If you ask the man in the street what he knows about chiropractic, you will be lucky if he has heard about it at all. If he has, he will probably tell you it is treatment which helps get rid of back pain. This is what chiropractors have become known for and as well as back pain we are great at decreasing or removing pain from conditions like sciatica, headache and neck pain as well. In fact, painful joints in many parts of the body can be successfully treated by a chiropractor.
We are however well qualified and experienced in creating a whole new picture of optimum health for our patients. This is where the real goal should be and with many of my patients, given a little education and open mindedness, I get to the bottom of many of their health problems which have eluded a solution for many years. The focus may not only be pain and joint problems, but general feelings of tiredness and lack of energy.
The problem may be that patient’s prime objective when they find us is to get rid of pain. So when we examine them and reach a diagnosis, it explains their current pain. This is also what insurance companies want to hear about. The treatment plan then becomes focused on pain reduction and elimination.
We do this well and when the pain has gone, the patient is happy and may think that this is the whole solution. They can go off about their daily life and repeat the whole cycle, which brought about their painful situation in the first place. That is, unless I have succeeded in helping them to understand the deeper meaning of health, being not just the absence of pain. In fact, this pain free point in time should be the start of the second phase of care, which would be more focused on rehabilitation. The patient – chiropractor bond should have brought about a greater understanding of the long term / original causes of the patients ill health.
In the case of low back pain for example, the loss of the curve in the neck, called the cervical lordosis usually present for many years before back pain occurs, could have been one of the long-term factors predisposing you to get back pain. Changes in posture generally are worrying signs of future spinal problems. Should I then wave goodbye to my pain free patient without warning her of the true situation? It is far better to give her the chance to rehabilitate the curve and correct the posture with a series of dedicated exercises. With fewer visits to me, for occasional check ups and adjustments the patient takes responsibility for their own health. This way she will enhance much more than her chances of recurring back pain.
The real question is when should this patient have first consulted a chiropractor, when she noticed her poor posture, or before that in order to prevent it happening?
Consider the forward head posture or “poked head” as it is sometimes called. Look around you and you will see more than half the population with this problem, whether sitting walking or standing still. Our present daily activities are constantly driving us into a forward bent posture with rounded shoulders and head jutted forward.
Sitting at computers, driving, texting and playing with hand held computer games has turned us all back toward the fetal position, totally flexed forward.
Figure 1 This head forward posture can be seen all over the world.
Could it be that this posture results in so many of the pain syndromes we see in our clinic? Can this posture adversely affect our thinking and decision-making? If we look at the research, many studies point to the conclusion that a straight or reversed curve in the neck results in stretching of the nerves, which supply the input to the cortex, the thinking part of the brain. Neck posture also has a vital influence on the brain structures responsible for the autonomic nervous system. This in turn regulates heart rate, lung function and heart function as well as the whole digestive system. Not the least neck posture ha a profound effect on vision including the eye co-ordination muscles and focusing muscles.
Faulty neck posture also has a huge effect on the lower spinal curves of the dorsal, lumbar and sacral spine, which have to adapt to the altered neck posture. So many of the important bodily functions can be affected, the least of which is low back integrity, which causes pain and may be the factor, which brought you to the chiropractor. Patients wonder why I am so interested in their neck, even though they came to see me about low back pain. I cannot explain this as fully as |I would like to, as well as the many other important instructions on the first visit, so I normally tell them the simple truth that it is all connected and one part of the spine influences the next. Gradually, as the treatment plan advances, I explain why together as a team the patient and I have to correct the lost curve in the neck and subsequently any other errant postural habits they have.
Correction involves intensive rehab, daily exercises to reshape the cervical curve and recondition the low back, which can be done with our team in our own onsite rehab studio.
Even when, and especially when a patient has been hooked on a certain way of exercising, a chiropractor who knows your back and postural problems and who had studied the anatomy, physiology and neurology of the human form, can give the correct advice on the progressive stages of exercise you need. It may not be what you want to hear but if it has brought you to a situation of pain and you want to remain in optimum health, you should listen.
I have an example. One of my patients loves to cycle. It relieves him of his stress and gives him that high he needs to be able to put up with his daily stressful lifestyle. The problem is that although he stays pain free for a while, he keeps returning to me with the same problem. His back becomes stuck in the flexed position, exactly the position he is in when cycling. I have asked him to stretch and do some extension based exercises, but he probably does very little of it. His cervical spine is also in a forward position. I am still trying to get this rushed patient to get the big idea and add some different rehabilitation exercises to his routine.
Another of my patients who has got the message has overcome long term nagging back pain. He is regularly doing the cervical spine exercises along with his regular football and swimming. He has never felt better and knows that his time is spent well, invested in the slower degeneration of his spinal joints and future pain free optimum health. He has an appointment with me on a monthly basis for a check up and adjustments to keep his spine healthy and mobile. This, for the patient and me is the most rewarding use of chiropractic care, as it benefits the patient for his whole life, not just a brief period. So when a patient, on his first visit to me says, “Am I going to have to come and see you for life”, my answer is, “Only if you want to”. When they say, will my pain go, I am always conservative, despite the fact that our results are very good indeed. I want to say, at that point, “Yes, but that may be the least of your problems”.