Chiropractic: How Long, How Often?

 

Patients commonly want to know:  "How often do I have to come in, and for how long?" In my chiropractic practice, each patient's Treatment Plan is tailored to the individual. Some patients come in for their initial treatment and one follow-up, and they're done. Some people need more. It depends on the person's problem, their general health, whether they've been injured, whether they follow Home Care Instructions, etc. As soon as each patient is sufficiently improved and able to continue healing on their own, I release them. I am always available to support them, should they need me again.

Hinge Joints

   Our knees, the joints in our fingers, & our elbows are “hinge” joints—-similar to door, window, etc. hinges---meant to move in one geometric plane.

Introducing a rotating force in these joints causes injury, sometimes mild with a relatively easy recovery, but sometimes serious sprains that are not only difficult to recover from, but may leave lasting damage to the joint tissues.

Another force these joints are not meant to tolerate is hyperextension. Taking a hinge joint  past its end point of tolerance for extension will cause injury. I often see this in patients who have propped their heel on a stool or ottoman, causing hyperextension of the knee.

       Lateral forces such as sometimes happen in football to players’ knees, often also injure & can permanently damage a hinge joint. 

Distant or Local?

Tingling or numbness in the hand or arm is a sign of nerve impingement, and finding a solution requires differentiating between a local origin, i. e. in the arm, wrist, or hand, or an impingement happening further away, perhaps in the neck or shoulder region.  

The patient’s presentation, orthopedic tests, and careful assessment of the neck and involved upper extremity will reveal the source of the the problem.

In some instances, there is more than one site of impingement, e.g., symptoms in the hand may be due to a “double crush”—-impingement in both the new and the wrist. 

Twist & Lift---A Bad Combination

  Lifting when the body is twisted to the side—either left or right—is a recipe for back pain, often in the thoracic region. 

An example is lifting a child into or out of a carseat. The lift + twist action often necessary to do this can torque the rib cage, stress and misalign vertebrae, & set off muscle spasms, 

As soon as the child is able to climb in and out of the carseat on their own, give your body a break and let them do it.

In the interim, take care to twist as little as possible when getting them in / out, and try to keep your body as close to them as possible while doing it. This creates shorter-lever stresses on the back and spine, helping to make it less likely that you will injure yourself.

Chronic Neck Pain

Successful treatment plans for chronic neck pain should include home care counseling for postures and ergonomics.

There are usually modifications that can be made in the patient’s positions & pastures during different activities—e.g., computer use, kitchen chores, sitting, standing, and sleeping—that will help.

An important key to change is the patient’s developing an awareness of their body’s positioning, and this may take some practice. I often recommend setting a timer, using it as a reminder to “check in”—where is my head? am I slumping? leaning in to see my computer monitor?

Using the right pillow for sleeping, changing the height of one’s computer monitor so that it is at eye level, getting computer glasses with corrective lenses if one is having a hard time seeing the screen, raising the height of one’s work space on the kitchen counter—-all are simple things that can make a big difference.