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Patients' Satisfaction with Chiropractic Care

When it comes to making important choices about treatment options for back pain, it's worth looking at the experiences of others who have found something that works.  In recent years, the Consumer Reports Health Ratings Center has surveyed the magazine's subscribers to do just that.  In April and May 2009, Consumer Reports released some of its findings publicly.  A summary appears below.  

About the Survey Participants

* More than 14,000 participants who had suffered from lower-back pain in the prior year but had never had back surgery.
* More than half reported that pain severely limited their daily routine for a week or longer.
* Many reported that pain interfered with sleep, sex and efforts to maintain a healthy weight.
* 88% reported that the pain recurred through the year.
* Most had tried five or six different treatments.

How Respondents Ranked the Healthcare Providers Who Had Treated Them

Healthcare Provider
Percent Who Were Highly Satisfied With Treatment and Advice*
Chiropractor    
59%
Physical Therapist+
55%
Acupuncturist    
53%
Physician, Specialist
44%
Physician, Primary Care    
34%*Defined as either Completely Satisfied or Very Satisfied.
+Difference in ranking for Physical Therapist and Acupuncturist were not statistically significant.


How Respondents Ranked Selected Back Pain Therapies

Therapy
Percentage Who Reported that the Therapy Helped a Lot
Chiropractic Manipulation
58%
Prescription Drugs
45%
Over-the-Counter Drugs    
22%
In July 2011, Consumer Reports published an updated report describing how Americans use alternative approaches to healthcare as well as their experience with various therapies and their providers.  Chiropractic care once again was reported to be the most popular approach to back pain relief and was ranked most highly in terms of patient satisfaction.  

Your Doctor of Chiropractic can help relieve back pain and restore mobility by using a drug-free, hands-on technique called "spinal manipulation" or "chiropractic adjustment".  He or she may also use other manual therapies, such as massage, to complement this primary treatment.  In addition, many chiropractors are skilled in designing exercise and nutrition programs for their patients that will help their bodies resist injury and function properly.  By focusing on both immediate pain relief and the underlying causes of back pain, your chiropractor can help you achieve a healthier overall lifestyle.

Every body is different. If you have questions about this article or whether chiropractic is an appropriate choice for your specific situation, please ask. We are here to help!

What 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

Do 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

Can Chiropractic Improve Golf Performance?

PGA golfers Tiger Woods and Padraig Harrington have used chiropractic services for years in order to improve and maintain their golfing performance.  Their successes suggest a benefit of chiropractic care, but it’s hard to know if it’s because of the care or because they are world-class athletes. Can chiropractic care help the average golfer improve their performance as well?
The very nature of the game of golf suggests a good match for players with chiropractic care. Golfing can involve considerable strain on the spine. Golfers need to move from a standing position quickly to club head speeds, requiring good posture, balance, and the ability to rotate the spine properly. Poor posture can create exaggerated or flattened spinal curves that can seriously affect swing performance. In fact, Tom Ward, PGA Golf Instructor, says, “Over 50% of all golfers will experience some sort of pain due to poor posture and the problems that arise from loss of proper curves in the spine.”[1]
By working with your spinal range of motion, chiropractic care can help correct golf injuries, maintain performance, and improve the posture needed to perform a good golf swing. When the chiropractor aligns all the vertebrae, the spine can move better. An individualized treatment plan including chiropractic adjustments, specific rehabilitation exercises and muscle techniques may make a significant difference in your overall performance and enjoyment of the sport.
Recent research confirms that chiropractic care can indeed lead to improved golf performance. A recent study published in the Journal of Chiropractic Medicine demonstrated that the combination of chiropractic care and stretching are associated with greater improvements in golfers swing when compared to stretching alone.[2]
Two groups of golfers participated in the study. One group received a program of stretching only, and the second received both stretching and spinal manipulation. The stretching program was the same for both groups, and both groups had similar average ages, handicaps, and initial swings. All 43 participants initially performed three full swing maneuvers, and the average distances were recorded. Over a 4-week period, all participants hit 3 balls before and after treatment.
After 4 weeks, the stretching only group showed no improvement in swing performance.  However the stretching and manipulation group did improve their swing performance and there was greater driving distance right after treatment each week. So it appears that yes, chiropractic care can help not only top golfers such as Woods and Harrington, but it can help you improve your golf game too.


References:

[1] Tom Ward, PGA Instructor. http://www.golflink.com/golf-tips/tips/ward032.aspx
[2] Journal of Chiropractic Medicine (2009) 8, 165-170.

Carpal Tunnel Syndrome (CTS), named from the carpal bones in the wrist that form a tunnel around the nerve leading to the hand, is an injury usually caused by repetitive and forceful movements that result in swelling around the tendons and pinching of the median nerve, causing painful tingling, lack of muscle strength and control in the hand, and pain shooting from the hand up to the shoulder. CTS is a risk to most workers, such as those who work on the computer and also store and assembly line workers, who receive micro-traumas to their hands and wrists on a daily basis due to awkward positioning, forceful and repetitive movements, and stressful activity. [1,2]

The usual treatment for Carpal Tunnel Syndrome can extend to heavy medication and surgery, however there are alternative methods of treatment that can alleviate the symptoms and effects arising from CTS. Chiropractic treatment for CTS has been studied against conventional non-surgical medical treatment by Davis et al. [1] and was found to be effective. This offers an alternative to sufferers who are intolerant to ibuprofen, or those who simply wish to avoid treating with medication.

The median nerve in the wrist, which when trapped causes Carpal Tunnel Syndrome, connects to the spinal cord through the openings in the bones in the areas around the lower neck. If these bones in the spinal cord lose their ordinary position or motion, this can cause problems in the wrists or fingers. Through chiropractic treatment, these bones can be reset to the correct position and can help to treat CTS.

If Carpal Tunnel Syndrome is detected early, then surgery can be avoided, and chiropractic treatment is the leading method of non-surgical treatment. Chiropractic treatment usually involves various methods [3], with a combination of rest, ice, ultrasound, and electrical stimulation, including:

· By chiropractic manipulation therapy of the elbow and upper spine, where the joint’s soft tissue undergoes manipulation [4];

· Nutritional supplements in the diet such as B6, a vitamin that has had long-term promotion in its treatment of CTS;

· Electro-acupuncture treatment; bracing, a technique that has had extensive success, by limiting extension and flexion in the hand, and with compression on the median nerve may encourage recovery and ease the swelling in the tendons;

· Exercises for the wrist and hand designed to encourage recovery;

· Reassessing the ergonomics of the work place to minimize stress the best way as possible.

Recent studies, such as that by J. Burke et al (2007)[5], concluded that using manual therapy intervention such as soft tissue mobilization (STM) has been found to help improve the signs and symptoms of CTS, with improvements to nerve conduction latencies, wrist strength and motion.

Carpal Tunnel Syndrome can become a serious health problem, and if left too long may require surgery. If it’s caught early, then chiropractic treatment is an effective, drug-free method to ease the symptoms and pains caused by CTS, and provide long-term relief from CTS.

[1] P.T. Davis et al., J Manipulative Physiol Ther. 1998 (Jun);21 (5): 317-326 (1998)

[2] R.Valente and H. Gibson, J Manipulative Physiol Ther 1994;17(4):246–9 (1994)

[3] R. Perez de Leon & S. Auyong, J Chiropr Med. 2002 Spring; 1(2): 75–78. (2002)

[4] P.T. Davis and J.R. Hulbert, J Manipulative Physiol Ther 1998;21(5):356–62 (1998)

[5] J. Burke et al., J Manipulative Physiol Ther. 2007 Jan;30(1):50-61. (2007)