Spinal Decompression

Low back pain results from a musculoskeletal disorder of the lower back. It can come in varied degrees of pain level. Many things can be the cause of low back pain, but most typically it is caused by muscular strain, injury to the lower back including the discs, ligaments, and muscles that are surrounding the spine area. There are a variety of treatments depending on exactly what is causing the pain, but one treatment that is gaining popularity is massage chairs.

Most people at one point or another in their life will experience some level of low back pain. It may be caused by certain disorders of the lower back, injury or just plain over usage. Some of these causes can be prevented where others may occur as symptoms from other diseases.

Some common disorders affecting the spine are Pagets disease, Ulcers Scheuermanns disorder, Ankylosing spondylitis, Pancreatitis, Pelvic inflammatory disease and Spinal stenosis. These conditions are best treated by a medical doctor. The treatments for these conditions range from medication to surgery and may involve physical therapy as part of the recovery process.

Many of the causes of low back pain can be prevented. They may result from improper lifting techniques, poor posture when standing or sitting or from injuries. It is always best to warm up your body so the muscles of the back are flexible. Pain associated with these items stem from muscle stiffness.

The common motion causing low back pain that can be prevented is how the body is used. From an anatomical point of view, the weight being put on the spine tends to be concentrated on a few muscles, ligaments and tendons in the lower back. This concentration of force tends to tire out these muscles causing them to become stiff and more brittle. If the force continues to be applied, then these soft tissues can become further fatigued causing them damage.

Massage chairs have found their way into more medical and chiropractic offices as a treatment to the muscles, ligaments and tendons of the lower back. The role of the massage chair is to help to loosen and relax these tight muscles. They have a number of specialized techniques that are applied for effective therapy.

For instance, a slow, continuous kneading of the lower back muscles along the ribs helps to stretch them to retain their elasticity. A rolling massage is applied to the whole spine. The rollers of the massage chair move slowly up the spine slightly adjusting each bone in the spinal column. The massage chair comes with a number of settings that can be targeted for effective relief.

Another common task of a massage chair is to provide heat therapy to full body. Special heaters are included throughout the massage chair. Areas that require heat to be applied are selected. The heat is used to reduce swelling and improve blood flow in the targeted area.

Massage chairs have the capability to apply traction. Traction is used to stretch out a given set of muscles. The rolling massage applies traction to the vertebra in the spine. Each vertebra is individually adjusted as the rollers progress up the length of the spine. Massage chairs can apply traction to the lower body and to the arms and shoulders.

If you are getting a massage, you might as well relax. Massage chairs incorporate MP3 Players where you can play soft soothing music. Music helps the mind to relax and to let go. This letting go releases the tension in the muscles that the mind is holding. This provides an important environment of relaxation in what may normally be a busy location in offices today.

As you can see the occurrence of low back pain is high considering all of its many causes. Almost everyone will have some incidence of lower back pain sometime in their life. For some the pain will be mild, but for others the pain can be quite severe. It is good to know your options and be educated in your choices. Find the right treatments for your and consult with your physician. Technology advances and massage chairs have become very sophisticated. Consider a massage chair a multi-faceted asset in your long term back care health.

Pain in the United States is a verifiable epidemic. Narcotic abuse is at an all-time high and pain in America costs well over $500 billion annually. In looking at the world of pain medicine, what are the 5 best practices for pain management to help move our country towards more effective outcomes?

1. Put in place pain practices that are integrated. What really needs to happen in this country is for patients to receive comprehensive type treatments rather than simply narcotic prescriptions. The easiest way to treat a patient's pain is to fill a prescription to minimize time spent on the visit. However, the most effective method is to have a coordinated pain practice with collaborative efforts including physical therapy, chiropractic treatment, pain doctors who can handle medication management, as well as perform interventional procedures.

2. Encourage dialogue between specialists. It's one thing to have an integrated pain practice where you have multiple specialists treating the patients incorporating alternative as well as traditional medicine. But if those specialists don't talk to each other about each patient, then it slightly defeats the purpose. With the various specialists discussing the patients, they can also help facilitate education among the different specialties and improve outcomes.

3. Individualized treatment plans. What is most profitable for a pain center is not always what is the best for providing outcomes to pain management patients. Each patient will necessitate a comprehensive workup so that the most accurate diagnosis can be made and an individualized treatment plan put in place. What may work for one patient may be completely inappropriate for another such as if a patient has fibromyalgia it might be inappropriate to incorporate deep tissue massage.

4. We need more research on interventional pain procedures. There is some research that exists showing that facet injections and epidural injections are effective for various pain conditions. However they are not large-scale Level One evidence type research so what needs to happen is more research. But also needs to be more research into better ways of treating pain with medication.

5. The world of technology is nicely integrated with pain management. As the last few years have gone by, interventional pain management procedures have elevated nicely along with technology. Procedures such as radiofrequency ablation and spinal cord stimulation continue to improve technologically so that the procedures take less time and are more effective outcomes for patients. This trend should continue over the next year.

Your back started to suddenly hurt. If you get an acute episode of back stiffness, the following recommendation should help you in the short term, however if your discomfort continues for over some days, it is urgent that you seek medical recommendation. Please do not let yourself get to the persistent agony stage just for the sake of not asking for medical help quickly enough.

Don't lie in bed unless the agony is so bad, you do not have any other choice. Even then, keep the bed rest to a minimum.

So try and keep moving as much as you can.

In the first 24-48 hours of pain, you should only apply ice packs, not heat. Always remember though to make certain your hot water bottle (or frozen peas, etc) are covered with a towel or something to prevent burns, and do not leave it on for more than 20 minutes.

If your back pain does not resolve within a couple of weeks, and you go to the doctors, you might eventually be diagnosed with a disc herniation or a disk, especially if your doctor orders an MRI.

So, what's that thing called a cervical disk or a lumbar disk?

For point of anatomy, the spine is divided in cervical spine, thoracic spine and lumbar spine.

The thoracic spine is your higher back, and it extends from T1 (thoracic one) to T12 (thoracic twelve). Your lumbar spine extends from L1 (lumbar one) to L5 (lumbar five). The end of your backbone is where your sacrum is.

The sacrum consists of five fused bones into one massive bone. The disks are located between each bone of your cervical, thoracic and lumbar spine. The disk divides the bones of your spine (the skeletal structures).

During your waking hours the disks leak water, due to gravity effects. When you sit you are adding weight to the backbone and the disk and water comes out. The water is revived into the disk, when lying down, etc, but it is revived at a slower pace.

When somebody starts aging, the fat and water within the discs go from thick to thin, and this can cause degenerative disc illness. The loss of liquid from your backbone is a leading reason for back trouble, particularly at the lumbar area. The annulus fibrosus makes up the marginal portion of the disk structure. The inner area of the disk is protected by the nucleus pulposos.

The pulp makes up the heart of the disk, which is polished and soft. The disks make up the first supporting force that regulates the spinal column, muscles, bones, and so on.

The annulus fibrosus is made of cartilage and collagen (connective tissue). A disc tear takes place when there's an interruption of the annulus fibrosus and the disk starts leaking. This liquid can irritate the encompassing ordinary tissue around the disk.

At times the connective tissue, lead to aberrant thickening, creating scars. A thin layer of scar tissue at the periphery of the tear may seal the leak of liquid but leave the disc subject to re-tearing.

An annular tear is more frequently than not due to an injury that increased the intradiscal pressure noticeably.

Will spinal decompression help in the case of a disk tear? Spinal decompression appears to be better in treating cases of lumbar herniated discs, than on cases of disc tear, because disc tears are more difficult to treat and they don't respond to treatment as well as herniated discs.

Gravity, back injuries, and physical activity cause pressure on the spinal column, and over time this leads to narrowing channels in the spinal column area. Spinal decompression therapy is for relieving the pressure on the spine, which can lead to sciatica and herniated discs. The process of compression is called spinal stenosis, and it causes pain, bulged discs, and the aforementioned other problems.

One reason why spinal decompression is helpful is it addresses the exact problem leading to back pain at the point of need. While the spine is compressed, it cuts off the flow of blood and nutrients between the vertebrae, which leads to damage and deterioration. Blood flow is necessary for every part of the body to function properly.

How Spinal Decompression Therapy Works

The patient is strapped to a table, which allows pressure to be placed on certain areas that work oppositely from the existing compression of the spine. A computer controls how the pressure is applied based on the area causing the pain. Although the process is not an immediate fix, it will force the vertebrae apart so blood can once again deliver nutrients where they are needed.

The spinal decompression table often is instrumental in relieving the pain and restoring the flow of fluids, negating the need for surgery. In many cases, the process fixes the problem permanently so that future treatments are not necessary.

Who Is A Candidate for Spinal Decompression Therapy?

Pinched nerves, degenerative disc disease, herniated discs, and sciatica are often the result of injuries that cause sudden and traumatic pressure on the spinal column. Automobile accidents and falls are primary reasons for back injury, but bad body posture and mechanics also lead to problems when they are not addressed. Many back problems come from age and the results of hard labor.

Spinal decompression therapy is only an option before pins, metal rods, or screws are placed in the back. Fractures are not treatable with decompression and diseases such as myelitis cannot be addressed either.

Those who have attempted other non-surgical methods for relieving back pain may find decompression helpful. Medications, exercise, diet, and steroid shots are often some of the first attempts to solve back problems. If they fail, decompression is a good choice before any consideration of surgery.

Anyone who undergoes spinal decompression must understand that it is a commitment. It can be costly and repetitive, but the only way it is helpful is if appointments are kept and the doctor's orders are followed closely.

Introduction of Cervical Spondylitis:

Cervical Spondylitis is a common spine problem refers to inflammation of the vertebral joints pertaining to cervical area which primarily affects the axial skeleton, peripheral joint & extra-articular structures. It may lead to cervical disc problem or nerve compression. It is one of the causes of neck pain which starts to increase gradually. Other symptoms of spondylitis include extreme pain and contraction in the cervical region of the neck and shoulders. The pain usually flows further downwards. It also causes neck stiffness that it becomes difficult to move the neck and shoulders.

Cervical Spondylitis Symptoms:

Symptoms can vary from mild to severe. Symptoms often develop slowly over time, but may flare up if you over-use your neck, or if you sprain a neck muscle or ligament. Symptoms include:

1. Neck pain

2. Shoulder Pain

3. Neck stiffness, particularly after a night's rest

4. Neck movement pain

5. Radiating pain from neck to arms on both side or back of head

6. Vertigo

7. Headache

8. Numbness of hands

9. Morning Vertigo

10. Giddiness

11. Weakness in hands

12. May feel irritable and fatigue, disturb sleep and impair your ability to work

Diagnosis of Cervical Spondylitis:

Examination often shows limited ability to bend the head toward the shoulder and rotate the head.

Weakness or loss of sensation can be signs of damage to specific nerve roots or to the spinal cord. Reflexes are often reduced.

Physical examination- The doctor may identify tender spots along the neck and evaluate your ability to move the neck in various directions. The function of the nerves and muscles in the arms and legs may be tested. Others include the following with possible findings:

• Spurling sign - Radicular pain is exacerbated by extension and lateral bending of the neck toward the side of the lesion, causing additional foraminal compromise.

• Lhermitte sign - This generalized electrical shock sensation is associated with neck extension.

• Hoffman sign - Reflex contraction of the thumb and index finger occurs in response to nipping of the middle finger. This sign is evidence of an upper motor neuron lesion. A Hoffman sign may be insignificant if present bilaterally.

• Distal weakness

• Decreased ROM in the cervical spine, especially with neck extension

• Hand clumsiness

• Loss of sensation

• Increased reflexes in the lower extremities and in the upper extremities below the level of the lesion

• A characteristically broad-based, stooped, and spastic gait

• Extensor planter reflex in severe myelopathy

B. The following Tests may be done used to show bone spur and other abnormalities and reveal the extent of damage to the cervical spine:

• CT scan or spine MRI

• Spine or neck x-ray

• EMG

• X-ray or CT scan after dye is injected into the spinal column (myelogram)

Outlook (Prognosis) of Cervical Spondylitis:

Most patients with cervical spondylitis will have some long-term symptoms. However, they respond to nonsurgical treatments and do not need surgery.

Possible Complications of Cervical Spondylitis:

• Chronic neck pain

• Inability to hold in feces (fecal incontinence) or urine (urinary incontinence)

• Progressive loss of muscle function or feeling

• Permanent disability (occasional)

Cervical Spondylitis Treatment:

They may be treated medically, by changing lifestyle factors or a combination of the two. However, they do not need surgery in most of the cases.

A) Lifestyle modification for Cervical Spondylitis:

Important lifestyle changes include using proper equipment and techniques in daily routine activities, and exercising regularly.

B) Conventional Treatment for Cervical Spondylitis:

The painkiller (analgesics and anti-inflammatory drugs) with some muscle relaxant with physical therapy. Eg: hot packs and TENS etc. is given in acute stage with gentle exercise being the mainstay for chronic disease.

C) Homoeopathic Treatment for Cervical Spondylitis:

Homoeopathy includes many effective medicines for the relief in cervical spondylitis symptoms:

Colocynthis vulgaris - Remedy for constrictions and contractions felt wherever in the body, thus, indicated in muscle cramps; headache; & neuralgia esp. pain radiating to right side of neck, shoulders, arms & hands.

Ruta graveolens - Acts on periosteum and cartilages indicated by pain in nape of neck, back, loins.

Hypericum perforatum- Acts on nerve endings releasing their compression & inflammation indicated in pain in nape of neck radiating to arms to fingers; pressure over sacrum; spinal concussion; coccyx injury from RSI (Repetitive Strain Injury) with pain radiating up spine.

Ledum palustre - Indicated in painful stiffness in neck & back after sitting esp. radiating to left side of neck, shoulders, arms & hands, aggravated by cold or cold water.

Cuprum metallicum - Indicated in hyperaesthsia of spinal column; twitching of muscles of back up to neck.

Dulcamara - Indicated in stiff neck esp. in damp weather; pain in small of back; shooting contractions in the loins, shoulders and arms.

Conium maculatum - Indicated in tension, stiffness & pain in the nape of the neck as from friction in the cervical vertebrae or sprains; pain between shoulders; vertigo & headache.

SPONDINTM Drops - It is a homoeopathic proprietary medicine, a unique combination of the above seven universally acknowledged homoeopathic medicines. This is useful in comprehensive management of Cervical Spondylitis/Spondylosis and relieving its associated symptoms and improving the quality of life in the patients.

Jack had it. Tiger has had it. Freddie is constantly battling it. Many of the elite of golf have had it.

The "it" is low back pain.

While very few recreational golfers have much in common with these legends, low back pain is the one thing shared by golfers of all skill levels.

Low back pain is reported to be the most common ailment affecting working age adults in the U.S., second only to the common cold. An astonishing 80% of Americans over the age of 30 will suffer at least 1 week of debilitating back pain during their lifetime.

Amongst the nations 30 million golfers, back pain is even more prevalent.

Golf and back pain go hand in hand. Many people, even golfers themselves, do not realize what a physically demanding sport golf really is. The amount of strain placed on the lower back joints, discs and muscles is tremendous.

Overstretching and straining muscles that are cold and tight cause many injuries. Golf can be rough on the back, but it is made even worse by golfers not stretching or warming up before or during a round.

Often overlooked is the fact that on public courses players take a shot and then wait around quite awhile before their next swing. This slow play causes the muscles to cool off and tighten up. Your next swing is with tight muscles making injuries more likely. Walking rather than riding a golf cart can help prevent this, but many courses do not allow walking.

The most serious problems for golfers include disc bulges, degeneration and herniation.

Symptoms of back pain that radiates to the buttocks, thighs or legs are very serious. These symptoms often mean that the cushions between the spinal bones of the low back have deteriorated or are bulging outwards into the nerves.

Once this occurs, it's definitely time to seek specialized help. Severe back pain and sciatica (leg pain caused by disc material irritating the sciatic nerve) can come and go and is often helped by chiropractic manipulation, acupuncture or physical therapy. But common questions to doctors specializing in back pain among golfers are: What about the cases that do not respond well to these treatments? And what can be done about the cases that seem to go away only to return a month of two later?

Moderate to severe back and/or leg pain caused by deteriorating discs that fails to improve with non-invasive procedures or often reappear, were often thought to require surgery. But today physicians realize that surgery has its place in treating these resistant cases, but only as a last resort.

Searching the medical literature you will soon find that the most common type of back surgery (discectomy) has at most a 50% success rate and that at 12 months post-surgery surgery patients are no better off than non-surgically treated patients.

Additionally, patients undergoing surgery are prone to additional surgeries later on. Second surgeries are usually fusions where two or more spinal bones or vertebrae are in various fashions tied or bolted together. These surgeries have even less impressive success rates.

The good news for golfers with severe back or leg pain is that advances in medical computer technology have lead to a promising new treatment called "non-surgical spinal decompression." This new treatment for disc problems that cause back pain and sciatica has been clinically shown to relieve pain and can actually reduce the size of disc herniations. All without the risk and potential side effects of surgery.

But golfers with back pain need to know that not everyone is a candidate for spinal decompression and expertise among providers varies greatly. Before embarking on a non-surgical decompression course, talk to an expert who perform the procedure and have an evaluation done. Only a health specialist that provides this treatment can tell you whether or not it has potential for you.

In every emergency department in the US, chronic pain is one of the most common symptoms reported. Research has shown that about forty percent of individuals who come in to the emergency room describe a chronic pain syndrome. This is truly not very alarming considering the Institute of Medicine survey from last year showed that over 30% of America is dealing with a pain issue.

The largest problem when people present to the ER with chronic is that doctors must decide between genuine pain management patients and those who are there just looking for illegitimate prescription narcotics.

Any prescription opiate with a street value is going to be obtained potentially under suspicious motives. Many will fake a painful condition to obtain an opiate prescription illegally so that they can sell or barter the narcotic and make money from it. A usual profile of a person who plans to sell or barter narcotics is a younger, well groomed person who knows a lot of medical terms. It may even make the doctor think the person is in a medical field he or she knows so much.

The person will claim to have an issue like or headaches such as migraines, back pain, maybe something off the wall like a sickle cell crisis, or potentially another problem that would lead into the type of opiate medication being looked for. When these people show up in the ER, they often ask for a specific drug, have a problem producing ID, refuse a complete workup, produce weird stories, and claim to have allergies that are very specific.

If the ER has signed up for a prescription drug monitoring program they can check and see if the person has been getting controlled substances already from multiple physicians.

Emergency doctors and ER personnel should ask for multiple types of ID along with talking to the patient's primary care physician. If there are just a lot of red flags, the local police should be called.

Patients who are addicts often have common features. There is often drug escalation along with the person using alcohol or illicit drugs too. People will obtain their opiates from nonmedical sources, and "doctor shop".

At times, even legitimate individuals in the ER may show signs of dozing off, slurred speech, and an overall appearance of being high. This is often why legitimate people get labeled as "drug seekers" because of their appearance and actions while in the ER.

In order to protect themselves, ER's often give out limited amount of opiates to these folks. This would not be enough to abuse or overdose with, but enough to reduce pain for 2 to 3 days until the patient can get in with their regular physician.

The emergency room is not the time to eliminate substance abuse, and it is also not the time to provide enough opiates to promote substance abuse. Ensuring a common sense approach and only providing limited opiates makes complete sense.

Many people have heard of different forms of treatment for back pain. From Swedish massage to deep tissue massage to having chiropractic adjustments done, it seems that everyone is suffering from back and neck pain and needs the latest treatment. Spinal decompression therapy, however, is a lesser known option for people suffering from back and neck discomfort. It was approved by the federal government in 1996 and has been proven to be safe and efficient for the vast majority of people who undergo the treatment.

Spinal decompression can effectively address a number of ailments, including arm and leg pain. Herniated or bulging discs in the spine and sciatica can also be treated, along with degenerative diseases like spinal stenosis and arthritis. Chronic tightness in the muscles from a lifelong habit of hunching over a computer can also lead to back pain, which this type of treatment can help alleviate. Thus, many causes of back pain can be treated with spinal decompression therapy.

Many causes of back pain can be found in an active lifestyle with improper warming up or cooling down. How many of us know people that simply put on running shoes and go for an hour-long jog with no stretching? Or people who play pick-up basketball games in incorrect shoes or go to the gym and use improper form on many of their exercises? All of this can lead to back and neck pain issues down the road for even the most active of us. Thankfully, spinal decompression treatments can help address these conditions.

This type of therapy is designed to stimulate more blood flow to the spine and discs and create the conditions under which a herniated or bulging disc can begin the healing process. As the therapy uses traction, the muscles in the back can relax without the danger of cramping or spasms. Many patients feel no discomfort during the procedure, and some even fall asleep while the spine decompression process is going on. The increased blood flow promotes healing by delivering oxygen-rich blood to the areas being worked on.

Spinal decompression is often part of a holistic therapeutic program. Some problems with the back may need to be addressed with other treatments, such as ice, heat, or compression. Patients may be given exercises to help strengthen the muscles of the back and neck, or to increase the flexibility and overall mobility of the joints. Traditional chiropractic adjustments may also be used for some patients to assist in the process.

Due to the fact that spinal surgery is often no more effective than alternative forms of back pain treatment, spinal decompression therapy should be an option considered by many people in pain. In fact, this kind of treatment is often used when surgery fails to fix a herniated disc and may be used after an operation in certain circumstances to promote heating. Spinal decompression has been proven to be a safe and effective process for men and women suffering from back pain, as well as a viable alternative to spine surgery.

It is rare that an injury, disc herniation or other condition affecting the spine leads to permanent sciatic nerve damage, but for those who find themselves the anomalies, the effects are devastating. A damaged sciatic nerve can cause an array of chronic symptoms including muscle weakness, severe pain, loss of sensation, inability to walk and loss of bladder and bowel control. Quality of life is affected by both extreme limitations on activity and constant, unpleasant physical stimuli.

It is important to seek treatment for sciatica, or impingement of the sciatic nerve, early on to prevent nerve damage. Injured sciatic nerves are treated in a variety of ways and usually heal within a year or two. However, in rare cases of severe injury or prolonged impingement, the nerve can become permanently damaged.

Stem Cell Therapy

Stem cells are the blank slates of cells: They can become other cells in the body. The cells used to treat back pain and other chronic pain conditions are called mesenchymal; they can become bone, cartilage, neuron or fat cells depending on the environment they are put in. Adult cells are used, which differ from embryonic cells that can become any other type of cell. Taking the cells from an adult eliminates the controversy surrounding embryonic stem cell research.

Mesenchymal cells can be derived from the patient's bone marrow, usually taken from the hip, or from the patient's adipose (fat) at the abdomen. The cells are injected into the injured site and, ideally, grow into the cell that area needs for rejuvenation. Studies are limited to animal trials at the time, but these show great promise for the ability of stem cell therapy to regenerate nerve cells. One such study can be viewed at http://www.ncbi.nlm.nih.gov/pubmed/21327572.

Stem cell therapy is a last line of defense against permanent nerve damage and the disability and chronic pain that result from it. This modern treatment provides hope to those who have undergone conservative treatments like spinal decompression and physical therapy as well as surgical treatments to no avail.

Accessing stem cell therapy is currently difficult. Many who seek the treatment travel out of the U.S. to locations that provide it. There are a few places in the U.S. that offer stem cell treatment, such as ASCI in Arizona, whose website can be found at http://www.stem-cell-center.com/. Insurance doesn't cover the therapy as it is not FDA approved or accepted as a proven form of treatment. U.S. clinics estimate the cost of treatment to range from $7,000-$10,000 - a substantial fee to pay out-of-pocket, but likely worth it to those facing lifelong nerve damage.

Another way to obtain stem cell therapy - without the cost - is to enter a clinical trial. Look for upcoming clinical trials frequently to stay up-to-date on what is available.

If you have suffered sciatic nerve damage, stem cell therapy may be the last hope you've been waiting for. Helping your body use its ability to regenerate itself may be the key to treating a number of chronic conditions.

With many chiropractors to choose from, how do you find the one that's right for you?

Finding and working with the right chiropractor can help you feel like a kid again - limitless, young, and able to do what you want to with energy and passion.

The following information should be used as a guide. Asking the right questions up front will maximize the likelihood of finding a good match and pay dividends in your health. Nothing is worse than making quick decisions only later to find out that your not happy and having to start over. Your homework up front is the key.

1) How many years has the doctor been in practice?

Make sure you seek out the help of an experienced chiropractor with a record of accomplishment. It may be obvious, but if you don't ask you will not know. A chiropractor who has treated patients with similar problems hundreds or thousands of times is going to offer better service, and advice, which translates to a better experience. This is an example of where "going green" doesn't pay.

2) If I have questions! Will the doctor speak to me on the phone prior to setting an appointment?

This author believes the answer should be a resounding YES! When I practiced in Atlanta several years ago, I put my staff on a project to find out how they were treated when they called local offices and pretended to be new patients. I wanted them to understand that our systems were in place for a reason: to meet and hopefully exceed patient expectations from the beginning. Interestingly, we found that the staff at most offices said the doctor would NOT speak on the phone. Instead, a new patient would have to schedule an appointment to ask questions. What kind of experience do offices provide potential new patients by being unwilling to communicate in the first place?

If an office policy includes parameters to offer "exceptional service', it shouldn't be conditional based on convenience or their rewarded financially. The policy should be in place because that's the way the company does business. This includes making sure the doctor is available to speak with patients on the phone and by email.

3) What type of services are offered and how much time is the doctor with a patient?

If we consider the patient's condition a constant factor, the time spent during a routine office visit can vary widely in different offices based on a number of factors. Generally most people are actually with a chiropractor between 5 and 15 minutes. Some chiropractors treat only the spine while others including our office, offer additional services beyond chiropractic care. Treatment for knees, feet, shoulder, and muscle disorders takes longer because it's more comprehensive.

If you have a specific condition such as migraine or headache pain, treating your condition may require specific techniques such as Cranial Meningeal Release Therapy. Most chiropractors do not use this method because it is an osteopathic treatment and requires additional training. If you are suffering from a disc condition such as herniated, prolapsed, bulging, or degenerative disc disease, non surgical Spinal Decompression Therapy should be considered and may help you avoid surgery. Does the office you're considering provide these services? Cold laser therapy is also a very effective treatment method that accelerates the healing process and reduces inflammation, pain, and muscle spasm. It's wonderful for shin splints, tendonitis, and joint pain in the spine and extremities.

Check to see if the doctor uses only one specific treatment method for most or all patients. This can be a red flag. Chiropractors who use multiple techniques with supportive treatment including physical therapy, exercises, muscle and joint rehab, and nutrition is evidence of progressive thinking.

4) What is the philosophy of the doctor and staff?

As author, Stephen Covey says, to "begin with the end in mind". Find an office whose intention is to build long-term relationships with people in their community. Based on your terms, you should be able to lean on your new chiropractic team with confidence when you need them. Answers to the first 3 questions should yield perspective about philosophy as well as treatment and time spent with patients, doctor-patient phone calls, and the overall experience you can expect from being a patient in the office.

Specifically ask questions about the philosophy on the type of treatments that are offered. This author has found that to create faster longer lasting results, a blended approach works best. In our office we offer 3 unique disciplines: Chiropractic, Physical Therapy and Rehabilitation. Within each discipline, a diversified menu of services is available and can be customized for patients to accomplish their goals and objectives based on their unique needs.

5) Is there anything unique about the doctor and his practice?

This is an opportunity for you to find out what makes one office or doctor different from another. If you are fortunate enough to speak with the doctor, they should be able to express something meaningful. If you speak to a staff person, find out how long they have worked for the doctor. What do they like about the office? What do they think about the doctor and how is his bedside manner?

Get past "he's a great guy" type answers and get to information that you will find meaningful. You may be surprised at what you hear.

6) What techniques and methods are used by the doctor?

In chiropractic practice, the methods used to deliver care are called techniques. They are systems of evaluation, diagnosis, and treatment. Many practices use only one or two methods and are very successful helping people. Depending on your particular problems, you might be OK or need a chiropractor who can offer more diverse services. Successfully treating complex biomechanical and muscle disorders as well as sports injuries in the shoulders, knees, and feet for example requires advanced specialized training.

The design and combination of methods used for each person's treatment should reflect their uniqueness as an individual based on their condition(s), age, and participation in sports and activities.

In our office the following methods are used routinely: Spinal Decompression Therapy, Cold Laser Therapy, Extremity Adjusting, Diversified, SOT, Gonstead, Flexion Distraction, Muscle Activation, Proprioceptive Neuromuscular Facilitation (PNF), Myofascial Release, 6 types of Electrical Muscle Stimulation, Activator, Drop Table, Pettibone, and Full Spine.

7) I want more information. Do you have a website with references online?

Go to the company website and read their references. You can find out a ton of information about a doctor and their office based on what others have experienced. An office that can offer this type of information is usually more progressive, and is likely a patient centered practice that offers more value.

Try to find common threads that are frequently expressed that give you confidence and peace of mind. Use our website as a guide and tool to search for the type of information that interests you. On our website for example, we have both video and written references from patients, and a separate section for professional references. People searching for a chiropractor, as well as our patients have commented how much they appreciate the letters and stories others have written. We are thankful for what people have shared because their experience helps educate others.