Thursday, March 15, 2012

Corrective Care vs Symptomatic Relief Chiropractic

Wait! You mean I have to sign a contract for you to provide me with care?
I had someone say, aren't you the guys that put people on 70 visit care plans and make them sign contracts? We don't put people on 70 visit care plans unless this is an extreme case. In the years I've been doing this and the 1000's of patients we've treated. I've seen maybe 2 or 3  people get put on a 70 visit care plan because they needed massive spinal correction therapy from 40-50 yrs of decay and degenerative change.

Do we correct 100% of the people, 100% of the time? Nope. But we certainly can make a difference with people suffering and help them to live healthier lives using the 5 principles for the rest of their lives. Maximize their life through the 5 essentials and you have the power to change someones life completely. As far as contracts go for service it depends what you want as a patient. Symptom based relief requires no contract of care. Simply feel better and we release you from care. Correctional care on the other hand is something completely different.

That is definitely one thing that most ML docs do differently, spinal correction and not the treatment of symptoms. Heavy on Pettibon Techniques (type of Chiropractic care) and scoliosis correction is generally the modus operandii. [Clear Institute in Minneapolis, MN founded by Dr. Woggon, internationally renowned doctor is the gold standard for scoliosis correction.] That is where the doctor I work for as an Associate got certified in scoliosis correction, The Clear Institute.

Wait! You can actually correct scoliosis without surgery?
For you Orthopods and Nueros, yes, we can do that without the use of rods/plates and screws. For you physical therapists, yes, PT is a necessity to teach the muscles and ligaments how to hold the proper positioning again. PT and Chiropractic go hand in hand and I have been amazed at the level of malevolence I have seen from some physical therapists towards Chiropractic. Yes, it takes not only Chiropractic adjustment (not manipulation you can manipulate a wrist or an elbow but we adjust the spine) but physical therapy, which we provide our patients with detailed homework to complete. I have seen X-rays pre/post where the patient does not have scoliosis anymore after treatment protocols were completed properly. Yes, it can take 3 visits a week for 8-12 wks to get something like that accomplished maybe even a year or 18 months of once a week to finish out the protocols, but it works. But I would say the most important protocol of all is to teach our patients the 5 essential lifestyle. 

But my doctor says there is no way to fix my problem with out surgery, how is it that you say we can? Maybe your doctor should have said, "There's no way that I know you can fix this problem without surgery." For those that have been dissuaded from Chiropractic care by an Orthopedic surgeon or Neurologist, I propose this: Maybe they don't want you to come to a Chiropractor or spinal correction care doctor because if we fix the problem for you they no longer have the option of doing surgery on you. Please note here this is not the case with traumatic injuries as trauma is not within our scope of care. Furthermore, if the disc is ruptured or vertebrae is Phase III fused you are now beyond the scope of corrective care. However, even if there is one segment that is Phase III degenerated, should we now ignore the rest of the spine? If you had a bridge in your mouth would you now stop brushing the rest of your teeth?

But I've heard of you doctors giving people contracts and making them come back to finish! 
The best analogy I have that I tell our patients is: just like visiting an Orthodontist it could take years and 36-40 visits to make the desired change. If one of yer kids needs braces you will see a bill for thousands and thousands of dollars and likely 3-4 years worth of Orthodontic care. Can you walk into the Orthodontist's office after a couple of months and say, "Hey, this just isn't working out! My kid complains his mouth hurts and he still doesn't have a perfect smile yet, so let's just forget the whole thing, you can take his braces off and I want my money back."  I would hope not. But if that was truly the case I'm sure your orthodontist would comply and release you from care and contract as long as you paid the balance of what you have received thus far. So too is the case with any Maximized Living Doctor whose patient does not get the bigger picture about correction and is only interested in eliminating pain from the equation to feel better. Now, once you get your perfect smile does the Orthodontist simply let you go? Or do they give you a retainer? If you do not wear the retainer, what happens? The same is true of spinal corrective care. You may need some retainer adjustments now and then to keep things where they need to be.

Just as it is with moving the bones of the mouth, so too it is with the bones of the spine. It takes time. Time and many visits that build upon the last with lots of effort to see a perfect smile such is the case with spinal correctional care. People seem to get it when it comes to their teeth but seem to have a hard time understanding this same concept with their vertebrae. Fortunately, after going through this analogy with a patient that is still complaining of pain or doesn't have their perfect result yet in just a few short weeks or couple of months, most people, seem to get the bigger picture and are willing to give it the time it needs to achieve the desired original outcome of correction. If they are out of pain now and have changed their mind that they no longer wish to have correctional care then by all means, we do not want a patient there, that does not want to be there. That patient would then be released from care and given a referral to a pain relieving Medipractor or Medical physician. That patient is not the right fit for an ML doctor is they do not understand the 5 principles or are not interested in correcting the problem, and simply treating a symptom.

But what about these 40 visit care plans? Isn't that a ridiculous amount of care? 
No, not at all. Correctional care is the only reason we would put someone on a 40+ care plan. Symptomatic relief could be achieved within 2 days to 2 weeks and should be handled with a 6-12 visit plan. Which by the way, 40 is probably average for spinal correction whereas 70 is practically unheard of.  Most Chiros that I know,  do a 12-24 visit care plan and release. A spinal correction care doctor must usually do more than 12-24 visitis to achieve a change in the spinal alignment. This is precisely why we take pre and post X-rays on our patients. Our patients can see the results for themselves with their own eyes. You wouldn't go to Jenny Craig and get on their weight loss plan with out weighing in first, would you?

Wait! You mean I have to see you guys for the rest of my life?
Once our patient understands the concept of the 5 essentials we get a patient for life. Get someone feeling better and discharge with, "When it hurts again come back and see me." will help many people get to feeling better fast and be ready to take care of their problem once they become symptomatic again. But, isn't that the same concept as waiting until your sick and diseased and THEN doing something about it? A Maximized Living doctor will teach their patients how to be preventative and not fall back into a crisis mode again where they must now seek immediate care based upon their pain levels. Which, by the way, if we evaluate how healthy we are based upon how we feel, we would be 90% wrong. Since 90% of the nerves in our body are proprioceptive and mechanoreceptive (how we relate to gravity and move) and have absolutely nothing to do with pain. Are you only going to see your heart doctor one more time? How about the eye doctor? Visit the dentist just once or twice more before the end of your life? Or do you only go to the dentist once you have a cavity and are now in crisis?

Pain and symptom based care works, but this is not what we do. You will not likely find any roller tables, electric stimulation, or symptom based relief care in a Maximized Living office. This helps the patient to feel better but that is not our ultimate goal because we don't treat symptoms. We fix problems that cause the symptoms. We tell our patients if that's all they want (is to get out of pain) we can refer them to a Chiropractor cheaper or closer to them or send them to their GP for pain meds or muscle relaxers. Unfortunately, treating symptoms will not fix their problem which is causing the symptom in the first place Ie:  Radiculopathy or Neuropathy, and the patient will constantly be in a Yo-Yo state of pain/no pain. For a future blog report we will discuss some medications and if they are helping or hindering the body from healing.

My best analogy I have for this concept is when the fire alarm goes off, the firemen go to the fire and put it out. They don't go to the alarm and say, "Ok, who knows how we can turn this thing off so we can't hear it anymore." If you wake up in pain and pop a pain pill and go back to bed that is the same as your fire alarm going off inside your house and you get up, yank the batteries out and go back to bed. The fire is still burning people and if you don't fix the cause you are always going to have the symptom! You may not hear it right now but just wait a while, it'll be back again. I know why you are taking the pill, so you can get back to sleep but just so you know, that is not fixing your problem, you are merely treating your symptom.

Once again, I reiterate, we do not treat symptoms. That's not what I (We as ML do) We will correct a lordosis/kyphosis of the spine or scoliosis so the pain or radiculopathy, neuropathy, muscle spasm or fasciculation does not present itself again. Correct a spinal mal-alignment that is causing arthritic change, DJD, DDD or stenosis is what we are about. Changing the shape of one's spine through adjustment and therapies is not an easy job, but someone has to do it.

So, are you saying that you can reverse the affects of the arthritic change? 
No, but we can stop it from getting worse. (Back to Dr. Wolff's laws) Putting the proper axial alignment back into the segment or segments, thus taking the pressure off of the bones thereby negates the reason(s) Wolff's laws presents. If you believe that arthritis is an age related disease, then, you've been lied to! Arthritis is a biomechanical dysfunctional disease that we as humans are more prone to get as we get older. Unless of course you refer to RA which is an autoimmune disease. I have seen patient's in their 40's that have the spine of a 80 yr old, just as I have seen patient's in their 80's that have a spine of a 40 yr old. It's not about age, it all comes down to axial loading and Wolff's laws, which by the way, is not a belief or a theory. You only get to be accepted as a law if it happens 100% of the time, just like gravity. Jump off a building and I guarantee you will hit the ground every single time. Take the pressure off a nerve that is going to a muscle or an organ and causing dysfunction or degeneration and symptoms and I guarantee you will heal, every single time. Not some of the time. Every time.

Well, I just don't believe in Chiropractic! 
What's nice about this statement is: you don't have to. Chiropractic is like gravity. It will work anyway, whether you believe in it or not. 


Can you prove that to me? Where is the clinical evidence that supports this nerve pressure & healing theory?
There is none. I would recommend you read some of D.D. or B.J. Palmers work to understand this concept and theory. I could argue the same thing about an apple seed. Prove to me that there is life there. Show me where it is! Yet, you plant it and life emerges. We will probably never know how this works, at least probably not in our lifetime. The answer is simple though: Give it what it needs and take away what it doesn't need. The apple seed just needs soil, water and sunlight. The body just needs the 5 essentials. Nothing more, nothing less.

Are you saying that everything in the body is run by my nervous system?
Yes. Cut the nerves going to your thyroid (giving it life and function) and then see if the organ is functioning properly. Is this a belief or is this a fact? I don't care what organ or muscle you cut the nerve to, you will see the same result. Subluxation is tantamount to slowly choking a nerve to death and not an immediate cut. You may not see or feel the effects for quite some time but if you leave the body in  a position that is not at ease or dis-ease for too long, you get a disease.


Do you only accept patients that need spinal correction?
No, Of course not. We will accept any patient that wants to be healthy and stay healthy. But, "wellness patients" are few and far between that actually come into our office feeling fine and are not presenting with any symptoms. Usually this is from a referral from an existing patient that just wants their friend or loved one to be checked for subluxation.


 Chiropractic can do wonders for people, even treat things you had no idea a Chiropractor could help with including infections. It is medically proven that Chiropractic care can raise your immune system, that is why a transplant doctor will tell you not to go see the Chiropractor.Kids especially need chiropractic care and may not be symptomatic with their spinal problem(s) for years to come. Would you rather wait until the child is sick or an adult with a disease or be preventative and get things fixed before something happens? That's why in our office we check all children for subluxation free of charge.


How do you know if you have a subluxation?
There really is only one way to know for sure. Instrumentation and/or X-rays. We use thermography in our office. A thermal device that reads the nerve roots temperature and can pinpoint exactly where the problem(s) may be. Combined with digital X-rays and you get a clear picture in a matter of minutes where subluxations can be affecting someone's health and function.

In conclusion:  As for the difference in symptom based relief care and a corrective care approach I give you the words of a dear friend of mine, Dr. Mike Stephens. He put it in surfing terms: "There are short board and long board surfers. Both techniques are vastly different and use a different approach to achieve the desired outcomes, but at the end of the day, you're both surfing." What most chiropractors do and what we do (as an ML Doctor) is vastly different, but at the end of the day, we are still helping people feel better and we are both still Chiropractors.

I look forward to any comments on these subjects from any and all to help alleviate some of the stigma of Chiropractic or the misunderstood Maximized Living Doctor.

Yours in health and wellness,

Jason M. Jewell DC
"Saving Lives one Spine at a Time"

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