If I Go Once, Do I have to Keep Going?

False—mostly. Like many things in life, this isn’t a black and white issue. Chiropractic can be used as a short-term acute treatment or as part of a long-term preventative and health maintenance protocol.
Sometimes a person may get injured, which can result in pain or limited performance. This can happen due to a car accident, lifting heavy objects in an awkward manner, or perhaps taking a hard hit while playing sports. This can result in debilitating pain that prevents the ability to continue with the same lifestyle that existed prior to injury—whether that means having to modify one’s occupation, an exercise routine, hobbies, or a specific daily routine. Chiropractic treatments are an excellent means to correct acute issues related to the spine. It is possible that a very short-term stint of care will properly address the pain or performance issue and result in healing for the patient that requires no follow-up.

I often have patients come in bent over in excruciating pain who are able to walk out of the office with little to no pain. Neither surgery nor medicine was required to make this patient well. These examples powerfully depicts how chiropractic is able to immediately resolve functional issues, eliminate pain, and get the patient back to the life they love to live.
While there are instances where chiropractic can be used as an isolated treatment option there is also a tremendous benefit to consistently using adjustments to maintain excellent health, manage and eliminate pain, and enjoy top physical performance. Many professional athletes such as Olympic hopefuls and NFL players include chiropractic as part of their training regimens. They know that their bodies perform optimally when their spine, joints, and nervous system are carefully maintained with chiropractic adjustments.
Think about it, you probably visit the dentist annually or semi-annually to ensure your pearly whites are in tip-top shape with a checkup and cleaning. Keeping a close watch on your spinal health and getting regular “check-up” adjustments or treatments is an excellent proactive step towards ensuring optimal spinal health. Some studies have shown that regular chiropractic treatments promote increased lung capacity, visual acuity, reaction time, balance, and cardiovascular health. The spine has an impact on all other bodily systems and therefore should be a priority for routine maintenance and wellness.
Discuss your health goals and concerns with your chiropractor to determine if they will best be met by consistent care over time or if perhaps reaching your goals will require a shorter duration of care.

The Brain and Pain

I found a couple studies that I wanted to share with you. I often discuss the brains role in pain processing and changes that occur in the brain as a result of pain. The psychological effect pain has on us is immense and is just starting to be recognized and understood. Here are the studies that, I think, help shed some light on how we, as health care providers and manual therapists, can help our patients.

• Bunzli, S., Smith, A., Schutze, R., Lind, I., & O’Sullivan, P. (2017). Making sense of low back pain and pain related fear. Journal of Orthopaedic & Sports Physical Therapy.

This narrative (not a study per se) is especially interesting to me because I deal with it all the time. The authors conclude that the Common Sense Model (CSM) can be used to cope with “fear-avoidance behaviors”. In the “Fear Avoidance Model”, patients foresee extremely negative outcomes of their pain and so they avoid any and all activity that might exacerbate the pain, which leads to disuse atrophy, depression and chronic pain. By using the CSM patients can 1.) identify the pain, 2.) know what causes the pain, 3.) understand the consequences of the pain, 4.) learn how to control it, and 5.) know how long it will last. With this knowledge the patient is able to better cope with and treat their pain.

• Kregel, J., Coppieters, I., De Pauw, R., Malfliet, A., Danneels, L., Nijs, J. & Meeus, M. (2017) Does Conservative Treatment Change the Brain in Patients with Chronic Musculoskeletal Pain? ASystematic Review. Pain Physician, 20(3), 139-154

This study reviewed 9 different studies which used MRI to determine if functional and/or structural changes occurred in the brain of patients suffering with chronic musculoskeletal pain after a course of conservative care. They found that conservative care seemed to produce both functional and structural changes in the brain and also that these changes were associated with positive clinical outcomes (decreased pain, increased function).