Tag: Cheshire chiropractor

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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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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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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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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.