Recent Article in JAMA Highlights Spinal Manipulation for Low Back Pain
“Patients should stay active as tolerated and begin with nondrug treatments, including superficial heat, massage…and spinal manipulation.”
This JAMA patient page provides some great information for both acute and chronic sufferers of low back pain. It reiterates some things chiropractors have been saying for decades. However, it is always nice to see recommendations from the broader medical community. Such as highlighting the importance of conservative care before drugs or surgery. Spinal manipulation, also known as the chiropractic adjustment, is again touted. A great first line treatment option for both acute and chronic cases of low back pain. Combined with exercise and other non-drug treatment options, spinal manipulation is safe and effective.
There are many options to choose from when picking a treatment for your lower back pain. You can easily take a supermarket approach. But, you don’t need to waste your time and money down the aisle trying the latest fads, creams, lotions, potions, and miracle cures. The tried and true combination of time, early return to activity, exercise therapy, and chiropractic spinal manipulation remain at the forefront of first line intervention for lower back pain.
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, and desk jockeys. Dr. Reich enjoys staying active through a variety of sports, time at the gym, and finding new vegetarian food spots. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.
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.
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
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.
