Tag: Back pain

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Should I See A Massage Therapist Or A Chiropractor?

Massage and Chiropractic Care

If you have aches and pains or an injury, you have a lot of options. The marketplace for treatment of injuries and insult to the human frame is large. If you think of this marketplace like a real supermarket you might look at the aisles and see shelves stocked with medication, patches, doctors visits, massage therapy, homeopathic remedies, acupuncture, chiropractic treatment, physical therapy, vitamins and supplements, yoga, and the list goes on.

But let us take two items off of the shelf and unpack them a bit. Narrowing the choice down between massage and chiropractic care for your problem, which do you choose?

A doctor examines a painful shoulder, will massage and chiropractic help?
Which type of practice is better suited to help relieve pain or other symptoms?

Similarities

Massage and chiropractic care are both interventions where the practitioner uses their hands to affect positive changes to irritated or injured tissue. Also, both treatments are conservative in that they do not rely on drugs or surgery to make these changes. Furthermore, massage and chiropractic are both considered very safe and non-invasive, with the most common side effect typically reported being temporary soreness following treatment.

Differences

Chiropractic care is performed by a doctor of chiropractic and often entails a full history, physical examination, diagnoses, and treatment planning before any adjustment or treatment is started. The doctor may order special tests such as x-rays or blood panels as well, depending on the history and exam findings.

Treatment in a chiropractor’s office typically involves an adjustment (spinal manipulation) or a series of adjustments. This is what chiropractors are chiefly known for prescribing as the therapeutic intervention. However, many chiropractors are also knowledgeable about and prescribe physiotherapy, nutrition, heat, cold, or electric therapies, exercises, and other modalities which can fall within a chiropractor’s scope of practice.

The Adjustment

The adjustment is the most well known aspect of chiropractic care though. So what is the adjustment, and how is it different from massage therapy? An adjustment is a fast impulse delivered to a joint, typically in the spine but also useful in the extremities at times, which stretches the joint past it’s normal end range of motion and results in a cavitation (the popping sound you may be familiar with hearing when you crack your knuckles). This fast release of joint tension often improves feelings of stiffness in a joint, pain surrounding the joint or adjacent soft tissues, and may relax tight muscles or reduce muscular spasm.

So an adjustment is most often delivered to joints in the spine or extremities, whereas massage therapy typically involves the soft tissues of muscle and fascia.

Massage therapists are licensed professionals trained to manipulate soft tissue. There are many benefits to massage therapy including increased circulation, lymphatic drainage, stress reduction, and more. However, massage therapists are not doctors and cannot diagnose or order special tests. You should still make sure to inform your massage therapist of any medical conditions you are experiencing before receiving a massage.

Massage and Chiropractic – Chocolate and Peanut Butter

As a chiropractor I have referred many patients to massage therapists for treatment. I have also personally utilized massage services for my own health. I do not believe that chiropractic is intrinsically better than massage (despite myself being a chiropractor) and will admit that for certain people and conditions massage is clearly a better tool to address some injuries and patient concerns. In fact, many chiropractors employ massage therapists in their offices and it is one of the chief adjuncts to chiropractic treatment in the United States. This is because massage and chiropractic care are so complementary.

For example, a patient may present with a bad ankle sprain with decreased range of motion and pain at the ankle. A chiropractic adjustment to the ankle resolves much of the pain and improves the available motion, but there is still much swelling and some discomfort about the joint.

The doctor prescribes some stretching and exercises for the patient to perform at home, and gives a referral to a massage therapist to address the soft tissue component of her injury. A referral for massage helps reduce the swelling and eliminates the remaining pain, and the patient is able to perform her home exercise with more ease, and is happy with her outcome and the collaboration because she knows a team is working together to resolve her presenting complaint.

I hope this post helps illustrate how massage and chiropractic are similar but different, and how they can often complement each other. Thanks you reading!

About the Author

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

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc.  located at 303 South Broad Street. 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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Grow Your Cup

Cup pain analogy

Pain has many components. Physical injury may be immediately obvious, but there are also social (being bullied or rejected at school or work) and psychological (depression, guilt) causes of pain. Therefore, to help understand how various contributors to pain can affect a person, the analogy of a cup may be useful. Then, using this analogy, we can begin to implement lifestyle changes designed to grow your cup. Also, please read this article by Dr. Lehman.

A picture of an overflowing cup
Pain results when the system cannot contain all the stressors affecting it. In other words, when the cup overflows, you feel pain. So to reduce or eliminate pain you can either reduce the harmful inputs causing your cup to overflow, or you can build a bigger cup.

So we recognize that pain is more complex than tissue damage. There are many people walking around today with damaged tissues and no pain. Think of the paper cut that doesn’t hurt until you notice it. Likewise, there are many people in great physical pain with no apparent tissue damage or history of physical trauma. If you need a health care professional to help guide you to feeling better or getting out of pain, hopefully they recognize pain is multifaceted.

Which Road to Travel? Probably Both

Armed with this information, there are two routes to travel if you are looking to reduce pain. First, you can limit the amount of negative input causing your cup to overflow. These negative stimuli can take the form of:

  • Stress
  • Tissue damage
  • Poor sleep
  • Anxiety
  • Bad habits

Secondly, you can build yourself a bigger cup. This is accomplished in several ways, such as:

  • Having fun / play
  • Fulfilling activities
  • Positive social interactions
  • Exercise
  • Better nutrition
  • Better sleep quality

In my opinion, both reducing negative inputs into the system AND building a bigger cup are important. Each person’s experience will dictate how much energy they should apply to each side of this model. But, if I had to choose one versus the other, I’d take building a bigger cup every time. Here’s why.

You will never be able to completely eliminate stress, toxicity in all environments or relationships, sleep disturbances, physical harm, eating an inflammatory diet, etc. Reducing and moderating all of these are important, but there is also no growth without stress. Arguing with your relatives may be stressful, but would cutting that stress out of your life also eliminate beneficial aspects of your relationship? It’s probably a better solution to keep the relationship intact but build strategies to deal with the stress of those topics of conversation that you anticipate will set you off.

Build Yourself a Bigger Cup

So, in my opinion, humans are adaptable, robust, highly resilient beings. We should be able to function and adapt to our surroundings and overcome challenges. It seems to me a more winning path forward is to adopt strategies to deal with stress effectively than to try and avoid stress at every turn. To get stronger, instead of avoid any task that requires strength. Exercise enough that a few days of poor eating doesn’t completely derail you. Because, at some point life is going to challenge you, and a bigger cup can hold more without spilling over.

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

About the Author:

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc.  located at 303 South Broad Street. He treats all types of patients including weekend warriors, seniors, high school athletes, victims of trauma such as auto accidents, physical laborers and desk workers. Dr. Reich treats patients Monday through Friday and can be found spending time with his wife and son, and their Boston terrier when not in the office.

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5 Tips To Improve Ergonomics While Working From Home

A lot more people are working at home lately thanks to the global pandemic Covid-19. This new situation can lead to challenges in setting up a work station which will be both comfortable and reduce the chances for strain and injury. So in this article I will outline several tips to improve ergonomics. Ergonomics means fitting the job to the person, which is important to consider while you work from home.

A drawing of a person working at a laptop on an article about ergonomics while working from home on the blog of Meriden chiropractor Dr. Erik Reich
Working from home can be stressful. Your work space shouldn’t be.

1. Practice Good Posture

Many tasks you will likely be performing at home while working will be done with your arms and hands outstretched to the front of your body. For example, typing, checking your phone, writing, using a laptop, and reading are all activities which place your shoulders and arms in a forward position. This posture is chest and shoulder dominant. This means your chest and shoulder muscles are contracted more frequently to position your arms forward and closer to center. This can lead to shoulder irritation and poor breathing patterns.

In order to counteract this predominance of the chest muscles and forward rounding of the shoulders, you should be mindful of sitting and working with your chest forward. Think of someone tying a string to your breast bone and pulling you up. In this way your chest leads in front of your shoulders and places you in a more “open” posture.

Furthermore, if you are sitting at a desk, be sure to adjust your chair so that you are at a comfortable height and your thighs are parallel or slightly higher than parallel to the floor. Your keyboard and computer should be directly in front of you, not off to the side. Also, the computer screen should be at least 18″ from your face and the top 1/3 of the screen should be at eye level.

2. Don’t Forget to Move

Even while you are sitting or standing to work at home, movement is important. If your work requires you to spend long hours at a desk, small movements such as tapping your feet, rolling your neck and shoulders, and fidgeting with your hands and fingers, can help stimulate blood flow and decrease stiffness. Short breaks to stand, pace, performs some air squats, calf raises, or desk push-ups can also be very helpful.

3. Set a Timer

If you are like me, sitting to write or type, or finish computer work, you may be prone to stay put for long stretches of time to complete the task at hand. What can be helpful is to use your phone’s clock timer or another inexpensive timer to set micro-breaks for every 20 minutes. This way when the timer goes of you have an auditory cue to get up and move for a few minutes, without becoming overly distracted.

4. Your Breathing is Important

When working from home you may be sitting a lot. Sitting places the hips in flexion and can impede full expansion of the lungs while breathing. Naturally while sitting you will tend to take shallower breaths.

Take some time to focus on deep breathing and you may notice your posture improves, your back feels less tight, and you don’t fatigue as easily. Keeping your shoulders behind your chest as previously discussed can help.

Furthermore, placing one hand on your chest and one hand on your stomach and taking a deep breath, you should feel the hand over your belly move. Shallow chest breathing where your diaphragm doesn’t expand into your abdomen limits rib expansion and decreases circulation. So make sure both hands are moving well when you breath, get your diaphragm involved!

With improved rib expansion while breathing your blood will carry more oxygen, your joints will circulate their fluid to provide nutrition to the joint cartilage, and your stress levels will reduce. Good breathing has many health benefits.

5. Take Walking Meetings

Many meetings these days are being conducted remotely. There are many apps which make this possible, and when working from home it may seem convenient of comfy to sit on the couch at your chair for the duration. I would suggest if possible that you walk or pace comfortably around your house while on these calls. You may have already been sitting for some time before the meeting starts, and getting back to more work following the meeting. So if possible try and use this time to move around.

So there are 5 tips which I hope you will find helpful during these times when you are working from home, whether by choice or due to the recent coronavirus pandemic.

About the Author:

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

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc.  located at 303 South Broad Street. 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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5 Signs You May Need A New Chiropractor In Meriden, CT

You may have had one of these experiences. A family member or friend may have told you about their awful experience at the chiropractor’s office. Maybe they were told they need to be seen three times a week for a year. Perhaps a treatment plan was offered but they would need to pay for the care all in advance. Or maybe the doctor advised them that they had a terrible condition that would need multiple x-rays and only that chiropractor’s secret/special/unique/proprietary technique was able to fix what was wrong.

Unfortunately in chiropractic, as well as the other healthcare fields, there are some bad actors. Furthermore, these practitioners may not even be aware that their actions are harmful, or without evidence, and essentially scamming people. No one wants to be duped, or the recipient of unethical practices. Evidence based doctors also don’t want patients exposed to bad actors, who then come away with the impression that all of chiropractic is a scam. If you receive a bad haircut, you don’t swear off all barbers and stylists. But if you have a bad experience at the chiropractor’s office, you may say “I tried chiropractic, what a joke”. To be clear, most chiropractors are ethical and do take their responsibilities to their patients very seriously. But no profession is without some bad apples.

Below I will list five signs your chiropractor may not be acting in your best interest. This list is by no means exhaustive, and context is important as well. Because some practices listed below may be reasonable depending on individual circumstances.

Reg flags waving in the breeze featured in a blog post about 5 signs you may need a new chiropractor or the chiropractic care you are getting is a scam.
Red flags that you may need a new chiropractor.

5 Signs You Need A New Chiropractor

  1. No Diagnosis or Treatment Plan is Given
  2. Excessive Number of Visits are Recommended
  3. The Doctor Refuses to Work with Other Providers
  4. The Doctor has Secret Treatment Knowledge Only They Possess
  5. Payment Must be Made Before Care is Delivered

Treatment Plans and Diagnosis

First sign, no diagnosis is given and no treatment plan is prescribed. Be wary of any health care provider who does not explain what diagnosis or hypothesis they are thinking of with regards to your symptoms. Also, clinicians should be able to lay out a treatment plan to address your concerns. If no diagnosis is offered or no treatment plan is laid out, that could be a sign your chiropractor doesn’t actually know what is going on with your symptoms or concerns. Generic non-specific statements like “sciatica” or “neck pain” are not diagnoses, they are symptoms. Likewise, your chiropractor should have some idea of how long it will take to improve or relieve your presenting symptoms.

Second, and this goes along with the first sign, chiropractic care should be individualized to each patient. Blanket plans of care where everyone is told to come in three times a week for two months is not patient centered. You may indeed need two months of care at that frequency, but most people who respond to chiropractic treatment feel better much sooner than that, especially if your symptoms have not been caused by trauma. Treatment plans where the doctor prescribes six months of visits at a time, and may ask you to pay up front, are especially dubious.

Working as a Team

Beware of any health care provider in the 21st Century who refuses to collaborate with your other providers. There is a history of animosity between the medical and chiropractic professions dating back to the 20th Century. This mistrust is still prevalent to a lesser degree, with some chiropractors skeptical of medicine and surgery. Also, some medical doctors, physical therapists, and surgeons view chiropractors with distrust and skepticism. Neither of these outlooks serve you, the patient, very well. Inter-professional cooperation improves health outcomes. Doctors refusing to deal with one another leads to worse outcomes, confusion, and mistakes being made. Find a healthcare team willing to collaborate on your behalf and cut loose any member of that team who refuses to deal with other members of YOUR team.

Secret Knowledge

In the chiropractic profession there are many named techniques. Of course, this is also true with the other manual therapy practitioners, such as massage therapists and physical therapy. Diversified adjusting, ART, Cox, Gonstead, Graston, McKenzie, and the list goes on.

However, claims that one technique is superior to another or a cure-all are unfounded and not backed by science. Be cautious of any provider who tells you they have secret knowledge. All of these techniques can be learned, but an unscrupulous provider may twist or re-brand a common technique, slap a label or their name on it, and all of a sudden they are out practicing like a guru who possesses the secret wisdom to heal what ails you. They’re also probably marketing themselves to other providers with $999 courses to spread their new superior methods. Don’t be conned by these charlatans.

By and large, we know what works to get people out of pain. Patient education, therapeutic exercise, return to activity, lifestyle advice…mix in some first aid care such as heat, stretching, or adjustments to bring pain levels down, and reassurance. None of this is secret knowledge.

Payment is Expected in Advance of Care

As a patient with a health concern you should expect your chiropractor to provide excellent care. A thorough history and exam, diagnosis, plan of care, and any treatments delivered should be appropriate and well explained. This is pretty standard stuff. What is also unfortunately encountered are excessive cookie cutter treatment plans that go on for months, with an expectation that you pay up front.

This is wrong for a couple of reasons. First, every patient should be treated as an individual. When an unscrupulous chiropractor hands you a piece of paper outlining the next six months of visits with a 20% discount if you pre-pay in one lump sum, they are more focused on their office’s cash flow than your health. Don’t believe for a second that you’re the only person in that office being given such a great “deal” on their care.

Second, pre-payment contracts can be illegal in some jurisdictions. They also often contain clauses which violate your rights to receive a refund if you don’t utilize all the visits. Furthermore, many of these arrangements are entered into under the rationale that such a long plan with so many visits is required to avoid catastrophic health conditions. Terms such as disc degeneration, arthritis, or spinal decay are used, and of course you had better pay all at once. This is called “scare care” and it’s a bunch of malarkey.

Don’t Get Scammed

There are many great chiropractors in the world. There are some shady ones out there too. Hopefully this article makes clear some of the actions a few chiropractors, and even some other healthcare providers, might take to inflate their bank account, or their egos. These doctors and practices rarely have the patient’s best interests in mind, as the patient is secondary to increasing revenue. The American healthcare system is a disaster which puts profits far ahead of people, and hopefully this post gives you some insight on practices to avoid when seeing a chiropractor or other health care provider.

About the Author:

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

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc.  located at 303 South Broad Street. 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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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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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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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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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.