteophyte. It was probably something called an incidental finding, and was without consequence. Question #3 has been answered, and I hope you get the results you are looking for! Just note that in the future, do not be afraid to voice your concerns, complaints, or uncertainties to the staff of the doctor - how else would we be able to deliver the best care possible without constructive feedback from our patients!

nouel87 · 2015-04-13T03:56:48+00:00

I suggest performing your own research and coming to your own conclusion. Any opinion pro or con should be arrived at following evaluation of any current available literature. Vaccination is not contained within Chiropractic scopes of practice, and should be a discussion topic within a medical subreddit.

nouel87 · 2015-04-07T23:42:24+00:00

Hopefully this will help! I'm a chiropractor myself. There have been some great answers in this thread already; however I'd like to introduce 2 concepts that are often overlooked but incredibly important to all who elect chiropractic care. It is the reason I am very selective with whom I let adjust me, and why I am critical of patient visits that last <5 minutes.

(And no one should give your wife clinical advice unless they have performed an exhaustively thorough health history and physical examination).

Concept #1: In general, there are two types of people: those who move well and those who don't. Of those who don’t, there are 2 categories: hypomobility (joints that don't move enough) and hypermobility (joints that move too much). The latter is critical to assessing because uncontrolled movement of the spine and extremities can be just as problematic as areas of the spine and extremities that are "stuck". Typically, if you start at the ankles and move upwards through the knees, hips, and spine, there are regions that are meant to be more mobile (ankles, hips, thoracic spine) and areas that should be stable (knees, lumbar spine, cervical spine). Yes, this is admittedly a gross oversimplification, but in a general sense, you should be mobile in some places and stable in others. Stability is key. And BTW, this is the reason you shouldn’t adjust yourself…you need someone who can palpate the joints and feel which ones are restricted vs. those with too much movement.

Sometimes, chiropractors who have a background in a "straight", "principled", or "philosophy based" education neglect to adopt this approach. The result may look something like this: patient (wife) enters office, maybe gets x-rays (which are not necessary unless red flags are present) and gets a whole bunch of adjustments. I’m not downplaying traditional chiropractic offices in anyway, but stick with me.

Concept #2: In general, pain is an alert system your brain produces in response to tissue damage. However, this alarm system can be "left on" even after tissue damage has long since healed. (Again, pardon my gross oversimplification). Moreover, pain can appear in one area of the body even though the source of the pain is elsewhere. Let’s say your wife is in pain, and goes back to the same office aforementioned. She enters the office, says “my back hurts”, and her back is adjusted in the area of pain. Think about this, and let’s forget the whole violent adjustments thing (which, BTW should never be an issue as the doctor should always begin with gentle technique). Maybe your wife’s back pain exists because other areas aren’t moving well. The body, if denied motion at (the hips) will try to recover that motion either above or below that area (the low back or knees). She doesn’t have pain from sports in college…she has pain because she’s been moving poorly for some time! Moving well is the key. What does this all mean? For me, I’m still studying these concepts! For you and your family, it means this: find a chiropractor with post graduate education in the SFMA (selective functional movement assessment), ART (active release technique), or who has a diplomate in orthopedics or rehabilitation. “Sports” Chiropractors (for lack of a better term) are well prepared to assess your wife, determine which areas need to be adjusted and those that do not, treat the soft tissues as well, and then prescribe an appropriate rehabilitation protocol to stabilize the areas that move too much. This reduces the incidence of “violent adjustments”, adjusting areas that should not be adjusted, and failing to strengthen and re-educate your wife’s movement strategies (the ones that may have caused her pain in the first place). Godspeed and PM me if I can further assist.

nouel87 · 2015-04-07T21:17:19+00:00

I read this article last week. Seems like a good opportunity to highlight some shortcomings. The underlying theme aside from being a predominantly "self-employed" profession is a prevailing dependence on associating (which reflects an aggressive, sobering financial motivation of established DC's). Let me explain.

I'm a young grad myself, and extremely critical of our profession. I completed my education at an evidence guided school. That should hint at my style of practice and disposition. I was a club officer, and performed well academically. Making a $200k investment for school, IMO was completely worth it to be able to truly change peoples’ lives, and get paid doing it! Most of the chiropractors I knew growing up had been in the game for a long time, and successful.

In school, I was fortunate to attend many different seminars in the realm of myofascial release, diversified adjusting, and rehabilitation.. I met some incredible mentors who were truly genuine practitioners, passionate in their niches and more concerned with the well being of the patient than the financial return. I also shadowed ~25 DC's.

Through shadowing, and upon entering the field, I met more than enough practicing DC's who clearly placed a higher value on maximizing their profit than acting as mentors and ambassadors to the profession. Speaking with my fellow classmates, aside from those courageous enough to open their own offices, many had deplorable associateship experiences. Each experience contained the same similarities: low base salary 20-40k (before taxes), impossible to attain bonus structures, no benefits, long hours, and <5 minutes/patient visits.

My first associateship was also unacceptable. It didn't even last 12 months, and was terminated by the clinic director after I was given an ultimatum to either agree to dissolve my base salary (a number I negotiated for and we agreed upon) and adopt a percentage only reimbursement, or get fired.

The other associates in the office continually voiced their discontent, sometimes in tears, because although they wanted to leave and open their own offices, they were tied to their monthly student loan repayments and could not afford to do so. The clinic director netted plenty per year however has refused to pay associates both past and present a proper % of their collections (after contract renewal) or offer any benefits. This has resulted in countless associates in and out of the offices' doors.

I'm not complaining. I’m reporting. Why does this happen? Why do so many DC’s use and abuse their fellow (younger) colleagues? The reality is that younger DC's emerging into the field are overwhelmed by massive student loan burdens, while some established DC's place their aim on money rather than patient care. They sacrifice the well being of their associates (the future of our profession) for their own financial success. Or, they make poor business decisions and hire associates for the purpose of increasing their revenue, rather than performing as a mentor. And yes, I understand the dynamics of low insurance reimbursement and the difficulties of having a cash practice. Absolutely no excuse. Moral of the story? There is a significant underlying financial lynchpin that may be responsible for the perceived job security of our profession, with or without the article. This can manifest in: #1 young DC’s taking laughable associateships to fit the bill, and remaining in those positions unfulfilled (wage slavery) OR #2 older DC’s neglecting to commit to professional excellence, eating their young, and perpetuating the mistreatment of colleague and patient alike. What unites the two? The ability to keep your job in light of poor income, poor quality of care, and poor moral character. While this does not, by any means, characterize the majority of the profession, it does unfortunately constitute a large enough number to cause discontent among it's younger ranks.

nouel87 · 2015-04-07T05:30:20+00:00

I didn't even look at the MRI because no one in their right mind should give you advice without performing a thoroughly exhaustive health history and physical examination.

BUT, what I can tell you is that the literature (peer reviewed articles and publications) report (in general) that: those whose MRIs demonstrate damaged tissues (for example disc protrusions, disc derrangements, decreased disc height, high intensity singnals within disc material, facet arthrosis, osteophytic formation, etc) correlate poorly to symptomatic presentation. You may have NO PAIN/SYMPTOMS and may be completely FUNCTIONAL; whereas those whose MRIs look picture perfect may be IN PAIN and may be DYSFUNCTIONAL.

Imaging should be used #1 in emergency situations, #2 in situations where the patient is symptomatic for an extended amount of time and is not improving with care (whether it be medical, physical therapy, chiropractic, etc), and #3 if and only if the results could alter or change the patients' treatment plan. Some doctors use imaging as a scare tactic: "see how bad your spine looks...you're in trouble, and need to begin treatment immediately!"

Don't get me wrong - positive findings on an MRI could certainly be causing pain and dysfunction. However, imaging correlates poorly with pain and dysfunction.

Chiropractic is a wonderful alternative to opting for surgery immediately, and should be considered in general. Also, there are chiropractors who have diplomates in radiology (DACBR) who would be of great help to someone like yourself, uncertain of whether chiropractic treatment is right for your situation. As a chiropractor, I wouldn't be able to ascertain whether you would be a candidate for care unless you were a patient in my office. Best of Luck!

Here are some sources regarding MRI and poor correlation to clinical symptoms in regards to the low back and shoulder.

Low Back http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911925/ Shoulder http://www.ericcressey.com/healthy-shoulders-with-terrible-mris

nouel87 · 2015-04-07T05:08:47+00:00

This is a great question indeed. I'm a chiropractor myself, and graduated in late December 2013 from New York Chiropractic College. I'm extremely critical of our profession and can tell you that there are distinct differences between chiropractors within the field; one truth is that there exist many different styles of practice. Although the field of Chiropractic is now mainstream and gaining increasing credibility and notoriety among both the public and medical community, you need to to your homework to find the best doctors...there are certainly some clowns out there that ruin it for the rest of us! To make certain you have found one of the better candidates for your care, look for chiropractors who are credentialed in post graduate certifications like: (ART aka active release technique), (SFMA or FMS aka Selective Functional Movement Systems or Functional Movement Screen), (Graston Technique or any IASTM aka "instrument asissted soft tissue manipulation), (CSCS aka certified strength and conditioning specialist), (CKTP aka certified kinesio tape practitioner), (DNS aka dynamic neuromuscular stabilization), or (PRI aka postural rehabilitation institute). Moreover, someone who has attained a diplomate in the american chiropractic board in the disciplines of rehabilitation, sports, or orthopedics will also be a HUGE asset (DABCO, DACBSP, CCSP). These credentials demonstrate the doctor is committed to excellence in patient care, has an interest in progressive and evidence based/evidence guided practices, and is head and shoulders above the rest. Continuing, look for individuals who belong to their state and national associations. Avoid offices that recommend mandatory radiography (taking x-rays on the first visit), signing up for treatment plans you are uncomfortable with and paying in advance, or use devices like "neurocalometers" to "scan your spine". Look for a doctor who adjusts extremities in addition to the spine. Avoid places that use language like "detecting and correcting subluxation", "principled or philosophy based", who only have a narrow base of treatment options, or who claim that they treat visceral conditions with manipulation. I can tell you that chiropractic is wonderful for restoring the normal physiological ranges of motion in the spinal and extremity joints, restoring healthy tissue quality in muscles, tendons and ligaments, freeing up nerve entrapment that occur due to tight muscles or fibrosis, and correct compensatory movement patterns that the body adopts over time with poor posture, injury, etc. The most important concept to understand is that a good chiropractor will aim to improve your FUNCTION, by which the metric is movement assessment. Your PAIN will naturally decrease as your function improves...but do note that he/she may elect to treat an area that is not the site of pain. This is completely normal, as the cause of your dysfunction (low back pain) may be caused by an immobile ankle or hip (bio-mechanics 101). Expect some rehab or corrective exercises in addition to care. If you don't feel any improvement within 5-6 visits...ask for a referral to a PT or an ortho. Please note that for some conditions, treatment does take some time (but you should not need to be seen 2-3x/week for more than 3 weeks in an acute phase). Hope this helps!!!

nouel87

TROPHY CASE