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Requisitions, Recommendations and
Referrals
In order to reach maximum
effectiveness treating patients, it is sometimes necessary to team
our efforts with those of other professionals. We recommend
here some of the professional services that we may at some
point recommend to our patients.
Diagnostics
X-ray, MRI and CT Imaging. While
not every patient need be X-rayed, injury events that are traumatic
need X-rays to rule out fracture. Long standing problems
require X-ray to evaluate for disk and joint degeneration. Our
facility does not have an X-ray unit. We utilize both the
Culpeper Regional and Fauquier Hospital imaging
facilities, where the films are read by a radiologist and a written
report is sent to our office as part of the
patient's file. Films are made available on
request for our review as well.
Patients need to realize that X-rays don't tell the whole
story. While X-rays reveal the height of the disk space
between vertebra and are therefore good indicators of disk
degeneration, they do not reveal much about the disk itself and
offer little value in the diagnosis of protruding and herniated
disks, which are the primary offenders in cases of "pinched
nerve." It is for this reason that either an MR or a CT
may be ordered for a cervical or lumbar spine. MR and CT
imaging are also necessary to evaluate the rotator cuff of the
shoulder or the meniscus and cruciate ligaments of the knee for
tearing and rupture.
Nerve Conduction
Testing. In traumatic neck injury due to auto
accident, where numbness into the fingers persists after 3 - 4
weeks beyond onset of treatment, nerve conduction tests
may be ordered and performed by Dr. Stergis,
Culpeper neurologist, to determine origin and severity of the nerve
compression.
Exercise
One of the best forms of exercise in general for most people
with joint and muscle issues is swimming and water
exercises. We do not recommend running or jogging as the
impact wears on the knee, hip and lumbar
joints.
Walking is
recommended, but not "power walking" or aerobic walking, which is
too fast a pace for injured tissues. We recommend slow,
smooth walking with no sudden stops, twists or turns.
Shopping centers are not good places to do such walking, because the
surface is often cement and the period of walking too long.
The long term answer for many orthopedic
problems is stretching and strengthening
muscle. While our office does have exercise equipment, it
is designed for short term strengthening over a 2 - 4 week period,
not for long term use. The patient may be advised to sign up
with Curves or Gold's Gym for achieving long
term goals of stability. Water displaces weight and makes the
legs and arms feel lighter. Senior patients with arthritic
joints seem to do very well with water programs at
Water Aerobics and it is expected that the
water facilities at the Wellness Center when
it is completed in Culpeper ought to be very welcome to the
community.
Sometimes when
specific programs of exercise are required for rehabilitation of a
difficult problem, a Physical Therapist is vitally
important. While at times services with a PT can overlap
those of a DC, careful coordination can eliminate 3rd party
concerns. A number of our patients have received excellent
care from Patricia Hennessy, PT at the Culpeper
Regional Hospital, Outpatient Physical Therapy.
Dentist
Sometimes neck and shoulder pain is the result of TMJ
syndrome. TMJ is a problem we treat, but it is one we
usually need the assistance of a dentist, who can evaluated the bite
and provide a bite guard for sleeping at night to prevent grinding
of the teeth. Not all dentists are trained in this aspect of
dentistry. One who is and one our office works well with is
Culpeper dentist, Dr. Olan Parr.
Massage
Therapy
We
recommend massage therapy for every person on the planet regardless
of age or whether they have problems or not! It is a
good means of providing yourself with preventive health care.
However, massage therapy is for more than preventive care. It
can be adjunctive with our care for many problems. We
know a number of massage therapists here in Culpeper as
patients and friends and recommend: Alice
Crane, Miriam Hudson, Debbie Ramero, Lydia Hooper, Barbara Nash and
Linda Burgdorf.
Nerve Block
Our practice involves the use of conservative treatments
that are designed to help the patient with the least possible chance
of injury through side effects. Prolonged drug usage increase
chances of side effect injury. The most non conservative approach is
surgery. Sometimes the gravity of the problem requires going
beyond the conservative approach of this office. One such
procedure, short of surgery, is the nerve block, where
hydro-cortisone is injected deep into the spine. Some severe
cases of disk involvement and pinched nerves have responded to nerve
block when they have failed to respond to our treatment. In
such cases, we may refer the patient to Dr. Kim,
orthopedist in Warrenton or Dr. Poss, (formerly of
Culpeper) anesthesiologist now with Winchester
Neurological Consultants. We also recommend Dr. Bart
Balint for chronic pain management in Weyers
Cave, VA
Surgery
While surgical procedures are on the opposite pole of
conservative chiropractic treatment, there are situations where such
a procedure may be carefully considered. There is no question
that surgery is the last step, because it represents the greatest
risk and therefore should only be considered when all other
conservative procedures have been given adequate opportunity for
success. Because of the serious, long term effects of scar
tissue, the surgical procedure that creates the least amount of
scaring is usually preferred, microsurgery being the ultimate in
tiny incisions. Ruptured tendons, muscles and disks are
orthopedic conditions for which surgery may be appropriate. Joint
replacement may be considered for severely degenerative hips
and knees. Over the 30 plus years that we have been in
Culpeper, we have from the beginning, when Dr. David
Couk (now retired) provided the sole orthopedic services
for both Culpeper and Warrenton, referred patients for surgical
evaluations to what developed into Virginia
Orthopedics, founded by Dr. Ben Allen and
his associates and Blue Ridge Orthopedics in
Warrenton, founded by Dr. Couk and his associates. Virginia
Orthopedics has recently added to its staff, Dr. Wahid M.
Baqaie, who does "minimally invasive" back
surgery.
Spiritual Needs
Sometimes patients suffer abuse or feel life has
treated them unfairly for some reason and there is an undercurrent
of anger repressed against the ultimate Being, who created them, the
Lord God. Pastors call this anger sin because that is
what the Bible calls it. Our physical bodies respond to
persistent anger negatively, resulting in many forms of disease,
including our bones and joints. Pastors can be a huge
source of help. They can identify root problems and lead patients to
a reconciliation with their Creator that brings about spiritual as
well as physical healing. Pastors can also teach these
patients how to pray and prayer has been identified by current
research to be an effective means of healing. Pastors are under
utilized in this significant role. In a society where health
care is expensive, pastors offer their services freely. Those
patients without a pastor to talk with, I recommend
Doug Sachtleben, pastor of Providence Bible
Church.
Call 825-8867 For An
Appointment | 
