Changing Views Toward Chiropractic Medicine

October 8th, 2008 by Dr. Greg Molis
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Back in the “old days”, the regular medical doctors looked upon chiropractors as “quacks”, practicing a form of medicine that had no effect on the patient. They figured that if no medicines were prescribed, then there was no effective treatment. The American Medical Association did everything it could to discredit chiropractic medicine. Times have changed and now both branches of medicine work together.

Today, chiropractors are the third largest group of health care providers, after physicians and dentists, who treat patients directly. The American Medical Association policy now states that it is ethical for physicians not only to associate professionally with chiropractors, but also to refer patients to them for diagnostic or therapeutic services.

What led to this change in the way the medical profession views chiropractors? Several factors are believed to be responsible:

The 1990 U.S. Supreme Court decision on a lawsuit, known as the Wilks case, that found the AMA and others
guilty of illegal conspiracy against the chiropractic profession.

Recognition by the established medical community that most medical therapies for back pain are ineffective.

RAND’s 1992 groundbreaking analysis of spinal manipulation that showed this intervention does benefit
people with acute low-back pain. This study directly influenced the Agency for Healthcare Research and Quality to include positive recommendations on spinal manipulation in its 1994 clinical practice guidelines on low-back pain. This federal agency issues such guidelines to help the medical community improve the quality of health care in the United States.

Chiropractors do not believe they can replace traditional forms of medical treatment. They do not treat the some of illnesses and conditions that a general practitioner does. Most chiropractors focus on problems of the spine, that is, conditions affecting the backbone and associated muscles and nerves.

Chiropractors most commonly adjust the spine by using their hands to apply forceful pressure, on areas that are out of alignment or that do not have normal range of motion. Sometimes this causes an audible “pop.” At times, a chiropractor will do an adjustment with an instrument called an activator. Chiropractors also use mobilization techniques (manual therapy that does not involve a high-velocity thrust) as well as physical therapy.

Although spinal manipulation is the key component of chiropractic care, most practitioners take a holistic
approach and include such things as nutrition counselling and exercise advice in their treatment program.

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Chiropractic Treatment for a Slipped Disc

September 5th, 2008 by Dr. Greg Molis
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A slipped (bulged) disc is one that has happened due to damage from an injury. The disc is like a supportive
cushion between the bones of the spine called vertebra. The disc can press against the nerve and cause inflammation of the nerve. As a result, there is pain along the path of the nerve, often radiating into the leg. When a patient visits a chiropractor for relief from the pain associated with this problem and to have the disc adjusted back into place, the doctor will take a history of other medical conditions and do orthopedic and neurological testing which are standards of practice in chiropractic offices.

Chiropractors use other diagnostic procedures that are unique to chiropractic and establish the foundation for a program of care. They look carefully at a patient’s posture and perform a postural analysis of the patient. They use techniques such as motion and static palpation to determine exact areas of restrictions in spinal joint motion. They palpate muscles and perform muscle testing, as well as perform tests for pelvic balance and determine whether there whether one leg is shorter than the other. X-rays of the lower back are taken if necessary. Depending on the findings, the chiropractor may call for an MRI or other imaging study of the back.

After analyzing this information from the exam and the X-rays, the chiropractor determines if the patient has suffered a disc injury. The crucial diagnostic question is, “what type of disc injury has occurred?” It is the answer to this question that will determine the chiropractic approach to treatment or referral. While most are, some patients are not good candidates for conservative chiropractic care. If there are unusual neurological findings with advanced loss of strength, sensation, and reflexes, the chiropractor will refer the patient to a
spine surgeon (for evaluation) prior to initiating any treatment.

Disc conditions are treated in chiropractic with a gentle program of low-force techniques. Chiropractors who treat disc conditions integrate their low force adjusting techniques in an organized protocol of evaluation and treatment. Throughout a program of chiropractic care for disc conditions, patients are asked questions regarding their progress and are often given special stretching exercises to do at home. They may be given instructions on home use of ice and/or heat. Evaluation of progress using neurological and chiropractic tests based on comparison with the initial findings are vital aspects of the chiropractic treatment. If a patient is not responding to the treatments, the chiropractor will usually refer the patient for imaging studies and/or a spine specialist consultation.

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Side Effects of Chiropractic Care

August 8th, 2008 by Dr. Greg Molis
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Serious side effects from spinal manipulation are rare. Strokes have been reported following manipulation of the neck, as a result of damage to one of the arteries supplying blood to the brain. However, the incidence of
strokes from manipulation of the neck region is estimated to be 1 in a million procedures, according to the Agency for Health Care Policy and Research. Likewise, the Agency states that the risk of a serious side effect from manipulation of the lower back are almost non existent.

Minor side effects of spinal manipulation such as soreness, headaches, fatigue in a low percentage of patients, are usually temporary. There may be soreness in the area that received the adjustment for a short time following the treatment. Through continued treatment these usually go away.

Chiropractic treatments are not recommended for disorders like osteoporosis, bone or joint infections, bone cancer, acute rheumatoid arthritis, and diseases of the spinal cord or bone marrow. It should also be avoided in an area that has been operated on recently, such as a spinal fusion, and near acute fractures and dislocations. Chiropractors do not treat fractures or severe sprains of ligaments or tendons.

In most cases of chiropractic treatments, relief comes quickly. If pain persists, patients should allow some time for improvement to appear; 2 weeks is generally sufficient in cases of acute low-back pain. If there’s still no change, or if the condition becomes worse, they should discuss alternative therapy with your chiropractor. Many chiropractors refer patients to specialists for further evaluation when a condition persists.

If a chiropractor discovers any dangerous problems that need immediate medical attention, he is likely to refer you to a medical specialist without delay. Tumors, fractures, or other suspicious findings viewed on an x-ray are also common reasons for immediate referral. The second most common reason to be in the hospital is complication from medication and surgery.

Because chiropractors don’t use drugs and surgery these common problems are avoided. Chiropractic is one of the few health care choices with a very low rate of side effects and complications.

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History of Chiropractic Care

July 12th, 2008 by Dr. Greg Molis
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Chiropractic care began in 1895 in Iowa when Dr. David Palmer used manipulation to adjust the spine of his patient, who was deaf following a fall down the stairs. Thinking he had discovered a cure for deafness he started treating deaf people. He only helped a few with deafness but started to see other problems like headaches, dizziness and lack of energy improve. At the turn of the 19th century in rural America, health care was a craft more than an art. There were numerous competing practitioners such as magnetic healers, herbal healers, hydro healers, bonesetters, and homeopaths and Dr. Palmer was considered to be another form of home remedy medicine.

As medicine flourished and doctors became better trained, those who practiced chiropractic medicine were shunned by the general medical profession for their lack of formal training in their field. Doctors of chiropractic retorted that practicing chiropractic and practicing medicine were different. To emphasize this difference, the chiropractic community developed a different vocabulary and rationale for its approach. Chiropractic care rejected the use of medicines and drugs and never incorporated the practice of surgery. Chiropractic was conceived as a more natural approach to healing, drawing upon the body is own recuperative powers.

Dr. Palmer started a chiropractic college in 1897, one that still bears his name, and began to teach the science of chiropractic medicine to those wishing to follow in his footsteps. However, chiropractic education remained a tuition-driven, inadequately financed enterprise that received no external support for research.

Chiropractic colleges upgraded their educational process by expanding the curriculum and employing instructors with Ph.D degrees to teach the basic sciences. As a result, chiropractors started to pass the Basic Science Board examinations. Further efforts to improve the quality of the educational process eventually led to the creation of chiropractic’s own national accreditation agency, the Council on Chiropractic Education, which achieved federal recognition from the Department of Education in 1974. This agency implemented educational standards for the curriculum and the admission processes and in doing so elevated the
standards of chiropractic colleges.

Chiropractic care has been attacked in the past by general medicine as an unscientific cult with no research to support its claims of efficacy. This is because there was no research done in the early years. However, in recent years there has been much greater collaboration between chiropractors and the greater scientific and clinical communities in training, research, and practice. Multidisciplinary practice is more common as are editorial and technical collaborations, joint research initiatives, and medical physician support of chiropractors in litigation matters.

Research has demonstrated that manipulation, a primary mode of care for the doctor of chiropractic, is effective in the treatment of acute low back pain. The inclusion of manipulation as a recommended treatment in the federal guidelines for the treatment of acute low back pain is the result of the findings of researchers both within and outside of chiropractic.

Research has also demonstrated the effect of chiropractic care in other conditions such as headaches, carpel tunnel syndrome and other conditions.

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The Training of Chiropractic Doctors

June 8th, 2008 by Dr. Greg Molis
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In order to graduate as a Doctor of Chiropractic, a person must graduate from an accredited chiropractic college and receive a Doctor of Chiropractic (DC) diploma or degree. In the United States the graduate is required to pass a national examination set by the Chiropractic Examining Board as well as a state entrance examination to qualify for registration in a particular state. Continuing professional education is required throughout the chiropractic career in order to maintain this registration and training.

The minimum academic requirement for the four-year program at the Chiropractic colleges is three full years of college. At least a “B” average is required. Many students enter the program with a bachelor’s degree in Science or Arts from an accredited university. In addition to high marks, three letters of reference, an essay, an autobiographical submission and an interview with the applicant are required before admissions status is determined. Students who are offered admission to a Chiropractic college must submit, at the time of registration, a signed health status report by a health practitioner and results of a tuberculin and/or chest X-ray.

Chiropractors are often in contact with people who are in pain, therefore, they must be empathetic, compassionate, patient and effective communicators. Physical strength, good eyesight and hearing, and a high degree of manual dexterity and perseverance are also beneficial in this work.

At the college level, those who are studying to become Doctors of Chiropractic have four years of intensive study in the sciences dealing with the body. They have to know the anatomy of the body, the bones and muscles and how they are interconnected. This involves not only study in Biology, but they also have to do many Chemistry courses. In addition, they are required to work with other Chiropractors as interns. Half way through their training chiropractor and medical doctors take the same “National Boards” test. To test their knowledge of the basic sciences.

In order to become a Chiropractor, it requires many years of dedicated study, just as it does to become a medical doctor. Many people think that studying to be a chiropractor is perhaps a one-year course learning how to use the different instruments you see in the office. However, you can be assured that your Chiropractor is a well trained professional who knows exactly what he/she is doing.

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Chiropractic Care During Pregnancy

May 15th, 2008 by Dr. Greg Molis
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Because of the precious cargo involved, you may think that chiropractic care during pregnancy would be harmful. Actually it is quite the opposite. It is often very beneficial to the health of the mother to get chiropractic treatments during pregnancy. A healthier pregnancy means an easier labour and delivery, and a better transition for the baby into this life.

It is quite easy to see the changes pregnancy causes on the outside of the body. The weight of the baby places increased pressure on the spine and pelvis, and towards the end of the pregnancy, changes are seen in gait pattern which makes it seem as the pregnant woman is walking with a waddle. There are many different hormonal changes and chemical reactions occurring both in the mother and the developing baby, all of which are controlled and coordinated through the nervous system.

Chiropractic adjustments often result in an easier pregnancy, significantly decreased mean labour time, and assists new mothers back to the same level of health they had before pregnancy. In studies that have been done on women receiving chiropractic care during pregnancy, women receiving Chiropractic care through their first pregnancy had 24% shorter labour times than the group not receiving such care. In addition, 84% of women reported relief of back pain during pregnancy with Chiropractic care. There is significantly less likelihood of back labour when receiving Chiropractic care through pregnancy because the sacroiliac joints of the pelvis function better.

Chiropractors also adjust the newborn babies after birth. Adjustments to newborns contain only ounces of force. But that force is directed into the spine to facilitate health and remove subluxations. This adjustment is done to alleviate subluxations caused by being constrained in the womb and by the journey down through the birth canal. Birth trauma to the spine is fairly common and occurs 10 to 20% of the time.

The children who suffer the most from ear infections, colic, allergies, asthma, frequent colds, or ADD/ADHD, commonly have subluxations as the underlying cause of their bodies not working properly. Even relatively easy deliveries can result in subluxations. That’s why every child should be checked, before health problems develop. That is preventive chiropractic care in the truest sense. Preventing subluxations in mothers also prevents subluxations in their babies during childbirth.

Remember our bodies, by design, are suppose to be healthy, even during pregnancy. Your chiropractor is usually very knowledgeable about diet and exercise related to your pregnancy.

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Chiropractic Care for Headaches

April 18th, 2008 by Dr. Greg Molis
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Visiting a chiropractor to get help with your headache problems is common. Chiropractors successfully treat headache sufferers without using any medication. The main cause of many headaches is actually problems with the spinal vertebrae in the neck. The reduction of neck muscle spasm following a chiropractic adjustment or manipulation to the cervical spine helps to relieve the pressure on the vertebrae and spinal nerves. An adjustment is a fast but short thrust aimed at one or more vertebral joints. This method has been found to be quite effective in the treatment of headaches.

The muscles at the back of the neck near the base of the skull often become very tender and sore with the onset or progress of a headache. These small, but powerful muscles, are attached to the fibrous lining of the scalp. This fibrous structure is called the aponeuorsis and is located under the hair and skin covering your head. Tension and tightness of these muscles exerts tension on this aponeurosis and gives the feeling of pressure over the scalp or of a band around the skull or the feeling that someone is standing on your head. Chiropractic adjustments are effective in reducing the tenseness of these muscles, thereby reducing the sensation of pressure around the skull.

Chiropractic treatment also reduces the nerve irritation that occurs with a subluxation (spinal misalignment). You can get relief from irritations of the muscles and tissues of the upper neck, as well as inflammatory irritation caused by related trauma to the spinal nerves of the upper cervical spine.

The quick and usually painless way a chiropractor relieves a headache is reason enough to seek this form of treatment. Instead of visiting your medical doctor for prescription medication or injections of medicine that make you drowsy, a chiropractor treats your headache and you can go on with your daily activities. In addition to treating the pain, chiropractic care for headaches works to prevent future headache episodes. However, the chiropractor will ascertain that your headache is the result of spinal nerve and vertebra problems.

The fact that most health insurance companies pay for chiropractic care means that you can visit your chiropractor for common ailments and receive the same level of medical attention as your would from your family physician, but without having to purchase and use medications.

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Chiropractic Care for Low Back Problems

March 10th, 2008 by Dr. Greg Molis
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Those who have low back problems, such as pain in the lower back and legs and loss of mobility, often seek the help of a chiropractor. They may have exhausted all other forms of medical treatment and have not gotten any relief from the pain. Once the first assessment is done, the doctor will explain what treatment will be given and how often it is necessary to come in for these treatments.

During the assessment, the doctor will look for three main things:

Do potentially serious problem such as a tumor, infection, a fracture or major neurological problems exist, requiring referral to another doctor.

If you have a condition that will respond to chiropractic care.

What type of care (or technique) will work best for you?

Once the doctor has made a diagnosis, he/she will begin a series of back manipulation treatments. Chiropractors use the term “adjustment” to refer to spinal manipulation. This is the specific manipulation chiropractors apply to vertebrae that have abnormal movement patterns or fail to function normally. The objective of the chiropractic treatment is to reduce the “subluxation”, which results in an increased range of motion, reduced nerve irritability and improved function. There are also specific techniques to treat disc problems.

The adjustment made by the chiropractor consists of a quick, usually light thrust applied to a vertebrae, which is often accompanied by an audible “popping” sound. The sensation is usually relieving, though minor discomfort can happen. It usually lasts for only a short time and is caused by the surrounding muscles are in spasm or the you tense up during the chiropractic procedure. The chiropractor will help you to relax before he/she performs this adjustment and it happens so quickly most patients don’t have time to tense up.

Your Chiropractor may also use physical therapy procedures to help you. He/she is very well trained in how to use things such as ice, heat, massage, traction, ultrasound, etc. for your benefit. PT, as it is called often makes adjustments easier and helps speed healing.

The chiropractor may also give you a set of exercises to do at home for specified periods of time each day. The chiropractic treatments combined with the exercise will result in reduction of pain and an increase in your range of motion.

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Different Types of Chiropractic Care

February 5th, 2008 by Dr. Greg Molis
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Just as there are different types of doctors, there are different types of chiropractic care. You can visit a chiropractor when you have back or neck pain, but you can also visit a chiropractor just to stay well. Chiropractors are concerned with the health of the whole body, not just the spine.

Chiropractic care deals with subluxations (misalignments of vertebrae causing nerve irritation) anywhere along the spinal column, not just in the lower back. Sometimes the vertebrae of the spine become misaligned or lose their range of motion for one reason or another. This misalignment puts pressure on nerves leading to and from the brain. A chiropractor helps put them back in place by using gentle and highly skilled adjustments.

Some chiropractors are “straight” chiropractors. This means they deal only with the location and removal of subluxations. Their philosophy is that once subluxations are remedied the body will naturally revitalize itself. Other chiropractors are called “mixers” because their practice and philosophy is that in addition to manual adjustments and treatments, chiropractic care can be combined, by the chiropractor, with other forms of healthcare, such as physical therapy, exercise programs and nutrition.

After an initial examination and discussion about any other medical conditions you may have, the chiropractor will decide on a method of treatment. There are three main kinds of chiropractic care:

Relief Chiropractic Care

This is to help immediate relief needed for acute pain and discomfort when a patient is in a lot of pain. The frequency of visits are determined by the amount of damage that needs to be corrected.

Corrective Chiropractic Care

This care typically is required for spinal problems that have occurred over a long period of time without proper treatment. This type of care requires long term treatment.

Maintenance Chiropractic Care

Many patients due to permanent spinal weakness from old injuries once they have relief from the problem and the pain, still need to have regular checkups with the chiropractor to ensure that you remain healthy. Usually these treatments are once every 2 to 6 weeks.

Chiropractic care involves the whole health of the body. Treatments involve using the internal healing systems in the body to relieve the spinal problems that can interfere with the nerves and cells. Therefore, receiving chiropractic treatments is a way of ensuring that every part of body is functioning as it should.

Chiropractic care is the most recommended form of alternative medicine. It is based on the belief that certain conditions are caused by impairment of your nervous system due to problems in your joints, muscles, ligaments, tendons and bones. While chiropractors do not use drugs or surgery, they sometimes do refer patients for medical care when they believe it is necessary.

Chiropractic care is safe and natural helping the body to draw upon its own restorative capabilities to heal. It teaches patients how to take control of their own health and avoid chronic pain. It also can help prevent problems before they start or get worse.

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Your First Visit To The Chiropractor

January 8th, 2008 by Dr. Greg Molis
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Most people do not visit a chiropractor as their first form of treatment. This usually happens when other methods have failed. Many believe that chiropractic treatment is painful but are surprised to find it less painful then other treatments they have had. A chiropractor is not only concerned with your spinal cord but with the health of your whole body.

The first visit to a chiropractor takes longer because he/she will want to know all about any medical conditions you have so as to know what form of treatment would be best for you. There will be forms to fill out. The chiropractor will review these sheets before you enter the office and
he/she may have some further questions to ask you about information you provided.For the immediate problem you are having the doctor will ask you specific questions such as:

When did the pain start?

Where is the pain located?

Are there any activities that make the pain worse or better?

Is it the result of an injury?

Etc.

The doctor will then proceed to do a thorough examination, not the kind you would receive from your regular health care professional though. The chiropractic assessment may include blood pressure, pulse and temperature readings, but also include neurological and orthopedic examinations of the spine and neck and of the part of the body where you have pain. These include tests on the range of motion of the affected part and the muscle tone and strength. Further chiropractic tests may be necessary to arrive at the assessment or diagnosis of the affected area.

Once the problem is understood, the chiropractor will determine if the condition will respond to chiropractic care. He/She will explain the condition from which you are suffering and the chiropractic treatment plan that will be used as well as how long these treatments may take. The frequency of visits varies you may only need one treatment or your condition may require regular treatment such as 2 or 3 times per week over a period of weeks or even months. The seriousness of your condition or the amount of pain you are in determines this frequency of chiropractic care. The intent is to lessen the pain so that you can perform your normal daily routine and to stabilize your problem.

After this has been done, the chiropractor will proceed to do the first treatment. Depending on the nature of your problem, you will probably need what is called an adjustment. This refers to specific manipulation of
vertebrae that have abnormal movements or fail to move at all. He/She may use the hands to do this manipulation or a small device to apply pressure to any areas of the spine that are out of alignment. Under normal circumstances, there is little or no pain associated with an adjustment. It may hurt or cause minor discomfort for a few seconds.

If you have had X-rays you should bring them with you, so the doctor will have a clear picture of your problem. If not,the chiropractor may want the ER to take an X-ray or have an MRI in order to provide you with the best chiropractic care.

Most, but not all insurance covers chiropractic care. You can call and get your chiropractic coverage before you go in. Or most chiropractic offices will call and find out your coverage for you.

Many who go to a chiropractor once get such relief, that for future problems they go to the chiropractor first.

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