Physical Medicine is a broad field poorly understood in the U.S. and I want to give the reader a brief explanation for a basic understanding of these treatment modalities
offered in this office that are both safe and effective.
Spinal Manipulation (SM): When most people think of chiropractors, SM is what comes to mind and with good reason because it is what chiropractors specialize in doing. We correct spinal subluxations by performing the art of spinal manipulation. SM is usually done by hand, but there are mechanical adjusting instruments that are also commonly employed. The Activator mechanical instrument and the Impulse electrical unit are two used in this office, which provide an adjustable power of impulse from very light for neck or sensitive areas to quite heavy for the thoracic, lumbar and hip areas, where there are strong muscle overlay of the joints.
How does Manipulation work to reduce pain? Joint manipulation is the quickest and best way to fix joint subluxation, which is simply joint "lock." Joints were designed to move freely through their normal range of motion. Patients sometimes refer to this as a "cric," a "kink" or a "catch" that prevents their normal range of neck or back movement. It is usually described as causes a sharp pain, restricting function. A joint in the spine is where a bony flat plat about the size of a half penny articulates with another above or below it. There is one on the left and one on the right at each the 24 segments of the spine, plus 2 much larger sacroiliac joints. They must all mesh and glide smoothly for proper function. Occasionally one or more joints can "jam" together, locking that segment. The solution to this problem is to bring motion back into this dysfunctional joint by applying manipulation to it, breaking the "jam", returning full motion to that joint. Please be sure to return now to the "Home Page" to click onto "Story of Chiropractic" and "Today's Chiropractic" located at the bottom of the page in the left hand column under "Community Content." Then to see how each vertebral segment and your spinal cord/nerves work together, move to the "Miscellaneous" column and click onto the "3-D Spine Stimulator."
Why does it take more that one, sometimes multiple visits to correct the subluxation? The usual cause of subluxation is a quick unexpected motion. Sometimes, it is a low force subluxation that one visit is all that is needed. Other times there is a strong force (falls, auto accidents) that not only subluxates the joint, but also sprains the ligaments that support the joint and strains the muscles and tendons that attach to the bone of the joint. These soft tissue injuries complicate the subluxated joint and is the reason why other modality treatments precede or follow the adjustment of the joint.
Risks of Manipulation: Manipulation is low risk (proof is the low cost of malpractice insurance for chiropractors), never-the-less, some risks still exist. One notable, but rare, is stroke when the cervical spine is adjusted. In normal individuals there is no risk at all. But in people with a weakness in the vertebral artery causing a ballooning of the arterial wall, sudden rotational and extension stretching delivered simultaneously may cause the the weakened wall to break. If bringing your head back and turning it to the right or left causes some dizziness, you need to make this know to your chiropractor. In 38 years of adjusting the cervical spine, no patient in this office has ever had such a side effect. Another potential side effect is fracture. Elderly women with osteoporosis are must vulnerable and need to be adjusted gently. Adjustable mechanical instruments (Activator, Impulse, see above) which we have in this office are very appropriate.
The 1st Adjustment: Following manipulation, there should be some relief from the sharp, catching pain, but often there will be ongoing soreness of the soft tissues for reasons explained above. For a few patients, the first adjustment may also create some short term additional discomfort, similar to what one experiences after the first "work out" of practice in athletics.
Other Modalities and Forms of Treatment:
Ultra Sound (US): US gets deep down to the bone and joint where the injury is located. It has long been used as an anti-inflammatory agent by breaking down the
exudates of injury into tiny molecules that can be absorbed by the body, cleaning up the injured area, speeding the healing process. Healing agents placed on the skin can be carried through
the skin to also speed the healing process. This process is called "phonophoresis." Our office has a number of US units with different size heads to accommodate the various sites of
High Volt Galvanic Muscle Stimulation (HVG): The body runs on and is healed by direct currents. Many patients are familiar with TENS units for home use. These units run on alternating current for numbing the tissue treated for temporary pain relief. Galvanic currents are direct currents that the body recognizes and responds to for increased speed in tissue healing.
Medical Acupuncture: Joseph Helms, M.D., founding president of the American Academy of Medical Acupuncture, states in his book Acupuncture Energetics that acupuncture "is probably the most thoroughly researched physical modality in medicine. More is know about its mechanisms of actions than about those of many pharmaceutical agents in routine use." The insertions of needles into specific acupoints along your spiine electrically stimulated produce increased nerve stimulation and amounts of the endorphins, enkephalons, cortisol and other neurotransmiters that are released in the cord, the mid-brain and pituitary gland. (Please refer back to the Home Page and click on the "Spinal Stimulator" again to see the parts of your body stimulated. Be sure to click on the C-1 segment.) Canadian researcher Bruce Pomeranz, neurophysiologist at the University of Toronto, has spent 20 years unraveling much of this research. It was because of this research that the FDA in March of 1996 moved the acupuncture needle into the same medical category as the syringe and scalpel. In addition to acupuncture meidating pain and inflammation, there is also growing reports that some of the neurotransmitters released by acupuncture influence the immune system as well. I was certified by the Virginia Board of Medicine to practice acupuncture since 1997, one year after the FDA made its ruling on the efficacy of the science.
Risks in Acupuncture Treatment: If the acupoints are stimulated with percussion, electrical or laser proble, there are no risks. If the acupoints are stimulated in a traditional way with needles, then there are a few potential side effects. The most common side effect is an occasional bleed of a few drops of blood, which can produce a small discoloration to the skin, like a bruise. Pneumothorax is a rare, but possible side efffect, should the needle pierce into the lung. Careful technique and knowledge of anatomy should prevent this side effect. Since 1997, no patient has ever been sent to the ER due to this complication in our practice.