While the chiropractic profession continues to grow in popularity, the experiences offered at a chiropractic office can differ dramatically, leading to some warranted confusion on what exactly a chiropractor does, and when you should go see one. Everything from visit length, diagnoses, explanations regarding the etiology of your pain, treatments rendered, and rational for those treatments can and will vary from physician to physician. In this weeks’ post I will go into detail my own approach to patient care, and shed some light on what to expect when you come in for a visit.
While I currently practice out of Sorrento Valley in San Diego, California, I completed my chiropractic training at University of Western States in Portland, Oregon. I chose this school for its emphasis on evidence-based education, working towards the integration of chiropractic with the wider, mainstream medical community. While chiropractic has traditionally been considered an “alternative” form of care, this view has been gradually, changing, with a new study published in 2019 showing that 54% of general care practitioners have recommended chiropractic as a complementary healthcare approach (1).
This increase in recommendations from general care practitioners can likely be attributed to the growing body of research supporting chiropractic adjustments as a safe and effective means of treating a variety of musculoskeletal complaints, including neck and low back pain (2, 3, 4), headaches (4,5), and shoulder pain (6) to name a few.
This conservative approach to treatment is a welcomed addition to more traditional forms of care that generally include medications, injections, and surgeries.
While these treatments certainly have their utility, the risks associated with these more invasive approaches would suggest saving them for times when a conservative approach to care is ineffective (7). To support this line of thinking, research looking at the effects of integrating chiropractic care with more traditional healthcare approaches has shown positive results (8, 9). In fact, Harvard health recently released their updated guidelines for spinal care, supporting chiropractors as the first doctors to call for complaints of back pain (https://www.health.harvard.edu/pain/where-to-turn-for-low-back-pain-relief).
Chiropractors are traditionally known for chiropractic adjustments—a high velocity low amplitude manipulation—as their primary means of treatment. Chiropractic adjustments help improve pain by effecting the descending neural pathways that play a major role in regulating pain felt throughout the body. In addition, adjusting a stiff joint stimulates a reflexive relaxation of the surrounding muscles to provide increased range of motion (10). I combine these effects with soft tissue muscle work to provide relief to tight and overworked areas of the body, releasing tension and restoring movement (11).
Along with traditional chiropractic adjustments and active manual massage, I incorporate a heavy emphasis on rehabilitative and home care exercise to provide pain-free movement strategies and encourage patients that their bodies are strong and adaptable. I am well versed in Dynamic Neuromuscular Stabilization (DNS), a rehabilitation system for assessing, diagnosing, and treating painful movement patterns. This system is based off the principals and theories of developmental kinesiology and is currently utilized to both decrease pain and increase performance by a large number of the highest level athletes across a variety of sports including the Olympics, baseball, tennis, golf, and surfing. DNS seeks to re-establish global movement patterns observed in human development over the first year of life to provide patients with pain free movement strategies (www.rehabps.com).
My approach to patient care has also been heavily influenced by pain research, and the multifactorial nature of a pain experience. Educating patients regarding their pain has been shown to help reduce reported pain intensity (12, 13). Teaching patients about the nature of their pain, why they get it, and what movements or activities are safe and what to avoid helps build confidence and provides patients agency in dealing with their pain experience.
Please visit www.movepastpain.com for more details regarding my approach, or follow me on Instagram @movepastpain_chiro for examples of exercises I commonly prescribe to patients.