The Treatment
Plan
After the history of the problem has
been discussed and assessed by examination, a plan of treatment will
be presented. This plan varies greatly depending on the
problem. Some patients have found that
preventive wellness plans are worth pursuing and will come
in monthly for spinal manipulation. Many other patients have
acute, sub-acute and chronic pain syndromes that require a different
plan, sometimes involving no manipulation, but often involving a
combination of manipulation and other modalities of treatment such
as Ultra Sound and Electrical Muscle Stimulation (EMS).
While there is not enough space to elaborate in much detail about
all the types of services offered here, I want to briefly touch on
the main ones so the reader will have a basic understanding of
these treatment modalities. All of these
modalities make up a part of the broad field of Physical
Medicine, which provides a course of conservative
treatment that is both effective and safe.
Manipulation
Spinal
manipulation is, of course, what all chiropractors do and it is the
one mode of treatment we have in common. The way in which we
do it, however, usually varies with every chiropractor.
The type of chiropractic manipulation used in this office is
referred to as "diversified" manual adjusting, which is usually
gentle, but can be as firm as needed. A
second mode of manipulation is with the assistance of a hand
held mechanical adjusting instrument called
an "Activator." This spring loaded unit provides precise,
uniform adjusting capabilities that are excellent for seniors who
are osteoporotic or those who have other health issues
requiring a softer, gentler adjustment. Three of
our adjusting tables have pelvic drop sections which are helpful in
the alignment of the pelvis. One table is a motion table that
is a specialty table designed specifically to reduce disk
protrusions and small disk
herniations.
What Good Does It Do?
Manipulation fixes subluxated joints
(joint lock). Joints were designed to move without
friction, freely and smoothly. But holding a position out of
the neutral position for an extended period of time (for example
head rotated to the left) can cause the joints in the cervical spine
to "jam" and lock together ("subluxate").
Patients describe it as a "catch." Instead of free
movement, there is restricted movement that is painful because one
of the bony facets is no longer gliding, but pinching.
There is almost always some muscle tightness associated with the
joint dysfunction. The solution to the problem is to
bring motion back to the dysfunctional joint. This is
accomplished by manipulation. Of course, as one would imagine,
strain and sprain injuries also cause joint subluxations as well.
Upper cervical subluxation is a common cause of
headache.
Risks of
Manipulation: One
notable, but rare, side effect that may be caused
by cervical manipulation is stroke. In normal individuals,
there is no danger at all. But in individuals with a weakness
in the vertebral artery which may cause a ballooning of the arterial
wall, sudden rotational and extension stretching
delivered simultaneously may cause the weakened wall
to break. If extending your head back and rotation
to either left or right while the head is extended, causes
dizziness, you should note this on your history form and
discuss this during your consultation. In 32 years of
practice, no patient has ever had such a side effect in this
office. Another potential but uncommon side effect is rib
fracture. People at risk involve senior women having
severe osteoporosis. In 32 years, rib fracture
has occurred only twice in this
office.
The First Adjustment: While manipulation
usually brings relief from the sharp "catching" pain,
you may experience some soreness the day after your
visit as your body begins to heal.
Ultra
Sound
Ultra
Sound is an energy that has the capacity to get deep. The body
is mostly water and once through the skin with a coupling agent, the
sound energy will penetrate to the bone.
Anti-inflammatory agents can be placed on the skin and carried deep
into the tissues by the sound energy. This procedure is called
"phonophoresis" and is very effective treatment for
many inflammatory joint and muscle conditions. Ultra sound is
a safe procedure. Yet, there is some slight risk
for superficial redness or burn. Brachial
neuritis is a condition that causes pain to radiate from
the neck into the shoulder, down the arm and sometimes into the hand
leaving some of the fingers numb. In addition to manipulation
of the cervical spine, ultra sound is our treatment of choice for
this condition, usually using 2 sound head simultaneously converging
the beams on the nerve roots as they exit the cervical
spine.
EMS
There are many very different forms of
electrical stimulating units. In this office, we use regular EMS
which is a good procedure for relaxing muscle or maintaining
muscular strength depending upon how the unit is setup. There
is also a deep form of EMS known as Russian stim which we use to
strengthen muscle. EMS is AC current. The body runs on
DC current and units that run on DC seem to simply work better for
inflammatory problems. We use Low Volt Galvanic and High Volt
Galvanic units as well as micro DC units that are among the best
energies to stimulate healing in the body. With DC units, one
electrode is always the negative electrode and the other is always
the positive one. The current goes one way from the negative
electrode to the positive and it pushes the negatively charged ions
in the immediate area toward the positive electrode, in much the
same way as one would silver plate a spoon. As with Ultra
Sound, anti-inflammatory agents can be place on the negative
electrode and pushed deep into the tissues. This process is
known as "iontophoresis" and like
"phonophoresis" is very effective treatment on any number of
inflammatory joint and muscle conditions. Sciatic
neuritis responds well to DC currents. Since Micro DC
is what makes acupuncture so effective, acupuncture is also an
effective treatment for sciatica and we will address it
later. While electrical therapy is safe, there are
some small risks of mild burn and increased temporary
muscle soreness.
Cervical and Lumbar Traction
We have found two types of problems that respond
well to traction. Both neck and low back pain that is
originating from disk narrowing can be effectively
treated with traction. X-rays are required to determine
whether there is disk narrowing. If cervical
spinal testing confirms the X-ray findings, then cervical
traction is recommended and the patient will be instructed how to
perform this at home. Lumbar pain is not so easy to
confirm by testing and if it is found on X-ray, we will advise
getting lumbar traction. Receiving lumbar traction at
home is difficult and it is therefore provided in this office.
(Inversion units can deliver mild lumbar traction and can be
helpful as a means of home treatment for narrowed discs.)
If lumbar traction eases the pain, a schedule of
treatment is set up for the patient.
Medical
Acupuncture
There
are many forms of acupuncture and they all provide good results
when performed by experienced acupuncturists. Some of
the various forms are: Chinese, Korean, Japanese, French
Auricular, Chinese Auricular, and Medical. Chinese is the most
common form of acupuncture practiced in the United States by
non-medical acupuncturists.
Chinese Acupuncture.Chinese acupuncture relies heavily upon
pulse diagnosis and 5 Element theory for treatment. To
feel a pulse at 3 places along the wrists
and identify each of these 6 pulses as one of 28
possible categories requires more skill and time than I
possess and is not used within my scope of practice.
Treating with 5 Element (Fire, Earth, Metal, Water and Wood) is to
trust in complex Eastern theory that has yet to
be validated by Western research and again not used withinr my
scope of
practice.
Medical Acupuncture of This
Office. Using Medical Acupuncture, much of my acupuncture
treatment is performed using the Chinese acupuncture meridians
and points of the involved areas of concern. While I
recognize the Chinese patterns of excess and deficient
energy, I use western diagnosis. In many
cases I use micro electric stimulation on certain of the
selected needles to increase the energy effects. These
procedures were validated by the careful research of
Dr. Bruce Pomeranz (See Home Page), in which he documented
that the electrical stimulation increased the production
of powerful neurotransmitters from the spinal cord and
brain that mitigate pain and inflammation. We began
performing medical acupuncture in 1997 and use it extensively in our
practice. Acupuncture can be used for most all medical
conditions, but I limit, for the most part, acupuncture
treatment to my specialty which is
neuro-musculo-skeletal problems.
Two Exceptions: One exception is
asthma which has responded well to acupuncture in
this office. The other is deep sinus
congestion that is not allergy
related. We do not treat addictions i.e.
tobacco, alcohol and food. We do not treat pregnant women nor do we
offer fertility treatment for couples.
Orthopedic
Conditions. Three general types of orthopedic
conditions have responded well to acupuncture for us. The
first is recent strain/sprain injury.
The needles can release the excessive energy that swells
from the inflammatory response. The needles in the
early inflammatory stage of injury of strain/sprain will drain
the excess energy causing much of the pain. The
second condition is a chronic stiffness that may be
the residual stage of a strain/sprain injury. Much of the pain
has left, but the final stage of stiffness remains. Needles
used on such patients are used with micro-electric
electrodes attached to certain needles along meridian
pathways. According to Chinese theory, this energy is pushed
through the "blocked" tissues and normalize blood and energy flow
that removes the stiffness. The third condition is mild
to moderate osteoarthritis. While no cure is possible,
the intensity and frequency of pain can be significantly
reduced. And is the more effective when
combined with glucosamine sulfate or
SAM-e.
Side Effects to
Acupuncture. Acupuncture is a safe procedure,
yet there are some possible problems the patient should be aware
of. Needle shock, while rare, can happen. In 8 years, we
have had two cases of needle shock. Low blood sugar from
lack of food predispose. Patients need to eat and drink plenty
of water prior to acupuncture treatment. Another rare
but potential problem (one that this office has not
experienced) is the needle entering into the lung causing a
pneumo-thorax. A more common problem is superficial bleeding
at the needle site that causes skin discoloration and sometimes
some temporary soreness. We do not treat pregnant ladies
with needle acupunture, unless they are in the last month. While
infection is a possibility, all needles are packaged sterile, used
once and disposed. We have, to date, not had any patient
develop infection from a needle stick.
Low Level
Laser
Low
Level Laser is one of the newer healing energies available in
the United States. It was first known for its success
treating carpal tunnel syndrome. But as the
technology and clinical experience advances, LLL is being used
effectively for a number of other musculoskeletal health
problems. In this office, we used the laser on selected cases
as a part of a research study through an Institutional Review
Board to gather more information on the treatment efficacy
of the laser for other conditions than just CTS. We have
been happy to see some good effects upon other stubborn
problems like TMJ, plantar
fascitis and tendonitis/arthritis of the
hand. Low Level Laser is a very safe
treatment provided protective glasses are worn for the eyes.
While a pacemaker would prevent EMS treatment, there
is no risk with LLL, as it is simply light, having no
effect on metals.
Call 825-8867 For An
Appointment
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