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Breaking Down the Braces Used to Correct Scoliosis

Scoliosis is easily recognized in children and developing young adults. Caught early enough, modern correction systems offer enough relief to all but erase the condition, leaving behind a well-formed spinal curve. But aside from early identification, the right course of corrective action is crucial.

Ideal Spine urges chiropractors to not only understand bracing for scoliosis, but to get familiar with the three main types of braces. Understanding their application, pros and cons, and modality for correcting scoliosis helps inform a higher level of patient care.

Take a look at the three chief types of scoliosis brace: The Boston Brace, the Charleston Bending Brace, and the Milwaukee Brace.

Boston Brace

The Boston Brace is a form of Thoraco-Lumbo-Sacral-Orthosis (TLSO) brace, meaning it has total contact with the torso. The brace is made from a cast of the patient’s trunk to ensure conformity and adjusted over time to restore proper curvature to the spine. It’s designed to hold a 20° to 45° advancing curve. Key correction points are molded into the brace for easy adjustment and braces don’t need to be re-cast as corrections take hold.

This brace lacks the metal support structure of the Milwaukee Brace, which means it can be worn under clothing without drawing much attention. This brace should be worn 16-23 hours per day. This brace is not suited for high thoracic or cervical deformations.

Milwaukee Brace

Now relatively antiquated thanks to advancements in materials and the lower-profile design of the Boston Brace, the Milwaukee Brace is nonetheless an important tool in correcting severe adolescent scoliosis. A Cervico-Thoraco-Lumbo-Sacral-Orthosis (CTLSO) brace, it’s another type of full-contact brace that must be worn up to 23 hours per day.

The Milwaukee Brace is recognized for its metal neck ring for added stabilization of the cervical spine. It’s designed to hold a 25° to 45° advancing curve. And though some custom braces are used to correct scoliosis, the Milwaukee brace is more of a preventive approach to stopping ongoing misalignment. Its heavy-duty nature makes it more applicable in severe cases still developing.

Charleston Bending Brace

Also known as the “nighttime brace,” the Charleston Bending Brace is minimally invasive and only needs to be worn at night. It’s asymmetrical design naturally forces a developing spine back into alignment by offsetting the compensation caused by scoliosis. Due to its lightweight nature, it’s generally only prescribed to correct a 25° to 35° advancing curve.

The Charleston Bending Brace is primarily effective in children who haven’t reached peak developmental maturity yet—usually 12-14 years old.

Stopping scoliosis with the right brace

These three braces serve as the foundational tools for correcting scoliosis in varying degrees of severity. Other braces do exist – the Chêneau-Gensingen Brace, Silicon Valley Brace, and the SpineCor brace, for example – but they simply haven’t had the same degree of proven success as the three mentioned above.

Ideal Spine recommends thoroughly assessing the severity of a patient’s scoliosis, looking at their age and medical history, and mapping a correctional Chiropractic BioPhysics (CBP) approach before outfitting a patient with a brace. To learn more about scoliosis bracing or for more information about the CBP approach, contact us today.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Here’s Why Patient History is a Cornerstone of Chiropractic

Many patients visit a chiropractor with a certain expectation of how the visit will go. They’ll lay down on the table while the chiropractor palpates their spine, pushing and pulling specific areas. They’ll hear pops and cracks, and feel their tension go away. And when they stand up, they’ll magically feel better!

Based on this generalization of chiropractic, it’s easy to see why patients can become uncomfortable when things don’t go this way. When the first thing a chiropractor does is ask them about their medical history, many patients can even become evasive.

At Ideal Spine, we believe patient education starts the moment someone walks into a clinic. In many cases, this means dispelling preconceived notions. To do that, patients need to understand why things aren’t going the way they expect.

Explain the nature of holistic medicine

Have you had any recent surgeries? Do you have any history of chronic pain? What medications are you taking? On the surface, to a patient, none of these questions have anything to do with chiropractic. Explain why you’re asking them and what they mean for the eventual delivery of care.

Patients need to understand that their medical histories are important for how treatment will progress. A chiropractor can’t perform the same adjustments on a senior with osteoporosis that they do on a middle-aged athlete. Likewise, someone recovering from a recent surgery may not have the range of motion they otherwise would.

Patient history prevents false starts in the treatment plan. More importantly, it protects patients from uniformed diagnoses and adjustments.

The best way to explain this is by explaining the nature of holistic medicine. An adjustment here could result in X, Y, or Z, depending on the factors at play. Having vital medical history information eliminates the unknowns, so a chiropractor can solve for X, Y, or Z – whatever will provide the best outcome for the patient.

The more you know, the more you help

If a patient complains of neck pain, a doctor’s first instinct isn’t going to be to prescribe surgery. Instead, they’re going to do a full exam, ask questions, and try to qualify the source and intensity of the pain. Visiting a chiropractor is no different, and medical history plays a vital role.

Neck pain, for example, is a broad concern. Getting as much information as possible speeds up a chiropractor’s diagnosis and ensures the right course of action is taken. Patients may not realize it, but that whiplash accident they had last year may only now be manifesting symptoms. Or, the shoulder surgery they had five years ago may have limited their range of motion, affecting the musculature around the cervical spine. The chronic plantar fasciitis they’ve been self-medicating for years may have caused instability in the lumbar spine, finally affecting the cervical spine. The list goes on and on.

Every piece of information is vital in putting together the puzzle of patient pain. The biggest contributor of information is patient history – both formally documented and informally told.

Set the precedent of informed care

In getting new patients to be forthcoming with important information, chiropractors need to break stereotypes and encourage patient education. A visit to the chiropractor is not random adjustments and audible pops – it’s a collaboration between patient and chiropractor that leads to informed care.

When patients understand how their medical history informs their care, they’ll recognize the importance of sharing it.

Ideal Spine advocates informed patient care through a structured Chiropractic BioPhysics (CBP) approach. For more information about CBP or for more tips on how to deliver world-class chiropractic care, contact us today.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Teaching Activity Modification Requires Constant Reinforcement

Humans are largely creatures of habit. It can be difficult to influence people to change the way they do things, particularly when they have years of a under their belts.

Chiropractors often experience this challenge with patients who require activity modification to prevent pain and amplify healing due to an injury or chronic condition. Enforcing non-damaging movements in patients outside the chiropractic office can be difficult.

This is why the team at Ideal Spine suggests chiropractors practice constant reinforcement when it comes to activity modification – particularly for patients with chronic problems in which harmful motions may cause lasting damage.

What is activity modification?

Activity modification represents a temporary change in the way everyday activities are performed. This is usually necessary to prevent future or further injury of the spine and nervous system following the identification of an injury or weakness.

Teaching patients about activity modification also helps them continue moving, in spite of fear of pain. It is an important aspect of at-home care. Patients should learn which movements to avoid, as they can put additional stress on the injured area, and ways to accomplish similar tasks without the added stress or pain.

Activity modification will not cure the patient’s ailments, but it may result in a reduction of symptoms – sometimes this reduction can be significant enough that the patient feels like their condition is gone. The goal is to help the patient to live as free of pain as possible and allow the body to heal.

During activity medication, patients should stay active to maintain adequate function and range of motion. Activity modification does not require complete rest or inactivity. In fact, too little activity may result in a worsened condition or the development of another problem, such as muscled degradation.

However, slight changes in movements to accommodate for symptoms may help the body heal from its injury and naturally ease symptoms over time – particularly inflammation.

Reinforcing modification methods to patients

Activity modification is usually only recommended for short periods of time – it is not a necessary life-long adjustment. However, this short timespan can work against patients who forget to make the modifications and instead continue to engage in potentially painful or damaging movements.

For patients with chronic problems, such as osteoarthritis, activity modification may need to be a more long-term care strategy.

Because activity modification is largely an at-home treatment method, chiropractors must work with their patients to reinforce the modifications during their appointments. The use of in-office demonstrations, pamphlets, videos, and discussions may help influence patients to use the modifications in their day to day lives.

It may help to provide patients with an approved list of motions and exercises they should focus on to maintain mobility. Emphasizing routine completion of the correct motions may overshadow the warnings against improper ones and successfully influence the activity modification.

Without the adequate completion and reinforcement of activity modification, patients may continue to do actions that worsen their injuries and prevent the body from healing completely.

Of course, activity modification is just one aspect of a much larger treatment plan for a variety of musculoskeletal problems. The team at Ideal Spine helps chiropractors implement the holistic treatments of Chiropractic BioPhysics (CBP) in their practices for a more comprehensive approach to patient wellness.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Testing for Range of Motion Diminished by Ankylosing Spondylitis

Back pain is a common complaint of chiropractic patients today, but certain conditions cause more unique symptoms that give professionals a better idea of what they are dealing with. In the case of ankylosing spondylitis, a very limited range of motion in the back and pelvis after persistent pain is sometimes enough to clue chiropractors in to the specific condition.

Limited range of motion can be damaging to patients. At Ideal Spine, we encourage chiropractors to become skilled at identifying range of motion loss as well as in treating it through varied methods to improve each patient’s quality of life. In order to do this effectively, thorough testing is required.

How ankylosing spondylitis affects range of motion

Ankylosing spondylitis is a type of arthritis largely affecting the spine. It can cause significant inflammation along the spine, resulting in stiffness in the back, as well as potentially in the knees, hips, and shoulders.

Persistent inflammation from ankylosing spondylitis often causes the joints and vertebrae to actually fuse together over time. This is due to the body’s healing response as it grows new bone and scar tissue at the inflamed areas of the spine. These fusions are usually weak but can cause rigidity in the spine, preventing flexible movement. Not all patients will experience this severe form of the condition, but many do.

Both the inflammation and the fusion can have a negative impact on the patient’s range of motion, prohibiting complete movement in one or multiple directions.

Identifying poor range of motion in your practice

When a patient is suspected to suffer from ankylosing spondylitis, it’s important to begin by testing their current range of motion capabilities. This provides a baseline before you create a treatment plan to potentially improve the conditions in the spine.

By evaluating the degree of mobility in different segments of the body – including the trunk, shoulders, hips, and knees – you may be able to tell almost immediately where the patient experiences symptoms of the condition the most.

Have the patient walk, sit, squat, and bend forward and backward as part of this testing, since many patients experience pain and stiffness around the sacroiliac (SI) joints. The areas of pain and those with limited movement will be the ones that should be targeted, in particular – particularly if the range of motion loss interferes with daily life.

Additional scans may be necessary to truly determine where new bone growth and fusion may be significantly hindering range of motion, versus where inflammation is merely causing stiffness.

Treatments for addressing ankylosing spondylitis mobility problems

There is no cure for ankylosing spondylitis, so a treatment plan using Chiropractic BioPhysics (CBP) methods is generally the best possible response. The earlier the condition is discovered, the more easily treatment may be able to stall symptoms. It can be difficult to ease more severe symptoms brought on by years of fusion and stiffness from the chronic inflammation.

Most chiropractic ankylosing spondylitis treatment plans include routine exercises and stretches to help stabilize the spine, strengthen muscles to support the spine and joints, and increase flexibility.

Rotating and moving certain body parts may be tough for people with ankylosing spondylitis, particularly in the hips and pelvic region. Slow but persistent stretching may help improve the range of motions in these and other areas, potentially alleviating discomfort while the patient moves.

By implementing Ideal Spine’s holistic approached to chiropractic testing and treatment, you may be able to significantly increase your ankylosing spondylitis patients’ mobility and comfort.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Linking Signs of Depression with Poor Spine Health

Even though depression is a disease rooted in the chemical makeup of the brain, it has close connections with the physical health of the rest of the body – including the back. Things like chronic pain and poor spine health can take a toll on mental health, potentially causing depression.

But what many people don’t realize is that the reverse can also be true. Depression may be able to create problems within the body.

The chiropractic experts at Ideal Spine teach the treatment methods of Chiropractic BioPhysics (CBP), a holistic approach to patient care. Part of this holistic course of treatment involves considering more than the physical when it comes to the spine – looking for signs of mental illness that may impact the health and healing process of patients with spinal conditions.

Chronic pain and depression

People who suffer from chronic conditions of the spine and nervous system may be more likely to develop depression. Suffering from chronic pain can be extremely isolating, which is also linked to depression. Additionally, living in consistent pain can create feelings of worthlessness and misery, as well as persistent irritability.

Chiropractors should be aware of this when speaking with their patients and creating treatment plans. Part of a holistic treatment plan may include therapy for the mind as well as the body.

Depression leading to back pain

Studies have also indicated people with existing depression may be up to four times as likely to develop back and neck pain as people without. It is not completely known why this occurs. There are many causes of depression, as well as many causes of back pain, and the combination of multiple factors may heighten feelings of pain over time.

Some signs of depression may contribute to or perpetuate back pain. One is lethargy or fatigue, which may lead to a decrease in physical activity and stretching. This can weaken the muscles surrounding the spine, potentially leading to subluxations or misalignments. It may also result in stiffness and tension in the muscles and joints of the spine, causing pain.

The link between the brain and body may also result in heightened sensations of pain due to inflammation. When the brain does not feel good, the body is unlikely to, as well, possibly worsening pain symptoms and causing depression patients to complain of back problems.

Helping patients with back pain and depression

Although chiropractors are not trained in the inner workings of the mind, they may be able to provide help to patients who display signs of combined back pain and depression.

Patients with chronic musculoskeletal pain may be interested in learning more about the link between chronic pain and depression. Consider providing resources for therapy or support groups to help your patients cope with their conditions outside of your office.

Discussions and questionnaires may also help you identify an existing link between depression and back pain in patients.

A combination treatment plan can potentially improve your patient’s quality of life and may even put them on a more likely path toward healing. For more information regarding holistic treatment of depression and poor spine health, contact Ideal Spine and learn from our spinal experts.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Distance Runners and Endurance Athletes Need to Keep a Standing Chiropractic Appointment

In the same way endurance athletes and runners should regularly visit an athletic trainer or a physical therapist to maintain good athletic performance, chiropractors should also urge their athletic clients to make routine visits for chiropractic adjustments and care.

Chiropractic has a lot to offer endurance athletes, from potential improved mobility to possibly relieving aches and pains due to consistent bodily stress. At Ideal Spine, we encourage chiropractors training in Chiropractic BioPhysics (CBP) methods to actively engage athletic patients and teach them how much chiropractic may be able to do for their performance and health.

Sustained periods of activity take a major toll on the body. Without a well-functioning nervous system and a properly aligned spine, the muscles, joints, and ligaments are less likely to perform their proper roles. This increases the risk of injury and may reduce overall performance.

Although the body is able to make up for tension or weakness by compensating during short periods of activity, long-term compensation of this kind may lead to more severe injury. It is much safer to resolve these problems and allow the body to function optimally prior to engaging in long periods of exercise as endurance runners, cyclists, and swimmers do.

Chiropractic benefits for endurance athletes

When discussing chiropractic care with patients who regularly engage in endurance activities, emphasize the potential benefits of routine visits.

  • Improve range of motion: A misaligned spine has the potential to significantly limit an athlete’s mobility and range of motion, whether in the shoulders, hips, or back. Pelvic misalignments are particularly common in runners and cyclists and can drastically alter the way they move. Routine chiropractic adjustments may resolve these misalignments, allowing the body to move more freely.
  • Reduce injury risk: By properly aligning the spine, chiropractic has the potential to ease mechanical loads on the body. In turn, this may reduce the risk of injury by alleviating the need for other body parts to compensate for tightness or weakness.
  • Relieve pain: If the athlete is experiencing pain in a particular area of the body that is the result of a misalignment or compensation, chiropractic may help alleviate pain and pave the way for healthier and pain-free movement as the patient continues to train.
  • Improve performance: Chiropractic adjustments may improve blood flow and lymphatic flow throughout the body, providing ample nutrients and oxygen to the muscles working hard during exercise. Combined with increased range of motion and reduced compensation, this improved flow may help improve the athlete’s overall performance.

Ways to help your athletic patients

Chiropractors have a range of tools in their arsenal to help endurance athletes feel better while training.

The most important method of care may be the chiropractic adjustment to correct misalignments and subluxations and restore optimal bodily positioning. This may require repeat treatment, due to the natural shifting of the spine after athletic activity.

Targeted massage may also be beneficial or even necessary to loosen tight muscles and allow the body to resume a natural position. Finally, chiropractors can use education, teaching their patients warmups and stretches they can do to ensure proper bodily alignment and preparedness before exercise.

Of course, a single chiropractic appointment is likely not enough to correct routine stress caused by endurance sports. To learn more about how to treat athletic patients in your practice, contact Ideal Spine.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Sagittal Cervical Alignment Outcomes Are Linked to Pain, Disability, and Neurophysiological Improvements

By: Deed E. Harrison, DC

Chronic cervical spine disorders is one of the leading causes of disability across nations and cultures.1 There exists an opinion in the spinal health literature that the presence and extent of the cervical sagittal plane curve is unrelated to spine pain conditions and patient health.2 However, in this author’s opinion, the number and quality of studies is weighted on the positive side of the equation; in other words, there is a correlation between neck pain and related disorders and the cervical curvature.3-6

Background Data Indicates That Cervical Spine Lordotic Curve Correlates to Neck Pain and Disability

Villavicencio et al,3 in their prospective, randomized, double-blind clinical study, enrolled 122 patients who were followed an average of 37.5 months. They3 identified that maintaining a consistent segmental sagittal alignment and increasing cervical lordosis was related to a higher degree of improvement in clinical outcomes as measured with the short-form 36 questionnaire and the neck disability index. Similar findings were identified in the study by Gum et al.4

Figure 1 demonstrates the normal state of the cervical lordotic curvature on the reading left, this person would be expected to have little to no neck related disorders. Then, the sequential loss of the cervical lordotic curve is shown in the consecutive images where progressive development of spinal arthritis and disc disease in different patients over time is shown (Levels 1-4).7

Figure 1. Image © Copyright CBP Seminars and Deed Harrison, LLC. Reprinted with Permission. All rights reserved.

Studies by CBP® Researchers Demonstrate Relationship to Chronic Pain

In two separate cervical spine investigations, McAviney and colleagues5 and Harrison et al.,6 compared the cervical lordosis in chronic neck pain populations to that in healthy participants without a history of neck pain or cervical spine trauma.

  • Statistically, persons whose cervical spine curves were below 20° were twice as likely to be in the chronic neck pain group. This finding was not age or gender dependent strengthening these findings.5,6
  • Participants with a straightened or reversed cervical curvatures were 18 TIMES more likely to be in the chronic neck pain group as compared to the non-pain group.5
  • Thus, a cervical lordosis less than 20° can be considered a type of cervical spine subluxation.

Randomized Trials Indicating Improved Pain, Disability, Neurophysiology

Recently, CBP researchers, lead by Professor Ibrahim Moustafa (Sharjah University, UAE) and Dr. Deed Harrison (CBP NonProfit-Idaho, USA) have completed a series of randomized clinical trials (RCT’s).8-11 These RCT’s were designed to test the hypothesis that structural correction of the cervical sagittal alignment will improve pain, disability, and neurophysiology measurements. Importantly, in two of the RCT’s it was found that restoration of the cervical lordosis towards the 20° magnitude concomitantly improved dermatomal somato-sensory evoked potentials (DSSEP’s)8 and the H-reflex9 in patients with both cervical spine and lumbo-sacral radiculopathy and chronic pain.

In two of the most recent RCT’s by this team of investigators,10-11 the effect of sagittal rehabilitation of the cervical spine on central nervous system latency (velocity) and amplitude was assessed. Correction of the cervical sagittal lordosis and head posture was found to statistically correlate to improvement central conduction time (spinal cord velocity) as measured with the N13-N20 potential. These two break-through RCT’s are the first studies to identify a statistically significant increase in the central nervous system’s conduction velocity resulting from correction of the subluxated cervical spine. Noteworthy, is the fact that traditional conservative interventions did not improve sagittal alignment and did not improve neurophysiology even though they were associated with temporary pain and disability improvements. Only the group receiving CBP extension traction methods were found to have statistically significant improvement in spine alignment, neurophysiology, and long-term pain and disability outcomes.8-11

References

  1. Noormohammadpour P. Prevalence of Chronic Neck Pain, Low Back Pain and Knee Pain and their Related Factors in Community-dwelling Adults in Iran: A Population-based National Study. Clin J Pain 2016 Jun 1.
  2. Christensen ST, Hartvigsen J. Spinal curves and health: a systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health. J Manipulative Physiol Ther. 2008 Nov-Dec;31(9):690-714. doi: 10.1016/j.jmpt.2008.10.004.
  3. Villavicencio AT, etal. Prospective, randomized, double-blind clinical study evaluating the correlation of clinical outcomes and cervical sagittal alignment. Neurosurgery 2011 May;68(5):1309-16; discussion 1316.DOI:10.1227/NEU.0b013e31820b51f3.
  4. Gum JL, et al. Correlation between cervical spine sagittal alignment and clinical outcome after anterior cervical discectomy and fusion. Am J Orthop (Belle Mead NJ) 2012 Jun;41(6):E81-4.
  5. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):187-93.
  6. Harrison DD, Harrison DE, Janik TJ, Cailliet R, Haas JW, Ferrantelli J, Holland B. Modeling of the Sagittal Cervical Spine as a Method to Discriminate Hypo-Lordosis: Results of Elliptical and Circular Modeling in 72 Asymptomatic Subjects, 52 Acute Neck Pain Subjects, and 70 Chronic Neck Pain Subjects. Spine 2004; 29:2485-2492.
  7. Harrison DE, Harrison DD, Janik TJ, Jones WE, Cailliet R, Normand M. Comparison of axial and flexural stresses in lordosis and three buckled modes of the cervical spine. Clin Biomech 2001; 16(4): 276-284.
  8. Moustafa IM, Diab AM, Ahmed A, Harrison DE. The efficacy of cervical lordosis rehabilitation for nerve root function, pain, and segmental motion in cervical spondylotic radiculopathy. PhysioTherapy 2011; 97 Supplement: 846-847. (Link)
  9. Moustafa IM, Diab AA, Harrison DE. Does improvement towards a normal cervical sagittal configuration aid in the management of lumbosacral radiculopathy: A randomized controlled trial Proceedings of the 13th World Federation of Chiropractic Biennial Congress / ECU Convention, Athens, Greece, May 13-16, 2015. Paper #184 Mediterranean Region Award Winning Paper.
  10. Moustafa IM, Diab AA, Taha S, Harrison DE. Addition of a Sagittal Cervical Posture Corrective Orthotic Device to a Multimodal Rehabilitation Program Improves Short- and Long-Term Outcomes in Patients with Discogenic Cervical Radiculopathy. Arch Phys Med Rehabil, 2016, 97: 2034-2044.
  11. Moustafa IM, Diab AAM, Taha S, Harrison DE. Demonstration of central conduction time and neuroplastic changes after cervical lordosis rehabilitation in asymptomatic subjects: A randomized, placebo-controlled trial. Proceedings of the 14th biennial congress of the World Federation of Chiropractic, March 15-18, 2017.

Helping Patients Understand their Neuropathy and its Causes

Pain is a hard thing for patients to understand. For them, pain is pain. They don’t care if it’s localized or referred, chronic or acute, nerve or muscle-based. They just want a solution that alleviates their pain and restores their quality of life. This is what makes explaining neuropathy so hard.

There’s often a gap in understanding between the explanation a chiropractor gives and a patient’s comprehension of what, exactly, neuropathy and neuropathic pain are. This further slides into a lack of understanding about how to treat or manage chronic pain. These misunderstandings often culminate in frustration when pain persists and chiropractic approaches are seemingly varied.

At Ideal Spine, we encourage a holistic explanation of neuropathy. Patients need to understand three very important factors:

  • Neuropathic pain is not localized; therefore, treatments won’t be localized;
  • Neuropathy has many symptoms and many causes, all of which require investigation;
  • Neuropathy may not be able to be cured, only managed.

Being upfront and honest about these critical factors will help set the expectation for patients seeking relief. They need to understand the process of assessing symptoms, understanding catalysts, and building a Chiropractic BioPhysics (CBP) plan to address them all.

Measuring the scope of pain

The first lesson for patients is an important one: Pain is much more than a feeling. Breaking the “pain is pain” generalization helps patients realize the holistic nature of the human body – specifically the central nervous system.

Take the time to help patients understand the concept of referred pain and why it occurs. Use their own situation as an example. Trace the chronic pain in their hands to a pinched nerve or explain how a vitamin deficiency has caused nerve inflammation.

Be sure to also emphasize that the nature of pain is a determinant for how to exercise relief. Nerve pain and muscle pain won’t respond to the same treatment, for example. Apply this and other aspects of pain understanding to patients to illustrate the scope of their pain.

Identify the cause of neuropathy

As mentioned, this is an arduous process that demands diligent investigation of all possible catalysts. CBP can help narrow the scope of focus through physical palpation, diagnostic imaging, and review of patients’ medical histories – but even a narrow scope still involves broad possibilities.

Explain to patients that investigation takes time and needs to be a collaborative process. A chiropractor can adjust treatments and explore options for relief; the patient must provide earnest feedback about how they feel and what works. It takes a comprehensive effort to identify the true cause of neuropathy.

Manage to the best of your abilities

In the mind of many patients, the story of pain has a definite conclusion once the catalyst is identified. That’s not always the case. Be honest and upfront about this with patients, while letting them know their CBP plan is tailored to deliver maximum relief and manage the intensity of the condition.

There’s a lot of misunderstanding about neuropathic pain and because of it, expectations don’t always line up. Ideal Spine encourages chiropractors to explore each patient’s situation with them thoroughly and set expectations upfront, so there’s clear direction and focus as you move forward with a CBP treatment schedule.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Advising on Chiropractic Manipulations Post Surgery

“I’ve just had surgery. Is it okay for me to visit a chiropractor?” This question and variations of it are some of the most-asked in the realm of chiropractic relief. It’s a great question and one that shows people are mindful of their health and recovery after an invasive procedure.

The answer varies among patients, but for the most part, chiropractic is generally considered safe for patients after surgery. If you’re able to resume light physical activity, you’re likely able to visit your chiropractor.

That said, Ideal Spine advocates exceptional caution when treating patients who have recently gone under the knife, regardless of their procedure. There are extra precautions and safeguards chiropractors must take to protect their patients from unnecessary stress and strain:

  • Inquire about the procedure: The type of surgery plays a big role in everything from recovery timeline to level of acceptable activity afterward. Chiropractors need to be aware of the nature of a surgical procedure to assess how to best treat their patient and avoid complications, aggravation of the injury, or unwanted side effects. Just keep in mind, chiropractors are subject to HIPAA compliance like any other caregiver.
  • Talk through the recovery: Have a candid conversation with patients about how their recovery is progressing. Ask about milestones, recovery timelines, their latest checkup, and how they feel. A good chiropractor will be able to gauge the feel of a recovery and it’s likely to affect the type of treatment they administer (or not administer).
  • Stay apprised of medical concerns: Does your patient have a heightened risk of injury due to an underlying chronic medical condition? Do they have a history of slow recovery after surgery? These things are important to know before treatment and need to be thoroughly evaluated by a diligent chiropractor. Because evaluation of medical history is part of the Chiropractic BioPhysics (CBP) approach, much of this information should come to light during the initial assessment phase.
  • Gauge thresholds: If you’re choosing to administer adjustments to a patient, take stock of their thresholds before diving into a full adjustment routine. Examine their range of motion and any pain associated with that movement. Also take into account variables like weight restrictions or limited mobility during the recovery process, both of which limit the range of adjustments that can be delivered.
  • Space appointments: Chiropractic, while healing, can take a toll on the body. When developing an adjustment schedule, be sure to accommodate surgical recovery times. For example, if a normal schedule calls for adjustments every 5 days, consider extending the recovery period to 7 to allow proper recuperation. Try to accommodate both the body’s increased need for recovery while staying aligned with optimal adjustment periods.
  • Encourage wellness and healing: Work with recovering patients to support their recovery not just through chiropractic, but traditional means as well. This may include advising on diet and light exercise, as well as supplementation or other gentle adjustments, like massage. Focus on recommending tips that improve blood flow and lower stress – both of which play into beneficial healing.

Chiropractic after surgery can be a beneficial support to the body’s natural healing processes, but only if undertaken properly. When developing a CBP plan for your patient, Ideal Spine recommends taking every precaution, including adhering to the tips mentioned above.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Teaching Activity Modification to Help Patients Cope with Chronic Pain

It’s the job of a good chiropractor not only to help correct a patient’s spinal alignment, but also to act in a proactive capacity. Diligent adjustments mean very little if the problem is recurring. Just like the objective of chiropractic is to treat the source, not the symptoms, so should the goal of every chiropractor be to treat the habit, not its effects. This starts with activity modification.

Activity is everything when it comes to long-term spinal health. Regardless of underlying medical conditions or lifestyle, variables like posture, ergonomics, and biomechanics are the prime determinants in spinal health. In realizing a recurring spinal problem, chiropractors need to trace it back to behavior enablers.

At Ideal Spine, we believe recognizing poor habits and teaching activity modification are core elements of holistic chiropractic. Giving patients the tools to preserve their spine health is the highest form of chiropractic excellence.

Identify the habit

Forward head posture. Anterior pelvic tilt. These conditions and many more are the flagrant signs of bad habits affecting spine health. Identifying these misaligned biomechanics is a chiropractor’s first clue in understanding why their patients continue to experience pain.

Bring these postural shifts and recurring problem to the attention of your patient. The first and best thing you can do is show them specifically what’s causing them grief. Then, extrapolate it. Trace forward head position to the poor posture of sitting at a disproportionate desk job with no ergonomic support. Then, show the strain of forward head position on the cervical spine, cervical nerves, shoulders, all the way down to the posterior chain.

This illumining experience sets the tone for severity and showcases the need for change. It’s the perfect preface for teaching activity modification.

Modify the habit

In addition to delivering precision adjustments to alleviate the effects of spinal misalignment, chiropractors also need to explicitly teach activity modification.

Using the example of forward head posture, it’s not enough to say “sit up straighter” or “get a better chair.” Have patients sit at a mock desk and physically show them the proper approach to correcting poor posture and mechanics. Touch the target areas for patients to be mindful of and explain the proper position relative to their habits.

Once patients are familiar with the shift that’s required to restore good mechanics, teach tips and habits that keep them mindful of these adjustments. This can include postural correction techniques, as well as stretching or lifestyle changes. It all adds up to activity modification, which breaks the cycle of chronic spinal misalignments.

Break the cycle

While delivering corrective relief is the primary role of a chiropractor, equally as important is teaching proactive wellness. Activity modification is a patient’s first line of defense against the habits responsible for their chronic pain and recurring problems.

Ideal Spine advocates a component of activity modification as part of a comprehensive Chiropractic BioPhysics plan. Teaching patients how to preserve the adjustments made and adopt long-term, healthy habits will reinforce overall wellness now and for the future.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.