One of the things people hear an awful lot is that if they see a chiropractor once, they’ll have to go back the rest of their lives to that chiropractor or another one. Sadly, that’s a common stigma associated with the profession, but I could not disagree with it more.
You May Not Need a Chiropractor
In my clinic, we like to see patients that we’ll call a “condition specific” meaning if you hurt your low back, you have a “low back condition.” You’ll come into the clinic, we’ll check you out, examine you, take a history and then make a determination what is the best course of treatment for you:
- OK, is it manipulation with chiropractic?
- Is it soft tissue massage?
- Is it clinical massage?
- Is it physical therapy?
- Is it yoga?
- Do you need an orthopedic referral?
- Can you manage this just with home exercise or stretching?
So initially, it’s really important to determine what is the problem that we’re dealing with? And once we make a determination of what that condition is, then we have a plan, and from that plan, we start moving forward.
Beware of the “Black Hole” of Chiropractic Treatment!
At Tulsa Spine and Rehab, we have a pretty intense, evaluation process followed by an exact roadmap for what we want to do. Paramount, I think, is the history taking. I sit down and visit with a patient for 20 to 30 minutes about what’s going on. Is there a history of the low back or are there any complicating factors? Surgeries? Have they seen other physicians? Different things like that. And then I want to get into more specific type of questions like, “What makes you hurt? If you’re sitting for extended periods, lying down, sitting to standing, sitting at your desk. It’s really important for me to paint a little bit of a picture. And when I’m painting that picture, many times I’m probably going to have a good idea, before I examine the patient, what the problem is. And then once we determine what that problem is, I talk about a plan or a roadmap, I think it’s very important that we just stick to that plan. A lot of times with chiropractic physical therapy, it also can be referred to as a “black hole”, you know? Where does it stop?
Let’s say that I’ve got a young athlete …a soccer player, and he’s had an injury. He comes in for the evaluative process and he leaves with the plan. What is that plan going to look like?
Well, one of things also that we pride ourselves on here are our conservative effective treatment plans. If a patient is not responding or hasn’t really turned the corner in say 4 to 6 visits, then I need to start thinking about… are there some other things going on here? Who else needs to get involved? Physical therapy? Do I need to send him out to an orthopedist?
A lot of times, the plan might be that we refer you out for MRI or X-Ray, or I’d like to get an orthopedic evaluation. Perhaps we’ll start by focusing on joint mobilization, soft tissue release, maybe do some general rehab. But most importantly, we’re going to give the patient things to do on his own that may include modifying activity, self management strategies, or a lot of times, just home exercise and stretching. Bottom line, we’re all accountable for our own health, and once we can get the patient on-board with what we’re doing, they generally ask, “What can I do on my own?”
Treatment Should Have an End In Sight
When I can get a patient out of pain, we can start to increase function. Let’s say that he’s unable to sit for 15 minutes. Well, that’s important. Let’s say that he works in an office job. I want to change or improve some of those functions. If just daily functions become limited, if he says, “I can’t bend over and put my shoes and sock on in the morning,” something’s obviously going on there. So, once we can obviously diminish their pain, it doesn’t always mean the problem is resolved. The goal is increased function, getting patients to change some things and get them on their own. Once they’re ready to spread their wings now, they’ll have a very detailed plan on how to do that.
So how rigid does your relationship with your chiropractor have to be? You don’t have to be locked in for LIFE! Just make sure there’s a plan. Make sure that plan is laid out clearly in front of you. What are the goals and expectations? I think that that’s a reasonable question to ask ANY physician, physical therapist or chiropractor.
