I was hit by a truck last year, and two weeks afterward I was still getting severe back spasms ~20 times a day and had a lot of trouble moving. So I went to a Chiro. He laid me on the table twisted my hips to the side… and then body slammed me. No joke. There was a moment of panic when I realized what he was doing and I thought he was going to kill me. But it was fine, and the spasms went away.
2 words (whether neck or back)… Robin McKenzie…save yourself time and money.
I would never let a chiropractor touch my spine, especially my cervical spine. I just admitted a 30 year old patient to the ICU for a vertebral artery dissection that occurred during a ‘manipulation’. He died the next day. This complication is rare, but well documented.
Just remember, bulging discs are NOT on a surgical path. So DC, PT, etc. treatment are NOT help prevent surgery. They are causing Palliative benefit. Making it feel better, at most.
Just remember, bulging discs are NOT on a surgical path.
True, but I think the true definition of a buldge, herniation, sequestration of a vertebral disc is not common knowledge, and in most cases such as this thread they are treated like the same thing all under the umbrella of a disc buldge.
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True, BUT I am making the assumption that the bulging disc dx is accurrate for the purpose of this thread.
Your question was “anyone have good success”. Yes. I have a L4-L5 diffuse bulge. What helped me was a machine called DRX. (Decompression/traction to a specific area). Manual manipulation helped a bit but after 3 months I still had significant pain and my chiro suggested the DRX machine. 1 week into it and I was 90% pain free. Took another 2 months to get that last 10% but so far so good. Back to swimming, biking and core work. Hope to be running very soon. Check it out and see if it is an option for your issue.
try a physical therapist before the chiropractor - subluxations in the chiropractic sense have no relationship to bulging disks, and there’s no good evidence that manipulation can help. Though
http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107/DSECTION=why-its-done
says,
"In some studies, chiropractic adjustment proved to be as effective as other, more conventional treatments. "
PTs can show you how to minimize the pain, and know the exercises and stretches necessary for rehabilitation.
Also note the bulging disk may or may not be the source of the pain. I have the bulging L5-S1 disk, as does a significant fraction of the population over 40.
The Mayo Clinic’s information on bulging/herniated disks is at
http://www.mayoclinic.com/health/herniated-disk/DS00893/DSECTION=1
It’s been edited since my first reading of it. It used to say:
“most adults - as many as eight or nine in 10 - experience low-back pain at some point. A herniated disk, however, doesn’t always cause this pain. Disk herniation is often the result of a gradual, aging-related, degenerative process. These changes are part of the aging process and often occur without pain. Because of the natural course of disk degeneration, one-third of all adults age 20 and older show signs of disk abnormality. But only a small number of these people experience discomfort. The portion of the disk that herniates tends to shrink over time, and many cases show partial or complete shrinkage after six months to a year. About 90 percent of herniated lumbar disks get better without surgery.”
Sounds good, if it is a bulge there is good literature to support a Mckenzie approach, with the protocol determined by symptom behaviour based on repetitive lumbar movement.
Correct me if I am wrong Jayhawk, but diagnostics in this case such as MRI are not necessary unless frank neurological symptoms are present, or conservative treatment of sufficient duration is not successful.
I would never let a chiropractor touch my spine, especially my cervical spine. I just admitted a 30 year old patient to the ICU for a vertebral artery dissection that occurred during a ‘manipulation’. He died the next day. This complication is rare, but well documented.
Ditto what Marisol stated—do you really think the malpractice attorneys and insurance actuaries of the world are part of some vast conspiracy to keep my malpractice insurance rates so low??? They MUST be, because even here in the middle of litigious SoCal I pay probably less than 10% for the same coverage that you pay for. That certainly says something about the risks involved in my sort of treatment and practice.
As far as the case you mention, you’ve shown correlation, not causality. And from a correlation standpoint, the patient died after you admitted him/her, not after CMT. I’m not trying to be an ass (I seem to come by it naturally), but several studies—search PubMed for Haldeman et al—have shown that while patients do suffer stroke following visits to chiropractors, a larger percentage/proportion suffer them following visits to general practitioners and an even larger group without visiting either type of health care pro.
I am assuming you’re a DC. If you can’t tell Im an MD. My treatment can and do have complications! BUT, for you to use THAT logic in youre defense of this case illustrates the reason why many physicians dont treat DCs well. Come on…
I never went to a chiro for my lower back and had a herniated disk, PT and swimming made it better. When I hurt my thoraxic area, and had tried conventional medicine and PT for 6 months, my doctor recommended a Chiro for me that they felt would not cause damage. A practice that was conservative.
For me it definetly helped. I saw a large improvement over a few months. My only complaint is they want to keep you coming back every month for for maintenance, but I really saw no benefit to that and I don’t believe studies prove “maintenance” to be effective either. Basically, they figured out how many visits my insurance would pay for a year and made a schedule. I tried that for about a year and stopped coming when I saw no further improvement.
The funny thing about this statement is that the natural history of a disk herniation is that it will eventually improve over time (or need surgical intervention, shudder). I herniated L4-5 about 20 years ago and it hurt like hell. I kept up my activity levels and amazingly, over about 3-4 months it got much better. Never had a problem with my low back since (although I am sure that if I got an MRI it would still show a herniated disk, just not all of the inflammatory response of the acute herniation.)
Just my 2 cents.
I am assuming you’re a DC. If you can’t tell Im an MD. My treatment can and do have complications! BUT, for you to use THAT logic in youre defense of this case illustrates the reason why many physicians dont treat DCs well. Come on…
But where’s the flaw in my logic? My treatments, as well, can and do have complications—bruising and soreness being number one in my own practice. I am stating that if there is this tremendous risk that would lead an ortho to state that no chiropractor will ever touch his “spine, especially my cervical spine”, then why does that risk not manifest in terms of malpractice insurance rates?
As for not being treated well by “many physicians”, I married into a family of MDs and they treat me great…as do those that refer patients to me…and to whom I refer patients. I am, however, aware of both MDs and DCs who treat each other like crap. My opinion of both groups is extremely low. I would hope for both your sake and the sake of your patients that you don’t fall into that group.
First, malpractice insurance rates simply reflect the likelihood of getting sued. They don’t reflect likelihood of winning a case, since most cases are settled. They don’t reflect liability. Lawsuit likelihood is a function of variables including patient population (healthy vs sick), patient income, poor outcomes, and patient perception of provider income. I would wager that chiropractors select healthier patients with more disposable income. Also, in general, twisting a relative healthy person’s back doesn’t invite as much risk as most medical specialties. For example, 1 in 4-6,000 women die in childbirth in the USA. You can bet every husband considers suing the OBGYN in each of these cases, regardless of whether the OBGYN did anything wrong. Additionally, 3% of babies are born with birth defects. I heard an ad on the radio to call a lawyer for ANY birth defect to see if you can sue the hospital. So forgive me if I don’t buy your malpractice insurance argument.
Sure, correlation does not = causation. But causation does go with correlation. My patient’s vertebral artery didn’t rupture walking down the road. And it certainly didn’t occur when we gave him an IV in his arm to get him to the CT scanner. The patient died because he had a massive stroke and went into asystole. That, also, is not because of the IV or oxygen we gave him in the ICU. But if you want to further discuss whether his stroke caused asystole or the normal saline and oxygen we gave him causes his asystole, we can. Though it seems out of your field of expertise.
As for pubmed, please cite the PMID IDs of the studies you noted. PMID 11340209 seems to confirm the association supported by hundreds of case reports. PMID 7783892 isn’t too optimistic either. 10920729 is pretty striking too. I cannot find the specific studies to which you refer.
Regardless, you are right that there are no randomized clinical trials. In the meantime, individuals have to weigh the costs and risks (ask a neurologist if he would have his neck manipulated) versus potential benefits.
I hate to interrupt a pissing contest, but every intervention has risks. The responsibility of the practitioner is to limit them and ensure informed consent. That being said the risks of a manipulation are significantly less than any surgical procedure, and controlling these risks is far more difficult as is achieving proving your patient was well informed, insurance rates likely reflect that.
Then I guess I should stop feeling so good afterwards.
That would be the endorphins released from the tearing. Have you had an x-ray before and after and determined that the adjustment actually adjusted anything?
That would be the endorphins released from the tearing. Have you had an x-ray before and after and determined that the adjustment actually adjusted anything?
I am not a Chiropractor or an advocate for but based on this statement I believe you are out of your element and need to learn what a manipulation is. Around here such an idea of the treatment is in part due to chiros telling people their joint is out.
I didn’t mean immediately afterwards- usually it feels a little more sore actually, but by the next day the stiffness and pain would be much better.
I did have x-rays at both chiropractors I’ve visited, and both revealed degenerative discs, which won’t be cured by anything. I can’t honestly remember anything else they revealed, as it’s been a few years. I’m not an MD or a chiro, so I wouldn’t know if an x-ray would look different if the problem was a pinched nerve or whatever else causes muscle spasms.
Yes. L4-5 and L5-S1 protrusion/herniation. (Confirmed in arresting detail by MRI.) Pain, burning and loss of strength down my left leg.
Treated conservatively with ART Chiropractor. I think the most important thing he provided was guidance on the gradual progression of using extension/traction type stretches as well as reassuring me to look beyond the immediate and know that I would get better. Also, he provided great support by telling me more than once that getting better would not be a linear experience - That healing would be a matter of improving and regressing…
David K
As to professional bias, this speaks well (to both sides of the discussion):
http://www.ncbi.nlm.nih.gov/pubmed/14589464
That 1:5.8 million statistic means I could practice 40 hours/week for 1400 years without ever seeing, encountering or causing a VAD. In that same 1400 years, how many times would I be struck by lightning, run over by a bus, etc?
And, in fact, if you read HERE and HERE, you’ll find further bias—that adverse events from ‘manipulations’ performed by people who are* NOT* chiropractors (a group including barbers, PTs, orthos, massage therapists) are attributed to chiropractors. That’s like blaming the anesthesiologist who was never in the room for the mistakes of the surgeon.
As for the med-legal argument, there is one and only one determinant of malpractice rates: the carrier’s perceived risk. To you and I, risk means lawsuit. To our insurance carrier, risk means costs. At the end of the day, I am a much lower risk (meaning much cheaper cost) for my carrier than is an MD. And a PT is an even lower risk—no responsibility to diagnose means no risk of failure to diagnose.