Responsibilities and Traits of a Reliable Chiropractor

Due to imperfect postures and lack of exercises people tend to suffer from pains and discomforts in the muscles and backbone. This is a medical condition, which requires the immediate attention of a chiropractor. S/he is basically a person who performs various techniques for proper spinal cord adjustments. Rotations and adjustments of other parts of the body are also done to align the muscles into their proper positions.

Chiropractors are trained medical practitioners who deal with a holistic way of treating conditions like pains. Their approach to problems is from the perspective of inducing wellness naturally and is not a symptom-based treatment. Different types of physical problems characterized by upper and lower back pain, headaches, soft tissue injuries, and muscle spasm are treated effectively and chances of recurrences are eliminated by a chiropractor.

A short list of the duties and responsibilities of a chiropractor

There are a number of responsibilities and duties of a chiropractor. Right from the assessment of the problems to providing treatment, there are loads of things that experts do like -

1. They examine the patients and determine the problems. They order the patients to do x-rays and other diagnosis, which will prove helpful for the treatment.

2. They monitor the progress of the treatment at every stage. They will correct any imperfections in the postures of the body and suggest exercises accordingly.

3. Sometimes, the therapists have to do adjustments on the patient's spine and articulations of the body. Such chiropractic adjustments help in relieving backaches and muscle strains.

4. Counseling is an important responsibility of a chiropractic practitioner. An expert often suggests proper dietary patterns and right sleeping habits to the patients. As such activities have significant effect on the wellness of the body; they are generally stressed upon by a chiropractic practitioner.

However, only experienced chiropractors are capable of performing the therapy in an effective manner. So, the first step of healing with the help of chiropractic methods is to choose a professional who has the following traits:

1. They should be patient listeners to your problems and queries.

2. Should be able to explain everything that you want to know about chiropractic treatment.

3. Focused and diligent experts can induce wellness in a better way.

4. Last but, one of the important traits is good analytical skills.

If you are seeking chiropractic treatment, you should know that when it comes to consulting a reputed chiropractor, Chicago comprises a few of the reputed clinics comprising experienced therapists.

Overuse Injuries - What Causes Them and How to Avoid Them - Part 3

In the last part of this three part series I will discuss the effects of biomechanical imbalances in the body and improper running technique on overuse injuries. These probably accounts for at least 50% of all sports overuse injuries. A biomechanical imbalance is any imbalance in musculature, ligament laxity or bony architecture from one side of the body as compared to the other (e.g. right leg vs. left leg). Many people ask isn't it common to have on leg shorter than the other? Certainly it is, but most are not aware that the greater the difference and the more stress imposed on that imbalance the greater the risk of injury.

I have lumped technique imbalance together with biomechanical imbalance because having a biomechanical imbalance almost always leads to improper technique (whether it is running, throwing, kicking, hitting, swimming, etc.). Prior to causing improper technique or injury, biomechanical imbalance almost always results in decreased performance and/or more effort required to receive the same result. In addition, the longer someone performs a sport using improper technique the greater the stress on the body resulting in a biomechanical imbalance. Realize that even with proper technique the more years spent doing a sport the greater likelihood of muscle imbalances leading to biomechanical imbalance.

So how does one go about identifying and preventing biomechanical imbalances and poor technique. Making sure you have proper equipment, e.g. shoes to correct pronation if you are an overpronator is a pretty basic example for runners. Performing running drills that focus on proper leg and arm movements like strides, butt kicks and high knees can help to train proper muscle firing patterns for runners. For major deficiencies in the foot, knee or leg the use of a custom orthotic or shoe lift from a qualified doctor or pedorthist may be necessary to run pain free. Make sure to have your spine and trunk muscles checked for misalignments as irritation here can result in tight and/or weak leg muscles leading to imbalances and then changes in running form resulting in injury. Good overall conditioning and muscle tone will allow the body to compensate for biomechanical imbalances for longer periods of time before symptoms or injury occurs. However, the number one prevention tool is earlier detection and correction or awareness of the biomechanical imbalance during training.

It is important for runners to have methods to aid in the early screening of biomechanical imbalances. The following is meant to be a guideline to help detect these imbalances. If detected it is important that they make their sports chiropractor or physician aware of any potential imbalances.

Home detection methods: We'll start at the feet and work our way up.

Pain that occurs every time a person does a specific activity is a pretty good indication that there is some imbalance or injury, even if it goes away part way through the activity.

Feet:
a) examine the soles of all tennis shoes for uneven wear patterns. Excessive wear on the balls or outer portion of the heel or uneven wear from one side to the other is an indication of a possible foot problem.
b) With the shoes off can you slide your finger an equal distance under both medial arches? From the back does it look like the Achilles bows in from one side to the other? Both of these can indicate fallen arches
(Failure to address can lead to ankle sprains, heel spurs, plantar fascitis, Achilles tendonitis, knee or hip problems)

Knees: Standing in front of a mirror look at the knee caps - do they look like they are sitting in the same place on each leg or is one higher, more medial, etc. Do the legs look bowed or knocked kneed? These imbalances can lead to chronic knee sprains, hamstring or quad pulls or Achilles tendonitis.

Put both feet together and then sit down in a chair without moving the feet. Look from above at the point on each lower leg just below the knee cap. Does one leg seem to be closer to you or stick out more than the other. This can be due to a hip or lower back misalignment and can lead to back, hip, knee or foot problems.

Pelvis and Spine: Since all of the major muscles attach to the spine and pelvis it is essential that there be good balance from side to side. Any spinal imbalance can create muscle pulls, sprain/strains, tendonitis, or neurological conditions including subtle muscle weakness. In addition, spinal imbalance can result in problems in any of the extremities as a result of the imbalance in muscles and ligaments leading to abnormal stress or due to nerve pressure. Unfortunately, there isn't enough space in this article to cover all the screening tests available for the spine.

In conclusion, being aware of subtle imbalances and having a good chiropractor or sports doctor to help you do this can go a long way in early detection and prevention of overuse injuries. In addition, practicing good technique also is extremely helpful in preventing overuse injuries.

For Chiropractors - Whiplash and Personal Injury Analysis - Penning's Method

This analysis method is by far one of the most useful for determination of loss of range of motion that I have found. This is a great way to show pre/post x-ray changes in a quantifiable way, and to show how the care you provided helped your patients by improving ligament stability in the cervical spine.

To establish hypomobility or hypermobility of vertebral segments in the sagittal plane, Penning's Method is a one of your greatest methods. This is done with functional examination of the cervical spine in flexion and extension, using radiographic analysis.

If there is a loss of range of motion present, several factors may be found in your patient. You as the attending Cape Girardeau Chiropractor will need to understand these variable factors in order to ensure that the "validity of assessment" criteria have been met according to standards. Doing so will also best help your patient should a personal injury case enter the court room and you find yourself on the witness stand.

The intention of this article is to briefly explain and help Cape Girardeau Chiropractors use this method of functional radiographic diagnosis of the cervical spine during flexion/extension. This will hopefully allow you to better serve your patients and to have solid pre/post analysis. There has been much research done on this topic by Dr Liberti, D.C., as well as many other Doctors and Physicians, such as Dr. Pennings himself.

Completion of Penning's Method

Penning's Method is known by many to be the most widely accepted and utilized method for determining flexion/extension motion. To start the extension film is superimposed on the flexion film, with the C7 vertebrae matching perfectly. Next a line is drawn along one of the edges of the extension film, onto the flexion film. You then do the same with C6. A second line is then drawn. You can now measure an angle between these two lines and this establishes the degree of motion between the C6 and C7 vertebra. You follow this sequence for the rest of the cervical spine to determine the degree of motion between all of the vertebrae. The average values of segmental motion are written about by Dr. Penning: Functional Pathology of the Cervical Spine, 1968 pg 1-25. These values can be compared to determine the amount of dysfunction present in your patient's cervical spine. It should be fairly easy for you to find some examples of these drawings elsewhere on the internet.

To reiterate this is a very valuable method for determining abnormal or pathological conditions such as hyper or hypomobility of the cervical spine.

Penning Method of Radiographic Determination of Loss of Range of Motion:

As an example if the normal for C2-C3 was 12.5 degrees and your patient was 20 degress, your percentage of normal would be 160%. If normal at C3-C4 was 18 degrees and your patient was 15 degrees your percentage of normal would be 83%. This is straight forward, if you would like all the normal values, these can easily be found on the internet.

The percentage of normal is figured out by dividing the patient's values by Penning's established normal values. For example C3-C4 15/18 = 83%. This essentially represents 83% of normal motion at the C3-C4 joint had been maintained. On the other hand you see that 17% of normal motion was lost when compared to the normal value as determined by Penning.

If you look at the C2-C3 level you see that you have 160% of normal motion, or 60% more than normal expected motion at this level. This is clear as to how to read this!

*Values above 100 are HYPERMOBILE

*Values below 100 are HYPOMOBILE

NORMAL at 100% (Values within 10% of 100 are considered to lie within the standard deviation of what is accepted as normal.) So anywhere between 90-110% for all intensive purposed is considered normal.

Further Analysis of example patient:

The interpretation of the above example is as follows; multiple areas of abnormal joint motion and dysfunction are present. Cervical Joint Hypomobility or a loss of normal joint range of motion was found at C3/C4, and C5/C6 motor units. Cervical Joint Hypermobility was present at the C2/C3 motor units.

You can also see a compensatory minimal Hypermobility present at C6/C7, but this falls within the normal standard of deviation.

Restated there are two areas of diminished joint range of motion and one with excessive motion involving the cervical spine segments during flexion/extension in the sagittal plane.

As is obvious, these abnormalities exist within the joints of the cervical spinal column and this analysis has been established radiographically.

As goes without saying, in addition to substantiating loss of joint range of motion, a Cape Girardeau Chiropractor should be looking to further evaluate possible existence of any neurological deficit (either sensory or motor). By simply looking at the mechanical and structural aspects of a particular case however, much can be objectively gained, and you will be able to stand with confidence in saying that structural integrity has improved on this patient if post care analysis shows improvement on Penning's Method. Any degree of improvement substantiates improvement to the patient's ligamentous integrity and of course increased normal range of motion. These two things alone could prove invaluable, should you find yourself testifying in court. I will soon be writing a Part II of this article titled "Objective Scales of Prognosis for Chiropractors doing Whiplash and Personal Injury Cases." If you have found this helpful I am sure this will go a long way to giving you the objective findings you need in validating patient care. If you need any further help finding more information on this, any Cape Girardeau Chiropractic Clinic can feel free to look at the resource box in order to contact me with further questions.

Are Trigger Points Causing You Chronic Back Pain?

There are many treatments for chronic trigger point back pain but the effectiveness of these treatments varies. One of the safest and proven effective methods is by starting chiropractic treatments. Chiropractic treatments address the source of the problem and not just mask the pain with medications.

The term trigger point is all about the place in the body that triggers the pain. Trigger point is a kind of muscle stiffness which resulted from the minute contraction knots developing in the muscle and surrounding tissue areas caused by overworked or injured part of the body. Usually, this happens from car accidents, sports-related injuries, sudden falls or prolonged incorrect posture.

For the chronic back pain, there are generally four muscle groups which are identified to be the trigger points for back pains.

• Gluteus Medius muscle group: This functions for the legs to be raised sideways and for the stabilization of the pelvis when walking. This muscle group is referred for when the buttocks and belt line are in pain.


• IlioPsoas muscle group: This functions for the stabilization of the trunk on the hips, lifting of the thighs and the flexing of the trunk forward. This muscle group is referred for when the low back is in pain.


• QuadratusLumborum muscle group: This functions in helping the spine stabilize and flexing the trunk sideways. This muscle group is referred to when the low back, hip, groin, and gluteal regions are in pain.


• Rectus Abdominis muscle group: This functions when flexing or curling the trunk on the pelvis and stabilizing the trunk during upright movements. This muscle group is referred to when the belt line, areas in stomach region, and mid back are in pain.

When these points are not treated, stress on other connected areas happen and this can change the way we walk or sit, not to mention the pain it is causing.

Treatments For Chronic Trigger Point Pain

One of the most common cures for trigger points is acquired from the services of physical therapist, massage therapist, and chiropractor. But some people cannot always avail their services because of the cost. That is why self-treatment instruments for trigger points are now widely available. However, the quality of both treatment processes varies. For both treatments, they put deep pressure on the points by massaging. Through this way, they help in relaxing the muscle, therefore removing the pain.

Another treatment is the trigger point injection. In this treatment, a small needle is inserted by a health care professional to the points of the back pain. This injection sometimes contains local anesthesia. When the needle is injected, it deactivates the trigger point, therefore, removing the pain. For people who have allergies, a dry needle is used, which means no medication involved.

Is Chiropractic Treatment Dangerous?

We've all heard stories about someone who was crippled or even killed by a Chiropractor. Sometimes we're even warned by our family doctor not to let our Chiropractor adjust us as it may cause a stroke. Even the L.A. Times recently called the safety of manipulation into question. Just how safe is chiropractic treatment? What are the facts?

1. Due to the extreme rarity of injuries caused by Chiropractic treatment and its unequaled safety record, chiropractic doctors pay only a fraction (i.e. 1/10 to 1/50) the malpractice rates compared to medical physicians. (1)

2. Only 19 deaths have been attributed to Chiropractic treatment worldwide over the latest 65 years studied (1934-1999). In fact, the risk of "serious injury" from anti-inflammatory medication including Aspirin and Advil is 400 times greater than from manipulation. (2)

In other words, it's much safer to have a chiropractic treatment for your neck pain or headache then taking medicine (over the counter or prescribed).

3. Nearly 10,000 studies have been performed on manipulation (making it the most thoroughly studied form of treatment for back pain) and the great majority have found the following when compared to medical treatment:

a. Increased patient satisfaction.

b. Shortened time to return to activities or work.

c. Less permanent disability.

d. Less costly.

The governments of several countries, including the United States (A.H.C.P.R.) and Canada (Manga), have found manipulation to be the most effective form of treatment for back pain. In fact, the Canadian report suggested that Chiropractors be the "gate keepers" for back pain saying that it would save Canada hundreds of millions of dollars if their citizens saw Chiropractor's first. After reviewing all published studies, it was determined that there were "no medical procedures that were as safe as Chiropractic treatment."

The British Medical Journal and the U.S. Department of Health and Human Services found similar results. In fact, the U.S. government reported that physical therapy and acupuncture were not "cost effective" and that surgery was useful in only 1% of cases.

Further, the report was emphatic that they should be employed only after conservative approaches (like manipulation) were first exhausted.

So why are there still news reports of the dangers of Chiropractic? Lets take a look at the last article that was reported by the journal, "Neurology", and reported in the L.A. Times.

The study found that seven out of the 51 people questioned who had a stroke were adjusted by a Chiropractor in the previous month. This compared to two of those in the control group. So an association was drawn between manipulation and strokes. The problem with making such an opinion is that headaches and neck pain are the early symptoms of this type of stroke. So of course more people with neck pain and headaches sought chiropractic care versus those who were in the control group who were pain free.

This illustrates the problem with association-type studies. They don't show the cause only association. For example, the following is a common example taught in research courses that warn against making conclusions from such studies.

Since there are more churches in violent neighborhoods, churches lead to violence. Actually, establishing churches are a reaction to people living in a violent neighborhood, not a cause.

In fact, another study published by the same journal, "Neurology," found fewer people having strokes if they were adjusted than the control group that wasn't. Unfortunately, that never made the newspapers nor did most of the other studies which showed chiropractic treatment far safer than all other medical treatments.

Why the media prints inflammatory stories while ignoring others that would put your mind at ease is beyond the scope of this paper. But it is unfortunate that people are being scared away from a treatment that is absolutely safer and more effective and by default being directed to one that has significantly greater risks.

Personally, between Dr. Murray and myself, we have practiced about 40 years and have never injured anyone (more than some temporary soreness as part of the treatment). The real danger comes from having musculoskeletal problems that are covered-up with drugs and surgery. Since the cause is not addressed this way, the patients often get worse, more discouraged and depressed and there are often side effects.

We use only the safest of all procedures and specifically screen for all risk factors that make manipulation unsafe. I'm sure you have already noted how thorough we are. This is the only way that you should be treated by any of your doctors. If you ever have questions about the risks or benefits of any procedure, always feel free to speak to us directly.

(1) Malpractice Statistics from the National Chiropractic Mutual Insurance Company, West Des Moines, Iowa.

(2) Terrett, A, Current Concepts in Vertebrobasilar Complications, NCMIC Group, Inc., 2001, p 199.

The Chiropractic Subluxation: What Is It?

The term subluxation is usually new to most people. It's not a word you hear very often unless you see a chiropractor. Subluxation, in chiropractic terms, refers to a joint that has become fixated or "stuck" and mispositioned, essentially losing its normal biomechanical function which simply means it doesn't move like it is supposed to. This can occur in nearly all of the joints in the body and likewise treated in nearly all of the joints in the body. In the spine, a subluxated vertebra can create interference with nerve function. This is caused not so much by "pinching" or compressing the nerve, although that is one aspect of it, but more through stretching, pulling and rubbing on the nerve that is associated with the subluxated vertebra. When a joint is not moving normally and functioning correctly, it can cause a dis-relationship between it and the nerves passing through and around it. This may create irritation of the nerve which causes inflammation which leads to pain and decreased function of whatever part of the body, whether it be organs, muscles or other tissues, it supplies. A specific chiropractic adjustment is meant to correct this problem, restoring the normal biomechanical function or movement of the vertebra and joint thus relieving any irritation of the nerve. This in turn helps relieve pain and allows the nerve supply to areas of the body function properly.

So can a subluxation really cause that many problems? The most common reason people see chiropractors is for relief of their pain. And, granted, that is the most subjective outcome that patients see. However, correcting the subluxation that is interfering with the nerve that is causing the pain is also restoring a vital function of your body, nerve transmission. Without getting into the anatomy and physiology of the nervous system, it is easily the most essential system in your body. It is, in essence, your wiring that controls and coordinates every single thing happening inside you right now. So when it's not working properly, it is inherently going to effect how your body functions. In 1921, a medical doctor by the name of Henry Winsor decided to study the relationship between organs and their nerve supply, particularly where it originated from the spinal cord. He did several autopsies and found that there was an overwhelming correlation between diseased organs and 'minor curvatures' in the spine where the nerves associated with those organs originated. If an organ is left with inadequate nerve supply it will not be able to function at its normal capacity. Other studies have found that just 8-10mm of pressure, about the weight of a dime, can reduce nerve transmission. A subluxation is much more than just a "bone out of place", it is a truly substantial problem that is often seen simply as an aggravation.

Most chiropractors have a true passion for what they do and desire to help as many people as they can. This usually comes in the form of getting patients out of pain but most also want to help their patients live a healthy life. By restoring the normal biomechanical function of your spine, chiropractors are not only alleviating pain but also allowing your body to function properly and as a whole. This creates an optimal state and opportunity in your body for it to do its job and heal itself as it was meant to do. Correcting subluxations is one step closer to restoring and preserving your health.

When is a Bladder Problem Really a Nerve Problem?

Integrative neurology combines the knowledge of medical neurology (the study of the brain and nerves) with complimentary techniques like acupuncture, chiropractic and herbal therapies.

You might do a double-take when reading about Interstitial Cystitis and Prostatitis in relation to neurology.

These conditions are normally treated by a urology specialist not an integrative neurologist.

Many times, however, no urological cause can be found for interstitial cystitis.

Emerging data suggests that some patients with chronic bladder or prostate pain actually are suffering from a type of pelvic neuropathy.

In those patients whose cystitis or prostatitis is due to pelvic neuropathy, Integrative Neurology techniques like laser or acupuncture can often produce dramatic pain relief.

Research suggests that some patients with cystitis, may have a unique form of bladder inflammation known as neurogenic inflammation.

For this type of inflammation, the usual therapy is most often inadequate.

But this same research suggests that neurogenic inflammation produced by one set of nerves, can often be suppressed by the action of another set of nerves.

These anti-inflammatory nerves are called the descending anti-inflammatory pathway. Stimulating them suppresses inflammation. You might be confused by the complexity of all this, but the take-home message is that sometimes we can stimulate one set of nerves that turn off the inflammation in the pelvic organs caused by over-activity in other, pro-inflammatory nerves. So for women with interstitial cystitis and men with chronic prostatitis that haven't responded well to typical urological treatment, integrative neurology techniques can offer substantial pain relief.

So men suffering from chronic prostatitis and women suffering from interstitial cystitis might want to consult with an Integrative Neurologist as an alternative source of treatment.