Medicare--Allowed # of Visits

  Medicare typically allows 12 chiropractic treatments (visits) per year.

However, certain things that often go along with aging are considered by Medicare to justify an extended, or longer term, of chiropractic care.

These conditions, called “co-morbidities,” may complicate, or impede healing, making the number of treatments necessary to resolve a chiropractic problem greater.

A common co-morbidity is spinal disc degeneration, usually associated with spondylosis, or bony spur formation around vertebral edges. Another term for this is DJD, or degenerative joint disease. 

Sciatica, spinal stenosis (narrowing of the spinal canal), and foraminal encroachment (narrowing of the opening(s) where the nerves exit the spine) are also co-morbidities, as are health conditions which may complicate or impede healing such as diabetes and osteoporosis.

Unrelenting Rib Pain

  Pain that starts in the front of the chest or in the back, near the spine, and develops along the path of a rib, and that is unresponsive to chiropractic treatment, may be an outbreak of shingles.

The patient will describe no injury or trauma, no upper respiratory infection or cough, which might be affecting the region. Yet the pain persistently worsens.

A shingles viral outbreak follows the path of the related sensory nerve, called a “dermatome.” Dermatomes wrapping around in the thoracic region resemble the paths of our ribs, so initial symptoms of shingles are often misinterpreted as rib pain.

Anyone who has had chicken pox carries the herpes zoster virus in the nerve ganglia alongside their spine. The virus is dormant until conditions such as hyperthermia or stress trigger an outbreak.

Low Back Compression

  Patients who present with central low back pain, especially if the lumbar curve is accentuated, often exhibit compression between the sacrum and the 5th, or lowest, lumbar vertebra.

The patient will often say they “just can’t get comfortable,” even in bed. Sometimes pulling the knees to the chest is relieving, but standing, as well as sitting, cause worsening of the pain.

I relieve the compression by appropriately-vectored adjustments with the Activator instrument, and give the patient stretches & exercises. 

Ergonomic counseling for correct sitting & standing postures is helpful to prevent recurrence of the compression.

OUCH!!--I've Got Gout!

  You wake up with severe, burning pain in the joint at the base of your big toe, and it’s swollen and red.

Chances are, you may have gout!

This is a type of arthritis that is of metabolic origin---too much uric acid in the blood causes sharp crystals to collect in a joint, usually the big toe, and more commonly in men than in women.

This happens because you consume too many foods high in purines, organic water-soluble compounds that oxidize to form uric acid. 

Meats are high in purines; so is beer, seafood such as scallops & sardines, beans such as garbanzos or lentils, vegetables such as asparagus or mushrooms, & wheat bran & wheat germ. Inflammatory foods such as sugar and wheat (all wheat in the U.S. is highly hybridized, thus containing foreign polypeptides that are highly inflammatory) are also culprits.

Your chances of getting gout are higher if you are overweight, drink too much alcohol, eat too many foods containing purines, or drink beverages sweetened with fructose (fruit sugar) or foods with high-fructose corn syrup (soft drinks, ice cream, sports drinks, breakfast cereals).

Gout is successfully treated by changing what you eat and drink. It is important to drink lots of pure (devoid of chlorine or other chemicals) water to help your body flush out waste products and toxins. 

Plantar Fasciitis

   Pain in the bottom of the foot, usually in the arch further back toward the heel, may be plantar fascitis. It is caused by injury or inflammation of the plantar (bottom of the foot) fascia. The plantar fascia is a band of fibrous connective tissue on the sole of the foot.

The pain may come on slowly, related to chronic pronation (a falling inward of the inside of the arch) combined with a “fallen” arch, or be more acute, due to an injury---landing hard on the sole of the foot, quick acceleration / deceleration when walking or running, or repetitive shock of hard heel strike during the gait cycle.

My treatment includes carefully aligning the bones of the foot with the Activator instrument, support of the arch with orthotics, exercises to strengthen the arch, stretches to maintain flexibility, and ice and other applications for inflammation.

The patient must not go barefoot---there must be NO weight-baring without orthotic support.