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What is Chiropractic?

Chiropractic is a profession of health care providers. Chiropractors treat conditions of the muscles, joints, and nervous system. The most common and widely recognized chiropractic intervention is the adjustment or “joint manipulation.” Chiropractors also employ other treatments such as exercise, physiotherapy, nutrition counseling, and lifestyle modification advice.

A picture of a chiropractor setting a patient up to be adjusted.
Chiropractic adjustment or manipulation is the most widely recognized treatment performed by a chiropractor. An adjustment is delivered to a joint to affect the motion of the joint. Adjustments also can relax surrounding muscles, and release pain modulating chemicals to reduce symptoms.

More Than the Adjustment

What is chiropractic? Well, most visits to the chiropractor involve getting an adjustment, or several adjustments. However, there are other important benefits to receiving chiropractic care. A skilled chiropractic physician will be able to identify and diagnose the cause of pain or other symptoms. Also, if the underlying problem(s) is amenable to chiropractic treatment, a trial of care will be recommended which may include patient education, adjustments, physical therapy modalities, stretches and exercises, and lifestyle advice all tailored to you as an individual.

If you present to the chiropractor and treatment is not recommended for you, an appropriate referral to a specialist should be made. Some conditions may not seem likely to respond to chiropractic treatment but many patients decide to go forward with a short trial of care, especially if they have already tried many other doctors or treatments without success.

Safe and Effective Treatment

Chiropractic treatment is non-invasive. It is also conservative in nature, and without drugs or surgery. Furthermore, there are typically few side-effects beyond soreness following some treatments. Therefore, many medical journals and societies are recognizing chiropractic treatment as a first line intervention. Especially for treatment of lower back pain, neck pain, and headaches. Also, chiropractic has shown itself to be efficacious in the treatment of joint pain. As well as tendon injuries, ligament sprains, disc herniation, and other insults to the human frame.

From the American Chiropractic Association’s website some key points:

  • DCs are licensed to practice in all 50 states and the District of Columbia–and in many nations around the world–and undergo a rigorous education in the healing sciences at institutions accredited by the U.S. Department of Education. 
  • A growing list of research studies and reviews demonstrate that the services provided by chiropractors are both safe and effective. The evidence strongly supports the natural, whole-body, and cost-effective approach of chiropractic services for a variety of conditions.
  • Chiropractor’s services are included in most health insurance plans, including major medical plans, workers’ compensation, Medicare, some Medicaid plans, and Blue Cross Blue Shield plans for federal employees, among others. 
  • Chiropractors are used extensively by amateur and professional athletes, professional dancers, and others to prevent and treat injuries as well as achieve optimal health and functioning.

About the Author:

Dr. Reich and son riding on his shoulders pictured in a blog post for What is chiropractic?
Dr. Erik Reich is a practicing chiropractor in Meriden, CT.

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

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Pain Between The Shoulder Blades

Do you experience pain between your shoulder blades? This type of pain can be a dull ache, burning between the shoulder blades, or it can feel like a hot poker is being thrust up under scapula. Pain between the shoulder blades is called inter-scapular pain. In fact, the scapula, or shoulder blade, is a common site of discomfort and pain. Also, this type of pain can have different causes ranging from mildly concerning to very serious.

A man being examined by a clinician, maybe a chiropractor, for shoulder pain.
Pain between the shoulder blades is a common symptom of muscle strain, poor posture or ergonomics at work, trauma such as a motor vehicle accident, and other underlying causes. Dr. Erik Reich is a chiropractor in Meriden who treats musculoskeletal conditions including pain between the shoulder blades.

Why Do I Have Pain Between the Shoulder Blades?

Some common conditions which can cause this type of pain are listed below:

  • Muscle Strain
  • Trauma
  • Herniated Discs
  • Arthritis
  • Overuse Injuries
  • Lack of Use
  • Nerve Entrapment
  • Acid Reflux
  • Scoliosis
  • Referred Pain

There are also more serious causes of pain between the shoulder blades such as:

  • Gallbladder Disease
  • Heart Attack
  • Thoracic Vertebra Compression Fracture
  • Shingles

In most cases this type of pain is easily identifiable by an experienced clinician. If you have shoulder blade pain which is persistent and has not responded to rest, a couple of days time, and maybe some hot or cold packs, it is probably a good idea to see a doctor and have your symptoms evaluated.

Furthermore, if you are experiencing shortness of breath, chest pain, or feeling lightheaded, and you suspect the cause of your pain to be serious or life threatening, don’t wait to call 911 and get urgent medical care. Trust your gut.

Can a Chiropractor Help My Shoulder Pain?

Many of the most common underlying causes of shoulder blade pain arise from the soft tissues. For instance, muscles, tendons, and ligaments, as well as nerves, bursa, and fascia can all contribute to shoulder pain. Therefore, because chiropractors are specially trained to treat soft tissue and joint dysfunction, a chiropractor may be an excellent choice of provider to evaluate and treat your shoulder pain.

In conclusion, it depends. However, a skilled clinician such as a chiropractic physician, who takes a thorough history and then performs an exam to rule out more serious causes of your pain, should be well suited to address the most common types of inter-scapular pain. Furthermore, the right doctor will make any appropriate referral if necessary. Such as for advanced imaging, special tests, or specialist provider.

A picture of a woman lying down prone being examined and treated by a chiropractor.
Chiropractic treatment for pain between the shoulder blades is gentle, non-invasive, and drug-free.

What is the Best Treatment?

Depending on what the underlying issue is, different treatments may be recommended.

First, patient education is vitally important in all cases. Because, patients who are well-informed make better decisions, experience less anxiety, and less apprehension about their symptoms.

For example, if the underlying cause of your pain is determined to be repetitive overuse such as from poor ergonomics at your job, the treatment may include activity and work station modifications and lifestyle advice to reduce stress on the involved areas.

By contrast, if your pain started following a slip or fall and you landed hard on your shoulder, first aid type treatment may include icing or applying heat to the area. Then, protecting the shoulder for the first couple of days, progressing to gentle mobilizations to the spine or scapula. Lastly, light exercise to increase blood flow to the involved tissues.

Next, as pain levels are reduced, patients are typically involved in more active treatments such as dynamic stretching and loaded exercises. Exercise improves blood flow to the muscles and other tissues, and improves and restores mobility and strength.

Seek Help for Shoulder Pain

If you or a loved on is experiencing shoulder pain or pain in the middle back between the shoulder blades, don’t neglect what your body is trying to tell you. Call for a professional to evaluate and diagnose what is causing your symptoms.

You may already know what the cause is in the case of recent trauma. But, you may also have no idea if the pain began without incident, “Doc, i just woke up in pain.” is something many patients tell me. So, whether you have a good idea why it hurts, or no idea at all, getting an evaluation and a working diagnosis is a good idea.

Also, getting an evaluation is an absolute imperative if you believe your pain is severe with red flags such as chest pain or shortness of breath. But most cases of shoulder pain are due to soft tissue injury or dysfunction, and can be treated conservatively without drugs or surgery.

About Dr. Erik Reich

photo of Dr. Erik Reich with his son on his shoulders
Dr. Erik Reich with his son.

Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, and desk jockeys with shoulder pain. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

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Stenosis Treatment in Meriden

Have you heard the term “lumbar stenosis” regarding back pain or leg pain you are experiencing? If you or a loved one suffer from lower back and leg pain, and have been told you have stenosis, you may have some questions. So, where can you find stenosis treatment in Meriden, CT? My name is Dr. Erik Reich and I am a chiropractor in Meriden, CT. As a chiropractic physician I have treated many people suffering from lumbar stenosis over the past 8 years of clinical practice. Many cases of stenosis respond incredibly well to conservative chiropractic treatment, which is both non-invasive and drug free.

Picture of a badly inflamed lumbar spine illustration, demonstrating lumbar stenosis. Dr. Erik Reich treats lumbar stenosis patients in Meriden.
Dr. Erik Reich is a chiropractor in Meriden who treats neuromusculoskeletal conditions including pain and disability arising from spinal stenosis.

What is Lumbar Stenosis?

Lumbar spinal stenosis is a condition where the spinal canal narrows. Then, the narrowing can cause pressure on the nerves resulting in pain or other symptoms travelling into the legs. Lumbar stenosis can have several causes. For example, it can be caused by bony changes such as osteoarthritis, or congenital narrowing of the spinal canal, and spinal ligament thickening. Also, disc derangement such as herniation can also lead to narrowing and stenosis symptoms.

Do I Need Surgery?

Recent studies comparing surgery for lumbar stenosis versus conservative treatment such as physical therapy show similar outcomes. However, surgery carries added risks. Granted, for certain people surgery is an absolute necessity. To rule out surgery, a thorough history and examination should always be performed.

The risks associated with surgery typically do not arise in non-invasive treatment options such as chiropractic care. Therefore, while outcomes may be similar, many patients opt for a conservative non-invasive approach before considering surgery.

How Can Chiropractic Treatment Help?

There are several key components to an effective chiropractic treatment plan for addressing lumbar stenosis symptoms.

First, patient education is a key component of any successful treatment plan. High quality, evidence informed education about the condition, expected outcomes, goals of treatment, and possible side effects should be relayed. With better information, the patient often experiences better results.

Second, pain needs to be addressed. However, pain is only one symptom of stenosis which must be dealt with. It is hard to accomplish the goals of treatment if you are in pain. So passive care such as heat, massage, joint manipulation or adjustments, flexion-distraction, and other interventions are warranted to reduce painful symptoms to the point where active treatment, like an exercise program, can commence.

Third, active treatment moves to the forefront. Once pain has been reduced or eliminated, active treatment should begin in earnest. You should expect guided exercises, home stretching, and nutrition counseling. Symptoms from lumbar stenosis typically respond well to active care. Positive changes can usually be felt within the first week or two of treatment. Although every patient is unique and “it depends.”

Dr. Erik Reich is a Chiropractor Providing Lumbar Stenosis Treatment in Meriden

photo of Dr. Erik Reich with his son on his shoulders
Dr. Reich, Meriden chiropractor, and his son.

Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, and traumatic injuries such as work and car accidents. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

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5 Questions to Ask Your Chiropractor in Meriden

So what 5 questions to ask your chiropractor in Meriden? Below are some common questions, but this list is by no means exhaustive.

1. How Often Do You Treat This Type Of Condition?

Most chiropractors have a lot of experience treating lower back pain and neck pain, as well as headaches and other body aches and pains. It is a good idea to ask the doctor how often they see the types of symptoms you are feeling. Also ask how comfortable the doctor is with managing your symptoms. If the doctor states that 30% of their practice is treating people experiencing symptoms similar to yours, it’s probably a sign they are comfortable managing that condition.

Like other doctors, some chiropractors specialize or have a preference to treating certain conditions or groups of symptoms versus other types of pain. For example, I feel very competent and knowledgeable about lower back, neck, and shoulder pain. I do not feel as knowledgeable about some types of knee pain. So it doesn’t hurt to ask. Because every provider is different and some prefer to focus their time and practice on certain conditions or regions of the human body. Be wary of a doctor who states they only treat one area of the body and claims to be able to effect distant symptoms. While not unheard of, a chiropractor who only treats the first three joints of your neck, even if you are calling about elbow pain, should be approached with caution.

A picture of a doctor holding a stethoscope with a question mark.
Meriden Chiropractor Dr. Erik Reich answers common questions new patients often ask when seeing a chiropractor.

2. Do You Take X-Rays?

In some cases x-rays are invaluable. However, routine x-rays for uncomplicated back pain are not recommended. With mounting evidence and guidelines being published regularly which advise doctors away from the over-utilization of imaging for most types of back pain.

Therefore, regular use of x-rays, especially for non-traumatic neck or back pain, should be avoided according to most researchers. Part of the reason for this change is the number of false positives which are seen in otherwise healthy individuals. X-ray imaging reports with scary sounding terms like degeneration, bone spurring, and spondylolisthesis can imply that something is very wrong with your spine, when in fact these are often found in healthy people with no history of pain or disability. What’s more, when a patient gets a scan and sees these findings, they are more likely to undergo more expensive tests, begin medications such as opioids, and have worse health outcomes overall due to the stigmatization of otherwise non-contributory imaging findings.

This is not to discount the legitimate usage of imaging, but in America, patients by and large are over imaged, over medicated, and have worse outcomes because of it. You can read more about the use of imaging in modern chiropractic practice here.

3. How Long Do Treatments Take?

Treatment plans should be tailored to the individual. Cookie cutter plans where every patient gets the exact same treatment are not your best interest. When asking how long a treatment will take be sure to exclude any time for history taking and examination. As these will make your visit longer, typically at your first appointment and any re-exams. Typically a treatment session can last anywhere from 10 minutes up to 30 minutes. However, a complicated case can take longer to evaluate and treat. Most patients in my office get a combination of hands on treatment and other modalities. Which may include adjustment to the spine or other soft tissue therapy. As well as guided exercise, and some passive modality such as a cold pack or electric muscle stimulation if warranted. A treatment session of this type would run around thirty minutes.

4. Will You Respect My Treatment Preferences?

The answer better be a loud “Yes”. Because patients are individuals with their own biological, social, and psychological make-up, treatment should be tailored to the individual. If a patient presents with a strong preference not to be adjusted, the chiropractor should respect this and not try to sell or trick the patient into accepting an adjustment, even if it is the doctor’s strong opinion that an adjustment is what is best for the patient. The pillars of evidence based practice are relevant clinical research, patient values, and clinical expertise. If my expertise and research backs a treatment, but that treatment violates the patients values, then a competent clinician should be able to come up with an alternative. This is important to honor the patient’s values, while making the best effort to make a positive change to the patient’s presenting health concern.

5. Do I Need A Referral?

In general you do not need to be referred to see a chiropractor. However, there are rare instances where insurance plans do require a referral for chiropractic services. If you are unsure about whether or not a referral is required by your insurance, check with your plan. If you do not have insurance, no referral is necessary.

ABOUT THE AUTHOR

A picture of Dr. Erik Reich, Meriden Chiropractor, with his son Leif sitting on his shoulders.
Dr. Erik Reich with his son Leif.

Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, to seniors, and traumatic injuries such as work and car accidents. He also enjoys spending time with his wife and son, and their Boston terrier Jarvis.

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Whiplash Treatment – Meriden, CT

Where should I get whiplash treatment near me?

If you’ve recently been in a car accident, you are no doubt under a lot of stress. Dealing with repairs, police reports, attorneys, and insurance companies can make you want to crawl in a hole. Because so many factors are involved after a crash, it is important not to neglect taking care of yourself. So, even if you don’t feel immediate pain or discomfort, seeking a professional evaluation and whiplash treatment following a car accident should be a priority.

Many people feel pain or other symptoms right at the time of the accident, still others don’t feel pain until a day or more after being injured. If you are in a state of shock or feeling no pain due to an adrenaline rush after a collision, symptoms may not develop for several hours or even days later. Especially if neck pain does develop or becomes worse in the 24-48 hours after a crash.

Photo of a woman holding her painful neck due to a whiplash injury on the website of Dr. Erik Reich Meriden Chiropractor.
Dr. Erik Reich Meriden Chiropractor specializes in gentle treatment of whiplash injuries.

Seek Treatment for Whiplash Promptly

Whiplash injuries are very common following car accidents and other accidents. Whiplash occurs where the neck is moved extremely rapidly. The speed and force involved with this rapid movement is often enough to stretch muscles, tendons, and ligaments beyond their limits. This can cause these tissues to tear or become overstretched. Which in turn results in pain, inflammation, muscle spasms, swelling, or cramping.

Pain from whiplash injuries can be intense or dull. Dull neck pain following an injury or accident may heal on its own, or it may not. If you are experiencing neck pain following a car crash, seeking a medical opinion is important because pain may not resolve on its own. The natural course of many aches and pains is to go away on their own some time after onset. However, whiplash injuries can linger, and left untreated can become chronic pain.

Neck pain and instability of the tissues in the neck due to whiplash can lead your body to respond by creating stability where it is lacking. This process involves laying down connective tissue, excess scar tissue, and in the case of bone, more bone, which is termed osteoarthritis. Chronic whiplash therefore has been associated with long term pain. Studies also indicate a tendency for increased opioid medication use, arthritic changes, and poorer health outcomes.

What Type of Whiplash Treatment is Best?

At Omni Physical & Aquatic Therapy Center, Dr. Erik Reich employs a number of evidence based treatment strategies. These treatments address the components of whiplash injuries. Treatment begins with an in-depth history taking process and review of relevant medical history. Followed by a physical examination to identify the involved structures and injured tissues. Then, an individual treatment plan will be discussed based on your body’s needs. Your personal preferences, and the doctor’s best clinical judgement are also important.

Care plans typically include some combination of both passive and active care. Passive care can be thought of as first-aid care. Hot packs, electrical stimulation to damaged soft tissues, and ultrasound are types of passive care which might be employed to reduce pain. As pain reduces, more active treatments such as stretches and exercises are introduced. Therefore, your neck and spine have the best chance of returning to pain free motion. Then you can enjoy the movements and activities you did before the accident which resulted in your whiplash injury.

Car crash typical of an accident that can result in whiplash injuries for the people involved.
Whiplash can be caused by auto collisions, sports injuries, work accidents, or other trauma to the neck and spine. Dr. Erik Reich in Meriden, CT specializes in treating head and neck injuries, and other spinal and muscular pain and loss of function.

Seek Treatment if You’ve Been Injured

Whiplash injuries can be extremely painful immediately following trauma. Or they may show up as dull worsening pain one or more days after an accident. But what is important is that if you’ve been involved in a traumatic event such as a car accident, get a professional to evaluate you. Even if you are uncertain if you sustained a serious injury.

About the Author

Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, to seniors, and traumatic injuries such as work and car accidents. He also enjoys spending time with his wife and son, and their Boston terrier Jarvis.

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New Year’s Resolutions for the Back Pain Sufferer

Happy New Year!

2019 is coming to an end. As we embrace the new year, and you are making your New Year’s Resolutions to finally kick back pain to the curb, keep these points in mind. Because as a society approximately 80% of us have or will experience back pain, this is the perfect season to resolve to beat the odds. At an annual health care burden in the billions of dollars, lower back pain is a scourge felt worldwide. But these New Year’s Resolutions can help you overcome one of the leading causes of disability worldwide.

  1. Exercise at least 20 minutes a day, 7 days a week.
  2. Stop smoking.
  3. Eat at least 6 servings of fruits and vegetables a day.
  4. Get more and better sleep.
  5. Seek help if your symptoms are not resolving.
Picture of a man holding his lower back in pain arched into extension with a caption stating that Dr. Erik Reich in Meriden, CT treats back pain in the blog for New year's Resolutions for back pain sufferers.
Dr. Erik Reich is a chiropractor in Meriden, CT who treats all types of musculoskeletal back pain.

Exercise for Your Back Pain

It may seem counter intuitive to exercise a part of your body that may be injured or in pain but science regularly backs this up. Therefore, one of the best interventions for both acute (new) and chronic (old) pain is graded exposure to exercise. If you are unsure of where or how to begin an exercise program while in pain, see resolution #5 – Seek Help!

Stop Smoking

Needless to say this is old news for a variety of health reasons, but in terms of back pain, smoking is very bad for both pain intensity experienced, healing time, and outcomes overall. I recently wrote a blog on this very subject here.

Eat Your Fruits and Veggies

Fruits and veggies pictured on the blog of Dr. Erik Reich Meriden Chiropractor for New Year's Resolutions for back pain sufferers.
Increased fruit and vegetable intake is associated with better healing and pain reduction.

When you consume more fruits and vegetables your body heals better, this is well documented in the scientific literature. Vitamin A is required for cell and bone formation, cellular differentiation, and immune function. Vitamin C is necessary for collagen and connective tissue formation and as a tissue antioxidant. Fruits and vegetables also contain fiber which is filling and satiety will reduce cravings for more inflammatory foods (processed foods, sweets, chips, etc.) which should be avoided when healing.

Better Sleep, Better health

Two recent studies in just the past month or two have shed more light on the important role sleep plays in your health outcomes. In one study which was discussed in this article, lack of and poor quality sleep was shown to increase pain felt by up to 30%. Furthermore, in another recent example, a study showed how sleep helps to clean the brain and allow your body to remove toxins.

Ask for Help

The human body is resilient. You are highly adaptable and given the right inputs the body will take care of the output. But garbage in = garbage out. So if you are experiencing back pain, make some simple (but not easy) lifestyle changes to give yourself the greatest chance to recover. Or if you are unsure of how to make these changes, don’t hesitate to reach out and get some help.

Dr. Erik Reich is available for appointments Monday – Friday and can be reached by phone at (203)235-0171.

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Why is Smoking Bad for Healing After Disc Injury?

If you want to get better faster and with less pain after a disc injury, don’t smoke.

Picture of an anatomical model of a lumbar disc herniation on the website of Meriden CT chiropractor Dr. Erik Reich
Scientific studies routinely demonstrate that smokers have more pain, decreased healing ability, and longer recuperation times”, states Dr. Erik Reich, a chiropractor in Meriden, CT.

It’s no surprise that smoking is bad for you. If you are a smoker, you’ve most likely been told by friends, family members, and your doctor to quit the habit already a million times. However, as a chiropractor, let me be perhaps the first to state it this way: smoking is terrible for your health after a disc injury.

In this study by Tsarouhas A et al. the authors state, ” Smoking habits were found to have a negative dose-dependent effect on the transcript levels of MMP-3 and MMP-13 and a positive correlation with pain intensity, suggesting an unfavorable role for smoking in the regression process of herniated disc fragments. “

In other words, smokers take longer to heal after a disc injury. Smokers also experience more pain with disc injury than non-smokers. Anyone who has had a cervical or lumbar disc herniation can tell you, they can be extremely painful and debilitating. Therefore, you should give yourself every advantage when you are trying to heal after such an injury to your spine. If you are a smoker, be aware that continuing to smoke during the healing process has been demonstrated to slow recovery, increase pain intensity, and result in poor outcomes. So stop smoking for disc health!

In sharing this study and the information in it, it is my hope that if you are a smoker experiencing back pain, but especially back pain due to trauma or disc injury, you seriously consider quitting immediately. I know you’ve heard it before about the negative health consequences of smoking cigarettes, but this study makes the connection between smoking and back pain in a way most people are still unaware.

Graphs of MMP levels from a study on disc herniations and the effects of smoking on the website of Meriden, CT chiropractor Dr. Erik Reich
Significantly lower MMP-3 (c) and MMP-13 (d) mRNA levels were observed in discs removed from patients smoking more than 20 cigarettes per day compared to non-smoking patients 

I have no doubt that studies coming out in the future will build on the negative relationship between smoking and back pain, but in the meantime if you want my clinical advice: stop smoking for disc health now to improve your outcomes from suffering a spine related injury. Of course this is in addition to eating a healthy diet and exercising regularly, and if you need help doing that call (203)2350171 today.

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Choosing a Chiropractor

What should you be looking for when choosing a chiropractor?

The chiropractic profession is varied, and there are many different styles of chiropractic treatment and practices out there. So how do you pick a chiropractor? I will list and discuss some key considerations when you are in search of a new chiropractor.

First, ask your family and friends for a recommendation, or even your primary doctor which chiropractors in the area they would see if they needed care. Friends, family, and your health care team will likely not recommend to you someone they don’t like and trust themselves.

Second, check online. You can do a quick internet search for the chiropractor’s name and the town or city they practice in and get an idea of their practice by looking at their website, checking reviews online, and even looking up their license to practice and check for irregularities. When you are choosing a chiropractor in your area, don’t neglect performing an online search.

Next, give their office a call. Did someone pick up right away or did you have to leave a message? If a receptionist, or even the doctor, answered, were they pleasant, easily understood, and helpful? Did you get a good first impression? These are important windows into the “feel” of the office.

Exterior photo of Omni Physical & Aquatic Therapy Center, Inc. in Meriden, CT where Dr. Erik Reich Chiropractor sees patients
Dr. Erik Reich practices in Meriden, CT at Omni Physical and Aquatic Therapy Center, Inc.

Things to consider when starting treatment.

Chiropractic treatment is varied, but there are certain considerations that you should be aware of when starting a treatment program. Many chiropractors utilize spinal adjustment or “manipulation” of the spine to alleviate neck or back pain. Adjustment of the extremities such as ankle or wrist may also be performed based on the presenting health issue.

As a patient, be extremely wary of any chiropractor who says they have a unique technique or treatment that only they can use or a new treatment which they discovered. Joint manipulation is practiced more frequently by chiropractors than other manual healthcare providers, but it is not exclusive or proprietary to chiropractors as a profession, and there are many different named adjusting techniques and styles but no one has a monopoly on getting someone better with an adjustment.

Furthermore, other treatment modalities practiced by any good chiropractic physician are not unique to the chiropractic profession. Education about your condition, an exercise program, stretching and other treatments of the muscles and tendons, and nutrition advise may be helpful and offered at a chiropractic visit, but none of these interventions are exclusive to the chiropractor. Be skeptical of any chiropractor who wants to sell you their own vitamins or supplements because they are the “best” or the only ones that work.

You should beware of excessive imaging. Years ago it was common for chiropractors to over-utilize x-rays for a variety of reasons. Be aware that current understanding and imaging guidelines do demonstrate their usefulness in ruling out fractures, dislocations, and other red flags. X-rays should not be taken in the absence of recent trauma or suspected disease, and x-rays are not indicated to monitor your progress as treatment progresses. If you are not in pain and the chiropractor wants to take x-rays, you should get a second opinion.

Avoid long term contracts, payment plans, and care which does not have a reasonable start and end point. When you see a chiropractor, you should start feeling better. Depending on the severity of the original injury or health issue, this may take 1 visit, 6 visits, or a month of visits, or even longer…but avoid any doctor who claims to know that you will need 3, 6, or 12 months of visits when they’ve only met you once or twice and want you to pre-pay for 6 months of care. Everyone responds and heals differently, but this can not be known that far in advance and especially not to the degree where you should pay up front.

What Makes a Good Chiropractor?

Choosing a chiropractor shouldn’t be difficult. However, because the market is so fractured with many different types of practices, and in America the healthcare system is so focused on profit and efficiency, patients need to be keenly aware of outdated and potentially harmful practices that are more focused on serving the doctor or benefiting the practice than providing benefit to you, the patient.

You need to look for a chiropractor who takes a patient centered approach, which uses best practices and current evidence to come up with an active treatment plan focusing on return to regular activity and eliminate or reduce pain.

A good chiropractor is therefore one who avoids gimmicky marketing tricks, reduces or eliminates unnecessary or wasteful imaging or other expensive tests, and works well with other members of your healthcare team including primary doctors, APRNs, orthopedists, neurologists, and specialists.

A good chiropractor takes a thorough health history and performs a detailed physical examination before working with you on a treatment plan that is individualized to your goals and preferences. Also, a good chiropractor will offer education, support, exercises, and lifestyle modification advice, to encourage active participation in the process of getting you well, and not rely solely on passive interventions such as heat, adjustments, ultrasound, etc.

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Graston Technique and IASTM

IASTM or Instrument Assisted Soft Tissue Mobilization, Graston Technique, and other forms of soft tissue manipulation are manual therapy techniques. These treatment methods involve the clinician using an instrument or tool to affect soft tissue changes in the body. Often this involves scraping, rubbing, and massage like actions over the involved tissue and underlying fascia. As a result, more blood and nutrients are brought to the area and tissue healing is improved.

Dr. Erik Reich demonstrates IASTM for pain and restriction at the base of the thumb.

How Does It Work?

Graston Technique and other forms of IASTM work as a form of deep tissue massage. These techniques have been studied and show some benefit for certain conditions in the scientific literature. Therefore, through a process of stimulating the fascia and cellular matrix, it is potentially remodeling the tissue for increased elasticity, better organization of connective tissue, increased blood flow, and pain relief.

During IASTM or Graston Technique treatment, the provider uses an instrument or tool to glide over the skin at the involved site of discomfort or dysfunction after applying an emollient to reduce friction. After that, exercise or another active rehabilitation protocol should be employed to capitalize on any improvement in range of motion or reduction in pain to the site.

What Are The Benefits of IASTM?

Some of the benefits associated with this form of soft tissue therapy are increased blood flow and healing, pain reduction, and increased range of motion or mobility. In other words, by stimulating the fascia and connective tissue through the use of an instrument or tool, changes are made to how your brain perceives the involved area, and signals are sent from the brain to the area. Also, local changes in the fascia and cellular matrix at the site of the therapy are possibly taking place to improve circulation and improve healing time, and increase suppleness of the tissue.

Are There Side Effects to Graston Technique or IASTM?

Side effects to IASTM are rare and usually minor, typically mild soreness at the site of the therapy. You may notice small red dots appear at the surface of the skin at and around the area of treatment. However, these petechiae (red streaks) or bruising are not the goal of treatment, although they may appear after a session and cause some discomfort. Soreness can linger for 1-2 days after a treatment, and you should contact your clinician or doctor if more serious side effects are felt.

A picture of Graston Technique tools layed out on a plain background. Dr. Erik Reich, a chiropractor in Meriden, CT employs Graston Technique and IASTM protocols with his patients.
Dr. Erik Reich performs IASTM and has completed coursework in Graston Technique to better serve his patients.

If you are suffering from a recent soft tissue injury and would like to see if IASTM can benefit you, give Dr. Erik Reich a call at Omni Physical & Aquatic Therapy Center, Inc. in Meriden, CT for an appointment at (203)235-0171.

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Degenerative Disc Disease as Diagnosis = Rubbish

American Academy of Orthopaedic Manual Physical Therapists Releases Position Statement Opposing Use of ‘Degenerative Disc Disease’ as Diagnostic Term

A series of spinal models is displayed in order purposing to demonstrate various stages of spinal degeneration. Dr. Erik Reich states this terminology of degeneration and disease does more harm than good.
“Degenerative disc disease is a term which is neither accurate or helpful, it should be abandoned.” states Dr. Erik Reich, Meriden Chiropractor.

The position statement released recently by AAOMPT is spot on. Few things are as upsetting to me as a clinician as when a patient presents to my office having been scared by this garbage terminology. Degenerative disc disease (DDD) is not degenerative or a disease.

As Professor Stu McGill, a world renowned spine researcher is oft quoted as having said, “A degenerative disc disease diagnosis is the equivalent of telling your wrinkled mother-in-law that she has degenerative face disease.”

AAOMPT says patients often react to the label ‘degenerative disc disease’ by losing hope and seeking more invasive and higher-risk treatments. They avoid beneficial physical activity for fear that exercise and movement will worsen their condition, possibly leading to chronic pain. The majority of spinal pain is self-limiting and can be managed appropriately without the need for medications or risky procedures such as injections or surgery. For those individuals who do need care, AAOMPT supports and encourages early physical therapy instead of high-risk procedures and medication. AAOMPT strongly recommends that clinicians avoid using the diagnosis of degenerative disc disease.

One of the key interventions a clinician can provide to a back pained patient is education about their condition. Telling someone who has had a diagnostic scan or imaging that they are suffering from a disease such as DDD, when in fact this process is a normal part of aging and not a disease at all, causes harm and creates a nocebo effect.

A nocebo in this case arises from a patient being told they have a disease where in fact no disease is present. This can lead to negative expectations of recovery, fear or avoidance of beneficial activities, and seeking more aggressive and invasive treatments when they are not indicated or necessary.

Unfortunately, use of this terminology is still prevalent. Hopefully that changes as more practitioners are made aware of the negative consequences to patients of using this type of poor diagnostic language.