The Chiropractic Patient Experience

By Dr. John A. Papa, DC, FCCPOR(C)

In last week’s article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care. This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice. Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.

Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain. Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.

First, a thorough Medical History is taken which documents an individual's specific

complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history. Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing. X-rays may also be ordered to help determine the source of pain or dysfunction. Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care. If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.

For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration. Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions. In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.

Chiropractors are trained to offer multi-modal physical therapy incorporating the use of

different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function. Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints. Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion. Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound). Acupuncture can be used to promote healing, decrease pain, and control inflammation. Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.

Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints. Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).

This article is a basic summary for educational purposes only. It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

 

Understanding Neck Pain

By Dr. John A. Papa, DC, FCCPOR(C)

 

Neck pain is a widespread experience among the general population, with 30-50% of adults reporting pain symptoms at any given time.  Once an episode of neck pain happens, most individuals will find it is a persistent or recurrent condition.  The purpose of this article is to outline our current scientific understanding of neck pain.

 

The cause of neck pain is usually multi-factorial, meaning that there is usually no single cause.  Factors such as overall physical and mental health, along with work and daily activities are just a few factors that can contribute to the development of neck pain.  Most causes are not the result of serious injury or disease.

 

 

Neck pain can affect people in different ways and is usually classified into the following categories:

 

GRADE 1: Neck pain with no signs or symptoms suggestive of major structural pathology, and little or no interference with daily activities.

 

GRADE 2:  Neck pain with no signs or symptoms suggestive of major structural pathology that limits daily activities.

 

GRADE 3:  Neck pain with no signs or symptoms suggestive of major structural pathology, with presence of neurologic signs of nerve compression (i.e. radiculopathy or "pinched nerve") and may include pain, weakness and/or numbness in the arm.

 

GRADE 4:  Neck pain with signs or symptoms suggestive of serious structural pathology (i.e. tumor, fracture, infection, systemic or visceral disease).

 

 

Evaluation of neck pain should include a proper medical history, along with a physical examination consisting of inspection, range of motion testing, and palpation for tenderness, along with strength, neurological, orthopaedic and functional testing.  Diagnostic tests such as x-rays, CT or MRI scans are only required in a minority of cases.

 

The majority of neck pain is classified as Grade 1 or 2.  There is scientific evidence to support the following treatments for Grades 1 and 2 neck pain: education, exercise, mobilization, manipulation, acupuncture, soft tissue therapy, and analgesics.  Conservative treatment of Grade 3 neck pain should proceed with caution.  The majority of Grade 4 neck pain will require specialty medical management.

 

Due to the persistent and recurring nature of neck pain, individuals need to have realistic expectations when addressing their symptoms as pain relief is often modest and short-lived. The scientific literature does not identify any “best” treatment that is effective for everyone.  Trying a variety of therapies or combination of therapies may be required to find relief and help manage neck pain.  It is important that individuals play an active role in managing their symptoms by participating in their usual daily activities as tolerated, exercising, and reducing mental stress.

 

Most people can expect to experience some neck pain in their lifetime that may or may  not limit daily activities.  For those with neck pain that may be interfering with their activities of daily living, a qualified health professional can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Understanding Neck Pain

 

By Dr. John A. Papa, DC, FCCPOR(C)

 

Neck pain is a widespread experience among the general population, with 30-50% of adults reporting pain symptoms at any given time.  Once an episode of neck pain happens, most individuals will find it is a persistent or recurrent condition.  The purpose of this article is to outline our current scientific understanding of neck pain.

 

The cause of neck pain is usually multi-factorial, meaning that there is usually no single cause.  Factors such as overall physical and mental health, along with work and daily activities are just a few factors that can contribute to the development of neck pain.  Most causes are not the result of serious injury or disease.

 

Neck pain can affect people in different ways and is usually classified into the following categories:

 

GRADE 1: Neck pain with no signs or symptoms suggestive of major structural pathology, and little or no interference with daily activities.

 

GRADE 2:  Neck pain with no signs or symptoms suggestive of major structural pathology that limits daily activities.

 

GRADE 3:  Neck pain with no signs or symptoms suggestive of major structural pathology, with presence of neurologic signs of nerve compression (i.e. radiculopathy or "pinched nerve") and may include pain, weakness and/or numbness in the arm.

 

GRADE 4:  Neck pain with signs or symptoms suggestive of serious structural pathology (i.e. tumor, fracture, infection, systemic or visceral disease).

 

Evaluation of neck pain should include a proper medical history, along with a physical examination consisting of inspection, range of motion testing, and palpation for tenderness, along with strength, neurological, orthopaedic and functional testing.  Diagnostic tests such as x-rays, CT or MRI scans are only required in a minority of cases.

 

The majority of neck pain is classified as Grade 1 or 2.  There is scientific evidence to support the following treatments for Grades 1 and 2 neck pain: education, exercise, mobilization, manipulation, acupuncture, soft tissue therapy, and analgesics.  Conservative treatment of Grade 3 neck pain should proceed with caution.  The majority of Grade 4 neck pain will require specialty medical management.

 

Due to the persistent and recurring nature of neck pain, individuals need to have realistic expectations hen addressing their symptoms as pain relief is often modest and short-lived.  The scientific literature does not identify any “best” treatment that is effective for everyone.  Trying a variety of therapies or combination of therapies may be required to find relief and help manage neck pain.  It is important that individuals play an active role in managing their symptoms by participating in their usual daily activities as tolerated, exercising, and reducing mental stress.

 

Most people can expect to experience some neck pain in their lifetime that may or may  not limit daily activities.  For those with neck pain that may be interfering with their activities of daily living, a qualified health professional can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.