upnorthkyosa said:
This thread is in response to my thread about my
back injury. I've opted to go to a chiropractor for treatment of my back problems. My wife and I researched a long time and we think we've found a good one.
Thus far, I've gone in for a number of adjustments and the progress with the pain has been slow. I'm supposed to get special shoes in order to treat the abnormal curvature of my spine and the fact that one of my legs is longer then the other.
The adjustments are somewhat painful, but tolerable and I'm sore afterward for a while. This injury has been a very frustrating experience and I'm wondering if I made the right decision to go with Chiropractic care. Does this stuff really work?
First, allow me to say...I AM a chiropractor, and love to see these posts. Secondly, I'm not JUST a chiro...I have spent many years in physical medicine as a PA at a top L.A. orthopedic clinic; and participated in a limited fellowship at CSUN in their brain and spinal cord rehab program...an internationally ground breaking disability rehab center, based on sound physical therapy methodologies and principles.
I'm one of the unique chiro's, in that half of my field loves my spread and swears by me, while the other half swears at me (some still really at war with MD's, and see people like me interacting with them as the work of the devil/Judas Iscariot). While at the ortho clinic, I oversaw the PT/Rehab division for pre-operative conservative care trials, and post-surgical rehab. Not bragging (because there are lots out there who have done more); just letting you know where I'm coming from. While playing with the PT's, I happenstanced to learn a lot of very neat muscle energy techniques usually only taught in osteopathic colleges or physical therapy schools. So here's my general take:
Screw the shoe inserts; like vicodin, they will only mask the cause of the disorder, not repair it.
DO continue to get adjusted...through some rather complex neurological mechanisms, manipulative technique stimulates a healing process and corrective repositioning/reduction of aberrant motion of the spinal vertebrae, which is ONE PART ONLY of the vertebral subluxation complex (VSC for short). Te VSC also includes muscle tonicity too much or tooo little; blood flow and inflammatory responses in the area, etc.
DO find a chiro who takes a rather odd approach to supplement (only) the care you're getting from the guy you're with now. "Upper cervical" chiro's are fringe wierdo's, who have done the best with recalcitrant pain disorders and short leg syndromes NOT responding to other approaches. I used to mock them in school; now I send my toughest cases to them for adjunct corrective care. Basically, if the top 2 bones in your neck are jammed or malpositioned, all kinds of stuff goes whack in your body. As an orthopedic PA I've re-tested folks after limited courses of Upper Cervical care, to see some wierd stuff come out of them...leg length discrepencies corrected; grip strength improves markedly; measurable changes in nerve flow on needle EMG/NCV tests, etc. Go for 6 visits, then throw their phone number away (they'll try to hook you for life).
DO find an excellent PT in the area who can show you how to best stretch your hamstrings, quadratus lumborum, iliopsoas, lumbar paraspinals, and piriformis. Should only take 1-2 visits of their time. Heck, you could probably find the stretches on the web at runners sites, but look up "post-isometric relaxation" along with it, for instruction on how to actually use the positions.
DO find a Rolfer to open your psoas. Again, they want to sell you a 10-visit program, which ain't bad, but can get costly. If you specifically ask for "psoas release" in one visit, you will have one of the singularly most painful experiences in your adult life, but over 50% of your back pain will be gone. Period.
Finally, learn the right way to perform squats, and start adding a 2x/week light squatting routine to your life. There have been some great studies regarding the resolution of chronic back pain just by adding squats. Balances the stability of pelvic stabilizing muscles, and re-teaches the muscles how to work in coordinated, concerted effort.
No one practitioner has all the answers. I became a chiro because of my own disabling back pain, and how much chiro helped (literally kept me walking and out of surgery). But there is more to the equation than adjusting (this is blasphemy for a chiro to say, by the way). Muscle length/strength balance issues play an ONGOING role to get the bones to stay put once the chiro has set them, and the best guys for that are PT's and Rolfers (good ones, anyways...they aren't all created equal).
I am anti-pain killers, because they hide the problem instead of correcting it. Shoe inserts are, to me, the chiro's crutch as the pain killer is the MD's. Correct the length problem; don't compensate for it. Upper cervical guys are best for that. And stretch those hamstrings...they connect to the pelvis, and everytime you throw those kicks, you're tugging on the pelvis to tip posteriorly (like dumping a bucket out towards the rear), stretching and stressing the bottom discs and facet joints in your back. Wristlocks and come-alongs work because they stress the soft tissues that bridge and gird a joint; you're doing the same thing to the joints in your back when you throw front high kicks or air kicks.
DO keep getting your low back adjusted. Irritation leads to imflammation which leads to the formation of small scar tissue bad guys in critical parts of joint tissues. Adjusting breaks up bad tissue, normalizes joint mechanics, and provides an impetus for future generations of scar tissue to form along the force vector lines of the tissues so they don't obscure motion.
For what it's worth,
Dave.
PS -- if you're looking for efficacy studies, I can send you the references. The premiere mucky-muck study available is a metanalysis called a CONSORT study, which looked at the effectiveness of various modalities for treatment of back pain, based on the weight and soundness of available research. They found chiropractic had strong evidence in support of efficacy of treatment of low back pain. I think Van Tulder was the name of the lead researcher, if you want to look them up on mdlinx.
