I don’t know how some doctors do it. Most oncologists have never had cancer. Most orthopedic surgeons have never gone under the knife. Few therapists have ever fought overseas and experienced post traumatic stress disorder. It must be hard to have empathy if you’ve never experienced the condition for yourself.
Steroid injections are a very commonly used tool in the medical community for dealing with lower back pain, but does this seemingly safe practice have a downside? Well, according to a recent study, steroid injections may pose an increased risk of vertebral fracture in older adults. In other words, a broken back.
Stain drugs are some of the most popular (and profitable) drugs of the modern world. They net $19 billion annually in the United States alone. The misguided notion that blood cholesterol levels are the end-all be-all predictor of heart disease has been pushed on the American people for decades. I will not address this issue in this post (although there are many great resources on this topic). Instead, I would like to cover a “not-so-rare” side effect statin drug users encounter that is commonly seen in a chiropractor’s practice: muscle pain.
Norton Shores Michigan Chiropractor – By now, just about everybody has heard about the outbreak of a rare form of fungal meningitis that was caused by a “bad batch” of steroid injections. These injections are commonly used in patients for the treatment of back pain. This outbreak occurred back in September of 2012 and resulted in more than 400 cases of meningitis nationwide, 32 of which died from the illness. Michigan led the way with more than 230 cases and 10 deaths.
Norton Shores Michigan Chiropractor – A 43 year old female came in with severe lower back pain. She had been experiencing “tolerable” back pain for years but it got much more debilitating recently. She was totally unable to work or sleep. The lack of both had her very frustrated, irritated, and depressed. She was flying off the handle at loved ones for no reason at all and had completely lost her ambition for the things she previously held dear. And although her situation got more dire, her medical doctor’s treatment for her dysfunctional back never changed: painkillers and muscle relaxers.After two weeks of misery, she had finally had enough and came into Zehr Chiropractic for treatment. After getting her Atlas and pelvis adjusted over the the past two weeks, she is doing much better. She’s sleeping better, her mood is better, and she is easing herself back into her work activities. This morning she asked me if she could get a copy of her x-rays to show her MD. She said,“I just want to show him the x-rays of my spine and ask him how the pills he kept prescribing me was supposed to fix this!”
The Loch Ness Monster.
Vampires (especially the emotional, glittery kind).
A French military victory.
“I’ve always wanted to see a chiropractor, but they always want you to keep coming back.” It’s a sentiment that always seems to hang over the chiropractic profession, like a rain cloud over Charlie Brown. It has been propagated by the medical community and other skeptics, as well as people who are skittish about giving chiropractic a try.
But where did this come from? Is it valid? Is it unique to the chiropractic profession?
The idea that anyone who seeks a doctor of chiropractic will be forever tethered to the chiropractor’s table is pretty silly. In our Muskegon practice, we put together a specific care plan for every patient, in order to alleviate their particular health challenge. We state, up front, that most conditions require maintenance down the road, but that part is UP TO YOU. No contracts in blood. No oaths. The ball is in their court.
But why don’t the conditions just stay fixed? Why do spines need maintenance? The reason is the time the problem has been there and the crazy stuff humans do to re-aggravate their conditions (I’ll have to tackle that in another post).
Delay of Game on the Offense. Five Yard Penalty. Still First Down.
It’s no secret that we are not every body’s first choice when it comes to health care so spinal problems usually fester for a long time until the patient shows up in our offices with neck pain, back pain, migraine headaches, sciatica, carpal tunnel syndrome, or fibromyalgia (to name a few). They’ll often find that they have also developed visceral symptoms such as constipation, asthma, acid reflux, or IBS.
They start by ignoring the problem. They may even self-medicate with over the counter meds or worse (scoring some leftover vicodin from their neighbor who recently had a knee replacement).
When it gets so bad they can hardly stand it, they finally show up at their medical doctor’s office. If it is not a fracture, tumor, or infection, they are put on more pain medications. Those will often take the edge off for a while, but when they fail, the doctor puts them in physical therapy. If the PT clinic does nothing but passive modalities (muscle stim, ultrasound, etc.) the patient will get some symptomatic relief but in most cases the problem will keep coming back. They go back to their doctor, who starts talking about injections, surgery, and pain clinics.
A percentage of folks won’t even bat an eyelash at needles and scalpels, but most people get pretty freaked out at this point. Spinal surgeries don’t have the best track record, to say the least. So they start looking at alternatives. Depending on how long this whole process takes, the patient has had this problem for YEARS. The longer the problem has been there, the longer the bones, muscles, ligaments, and tendons have remodeled and become dysfunctional.
Because of this phenomenon, patients with chronic problems are a lot tougher to fix and they need maintenance care in order to keep things in place and stay healthy. Again, this is up to the individual patient. This concept makes sense to most people (especially if they’ve lived it) but gets a lot of scrutiny from the medical profession.
Once Again, the Pot is Calling the Kettle Black
The next time you hear someone criticize your chiropractor for advocating spinal health maintenance, ask them if they are on any medications (as they probably are on a first name basis with their pharmacist). Have you ever met anyone on a blood pressure medicine regimen that only lasts 6 weeks?
You mean, they have to take those things daily? For life?
Think about that for a second. The same people who criticize a monthly adjustment have no problem whatsoever instructing someone to take a medication twice daily until kingdom come. How many people do you know have been taking aspirin or ibuprofen daily for their back pain and headaches….for years?! Apparently, those anti-inflammatories and painkillers aren’t permanent. Shocking.
I have never, ever needed to see a patient multiple times every single day in my office. In fact, chiropractic patients have to come in less and less over time while most people on medications have to take more and more. The body starts to get immune to medications so they have to up the dose in order for it to be effective. Meanwhile, your liver and kidneys have to filter all that gunk, not to mention all the other pills that you have to take to counteract the side effects from the first medication.
I understand people’s concerns with maintenance chiropractic care. There is a cost involved. And insurance doesn’t always cover it (if it covers anything at all). But with all the pills and surgeries you WON’T need, it pays for itself over time. Not to mention, how in the world do you put a price on being able to move, function, and feel good? Chiropractic care is cheap compared to the alternatives out there. Maintaining good spinal health is a habit. Just like exercise. Just like good nutrition. Just like getting enough sleep. So, do you have to keep coming back? Only if you want to stay healthy.
Chiropractic. The word itself is so polarizing. Some people hear the word and roll their eyes while others just can’t wait to tell you how great THEIR chiropractor is. Why is it viewed so differently among people? Why is it largely misunderstood by the medical profession? Is it new wave or a modern version of the healing practices of antiquity? There are many questions and (depending on whom you talk to) even more answers.
There is one thing about chiropractic that I truly love above all else. Although the profession has seen many advances and changes, the principle behind chiropractic has never changed. How many professions can say THAT? Misalignments of the spinal joints cause damage to the joints as well as dysfunction in the nervous system, which (in addition to pain) can cause dis-ease throughout the entire body resulting in a myriad of symptoms and illnesses (neck pain, back pain, migraine headaches, sciatica, fibromyalgia, extremity numbness, etc.). Chiropractors utilize non-surgical, non-pharmaceutical means to realign the spinal column to promote healing in the joints and remove pressure from the nervous system. The principle seems pretty straightforward for most, but this idea was vehemently challenged by the medical establishment in the early part of the 20th century.
Adjusting Spines?!?! That’s a Felony!
At the very least, the medical profession thought chiropractic was useless chicanery, at worst they warned that chiropractic adjustments were harmful to one’s health (reminds me of a story about a pot and a kettle…hmm). In fact, the medical profession fought so hard against chiropractic that doctors of chiropractic were put in jail for “practicing medicine without a license” in the 1930s. Of course, by not prescribing medications, stitching up wounds, or treating fractures, it boggles the mind how anyone would try and accuse chiropractors of trying to “practice medicine.” It didn’t matter what the treatment was, medical doctors could not stand the thought of people needing anything but drugs and surgery for their health. It just wasn’t scientific enough. This was in the days when lobotomies were done routinely, physician endorsement of cigarettes was common, and only a decade after bloodletting fell out of fashion, but that’s besides the point. Doctors of chiropractic sat in jail so I could do what I do today and all they were trying to do was offer an alternative in order help to their fellow (wo)man. Meanwhile, politicians have been allowed to run free for decades (just kidding…sort of).
Once it was proven that chiropractors were not, in fact, “practicing medicine,” they were allowed to return to their homes and their practices. The chiropractic profession was established as its own entity, with its own set of
guidelines on education and scope of practice. It was spelled out very clearly what a chiropractor could and could not do and they were clearly second class citizens in the healthcare field.
Although the law of the land clearly placed medical doctors as the gatekeepers to health care and chiropractors as obvious adjuncts to medical care , the medical establishment didn’t stop there. It just wasn’t good enough. They wanted their competition out of the picture altogether. Hence, the American Medical Assocation conducted a decades long smear campaign against chiropractic. In medical schools, clinics, and hospitals, chiropractic was considered unscientific and unsafe (again, by the same people who thought cigarettes were OK) and this mantra was to be repeated by every doctor, student, professor, nurse, etc. It was not to be questioned and no proof of these claims was needed. It was accepted as dogma. Their bylaws also clearly stated that any medical doctor who “associated” with a chiropractor would be ostracized for doing so. What this meant is that no medical doctor at any time could ever refer a patient to a chiropractor. This effort was supposed to drive every DC out of business and kill chiropractic care forever. But they underestimated one small thing: the actual patients. People with health care problems don’t care about politics or egos. They want help and they were willing to see chiropractors in order to get it. This alone kept chiropractic alive.
Apparently, medical doctors still couldn’t stomach the notion that anyone would even dare to help people with their health while lacking the initials “M.D.” after their name. They felt that anyone outside the “cool kids club” shouldn’t be allowed to offer any services related to health care! Well, they have a name for that type of business model. It’s called a monopoly. And those are illegal in the United States of America. So in 1976, Dr. Chester Wilks and four other chiropractors sued the American Medical Association, as well as several physicians, for violations of sections 1 and 2 of the Sherman Antitrust Act. It was a true David vs. Goliath battle. More like David vs. an army of Goliaths.
The legal process is long and when you have an army of lawyers like the AMA does, you can drag it out even longer. However, in 1987, Judge Susan Getzendanner ruled that the AMA had engaged in an unlawful conspiracy in restraint of trade “to contain and eliminate the chiropractic profession.” She went further, stating that the “AMA had entered into a long history of illegal behavior.” She issued a permanent injunction against the AMA to prevent such future behavior. To this day, the AMA can not publicly or privately denounce the profession of chiropractic with baseless allegations. It did not force them to play nice with chiropractors, they just couldn’t officially bully the profession anymore. Of course, the AMA used every bit of their financial and political might to appeal (they petitioned the supreme court three times), but the injunction was upheld. Apparently, you just can’t point at a competitor and call them a quack without evidence, especially when you’re going to profit financially because of it.
There is no “Rx” in Team
Dr. Wilks imagined a world where medical physicians and chiropractors could provide the people of this country with the best health care possible, pooling our resources and working together for the greater good. So where are we now? Well, that depends who you ask. Just the mere fact that chiropractic is still around is significant. With all the profession has been up against, we still stick around. Why? Results. If we weren’t getting the results, there is no way we could have weathered the storm and survived as a profession. Chiropractic has been the ultimate “grass roots” story in health care. No huge multinational companies to fall back on. No limitless advertising campaigns to promote it. No major political clout to receive funding and entitlements from the government. Every time the profession has had its back against the wall, it was the patients themselves who helped chiropractors fight for their right to practice.
As the result of the Wilks lawsuit and others like it, things have changed “legally” but discrimination against chiropractors is still abound in the medical establishment. Patients often tell their MD when they have had results in our office after the doctor’s treatments have failed. Instead of expressing relief that their patient’s migraines are gone, most get dismissive (even snippy) about the patient coming in to see me in the first place. On the other hand, some patients tell me that their doctor is happy for them and they encourage them to keep seeing me because they see the results. We even have a couple medical doctors and osteopaths in the Muskegon area that refer patients to us. So I have to admit that things are improving.