Chiropractic Treatment Chelmsford MADr. Mark Chiungos
Chiropractic treatment by licensure and philosophy is drugless and noninvasive (non-surgical). Chiropractors use manipulation (adjustment) as their primary tool. Manipulation is the skillful act of introducing a controlled and practiced force either manually (Chiropractic means performed with the hands) or instrument into a joint (Two bones with separated by cartilage). The goal being restoration of proper movement and function with a decrease or complete reduction of the signs and symptoms of inflammation. In many states Chiropractors are also allowed to use other modalities such as Ice, heat, ultrasound, traction, laser to aid in the reduction of the symptoms caused by subluxation. Chiropractic is very safe. One excellent measuring stick of safety is how much Chiropractors pay in Malpractice insurance compared to other medical professionals. Insurance Professionals assign cost after careful analysis of the history of risks and complications involved in any professional procedures. Chiropractic Malpractice cost is slightly more than Massage Therapy and magnitudes less than even your Primary Care Practitioner. It’s about risk; on occasion some temporary soreness and/or stiffness may occur; less frequently aggravation of presenting symptoms or initiation of new symptoms; rarely bruising, swelling, even more rare separation/fracture; and extremely rare, nerve or vascular injury may occur in conjunction with the process of a Chiropractic Adjustment.
Phases of Chiropractic Treatment
In my Model I look at chiropractic Treatment in two phases; Acute and Chronic. In the acute phase a patient would present with symptoms of Inflammation associated with tissue damage; rubor (redness) Calor (Heat), Tumor (swelling), dolor (pain) and functio laesa (loss of function). This phase applies to first time injuries of the spine as well as exacerbations (reaggravation) of past spinal injuries. In a chronic phase (non acute) There may or may not be subtle signs of Inflammation. The past history of the patient is often checkered with moderate to severe episodes of spinal pain. X-rays may show areas of spinal degeneration or poor positioning and MRI’s will often show fatty infiltration in what used to be healthy tissue. The patient has a clear lay understanding that there is a good chance, left untreated, that moderate to severe episodes of acute pain are more likely in their case versus a person who has never had pain of spinal.
Strategies, protocols and goals are fairly clear for both phases of treatment. Acute Phase; reduce inflammation and restore proper motion and function by manipulation supported by ice or modalities that mimic it. Chiropractors may even take on the dual role of Physical Therapist by introducing and monitoring exercise. I personally do not as there are many great professionals I can point my patients towards if they are so inclined. The acute phase typically has an initial incident followed by care with the goal of releasing the patient appropriately to resume normal activities. This care is typically covered by third-party insurers as medically necessary. There are limits to benefits that need to be discussed before care begins.
Chronic Phase; reduce stiffness and symptoms of degenerative joint disease and restore proper motion and function by manipulation supported by heat or modalities that mimic it. This is the area dominates my practice. It is currently thought that often following acute episodes of pain due to spinal origins that permanent damage to the cartilage, capsules, muscles and boney structures can cause degeneration of the physical structures and improper reprogramming occurs at the spine, cord and central nervous system predisposing the patient to reoccurrences of the problem often increasing in severity and duration. This population seems to benefit from regularly scheduled adjustments known as maintenance, supportive or Palliative care. Typically, not covered by any third-party insurer.
Chiropractic Treatment Plans
Chiropractic treatment planning is a dynamic process. Recovery is often accelerated or decelerated by the patients’ health status; smoking, diabetes, arthritis, diet, age, activity level are just a few of the factors that influence recovery. I understand this and do not have a one size fits all approach to scheduling treatment. I prefer to see a patient twice a week for two to three weeks initially. Once I see progress I test for stability of gain by adding more time between visits. I adjust accordingly at each visit based upon what I hear as well as see and feel. I believe this saves the patient, myself and the healthcare system money in the long run.