Chiropractic adjustment causes stroke, really?

According to the recently published Medline Plus article, August 7, 2014, Could Chiropractic Manipulation of Your Neck Trigger A Stroke?, Dr. Jose Biller, chair of neurology at Loyola University Chicago Stritch School of Medicine, stated, We strongly believe that patients should be informed of this association before undergoing neck manipulation.”

OK, So I have been a chiropractor for almost 20 years, I know about 50 chiropractors personally.  Have worked with a half dozen or so.  I have done thousands of neck adjustments and I taught and evaluated technique at a major Chiropractic College so I feel I know a thing or two about adjustments.   So if you figure in all those adjustments I figure that HAS to be way over 1,000,000 adjustments to the neck, and yet I have never heard of one incident.*

Every month or so someone will come to me and tell me that their friend’s father’s neighbor’s uncle had a stroke from a chiropractor.  Seriously??.  This happens at least once a month.  Never is it the person I have spoken to or someone they directly KNOW.  It got me to thinking, so I looked up everything I could about strokes, CVAs, dissections, etc on the web.  Lots of passionate info on the ‘evil’ chiropractic adjustment.  Not one MRI, CT, Coroner’s report, or other documentation.  It seems that with that kind of problem there would at least be something… NOPE.

So, if you are reading this and HAVE info, please send it to me.  I would be a great supporter of change to chiropractic and neck manipulations… But keep this in mind.

Even if they do happen (I believe they can and do occur, but not at a ‘significant’ rate to muster an outcry).  I do also believe.  Now (* see above)  an ‘incident’ would be something serious.  The stroke, Cerebro-vascular accident, carotid or vertebral artery dissection, even a hematoma would be significant.   However, sometimes people do suffer pain, stiffness, achy-ness, dizziness, lightheaded-ness after an adjustment.  That, in my experience,  is also rather rare.

Let’s look at this another way.  An anesthesiologist’s mal-practice insurance is almost as much as I can make in a year.  (around $60,000, go ahead, look it up.)  and like car insurance, the rates go up with more risk.  Ever insure a kid?   A General Practitioner’s (your average family care MD) insurance is about $8,000.00 a year.  Now get this… for me, my insurance is about as much as you would pay for liability on a 1998 Nissan minivan.  Yup, just over $1,000.00  THAT is a YEAR.  for the same limits as the GP (MD).  So do the math.  The insurance company does not love chiropractic more or less than any other profession, nor do they give any discounts to make it lower than the insurance for an MD.   It’s all about that math…

OK, so our insurance is low, really low.  That should be an indicator of risk.  I can find no police reports, coroner’s reports, mal-practice claims that discuss stroke either.  (SEND ME ONE IF YOU HAVE IT) Seems those that are up in arms about this would have some hard documentation. Although there is what seems to be a valid case from Canada, but that was years ago.   ( If it is true, it still is a very tragic and terrible thing to have happened…)

In summary, I think I am a good person, vigilant about my art and science of chiropractic, I love and care for people and would NEVER do anything that I would think could harm my fellows.  I would tend to believe I am a rather average personality in chiropractic and not over cautious or over zealous, neither are any of the 50+ I know and have worked with.

I would imagine that if anyone had a stroke it would be all over the news, right?  It is such a rare event I would think it would get a lot of press.   Nothing… Try looking it up.

Let me know if you know something I don’t.  Send me the documentation.  I really want to know.  Of course we would need to change some protocols if it is a fact that CHIROPRACTORS giving CHIROPRACTIC adjustments are doing this.  We can change, we definitely would change.  We love our patients and have not only taken an oath to help but also sincerely care for our patients.

I would take out cases done by Osteopaths, Massage Therapists, Friends, That ‘guy’ at the gym, Trainers, Hair stylists, MMA fighters, any one that is drunk, Martial Arts teachers, Acupuncturists, Physical Therapists and the whole shebang that THINK they can do a chiropractic adjustment.   Not the same technique nor the same forces involved in the same vectors etc.  (I can go over that another time.)

So here is my stand.  Yes they (strokes) can happen from a chiropractic adjustment.  Yes, that is tragic, an accident, largely unforeseeable.  Preventable?  Mostly.  There is ALWAYS an exception to the rule,  unfortunately.   From negligence?  mostly no. Does there have to be legislation?  no, go after something big first, something that is really causing problems with the public in real significant numbers like prescription anti-depressants or pain killers and suicides.

Am I going to change how I work?  no.  I am tedious in checking patients, I  treat each one gently.  My technique is solid and I am confident not harmful.   Should there be studies?  Yes, you betcha.  However you might find out they are more helpful than you feared, tread lightly, and do good scientific study.

 

Nuff said.

Dr. Sean

 

 

 

 

 

A remedy for General Anxiety Disorder with Acupuncture and Meditation

Meditation training and acupuncture for anxiety, panic attacks, stress, and worry…

Acupuncture treatments are well known to facilitate relaxation and whole body harmony.  Meditation can enhance the effectiveness of that effect as well as train you to see anxiety rising in your body and give you effective and realistic tools to stop it in its tracks.  We find that worry, stress, and anxiety are common in today’s world.  We also have discovered that if you practice being upset, worried, or stressed you will automatically ‘go there’ when something occurs that is either out of your control or not what you wanted at the time.  Meditation PRACTICE allows us and trains us to see and be in the world in this present moment and to become aware of the changes in our minds and bodies.  With this powerful practice we can better control and guide our minds to live the life we want and deserve.  Not to become a slave to our ‘gut’.

Acupuncture has a very specific set of points that can change person to person for stress, anxiety, depression, worry, and panic disorders.  Once we have determined the pattern you are in, this therapy does not help you identify the cause but instead realize and acknowledge the process and stop it before it ramps up to a full blown episode.  With a few treatments you can start to feel calm much more of the time, feel balanced, centered and in control.  Therapy will give you the why’s we work on HOW you are going to manage and get through it, effectively.

The trend I am seeing in my practice is a large number of people diagnosed with GAD or some other similar syndrome.  They tell their medical doctor and promptly get a prescription that can last as long as eight months, just to start.  Few are going to a therapist.  I find therapy is helpful to some, but many times it is like archaeology, it digs deep into your past and re-lives and re-ponders the old problems rather than develop a strategy to cope and control the effects.  Stress happens to everyone, EVERYONE.  It is the response that can get out of control. This is why some people have panic attacks and others do not.  It is a ‘timing’ problem, not a coping problem.  The body gets into a pattern and every time the initial stimulus starts we begin a cascade of stress and release of hormones.  The Vagus nerve then reads that as a major problem which releases more stress hormones and the event begins.  If you let it go, you have a full blown panic attack.  If you can catch it in its earliest stages, you can stop it or at least buffer it.

The course of treatment lasts four months (about half the time of a medication regime).  Twice a week meditation and acupuncture in a safe, calm relaxing environment with an anchoring essential oil formula you can take with you.  The meditation practice will start with tuning into your body while in an acupuncture treatment session, appreciating and really understanding what it IS to BE relaxed.  Guided meditation, specific to YOU is offered along with techniques to use at home and work to enhance the benefit of being HERE NOW…  Total cost for the four months is $1000.00  as a discounted package, to go through the entire program is essential, as it is a practice of the mind and body,  would cost about $2,000.00.  ($60 per acupuncture treatment with personalized essential oil for grounding ($15), then guided meditations while you are getting treatment ($49) each)  The schedule is a minimum of twice a week for up to an hour each session, with the gradual decrease in frequency after the second month to no less than once a week. After the fourth month, maintenance is highly recommended on a once a month basis. (billed separately)

Post Surgical Chiropractic Treatment?

Most of my practice as a chiropractor over the past 17 years has been to keep people from getting surgery.  I have to say, I have been pretty successful with that.   I have had only three patients that had low back pain so bad that conservative care did not help.   All three worked very hard at educating themselves, sticking to their protocols and schedules and really attempted to beat the odds of having the operation.  Although I did not feel like a failure for ‘letting’ them get the operations, I did feel responsible for their well being and helped them research different options to find the right surgical procedure for them.

This of course consisted of advice on which questions to ask the surgeon and whether they should have a neurologist or an orthopedist do the job.  In my opinion, I would always have them go for the neurologist surgeon.  They are far more ‘dainty’ in their work and are interested in the details of the operation.

Now that the ‘Silver Tsunami’ has begun, I find many patients come to me with back pain, forget they had surgery 35 years ago and want treatment.  When they are on the table, I see scar tissue on their lower back and, well, the whole plan changes.   Not that I turn them away, but a whole new list of questions begins, reviews of x-rays, detailed history and real detailed functional capacity evaluations begin.  I want to know if I could even help them at all.  I can improve range of motion with training, adjustments to the spine and extremities where there was no surgical changes.  I can teach them stretches and modifications of their work stations/situations that help etc…

What I cannot do is change the surgical area.

What can be done to a post surgical patient depends on the type, extent, and age of the surgery, the scar tissue that has inevitably built up, the current level of flexibility and general health of the patient and more…

There are a couple scenarios I have come across in my practice that deserve review and explanation to get the point across.

1. Let’s call him ‘John Q’.  John had surgery for lumbar scoliosis in his early 20s, a Harrington rod on each side of his spine was surgically bolted to the vertebrae in his lumbar and thoracic spines and a keloid  scar went from between his shoulder blades to his sacrum.  His spine was as straight as an arrow!  (better have been).  He had good range of motion and could almost touch the ground with forward bending but rotation and side bending were reduced.  His complaint was upper back pain, ache in his thoracic and lumbar areas as well as pain in the rump on the right.  After sending him for his full physical and new x-rays to see if the rods had broken (yes, it happens…) we got to work.  Hmmmm… Cannot adjust where the rods are… but can work on the Sacrum, Ilium, neck and upper thoracic spine.  OK, ok, wait a minute… why the neck?  Let’s leave that for a whole other time, but the quick and dirty is that the whole body wants to and has to work together to get you easily through space and time.  The neck will try to loosen to make up for differences elsewhere etc…

So what did we do?

This is what worked…

1. Massage to the muscles of the whole spine, including trigger point work and work on the keloid scar on his back with Arnica extract oil.

2. Chiropractic adjustments to the Sacro-iliac joints with S.O.T. blocking and Full-Spine style hands on adjustments.

3. Chiropractic adjustments and therapies to the neck to improve (His unique) alignment, and reduce muscle tension.

4. Stretches and exercises to improve over all flexibility, strength and stability.

This took only a couple weeks to see real subjective improvement.  His neck regained stability and motion, his scar softened and did not hurt, his back no longer ached.

There is no possibility of ‘correcting’ the curve of  someone that has had this type of surgery, and trying to go for that ‘text book’ range of motion and alignment would only make John much worse.  He was released from any ‘active care’ and was taught that when his own ‘tricks’ and exercises do not give relief, he should seek massage and chiropractic care.  It works for him quite well.  His quality of life is maintained and stress is reduced, his whole outlook got better because there WAS HOPE and someone to LOOK and figure out what could work.  He was told his life would be painful and that he should just accept it.   Nahhhhh… c’mon.  We did it…

The next case example…

Sue, we’ll call her.  A 50 something exec, lots of travel for work.  History of laminectomy one year prior.  Scars almost invisible (great arthroscopic work!)  Pain comes and goes, very tight quads, back muscles as well as rump muscles.  Good range of motion overall.  Pain gets so bad she must frequently get up from sitting, lying down, has to take muscle relaxants and pain pills to get through the day.  Other providers were more than happy to supply her with great drugs, and tell her ‘that’s the way it’s going to be, so take your meds.  Imagine how bad it would have been without the surgery?!’  (Her pain levels and patterns were very close to those from before surgery*)

OK, this one was easy, we had no hardware to deal with and adjusting her lower spine was easy in the prone position, pain was usually relieved immediately.  We gave her stretches for her hips, back, knees, and helped her learn to lift again with her back care in mind.  She required visits after or before most trips and occasional care here and there to keep her pain free and mobile.

SO, what did we do with both of these people?

We did not use special machines, lasers, muscle stim, ultrasound, gizmos, gadgets, elixirs, potions, medications or anything like that… we used TLC, hands on care, and Education.

There are simple stretches for the low back that have worked in 10 of 11 cases when done, there are simple and easy

*Failed Back Surgery (see more) http://www.ncbi.nlm.nih.gov/pubmed/21463472

27 reasons you SHOULD get an x-ray…

First of all, we do not have an x-ray machine in our chiropractic office.  I generally send patients out for needed films or studies, and only for the most obvious reasons (the ones I have listed below).

Having an x-ray is a great idea, you get the ‘inside’ info.  There is a lot one can tell just from an x-ray.  Of course an MRI or CT scan is better for some problems.  If you have recent x-rays (any in the past year or so) you do not need new ones unless things worsen or don’t get better as expected.   I always suggest that people immediately get a copy of their study so they can keep it in their own file.  Do not rely on the office you had the films done to have the time or interest in getting you copies at a later date.  That is too much of a hassle.  Bring them to me, I will go over them WITH you… answer all your questions and explain it all… (I used to teach and tutor x-ray evaluation in Chiropractic College)

Reasons that YOU should want to see an x-ray are:

1. Abnormal posture- you are bent over, in pain, cant move well… a good idea to see what is ‘twisted’ or ‘off kilter’
2. Partial dislocation/subluxation of spine-(or any joint)
3. Spinal deformity/ posture- this is upon closer inspection, lumps bumps, etc…
4. Trauma- possible fracture or dislocation.
5. Birth trauma…(a whole new blog is coming on this)
6. Restricted or abnormal range of motion-
7. Abnormal gait- if you are limping significantly, and don’t have a good reason why.
8. Axial pain (pain along the mid line of the body.)
9. Radiating pain-Pain that starts somewhere and travels down an arm or leg, could be something in the spine.
10. Headache- not just any headache… usually from trauma, or one that is ‘the worst you have ever had’
11. Short leg/ pelvis imbalance- see gait,
12. Spinal instability-when your spine clunks or clicks a lot… even with just normal movement.
13. Follow up of deformity-If you HAD a deformity and it went away…
14. Suspected osteoporosis- age, gender, race, activity level, and other factors determine this.
15. Facial pain- deep pain
16. Systemic health problems-diabetes, asthma.
17. Neurological conditions-numbness tingling, ache, inability to move, weakness…
18. Delayed developmental conditions
19. Eye or vision problems-related to a headache, neck pain, etc. not from strain or too much time at a computer.
20. Hearing disorders-related to trauma, headache, neck pain.
21. Spasm, tenderness- that will not go away.
22. Abnormal pelvic morphology- If your hips are messed up, we need to see this area…
23. post surgical evaluation- we want to see exactly what was done and what scar tissue there is.
24. spinal degeneration and arthritis- (also other areas) see OLD fractures too…
25. Congenital anomalies-a thing or problem you were born with.
26. Pain upon spinal movement-
27 Red flag conditions. Pain that wakes you at night, cough that won’t go away, etc… we have to check and make sure there are no tumors, infections, cancer, etc.

Now, not to scare the heck out of people but fracture is not the first thing you are looking for, sometimes we look for infection, tumors and other things.

Live well, be well… Remember motion is life!  so get moving.

Dr. Sean H. Thompson, Chiropractor, Acupuncturist

Natural BodyWorks Treatment Director

Parker Colorado

Case Study for Chiropractic care of a bad back.

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Tom’s back all out of whack:  Tom, a 43 year old insurance salesman, slipped and fell two days ago while brushing snow off his car.  His low back popped and he had immediate pain.  Later the pain turned into spasms with some pain going into his right rump, he could not sleep well and sitting made the pain worse. 

Tom came in bent over from pain and had a hard time getting on the table for me to check him.  We performed some basic exams just like you would have at an orthopedic surgeon or neurologist’s office, and was able to relax him with some emergency care so he could lie on the table and get some treatment.

We determined that a lumbar (lower back) disc was injured and swelling causing his pain and muscle spasms.  This affected his lower back, rump and thigh muscles.

Immediately we were able to start therapy to loosen the muscles and relax the nerves.  Once he was loosened enough we were able to do some gentle adjustments (without twisting his back). 

We heard two distinct pops in his lower back which relieved his pain and spasm by almost 50% on the first visit. At his next appointment he related he had been sore but a little better.  Tom has only needed three weeks of care to be 90% pain free, walking straight up again, and now has no pain in his rump area.    

Simple and concise adjustments to the spine can replace a joint that is locked in the wrong place, being the result and cause of spasms.   Tom may have future low back stiffness, he gets treatments each month or so to help him maintain flexibility and muscle looseness.  He also does the stretches we taught him. 

If you know someone like Tom, please give them our phone number so we can help them get back to their lives.