Wellness Posts by DrPlemon

Fibromyalgia Demystified

2010-08-03T11:48:30Z

Wellness.com - Fibromyalgia Demystified by DrPlemon

Fibromyalgia. The very word frightens some and puzzles most.

What is it? What causes it? How is this condition diagnosed? Does it even exist?

I have never come across a condition that is as misunderstood (and mistreated) as fibromyalgia. While I was in chiropractic school, it seemed like you got a different answer depending on which professor you asked or which book you read. Nothing seemed to agree. Every other neuromusculoskeletal condition had a specific set of symptoms, positive lab values, etc. Fibromyalgia was pretty much understood as something that was diagnosed by exclusion. If it’s NOT rheumatoid arthritis, multiple sclerosis, etc. and nothing else seems to fit, the patient had fibromyalgia.

Unfortunately, this lack of understanding is still pervasive throughout the medical community at large. Many physicians do not understand this condition at all while some still contend that it only exists in the patient’s mind (which is why it used to be called “psychogenic rheumatism,” which translates to "pain that is generated in the mind"). These patients are often shuttled from doctor to doctor and subjected to a shotgun approach of multiple medications to see if they can find enough relief to get through the day. They are often told that they are just depressed or stressed and told to seek counseling. Most fibromyalgia patients I meet are often stressed and depressed BECAUSE of fibromyalgia, not the other way around. They have lost friends, spouses, and jobs because of the debilitating effects of this condition, while their doctors tell them that there pain is not real. Wouldn’t that make YOU depressed?

Fibromyalgia Defined
To understand fibromyalgia, we must first understand what the word means. Broken down, it translates to fibro = fiber, myo = muscle, algia = pain, so muscle fiber pain (for some reason they dropped the second "o"). Fibromyalgia is characterized by widespread, chronic pain throughout the muscles and soft tissues of the body. The pain is severe and is often accompanied by digestive troubles, sleep disorders, mental impairment, headaches, and extreme fatigue. It is also commonly referred to as Chronic Fatigue Syndrome because the extreme fatigue is the most prevalent symptom for some. This condition affects more than 6 million people nationwide, a number that is steadily growing. For reasons unknown, women make up 80 to 90 % of fibromyalgia sufferers. For years, medical doctors referred to fibromyalgia and chronic fatigue syndrome as the “yuppie flu.” This term was used to describe what some doctors thought were a bunch of bored housewives whose pain was the direct result of depression and a lack of attention from their well-to-do husbands. How’s that for compassion?

Current Research
Regardless of the incredible misunderstanding surrounding this condition, there has been some very important research done about fibromyalgia and its orgins. Fibromyalgia is the direct result of a dysfunctional central nervous system. Patients exhibit an increased sensitivity to physical stimuli. What a normal patient may perceive as light touch or pressure, a fibromyalgia patient may perceive as excruciating pain. The role of the central nervous system also explains why the pain moves around so much. If it were a single nerve being irritated (like sciatica or carpal tunnel syndrome) the pain would stay in the area surrounding the innervation of that nerve. However, with fibromyalgia, the pain changes from day to day, both in location, severity, and type of pain (burning, aching, stabbing, etc.)

According to research done by the University of Michigan, fibromyalgia patients also show increased senstivity to pressure and sound, as well. This proves that fibromyalgia is NOT just a pain problem, but a central nervous system processing problem. Fibromyalgia patients have shown dramatically increased levels of substance P, a hormone released when you feel pain. Fibromyalgia sufferers exhibit substance P levels 3 times higher than normal!

Diagnosing Fibromyalgia
Since there is no gold standard test to indicate the presence of fibromyalgia, the condition is primarily diagnosed by the patient's symptoms. All lab tests and imaging studies will be negative for diseases such as multiple sclerosis, mononucleosis, and Lyme's disease. In order for a patient to be diagnosed with fibromyalgia, they must have chronic widespread pain for at least three months. The pain must be transient, passing into all four quadrants of the body. Many physicians make the diagnosis by palpating 18 pre-determined tender points. If 11 of those points are tender and all other criteria are met, the patient is diagnosed with fibromyalgia.

Treatment
Most patients who have been diagnosed with fibromyalgia are on a myriad of prescription medications, including pain meds, anti-inflammatories, muscle relaxers, sleeping pills, anti-depressants, and anti-anxiety medications, to name a few. Recently, so-called “fibromyalgia medications” have come in vogue. These medications are not new, by any means. They are actually anti-seizure medications that have been recently re-packaged to treat fibromyalgia patients because they literally “turn down” the patient’s brain function (sounds great, huh?). This may improve some symptoms in some patients, but side effects are common and varied. I have done several workshops on fibromyalgia and have met literally hundreds of patients with this diesease, yet everyone I know who has tried a fibromyalgia medication was forced to quit because the side effects were not worth it. Weight gain, dizziness, drowsiness, headaches, memory loss, suicidal thoughts, weakness, and sleep disorders, to name a few. For those of you keeping track at home, you will notice that some of the side effects are the same symptoms that fibromyalgia patients are suffering from in the first place! If that doesn't sound bad enough, there is a new drug that has been cleared by the FDA to treat fibromyalgia. The chemical name for the drug is amma-Hydroxybutyric acid. You know it better as the "Date rape drug." That is not a joke.

Obviously, with some of my patients, they are in such pain initially that they need some sort of pain medication to get through the “bad days.” Part of the goal of our treatment is to limit the dependency on pain medications as a whole. I would NEVER tell any of my patients to up and quit their medications cold turkey, even if they are not working. They must work with their medical physician in regards to weaning themselves off of prescription medications.

Forgive me if I sound a bit harsh when it comes to the medical treatment of fibromyalgia. Please understand that I truly believe that the medical doctors are doing everything they can to bring some relief to these patients. The only problem is, they are not treating the cause of the patient's problem, which is why any benefits from medications are usually short term, at best. They are merely covering up the symptoms. Before I talk about our treatment for fibromyalgia patients, let me address some other crucial factors in the management of any fibromyalgia case.

Getting the Right Kind of Exericse
Exercise is an important factor in fibromyalgia patients, but it must be handled properly. In general, exercise is a crucial part of any healthy lifestyle, but fibromyalgia patients suffer from a phenomenon called “exercise intolerance.” They often have flare ups of extreme pain and fatigue after activity, making vigorous exercise next to impossible. However, the goal is to maintain muscle tone and range of motion in the joints and soft tissues, as well as cardiovascular health. The best exercise plan for fibromyalgia patients consists of low impact activities, such as walking, light yoga, swimming and water aerobics. Weight training with a light weight / high repetition approach may be beneficial, as well. Since symptoms are often inconsistent, patients are often tempted to do way too much on a good day and often end up bedridden for days afterwards. Working closely with a therapist that is well versed in fibromyalgia is advised to avoid overtraining and ensure proper muscle balance.

Nutrition
Good nutrition is absolutely essential for people suffering from fibromyalgia. I cannot stress this enough. Diet modifications are an absolute must. There are many factors in the Standard American Diet (SAD) that cause chronic inflammation in the body, which complicates the symptoms of fibromyalgia.

For starters, the average American consumes way too much carbohydrate in the diet, especially in the form of refined sugars. Newer research is proving that an abundance of sugars, not fat, in the diet is contributing to many of the diseases of civilization, including type 2 diabetes, heart disease, and obesity. Ever since the powers that be told us to go on a high-carb, low-fat diet, we have seen the rates of these diseases skyrocket.

An imbalance of the ratio of Omega-6 to Omega-3 fatty acids in the diet is another key contributor to chronic inflammation. Omega-6 and Omega-3 fatty acids are essential in the diet, but like most things in life, balance is key. The "optimal ratio" of Omega-6 to Omega-3 is 4:1. The average American's ratio is upwards of 20:1! The reason for this is the abundance of processed food in the SAD diet, since processed foods use oils that are rich in Omega-6. Omega-3 fatty acids are found in oily fish, flaxseed, and fish oil supplements. Sadly, Omega-3 fatty acids used to be more prevalent in meat and dairy products, but the common practice of feeding grains to livestock has caused the meat to produce more Omega-6, which further adds to our imbalance! If you can acquire grass fed beef and free range chickens, you can help balance your Omega-6 to Omega-3 fatty acid ratio, plus you help out some forward thinking farmers! For more information on this topic, click here: Omega-3 and Omega-6 fatty acids.

The biggest thing to keep in mind is food quality. Eating real food is the best way to limit your intake of refined sugar, processed fats, and harmful artificial additives. How do you know if you are eating real food? Check the ingredients. If the ingredient list is "egg," chances are you are eating real food. If the ingredient list is packed with words like "partially dehydrogenated" and "monosodium dihexaglutamic fluxcapacitor benzoate," you are probably eating something that is not fit for human consumption.

Other things to be avoided in a fibromyalgia-friendly diet include: refined sugars, artificial sweeteners (aspartame), MSG, caffeine, yeast, gluten, dairy, and baked goods. I could write an entire post on my own journey regarding nutrition and what I have discovered about the Standard American Diet and how I have not only lost weight and improved my overall health, but that will have to wait...

Why Chiropractic Care?
There is a link between fibromyalgia and previous trauma, especially to the central nervous system. Remember that I mentioned before that research has proven that fibromyalgia is a central nervous system processing problem. The central nervous system is contained within the head and spinal column. Injuries to the head and spine cause irritation and dysfunction to the brain, spinal cord, and nerves, which can potentially affect every organ, tissue, and cell in the body.

Because of this, many patients have sought out chiropractic care for help with the symptoms of fibromyalgia since we specialize in finding and correcting nervous system dysfunction. If a misalignment of the spine exists, specific adjustments to the vertebral column, especially the Atlas (C1) vertebra, can help alleviate the symptoms of fibromyalgia by relieving pressure on the delicate structures of the nervous system. We do not treat the symptoms. We do not cover up the pain, or artificially turn down the function of the brain. We remove nervous system interference so the body can work the way it was originally designed to. It is just that simple.

Renowned rheumatologist Frederick Wolfe, MD in his research on fibromyalgia concluded that chiropractic was “among the best” treatments for fibromyalgia patients. Peer-reviewed journals have also published studies that indcate the effectiveness of chiropractic for fibromyalgia sufferers. Of course, chiropractic has never been as mainstream as allopathic medicine so, unlike the plethora of Lyrica ads the average American will likely see on a regular basis, our message is just not getting out there.

Chiropractic Success Story
One great case of note is that of Brig. General Becky Halstead (click for her story), the first woman general in the U.S. Army to command in Iraq. General Halstead suffered from fibromyalgia during her service. "Traditional medicine did not work for me," she said. I would love to see an MD diagnose HER with the “yuppie flu!” After getting nowhere with the military physicians, she decided to give chiropractic a try, and she has fought hard to make sure that that the armed forces continue to make chiropractic care available for our soldiers. “The adjustments and nutritional advice I received from my chiropractor helped in treating the fibromyalgia and made me feel better on a day-to-day basis. Chiropractic care provided me with a better quality of life.”

We have seen some incredible results with fibromyalgia in our own practice. This depends on the patients’ own circumstances and overall healthcare picture. By and large, if we can achieve and maintain the stability of the upper cervical spine and relieve the extra stress on their nervous system, patients absolutely can do better while under our care. Only a doctor of chiropractic can tell you whether spinal misalignments are a contributing factor in your fibromyalgia. It may be the one missing piece to the puzzle.

Just like any condition, the earlier we can get to the problem, the better.

A Chiropractor's Confession

2010-08-03T11:46:16Z

Wellness.com - A Chiropractor's Confession by DrPlemon

For years, people of all ages from all walks of life have consulted my office for help with a variety of health conditions: headaches, back pain, numbness in extremities, fibromyalgia, etc. However, I have a confession to make. I haven't healed a single one. Zero. Zilch. Nada.

Yet I have patients say to me all the time "Thanks, doc! You healed me! I feel great!" I humbly accept their gratitude, but in the back of my mind I know that there is absolutely no way I healed their condition.

Now before you assume that I am merely being modest, let me explain what I mean. It is NOT my job to heal the patient. In fact, it is not even possible. Only patients can heal themselves. However, when the cause of the problem involves the nervous system because its function is being compromised by vertebral subluxations, then chiropractic care can go a long way in removing the interference so the body can heal itself. I could adjust a corpse all day long but nothing is likely to happen (outside some cheesy sci-fi flick). Without the ability to heal, no treatment works. Ever. Of course, we help all sorts of folks in our office regain their health, and they are as grateful for the help as were are to provide it. However, we are only allowing them to tap into what they already have, by helping their bodies function the way they were designed to function! Simple, isn't it?

ILet me give you a simple scenario and apply a similar principle, albeit from a slightly different angle. Picture yourself out on the deck experiencing a beautiful spring day. The iced tea is cold, the sun is warm, and your Ipod is providing a fitting soundtrack for the perfect day. Unfortunately, when you get up off your towel to answer an ill-timed phone call (probably a telemarketer anyways), you get a sliver shoved deep into the end of your finger.

Ouch.

Your body is experiencing pain. What a horrible sensation. Or is it?

Without pain, you would not be aware of this little foreign invader, but this pain is putting a big damper on the enjoyment of your spring day. Luckily, you have some Vicodin left over after that bad ankle sprain last year that you've been meaning to get rid of, so why not kill two birds with one stone? A few pills and a band-aid later, the pain fades into the background, hardly noticeable, but as luck would have it, it came back the next morning. But you're out of Vicodins. You could go and get some more pain pills or, better yet, go to a pain clinic and get an injection or a nerve block. Problem solved, right? The pain is gone. Life is good again.

Until the injection wears off. Then what? More pills. More injections. But every time the pill or shot wears off, that pain comes back again. You have consultations with experts that have lots of letters after their names. They order tests with even more letters, which are interpreted by more experts who prescribe even more medications. Now they recommend invasive surgery, to cut the nerve to your finger, or fuse the joints, rendering the finger useless, but they think it might decrease the pain. You don't know what to do. Now you're not sleeping. You toss and turn. So you end up on sleeping pills. Sooner or later, some people start to hint that maybe that sliver isn't even there! This causes anxiety. Xanax to the rescue! But now you can't think straight and your quarterly evaluation was less than stellar and your boss is "concerned." Your stress and lack of motivation (in addition to the side effects of the steroid shots) have caused considerable weight gain. None of your clothes fit. Now, you're depressed. Sure, you have less pain but at what cost? Are you any better off than when you started?

Of course not, because you still haven't dealt with the CAUSE of your problem. The splinter is still there. Every single treatment you have tried has done nothing but attempt to cover up the problem. Where has it gotten you? Depressed, anxious, sleep deprived, overweight, stressed, and much lighter in the wallet.

I know what you're thinking. No one in their right mind would be dumb enough to let someone treat their finger that way. Maybe not. But it happens with the spine. Every single day. I meet people all the time that have been through that exact same scenario. Just replace the word sliver with a spinal misalignment, aka subluxation. These people never had long term success with their spine problems because no one ever bothered to treat the CAUSE. They were too busy trying to dull the SYMPTOMS.

As I said before, Doctors of Chiropractic will never claim to heal you. In addition, we will not merely treat you like a symptom and act to merely dull your pain or be just another Band-Aid. But what I can promise you is that this profession has worked tirelessly to help people achieve better health through chiropractic. You will only get better if you address the cause of your problem. If you have been spinning your wheels with the same old pills and potions and getting the same results, you might want to consider adding a chiropractor to your health care team.

The Neck Bone's Connected to the...Leg Bone???

2010-08-03T11:45:35Z

Wellness.com - The Neck Bone's Connected to the...Leg Bone??? by DrPlemon

As a Chiropractor, I love it when making an adjustment to one area allows changes to occur elsewhere in the body. This is especially true when adjusting the Atlas with the Atlas Orthogonal Technique, because upper cervical misalignments can have such a profound impact on the overall function of the spine. This requires the doctor to treat the whole patient, instead of only focusing on the area of complaint. This difference in philosophy is what makes chiropractic unique in today's health care climate.

Let us first take a look at the philosophy of "traditional" medicine. In most cases, aside from the rogue medical practitioner who thinks outside the medicine cabinet, medical practitioners utilize a Mechanistic approach to health care. Mechanism is defined as "the belief that living things are like machines or artifacts, composed of parts lacking any intrinsic relationship to each other, and with their order imposed from without." In practice, they listen to the patient's laundry list of complaints, check the areas that are statistically most likely to produce those complaints, and treat those specific areas from without (with drugs or surgery) in the hopes that the condition will improve. If the condition does not improve, they simply remove the part and replace it (if possible), with little regard for the consequences of those additions or deletions. This approach is similar to what a mechanic does with a car. If the brakes squeak, change the brakes. If the engine knocks, you take it apart and overhaul it.

For instance, a patient could come in with a complaint of left knee pain, right arm numbness, and headaches. A "traditional" medical practitioner would immediately think: "What's wrong with that patient's knee, arm, and head?" They would ask the patient some questions, visually inspect those areas, maybe do some blood work, and then take some specific imaging of the symptomatic areas. If the x-rays, MRIs, or CTs of the knee, arm, and head come back negative, they treat the condition "conservatively" with pain medications, anti-inflammatories, and maybe some Xanax. (Of course, I would argue that anything with a long list of side effects should never be considered "conservative," but I digress). If the imaging comes back positive, the patient gets referred to a surgeon. You get the idea.

Any Doctor of Chiropractic worth his or her salt employs a philosophy of Vitalism when treating their patients. Simply put, vitalism describes a philosophy stating that we as human beings are more than the mere sum of our parts. Every aspect of a living thing is interconnected to the other in a multitude of different ways, with each organ, system, and tissue working together to maintain homeostasis. What happens in one area affects another, so great care must be taken when attempting to make changes to one's anatomy. What that means in practice is that we do not focus solely on the area of complaint. We understand that everything is connected and every facet of our well being plays in to our health care challenges.

When someone has a complaint of wrist pain, I don't put blinders on and only check the wrist. I move up the chain and check the elbow, shoulder, upper back, and neck. I talk to the patient about their job and about ergonomics. I ask the patient about leisure activities and hobbies. The patient may have to perform certain exercises and stretches to reverse some postural stress. I may have to refer them out for some soft tissue work. The point is, any doctor employing a vitalistic approach looks at the whole patient, trying to get down to what is really CAUSING the problem, instead of just treating a symptom because that's what the insurance company allows.

The confusing thing about this is that both mechanistic and vitalistic philosophies work, depending on the situation. For instance, if I fall off my mountain bike and impale myself on a sharp stick (it could happen) I wouldn't be knocking on a fellow DC's door hoping to get an Atlas Adjustment. I would go to the ER and have someone remove the foreign substance and stitch me up. I may even need some antibiotics to ward off infection. I certainly wouldn't be concerned about a hidden cause of my problem, because a stick protruding from my abdomen should be obvious. So yes, in acute life-threatening situations especially, a mechanistic approach works wonderfully. And thankfully, we live in a country where good acute medical care is available. My mother suffered a brain aneurysm last winter and her life was saved by modern medicine (and a fantastic surgeon). Where mechanistic philosophy falls short, however, is in chronic conditions, where many different stresses and imbalances build up over time to cause the symptom. This is where vitalism shines, because the doctor(s) will look at the whole person to find that imbalance and treat it from multiple angles, considering diet, lifestyle, physical imbalance, stress, and other potential contributors of the problem.

Where am I going with this? The reason I bring this all up is that I see this philosophical difference play out in my office all the time. A recent example is a patient with a complaint of lower leg pain and numbness. In addition to self diagnosing and medicating via Dr. Google, she had seen her primary doctor, a therapist, and another chiropractor for this problem over the course of 4 months. Each one employed different treatments including pain meds, supplements, stretches, exercises, and adjustments, all focusing on her leg (and in the case of the PT and DC, her lower back). However, that is where their focus stayed; only on the leg and lower back, and that is why they failed.

Upon consultation with this patient, I found out that she had been involved in a rear-end collision about a year prior. I asked her if she had any neck pain and she said "sometimes, but I think that's because of how I sleep. It could be stress." No doubt, this sound advice came from Dr. Google himself! I could have easily ignored her neck and focused on her lower back, but I investigated. She had obvious tenderness and diminished range of motion in her cervical spine on examination. She also admitted that her neck "clicks" a lot when she moves it just right, which she kindly demonstrated for me. Stress doesn't cause that! I evaluated her leg and lower back as well and found pain and problems with motion, as well. So the lower back condition that her PT and previous DC were treating was definitely there. However, it wasn't until I adjusted this patient's Atlas that she started to respond, with her leg pain completely gone after a couple of weeks and her numbness disappearing shortly after. I will not go into a lengthy explanation as to how an upper cervical misalignment can affect the lower spine and legs (although this might help) but suffice to say that the neck bone is indeed connected to the leg bone, despite what the popular children's song says. Those who understand vitalism realize that every bone is connected, eventually.

Is Your Desk Job Killing You???

2010-05-12T08:18:29Z

Wellness.com - Is Your Desk Job Killing You??? by DrPlemon

Why would someone complain about having a desk job? It requires little physical effort, and you get to sit all day. This obviously keeps the pressure off your feet and is great for your back, right?
Wrong. Prolonged sitting is one of the worst things you can do for your spine and your health in general. In fact, the British Journal of Sports Medicine published a study indicating that prolonged sitting leads to heart disease, diabetes and premature death! All that from pushing pencils!

So, why is sitting all day so bad for you? First of all, the body was not designed for it. When you use the blunt end of a fork as a screwdriver, you don't get great results, do you? You usually end up wrecking your fork. Human beings are used to spend the day doing all sorts of things; hunting, gathering, building shelter, farming, etc. This variety of activities works the various muscles throughout the day, keeping us strong, limber, and balanced. Movement of the joints also allows nutrients to be brought in to the joints and waste products to be forced out. Now, because of a phenomenon called specialization, most people do the same thing; all day, every day. And since our workforce is becoming more and more technology-based, work mostly revolves around a computer. While some think this is progress, your body sees this as a crisis and treats it as such.

Sitting in a fixed position for hours on end keeps the muscles that support our trunk, neck, and shoulders in a fixed position, which promotes fatigue. The blood vessels are squeezed, which reduces blood flow to the muscles when they need it the most. These muscles are more prone to strain and cramping. This often leads to "weekend warrior" injuries because people who are sedentary all week try to use their muscles to do things that they are not accustomed to doing.

Since most of our duties are performed in front of us (on the computer, writing, talking on the phone), the flexors become tight while the extensors become weak, leading to muscle imbalance. This decreases range of motion and creates poor posture. All of this leads to pain and dysfunction down the road if left untreated, which is usually when patients come to see me or another Doctor of Chiropractic that specializes in restoring proper function of the spine. The longer the problem has been there, the harder it is to treat and the longer it takes to "re-train" the muscles to work properly.

But before you turn in your two weeks' notice and buy a beet farm on Ebay, be advised that there are steps that can be taken to prevent this problem.

1. Get regular exercise, especially on work days. Squeeze in a workout or a good mall walk over lunch or get to work 20 minutes early and do a few laps around the building or climb some stairs. Get a "workout buddy." This makes exercise more fun and makes you both accountable.

2. Maintain a healthy weight. This cannot be stressed enough. If placing too much stress on the joints because of your job wasn't enough, excess weight just magnifies the problem. Improve your diet, get more exercise, and you will live a longer, healthier, happier life. Guaranteed.

3. Stretch, stretch, stretch! There are many stretching programs designed to help reverse the damage done from prolonged sitting. Ask your doctor of chiropractic to help put together a stretching program to meet your needs. This should be done at least twice per day to get the most benefit.

4. Eat a nutrient dense diet. Your muscles, joints, and soft tissues require the proper nutrition in order to function properly. You are what you eat, after all.

5. Stay hydrated! Most adults need 6-8 cups of water per day in order to function properly. If you drink a lot of caffeine, you need to drink more (caffeine is a diuretic, causing you to lose more water through your urine).
Be a river, not a sewer, people.

6. Maintain good body mechanics. Sit with your shoulders back and head straight. Anterior head carriage (think Shaggy from Scooby Doo) leads to the loss of the normal forward curve of the neck, which leads to muscle tightness, pain, and arthritis. Have your workstation inspected by an expert in ergonomics.

7. Keep your back and "core" muscles in shape. Yoga, Pilates, or other "core" exercises can help prevent back problems, if done properly. If these exercises hurt, chances are it's too late for prevention and you need to work with a Doctor of Chiropractic first to alleviate spinal dysfunction BEFORE you strengthen (this is similar to having a broken arm re-aligned before you do rehab).

8. Laugh and smile. Stress in the workplace causes muscle tension and can aggravate pre-existing spinal problems. However, spending your time noodling around on YouTube in search of funny videos may cause you MORE stress when your boss finds out, so try and find healthy (and productive) ways to manage your stress throughout the day. (Hint: taking your frustrations out on a heavy bag at the nearest gym during lunch would be a GREAT choice since you'll be killing two birds with one stone!)

You Wouldn't Take Your Car to a Proctologist, Would You?

2010-05-12T08:14:45Z

Wellness.com - You Wouldn't Take Your Car to a Proctologist, Would You? by DrPlemon

A patient walked in with VERY acute lower back pain (let's call him Mr. Smith). He was in visible pain and had a hard time sitting still during the consultation. He is an avid weightlifter and said this pain started after doing some dead lifts with "very heavy weight." Most people outside of the chiropractic profession would immediately diagnose him with a muscle strain and prescribe him muscle relaxers, pain relievers, and anti-inflammatories and tell him to rest. However, once we started talking I found out that he has had a "numb and tingly" spot in his upper back for years. He also had a bout of somewhat severe back pain a few months back that WAS treated by his primary with pain meds. When he mentioned the numb spot in his back, he was told that it was "no big deal." Yet there he was, a healthy 25 year old who could hardly get out of a chair.

This is a perfect example of a patient who has had some spinal problems in the past, but the symptoms came and went, so they were largely ignored and passed off as a "pulled muscle" or a "sprain / strain." They were forced to suspend certain activities for a while, take some ibuprofen now and then to get through some rough patches, but they always seemed to come out okay after several days. They were told it was no big deal by their primary doctor, so they treated it as such. Until "IT" happens. And by "IT" I mean the catastrophic acute low back pain incident, described as a "pain like no other."
"Pain meds don't touch it."
"I am unable to work."
"This is unbearable."

"The pain is an 11 out of 10"

The problem is that Mr. Smith's situation should never have come to this. When he FIRST had trouble with his back, a little light bulb should have went off in his head that said "Chiropractor." Just like someone thinks of a dentist when they crack a tooth, an optometrist when they are squinting at far away objects, or a plumber when the sink backs up. With any problem, you should seek an expert. Your auto mechanic is probably a pretty handy guy and he could likely help you with that leak in your basement, but what he is BEST at is keeping your car running properly. Doctors of Chiropractic are the ONLY practitioners trained to find and correct subluxations of the spine. Other practitioners "dabble" a bit, taking weekend seminars on joint mobilization or perhaps watching a youtube video on manipulation, but when you are dealing with the structure that houses and protects your spinal cord, do you want someone who dabbles, or someone who specializes?

Primary medical physicians are trained to find and treat systemic diseases, which is exactly what you need in the case of an appendicitis, autoimmune disease, or kidney infection. I may be generalizing here, but in most cases, they are not joint experts. They certainly are not spine experts. So why do people allow their primary doctor to be the authority on their back and neck problems? Usually because their insurance covers it, they don't know who else to ask, or they had a scheduled check-up anyway and figured they would bring it up. Unfortunately, the most common treatment from their medical physician is pills and reassurance that it's only a "pulled muscle" or "inflammation." But what's "pulling the muscle" and why is the inflammation there? These are logical questions to most people, but they don't ask. They just take their medications like a good little patient and pray for the best.

Back to Mr. Smith. Upon examination, it was apparent that he was suffering from some major mechanical dysfunction in his spine. There was asymmetry in his posture, extreme tenderness in the tissues surrounding the spine, and muscle spasms throughout his lower back. His range of motion was non-existant in his lumbar spine, but diminished in his upper back and neck, as well. Clearly, this was more serious than a "pulled muscle." His x-rays told the story. He exhibited no less than an 18 degree lateral curvature in his upper back, sitting on top of a 10 degree curve in his lower back! So much for the simple "pulled muscle theory." This was a spine that had been under serious duress for a significant amount of time. But with the medications and the reassurance that it was "no big deal," it got missed and ignored for years. Mr. Smith has been treated in my office for the past several weeks. After his first treatment, he got up and walked out under his own power (his mother literally had to help him into the office initially). He steadily improved over the next few weeks until he was able to fully resume his activities with no pain. However, we did not suspend treatment because the pain was gone. Symptoms come and go, regardless of the condition, just like they came and went before treatment. We resolved to see this thing through. As a result of treating the condition properly, his follow up x-rays demonstrated a complete resolution of the curvature. That type of correction takes time and effort, but ensures him not only an absence of pain, but a healthy, longer lasting spine. That would NOT have happened with a so-called "quick fix."