Online Chat - Chiropractor
January 20, 2010
Emporia chiropractor Rodney Shaw will answer your questions about chiropractic services.
Moderator: Today we have Rodney Shaw answering reader questions. Rodney is a chiropractor in Emporia for nine years. Don't forget to refresh your screen to keep up with the chat.
moderator: What education is required to become a chiropractor?
Rodney Shaw: Doctors of chiropractic must first complete a bachelor's degree before applying for admission to a chiropractic college. Chiropractic college is 4 years long and includes a minimum of 4,500 hours of study including, Basic sciences like anatomy, physiology, pathology, biochemistry, clinical sciences, X-ray interpretation and differential diagnosis, as well as chiropractic philosophy and hands-on practice.
Absolute: Can you please cite some research that demonstrates the effectiveness of chriopratic care.
Rodney Shaw: In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care. -- Korthals-de Bos et al (2003), British Medical Journal "Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache." -- Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001) "In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group (general practitioner). Manual therapy scored better than physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care." - Hoving et al (2002), Annals of Internal Medicine Acute Low Back Problems in Adults. Clinical Practice Guidelines. Bigos S, et al. Agency for Health Care Policy and Research Publication No. 950642 (U.S. Department of Health and Human Services) -1994. The Appropriateness of Spinal Manipulation for Lower Back Pain. Shekelle PG, et al. RAND Corporation, Santa Monica, California - 1992. The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain. Pran Manga and Associates. University of Ottawa, Canada - 1993.
moderator: How safe is chiropractic care?
Rodney Shaw: Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of neuromusculoskeletal complaints. Although chiropractic has an excellent safety record, no health treatment is completely free of potential adverse effects. The risks associated with chiropractic are very small.
moderator: What problems can chiropractic care help
Rodney Shaw: Chiropractic is effective at treating back pain, neck pain, headaches, shoulder and arm pain, carpal tunnel syndrome, leg and knee pain, so basically all non-surgical musculoskeletal problems.
moderator: How do you know when you are in need of chiropractic services?
Rodney Shaw: If you have neck or back pain, headaches, shoulder or arm pain, hip or leg pain. Even if you do not have these symptoms you may be in need of chiropractic care, because all of these problems started long before they were painful. Just like a small cavity in your tooth, it does not hurt until it gets worse. A chiropractic spinal exam can find areas of the spine that are not moving properly. Once detected, these early problems can be corrected with just a few office visits. If left to get worse, they will become neck pain, back pain, etc. These painful problems will take longer to treat. So a quick spinal examination could go a long way towards keeping you healthy.
moderator: What do you do in an initial evaluation to determine if chiropractic services are needed?
Rodney Shaw: I take a detailed case history, perform an orthopedic, neurological, and chiropractic examination of the problem area or of only the spine in the case of an asymptomatic patient. Based upon my findings, I will report my recommendations for care to the patient and they will decide if they wish to begin treatment.
moderator: What are some of the latest trends in chiropractic services?
Rodney Shaw: The profession is using more technology then they have in the past. In my opinion, the old methods of using your hands to discover an area of joint dysfunction are still the most effective.
mythoughts: Does popping bones back and forth not wear them down, making it easier for them to pop out again in the future?
Rodney Shaw: When someone presents to my office with neck or back pain it is usually because the joints between two vertebra in there spine are jammed "not moving like they should". The "popping" with an adjustment is from those joints being freed up to move properly. Once they are moving properly, if I was to adjust those joints everyday for long time the connective tissue around that joint would become stretched out lead to instability of the joint. That is why I treat patients frequently until they can maintain the proper motion in those joints. This is called the relief phase of care because that is when the pain goes away. The next phase is the rehabilitation or stabilization phase which involves less frequent adjustments while strengthening the muscles that support the joint. Once the joints are able to maintain proper motion for longer periods of time adjustment frequency is reduced even farther. At this point patients move into the Wellness phase which involves monthly or every other month checkups to make sure everything is still moving properly.
jmb232: I see some DC use a device called an "activator", How does this work? In my personal experience I thought it did very little and I was able to benefit much more by a traditionial adjustment. Could you explain why? Thank you Dr.
Rodney Shaw: The Activator technique for those that are not familiar is a method of adjusting the spine by using a hand-held spring loaded instrument that delivers a force directly into the joint that needs movement. I do not practice the activator technique. I have respect for it, because I know chiropractors that use this method and get good results. I use a more hands on adjusting technique that uses a quick controlled thrust to restore motion to the joint. New research is showing that the effectiveness of chiropractic is partially due to stimulation of nerves in the joint that is being adjusted. My theory as to why you benefited from manual adjusting and not activator is due to the difference in the amount of stimulus to the joint being adjusted. Your body may simply require the stronger stimulus from a manual adjusting technique. I have seen many patients that do well with one technique and not another. We are all unique so find out what works for you and enjoy the results.
moderator: How long does it take for a person to notice a different when having chiropractic work done? How long do the results last?
Rodney Shaw: It depends on what the problem is. Everyone is different some people require a few treatments before they see any benefit others will see some relief almost immediately. The results will also vary based upon the individual. I have had patients that were treated a few times and there problem never returned, others see short term relapses.
powercat: Do you use a popper gun? I went to a chiropractor once who used a thumper thing on my neck. What is the benefit of that and do you use that method, if not, what do you do?
Rodney Shaw: That "popper gun" that you speak of is the activator technique. The activator technique is an effective chiropractic method. I use a more hands on adjusting technique that uses a quick controlled thrust to restore motion to the joint. I also use a technique involving a table that assists in making the adjustment thrust quicker and less painful.
hometownkid: How come when I pay cash for chiropractic services it seems to be 25% to 75% cheaper than when I use my insurance? I getting the same service but two different prices?
Rodney Shaw: In my office, I charge the same fee for service whether the patient has insurance or not. Each patient's problem is unique so an office visit for one patient may not be the same for the next because I customize my care to the individual. There are even cases where it seems like I did the same service but because of the complicated coding systems that insurance companies require one little difference could mean a difference in what service gets billed. The only way for you to know for sure is to ask your chiropractor. If he can not give you a satisfactory explanation then I would find a chiropractor that could.
quarterback: I have been told by my doctor to never go to a chiropractor for my condition. He did not explain why but why would he tell me this?
Rodney Shaw: Some medical conditions make spinal adjusting dangerous. Any disease that affects the strength of the bones would be a contraindication to chiropractic adjusting. You should ask your physician exactly why you should not use chiropractic. In many cases, the chiropractor can change his technique to make it safer for difficult medical conditions.
Moderator: At what age do people start needing chiropractic services?
Rodney Shaw: At birth, all newborn babies should be checked by a chiropractor. Because the birthing process is very difficult on the baby's spine. The chiropractor can check the baby to see if there are any restrictions of motion of the spine.
Moderator: That's all the time we have for today. Our thanks to Rodney Shaw for answering questions.