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Did you hurt your back shoveling after the latest blast of winter snow? Or perhaps overdo it in fulfilling that New Year’s resolution to return to the gym? It might be time to visit a chiropractor.

The four-letter word ‘pain’ is the main reason people come here,” says Dr. John Warner, a chiropractor who runs the Colorado Health and Wellness Center in Colorado Springs with his wife and fellow chiropractor, Gail. However, he adds, “They also come just because they want their health to improve.”

Chiropractic, as defined by the American Chiropractic Association, is “a health care profession that focuses on disorders of the musculoskeletal system and the nervous system and the effects of these disorders on general health. Chiropractic services are used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.”

The typical patient, Warner says, is one who doesn’t want to rely on a cabinet full of pain meds. “We try to get the patients better without drugs or surgery. That has been the basic premise of chiropractic for 125 years.”

Although that premise hasn’t changed—and hands-on adjustments to affected joints and tissues remain central to chiropractic care—the field has seen many changes, Warner says. That includes new technology and tools; his clinic, for example, offers Acoustic Wave Therapy, which utilizes high-intensity sound waves to increase local blood circulation and relax muscle and connective tissue, among other things. The clinic also offers spinal decompression therapy, which gently stretches the spine in treating herniated discs and goes beyond older traction methods. “The technology is getting better all the time,” Warner says, “and the results are fantastic.”

Dr. Jeff Matthews, of Matthews Chiropractic, also takes advantage of new technology. For example, although adjustments are still done by hand, he also uses the Impulse iQ adjusting instrument, which is controlled by microcomputer circuitry and produces a controlled force to treat areas of the body; patients typically feel a light tapping sensation.

“It’s very research-driven,” Mathews says of the Impulse iQ, just one of the adjusting instruments available to chiropractors. “It uses speed as its force driver.” (The gentle thrust is faster than the body’s tendency to tighten up and resist the adjustment, advertising for the Impulse iQ states.)

Therapeutic techniques continue to evolve. Mathews employs his own “eclectic mixture” of approaches, including the Fascial Distortion Model, which focuses on the body’s connective tissues. He also offers trigger-point dry needling; it involves inserting solid filament needles through the skin and into areas of knotted or hard muscle. Although dry needling uses similar tools to acupuncture, the two differ in their practice and their goals, and dry needling is rooted in Western medicine, according to the Mayo Clinic.

Meanwhile, chiropractors are branching into specialized areas of expertise, such as chiropractic functional neurology, orthopedics, and radiology, which require a huge postgraduate commitment for additional education, Warner says.

Perhaps the biggest misunderstanding about chiropractors is that they’re “just” back pain doctors, he says. “That is a complete fallacy. We do good at back pain, and studies show we should be the first doctor of choice for back pain. However, we do so much more than that.”

For example, athletes—from professional athletes to weekend warriors—turn to chiropractors to relieve pain and improve performance, Warner says. Patients at his practice have ranged from high school football players to NFL offensive linemen, professional wrestlers, Major League Baseball players, and more. Mathews treats a lot of running injuries.

“We treat any moving part that hurts or isn’t moving as well as it should,” Mathews’ website states, listing not just neck and lower back pain, but headaches, jaw pain, foot and ankle pain, overuse injuries, and more.

Another notable change: attitudes toward chiropractic care. “It’s becoming more and more accepted,” says Warner, a 1982 graduate of Palmer College of Chiropractic in Iowa. “I now have medical doctors, neurosurgeons, orthopedic surgeons, podiatrists who all take me out to lunch. Thirty-seven years ago, that was unheard of. The medical doctors all seem to want to know what the magic sauce is that we provide our patients.”

His practice brings many disciplines together. In addition to four chiropractors, there is a chiropractic radiologist, two medical doctors, two physical therapists, a physical therapy assistant, two metabolic weight loss coaches, and a trainer. “We do a lot under one roof,” Warner says.

Does It Work?

A growing list of research studies and reviews show services provided by chiropractors are safe as well as clinically and cost effective, according to the American Chiropractic Association, which lists several studies on its website, www.acatoday.org.

For example, the ACA notes the following:

In 2017, the American College of Physicians released an update to its low back pain treatment guideline that recommends first using nondrug treatments, such as spinal, for acute and chronic low back pain.

An analysis in the Journal of the American Medical Association in 2017 supports the use of spinal manipulative therapy as a first-line treatment for acute low back pain.

Critter Chiropractic

“Caring for man and man’s best friend” is the tagline at Mathews Chiropractic. Dr. Jeff Mathews treats not only people, but animals—specifically dogs and horses. (In the case of horses and other equines, Mathews travels to see them; don’t expect them to be hanging out in the office.)

In Colorado, chiropractors must undergo additional education to work on animals. In addition, Mathews took the extra step of getting certified by the American Veterinary Chiropractic Association.

Because animals can’t talk about their pain, Mathews relies on function to analyze the problem. With horses, a sudden resistance to being ridden, a change in gait, and reduced performance are among signs of trouble. With canines, a change in a dog’s behavior is typically what drives an owner to seek help.

“They’ll say that the dog can’t get up, won’t get up on the bed, won’t get up on the couch, can’t get into the car, can’t do stairs, can’t eat standing up…There’s some sort of altered behavior.”

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We are excited to announce that the new Hill Air-Flexion and Distraction Table has been added to our practice!

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Trigger Point Dry Needling

Jessica Stepien, P.T., D.P.T.

fig01 Figure 1. Trigger point complex. Image courtesy of Medscape.com, 2011, available here.

Trigger point dry needling, also known as intra- muscular stimulation, is a technique using a solid filament needle to treat hyperirritable spots of the skeletal muscle. These hyperirritable spots are called trigger points and are typically associated with palpable nodules in taut bands of tissue. (Figure 1) Physical therapists insert a dry needle, without medication or injection, in trigger points to treat myofascial pain.1

As far back as the 16th century, myofascial pain syndromes have been recognized by medical practitioners as causing sensory, motor, and autonomic symptoms and dysfunctions. Myofascial pain syndromes are associated with the palpable nodules or taut bands known as myofascial trigger points. Dr. Janet Travell is recognized for bringing attention to myofascial trigger points in the mid 1900’s. Dr. Travell started her medical career in cardiology and later shifted to musculoskeletal conditions due to her interest in muscle pain and the impact of referred pain on patient’s dysfunction. Myofascial origin of pain was discovered through an injection of hypertonic saline into trigger points which produced referred pain patterns. Initially, injection of an analgesic medication into the trigger points produced a decrease in a patient’s symptoms, pain, and the sensitivity to touch of the trigger points.2 After further research, it was discovered that the actual insertion and stimulation of the muscle with a dry needle produced pain relief without the need for medication. Thus, the development of trigger point dry needling began. (Figure 2)

The perpetuating factors of myofascial pain syndromes are low level musculature contraction, unaccustomed eccentric contraction, muscle overloads, and muscle fatigue. These factors can be caused by, but not limited to, mechanical dysfunctions such as forward head postures, joint hypermobilities, ergonomic stressors, poor body mechanics, and scoliosis.

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Maintaining movement and range of motion in all of our joints is essential to aging well. Here is a medical journal article which reports the most common cause of disability in the US is bone and joint arthritis. The number of people diagnosed with arthritis is increasing 1 million per year. Your motion and mobility will directly affect the health of your joints!

MMWR Morb Mortal Wkly Rep. 2010 Oct 8;59(39):1261-5.

Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation — United States, 2007-2009.

Abstract

Arthritis is a large and growing public health problem in the United States, resulting in costs of $128 billion annually, and continues to be the most common cause of disability. With the aging of the U.S. population, even assuming that the prevalence of obesity and other risk factors remain unchanged, the prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation (AAAL) is expected to increase significantly by 2030. To update previous U.S. estimates of doctor-diagnosed arthritis and AAAL, CDC analyzed National Health Interview Survey (NHIS) data from 2007–2009. This report summarizes the results of that analysis, which found that 22.2% (49.9 million) of adults aged ≥18 years had self-reported doctor-diagnosed arthritis, and 9.4% (21.1 million or 42.4% of those with arthritis) had AAAL. Among persons who are obese, an age-adjusted 33.8% of women and 25.2% of men reported doctor-diagnosed arthritis. Arthritis and AAAL represent a major public health problem in the United States that can be addressed, at least in part, by implementing proven obesity prevention strategies and increasing availability of effective physical activity programs and self-management education courses in local communities.

Physical activity in the US decreases with age. 42% of children obtain the recommended 60 minutes of physical activity and 8% of adolescents. 30 minutes a day is recommended for adults and less than 5% of adults are achieving this. If you would like any help, please let us know!

This article demonstrates that hypomobility (not enough motion) leads to Osteo Arthritis. Increasing mobility can put the brakes on this degeneration. There is a window of opportunity to stop and even reverse degenerative changes. If boney changes have become established then it’s too late to have much effect on them. It’s critical for people with joint hypomobility to increase mobility as early as possible.