Frequently Asked Questions
Annandale Family & Sports Chiropractic emphasizes the importance of an appropriate history and examination in directing proper care. When a patient initially presents to the clinic, a thorough history and examination are performed. This process facilitates identifying whether the patient has a medical condition, in which case an appropriate referral is made, or if the patient’s condition is one that could potentially respond to Chiropractic Manipulation Therapy. When it has been determined that Chiropractic Manipulation Therapy is appropriate, a clinical trial of care begins. A trial of care averages three to five dates of service dependent upon multiple factors including duration and severity of symptoms. A trial of care provides a tool in which to continuously re-evaluate the patient’s condition:
- Has the patient’s condition resolved completely?
- If the patient’s condition has resolved partially, has the response been adequate enough to justify the continuation of care?
- Has the patient’s condition failed to respond? Is a referral necessary, and if so, to who?
- Are plain film radiographs or advanced imaging necessary?
- Would adjunctive care such as exercise rehabilitation, acupuncture, or nutritional therapy benefit the patient?
A trial of care directs care based on each individual’s needs and rate of response.
How many treatments or how long does take to experience a significant reduction in symptoms is a complex question. Every individual patient is different. There are a multitude of factors that play a role. These include the duration of symptoms, the intensity of symptoms, the severity of the injury, underlying conditions such as osteoarthritis, age, prior history of trauma, current physical condition, genetic factors, dietary habits, amount and type of fluid intake, body composition, time of year, current weather, the patient’s attitude, and what phase of healing the patient is in.
Generally speaking, an older individual who has neck pain as a result of a severe motor vehicle accident, whose symptoms have been present for 6 months, who has a previous history of cervical osteoarthritis, is overweight, and is a smoker is going to respond to treatment much slower than a teenager who is an athlete with no past history of trauma, who woke up with neck pain two days ago from “sleeping wrong”.
Since there is so much variability in how people respond, this is the reason why a clinical trial of care is such an important tool. It provides a continuous model in which to assess each patient’s condition against what are reasonable expectations.
- Has the patient’s condition resolved completely?
- If the patient’s condition has resolved partially, has the response been adequate enough to justify the continuation of care?
- Has the patient’s condition failed to respond? Is a referral necessary, and if so, to who?
- Are plain film radiographs or advanced imaging necessary?
- Would adjunctive care such as exercise rehabilitation, acupuncture, or nutritional therapy benefit the patient?
A trial of care directs care based on each individual’s needs and rate of response.
Chiropractic healthcare is generally regarded as one of the safest drug-free, non-invasive therapies utilized for the treatment of neuromusculoskeletal conditions. Chiropractic healthcare has an excellent record of safety, however, just like any other healthcare treatment, there is always a risk of potential adverse reactions.
The risk of an adverse reaction associated with chiropractic treatment, however, is minimal. Many patients experience some level of relief either immediately or within a few days of treatment. However, it is not unusual to experience some level of temporary soreness after treatment, what is termed “Delayed Low-frequency Recovery”, formerly known as “Delayed onset muscle soreness”. This soreness is similar to what is typically experienced after some form of exercise. Current research demonstrates that mild discomfort or soreness following spinal manipulation typically fades within 24 hours.
Neck pain, as well as certain types of headaches, can be treated effectively through cervical manipulation. Cervical manipulation, sometimes called “adjusting”, has a therapeutic effect by improving joint biomechanics, decreasing muscle spasm, and increasing range of motion. This can decrease the symptoms associated with neck pain.
Neck manipulation is an extremely safe procedure. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, there is not yet a clear understanding of the connection. The occurrence appears to be very rare—1 in 5.85 million manipulations— based on the clinical reports and scientific studies to date. When presenting to a doctor of chiropractic, it is imperative to be very detailed about the symptoms you are experiencing. This will facilitate the doctor in performing a thorough history and examination, which promotes the administration of the most effective and safest treatment, including referral to another healthcare provider.
It is important for patients to understand the risks associated with some of the most common treatments for musculoskeletal pain -- prescription and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) -- as these treatments may carry risks significantly greater than those of chiropractic manipulation. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers like ibuprofen.
(Adopted from the American Chiropractic Association www.acatoday.org)
Annandale Family & Sports Chiropractic utilizes multiple chiropractic techniques in treating patients. They include Diversified, Activator Methods©, extremity, and Thompson Techniques. Dr. Uecker primarily utilizes Diversified Technique, however, will use the specific technique which most efficiently promotes therapeutic response in each individual.
Diversified Technique:
This is the most commonly utilized chiropractic technique and what is likely most familiar to patients. It is a conglomeration of what are considered the most effective techniques in treating various joints within the human body. Diversified technique entails utilizing a high velocity, low-amplitude thrust (a quick, shallow force in which the Doctor typically utilizes his hands to deliver the thrust). Frequently, when a patient is treated via Diversified Technique (a manual therapy) an audible popping sound can be heard or perceived by the patient. Scientifically, this is a phenomenon called “cavitation”. Cavitation is the result of carbon dioxide gas being released from the joint capsule into the synovial fluid within the joint. This can occur when a joint is put under enough stretch that it creates sufficient negative pressure within the joint, thereby drawing gas from the joint capsule into the fluid and resulting in cavitation (or popping). This can occur with chiropractic treatment or just by stretching. It can occur in healthy functioning joint, or a dysfunctional joint. Cavitation is an independent phenomenon that has no impact on the effectiveness of chiropractic spinal manipulation therapy, whether cavitation occurs, or not.
Extremity Manipulation/Adjusting:
This is the application of chiropractic manipulation therapy on joints other than the spine, for example, the shoulder joint, elbow, knee, ankle, wrist, and so on. Examples of conditions treated via extremity adjusting/manipulation include tennis elbow, carpal tunnel, ankle sprains, IT band syndrome, etc.
Activator Method:
This is a hand-held, spring-loaded instrument. Instead of the manipulating/adjusting forces being delivered by hand, force is generated with the small instrument that delivers a lighter, but quicker thrust than can be delivered by hand. Activator can be used as a primary treatment method for all patients or a selective method for patients who may not desire manual manipulation/adjustment or where manual manipulation/adjustment may be contraindicated, such as osteoporosis.
Thompson Technique:
This is a specific chiropractic technique that uses a special table with several segments called drop pieces. These segments can be cocked up a fraction of an inch. When the corrective force is administered, the table will drop this fraction of an inch. The drop pieces assist the doctor in applying the corrective force while minimizing the amount of force needed for the manipulation/ adjustment. Cavitation of the joint may or may not occur (see Diversified Technique above for an explanation of the phenomenon of cavitation).