Why Do You Treat Areas That Are Not Where My Pain Is?

This question is one of those that gets asked quite frequently. The default answer has been along the line of “looking at a leak in your ceiling, in that it could be coming from the sink directly above, or from a leak in the roof 30 feet away”. Hopefully, this will better define our approach which was taught to me by a professor of mine, Alejandro Claraco, M.D. at McMaster University in Hamilton, Ontario.

We take a “Global” approach in the treatment of musculoskeletal complaints. At times, according to the exam findings, we will adjust, release or stimulate one or more of the following areas of influence to your pain or dysfunction:

•          Local area: where peripheral nerve trunks are “plugged in” to associated muscles, joints, etc. This area is treated to effect, regulate or normalize that particular region where the pain, weakness or hypertonicity is manifesting. For example, I saw a patient who stumbled and sprained an ankle. It was obviously beneficial to address that immediate area first, and so I did via Active Release, mobilization, as well as electrical stimulation, all with the intended goal to reduce swelling and increase range of motion and ability to bear weight on the injured limb. In this particular case, there were other issues north of the ankle that were longstanding, and mechanically hindering the normal gait with walking and running, so they needed to be addressed as well; but for some, that may have been the sole issue that after a few treatments, the case would be closed.
•          Spinal Segmental area: this area manifests or provokes symptoms via indirect stimulation of the spinal nerves through the surrounding muscles of the spine (close to the spinal midline). Most often, this area is addressed by spinal adjustment, manually, or by instrument. It is important to realize here again that symptoms are not always initiated by the immediate area. A patient complaining with arm pain may have their neck involved; sometimes, however, the upper back may be the primary issue.
•          Systemic Regulatory areas: are predominantly along the upper and lower extremities, as well as on the head and ears. These points are sometimes addressed to affect the muscles and other organs of the body (ill-functioning nerves are often overlooked as a contributing causative factor in, say, cardiovascular, endocrine or digestive malfunction).  While I am not in the habit of advertising for patients to come in for complaints involving non-musculoskeletal problems, I know too well that there are times when there is an electrical malfunction that allows these problems to develop. I first witnessed this early on in my practice when patients brought up the issues they were experiencing prior to the care they received for their spine and wondered why they could now breathe better without congestion, have better bowel movements and not have to get up to urinate so often. Nerves are extensions of the brain that control and coordinate every organ in the body, including skin, muscle and glands. Let me emphasize that there can be a number of causes to a malfunction, but simple modulation, or normalization by chiropractic as well through other soft tissue techniques may save one a lot of expense and time. If there is any doubt as to whether more diagnostic or revealing tests need to be made, I will either have them ordered directly, or work through your primary care provider to get them done in a timely manner, in some instances, even prior to beginning any treatment. In cases involving Medicare, the primary care doctor is always needed in ordering any specialized tests (government controlled).

The strategy or methodology employed on each patient will differ according to particular presentation and examination findings. Some of these procedures may be recommended to expedite a patient’s care, but, may not be covered by their insurance. Patients ultimately will have to make the informed decision of which procedures they would like to pursue. While I will emphasize what needs to be done to accomplish the quickest resolution of one’s issue(s), the individual may desire to proceed without, say, Active Release or rehabilitative exercises, understanding that it may take longer. If I sense, however, that the procedures are necessary and not opted for, I may suggest that we do not begin care, as your best interests, as well as my reputation for success, are paramount goals that I do not wish to compromise. I look forward to continue in gaining your trust for your health needs in the coming year!