You woke up with pain this morning, just like you have every other morning for the past few years. But today is different; it's bad enough you can't reach the coffee on the top shelf of the pantry. Well, that's the final straw! Nobody messes with your ability to get your morning coffee; not even your own body! You finally decide you need to see someone about your problem, but who do you see? You remember your friend has referred you to Cumberland Chiropractic and Sports Medicine before, but all you can think of is the horror stories and stereotypes around going to a chiropractor. Well, let me put your mind at ease friend! Let's debunk some of the biggest myths surrounding going to a chiropractor.
Myth #1: You HAVE to get an x-ray on your first visit to be treated!
X-ray is a fantastic tool chiropractors use to look for very serious injuries and conditions like fractures, joint dislocations, severe arthritis, tumors, etc. Some chiropractic techniques require the doctor to take an x-ray of the spine or area of complaint to evaluate the patient for "spinal or joint misalignment and/or postural changes" to correlate to the problem being described by the patient. In some techniques, they will take an x-ray even if the patient does not have pain. Another round of x-ray may be taken after the patient has been treated for a while to see if any changes are occurring. The most recent guidelines and research show that this is NOT the standard of care. MOST patients that do not have a recent history of trauma or another underlying medical condition DO NOT require an x-ray to be treated. But your doctor should be taking a detailed medical history, performing a thorough medical and orthopedic examination, and using the most recent guidelines to decide if you need an x-ray before treatment begins. If you are in doubt about whether you need an x-ray or not before treatment, make sure to ask your doctor! They should be able to give you a firm and clear explanation for why you should or should not require films. Below is a link to the American College of Radiology guidelines for imaging criteria if you're curious about the most recent guidelines!
Myth #2: The bone is "out" and needs to be "put back in."
We hear this every day from patients that have been trained to say this. "My L5 is out!" or "My hips are out and need to be realigned." And logically it makes sense, doesn't it? A bone is out of place, the chiropractor pushes the bone, a "popping" happens, so something has to have moved back into place right? Well not quite. The term "out of place" really puts a gross image of extreme misalignment into the brain, that can scare a lot of people. If a bone is truly "out of place," more than likely the patient needs to be in the ER. Bones that have moved that far out of normal joint alignment (like a joint dislocation) could be severely compromising blood vessels or nerves that could permanently damage those tissues. In some states, it's not even LEGAL for chiropractors to reset fully dislocated joints! Most "misalignments" that come into a chiropractic office are actually a result of decentrated joints or joints that do not have IDEAL contact between the bone surfaces so the joint's range of motion is decreased. This is usually caused by a muscular imbalance pulling the joint into a stressed and less than ideal position. Some tissues are too tight, while others are too relaxed or the brain has just shut them off due to underuse. The patient may feel "misaligned" or stiff because of the decreased joint motion. When a chiropractic adjustment occurs, the doctor is simply restoring the proper motion of the joint by allowing the bone of the joint to move into their ideal position, which may only be fractions of a millimeter. If the muscular imbalance is not addressed, the joint will slowly return to the less than ideal contact and the range of motion will decrease again. Performing specific muscular release and strengthening to maintain ideal joint centration is key to keeping joints healthy.
Myth #3: You need a long treatment plan that you must pay for upfront to fix your problem!
This one is something we hear WAY too often. The patient is told they have disc degeneration, arthritis, or "poor curves" in the spine, and the only way to keep it from getting worse is by getting treated anywhere from 30 to 60 VISITS (That is not a typo, I've heard this from patients before)! The patient needs to then decide if their health is the most important thing in their life and "make an investment" in their health by paying for the entire treatment plan on the first or second day, which could be thousands of dollars. Once that treatment plan is done, the patient will need regular visits for the rest of their life to prevent the problem from getting worse.
Here's the quick and dirty version of my point: there is no way to tell a patient how long it will take to treat their problem. The research on this topic is a compilation of other clinicians' experiences treating the problem that they documented and published. Every person and their bodies are unique! Some respond quickly to treatment while others take much longer or don't respond at all. The only evidence there is to give an estimate on a treatment plan for a particular problem is experience in treating that problem. Your doctor should be transparent and reasonable when setting your treatment plan. Your provider should also be including YOU in your own care! The last thing your doctor should be doing is creating a dependency for them to treat your problem. The goal of any treatment plan is to help you fix the things you cannot do yourself and slowly transition you into self-care at home with exercises, home or workplace modifications, and coping strategies. Research shows that patients on SHORTER and patient involved treatment plans respond to care quicker and have longer-lasting benefits compared to those on longer treatment dependent care plans.
"Mr. Jones, my previous patients with a condition similar to yours have typically responded in 6-10 visits, but every person is different. You may respond slightly faster or slower. We will be assessing your progress during each visit, and I will change your treatment plan as needed, but let's start with 3 visits per week for 2 weeks to start. What will speed up your recovery is if you are very intentional about performing any at-home exercises or lifestyle modifications we suggest. You'll be helping treat yourself and won't need to come to see me as much! But if you are not responding well to care during your initial treatment plan, we will look at other options for care to save you time and money, and to get you to the right provider as quickly as possible."
Hopefully, you feel more comfortable looking for a chiropractor now that we've busted a few common misconceptions! When choosing your chiropractor, make sure it is someone that is using the current best guidelines and is up to date on research, but also make sure they are addressing your individual needs as a patient. Patients are people, not machines to be fixed with protocols. Ask your provider questions about your care BEFORE treatment start.