Chiropractors are physicians that specialize in treating disorders of the musculoskeletal system. They are referred to as chiropractors, doctors of chiropractic and chiropractic physicians. Depending on which educational institution they graduated from, the style in which they practice will vary. There is a distinctive ideology divide within the profession that stems from different teachings about the role of chiropractic within the medical community. Some chiropractors believe that chiropractic manipulations are the only necessary treatment for the improvement of all bodily ailments. They attribute all forms of dysfunction as the end result of subluxations of the spine. They believe that when a subluxation has been corrected with spinal manipulation, the specific health issues will resolve. This form of chiropractic is based upon the belief that subluxations in the spine lead to dysfunction of the nervous system which in turn will cause health problems. The other type of chiropractic physician practices as an evidence-based physician. They will refer to other specialties when necessary and offer services such as physical therapy exercises, rehabilitative programs and nutritional counseling. This type of chiropractor generally works within a group of other physicians or other providers. Depending on what type of  chiropractor you feel most comfortable with, it is important to research the chiropractic physicians in your area to find out who you feel will be the best able to help with your specific health care needs.

Initial Chiropractic Consultation

An initial chiropractic consultation will begin with filling out an intake form, detailing your past and current medical history. A discussion with the chiropractor about any health issues will better enable them to create a treatment plan if it is decided that chiropractic care is indicated and appropriate. Following the discussion of the health history, a physical examination will be performed to help reach an accurate diagnosis. Diagnostic imaging may be necessary for some patients. After the health history and physical exam are completed, the following care you receive will vary at this point depending on what type of chiropractor you have chosen. It is generally advised to avoid a chiropractor that recommends a high number of visits and requires a patient to sign forms agreeing to the high amount of visits and possibly requiring payment in advance for treatment. As with any health care practitioner, if treatment is providing no improvement or if symptoms are worsening, speak to the doctor to discuss other forms of treatment that may be more beneficial.

References Cited in this Article

www.bls.gov

An episode of vertigo is similar to dizziness as the person does feel dizzy but it also differs from dizziness in that the person actually feels as if they are moving or that their environment is moving. The most common cause of vertigo is due to changing positions. Going from sitting to standing, bending over and then standing straight again, or standing up from a position of lying down can cause vertigo. These episodes of vertigo are called BPPV, or benign paroxysmal positional vertigo and are typically not serious and can be effectively treated. Other causes of vertigo include inner ear disturbances such as inner ear infections, decreased blood flow to the brain, a tumor present in the nerve tissues called an acoustic neuroma, trauma to the head or neck, episodes of migraines, arteriosclerosis, diabetes and a condition called Meniere’s disease. An episode of vertigo can last for only a few minutes or as long as a few hours. Aside from the feeling of motion that is not actually present, nausea and vomiting may also occur as well as unusual eye movements, increased sweating, a ringing in the ears, hearing loss, trouble with walking and talking and vision changes.  

Reduce the Frequency

While most cases of vertigo are harmless, it is important to tell your doctor about any episodes that are present. A health history will include questions about the duration and frequency of vertigo, if any recent trauma such as whiplash has occurred and if there are any other symptoms present with the feelings of movement. Lab testing and an EEG may be helpful in examining blood sugar levels and heart rhythm as well. If something other than vertigo is suspected, a CT scan may be requested by the primary care physician to rule out any trauma to the brain or neck. If the cause of vertigo  has been diagnosed as being caused by an inner ear infection, treatment will include antibiotic medication. There are medications that can also be used for other causes of vertigo as well as vestibular rehabilitation exercises that work to place the body in specific positions that would normally cause vertigo and to repeat these positions until the vertigo is no longer present. There are simple ways to reduce the frequency of vertigo including changing positions slowly, eating small amounts of healthy snacks between meals to keep blood sugar levels steady, seeking medical attention immediately following any head or neck  trauma and receiving care promptly if an ear infection is suspected. For people who are at high risk for stroke, high blood pressure and high cholesterol, seeking immediate care when vertigo is present can help to avoid a more serious outcome.

References Cited in this Article

www.mayoclinic.com

www.emedicinehealth.com

www.neurologychannel.com

An ulcer is a sore that can develop in the lining of stomach, the duodenum (the beginning of the small intestines below the stomach) and the esophagus. Ulcers of the stomach are called gastric ulcers, ulcers of the duodenum are called duodenal ulcers and ulcers of the esophagus are called esophageal ulcers. Gastric and duodenal ulcers are also referred to as peptic ulcers.

Formation

Ulcers can form in the lining of these structures if there is too much acid and pepsin present. Too much acid and pepsin can cause damage to the lining of the stomach, duodenum and esophagus and this damage can lead to ulcers. The formation of ulcers may also develop even if acid levels are normal; if there has been previous damage to the lining from other causes, normal acid levels are strong enough to cause an ulcer in the damaged lining. The stomach lining is protected from acid and pepsin by bicarbonate formation that coats the lining and circulation of blood that generates new cells and repairs damage to the lining. If there is any impairment of these functions of the lining, an ulcer  may form. The most common cause of ulcers is the presence of the bacterium, H. pylori (helicobacter pylori). This spiral-shaped bacterium is found in the stomach and can burrow through the stomach lining, attaching to the stomach wall and  producing an ammonia-enzyme called urease.

Risks and Symptoms

Because of the risks and symptoms, it is important to seek treatment for an ulcer immediately. Left untreated, an ulcer could become a bleeding ulcer (the ulcer has reached blood vessels), a perforated ulcer (a complete hole has been eaten into the stomach or duodenum and allows food and bacteria to pass through the hole)  or cause a narrowing of the opening of the intestines. When an ulcer is present, a person may feel nauseated and fatigued and experience a burning sensation in between the breastbone and belly button. When someone has a bleeding ulcer, blood may be present in the stool and in vomit. There are instances where a person has an ulcer but feels no symptoms.

Diagnosis and Treatment

When an ulcer is the suspected diagnosis, an upper GI x-ray series with contrast may be performed.  Barium is a chalky drink that is swallowed to allow the ulcer to be seen on x-ray. A more detailed procedure called endoscopy may be done that allows a physician to send an endoscope through the esophagus, stomach and duodenum searching for an ulcer along the pathway. It is also important to determine if H. pylori is present because if it is, eliminating the bacterium will most likely cure the ulcer. Medication is used for the treatment of ulcers along with the recommendation of dietary and lifestyle modification. Proper diagnosis and treatment will help the healing process to begin but if no improvement is noted after several weeks of treatment or if symptoms worsen during treatment, surgery may be required. 

References Cited in this Article

www.healthscout.com

www.medicinenet.com

Chiropractic Care

An initial visit will go as follows: first, a Chiropractor will take a detailed case history followed by a physical exam.  The physical exam is focused to the complaint at hand.  It could be a head/neck exam, thorax exam, ears, eyes, upper extremity, lower extremity, or spinal exam.  Next, he/she will then locate the areas of subluxation in the spine and/or extremities.  A subluxation is another word to describe a “slight dislocation” of a bone.  If x-rays or additional studies are warranted they will also be taken at this time.  Finally, the Chiropractor will then address the areas of subluxation using HVLA thrusts in the line of drive of the mis-alignment.  This will ultimately restore range of motion and eliminate any interference to the nervous system.  The nervous system is the most important organ in the human body and controls and coordinates every organ system and body part.  Post adjustment, the Chiropractor will answer any and all questions the patient may have and discuss further treatment if necessary.  In addition, the Chiropractic may choose to provide corrective care for the Scoliosis patient known as Chiropractic BioPhysics (CBP).  They will set the patient up on mechanical traction to re-shape the ligaments of the spine that are essentially deformed.  They will start out on these particular tractions for a time of six minutes and slowly increase this to twenty minutes.  A post x-ray analysis is taken to view the changes after a specific period of time.  Children and Scoliosis don’t have to co-exist; have your child evaluated today by a Chiropractic physician. 

Rheumatoid Arthritis is an inflammatory condition that leads to swelling of the joints and surrounding structures causing pain and sometimes deformity.  Early symptoms include: fatigue, morning stiffness that lasts more than an hour, a loss of appetite, muscle aches, and weakness.  Joint pain will later follow and is typically on both sides of the body in the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes, and the neck.  When the lining of the joint becomes inflamed this causes the synovial fluid to cause swelling in the affected joints.  Some additional symptoms related to Rheumatoid Arthritis (RA) are: reduced range of motion, a low-grade fever, pleurisy, numbness, tingling, skin redness, swollen glands, and anemia.  Noticeable joint destruction is noted within 1-2 years of the onset of the disease. 

X-ray changes seen with Rheumatoid Arthritis (RA)

Although diagnosis is made by a detailed case history, physical examination, and laboratory studies; x-rays are equally important in the diagnosis of RA.  The changes that the physician will notate on an x-ray include the following: narrowing of the joint space, periarticular osteopenia, juxtaarticular bony erosions, subluxation and gross deformity, and periarticular soft tissue swelling.  The erosions seen with RA include Haygarth’s and Bouchard’s nodes.  These affect the MCP and proximal interphalangeal joints respectively.

Treatment

Unfortunately, Rheumatoid Arthritis is a chronic condition with no known cure.  The best treatment programs available for RA patients include medical, social, and emotional support of the affected patient.  Treatment is aimed at reducing pain and inflammation, reducing or eliminating the progression of deformities before they set in, and increasing range of motion and the patient’s quality of life through diet and exercise.  Treatment may include pharmaceutical medications, reduction of stressors to the joints, physical and occupational therapy, Chiropractic care, Acupuncture, massage therapy, and sometimes surgical intervention for severe deformities. 

Chiropractic Care

Chiropractic care is essential for anyone suffering from an arthritic condition.  The Chiropractor’s job is to reduce pain and inflammation, increase range of motion in all joints, and reduce subluxations or mis-alignments within the spine and/or extremities to prevent diseases from occurring within the human body.  They work on the most important body system in the human body-the nervous system.  The nervous system controls and coordinates every organ and body part.  Chiropractors utilize static and kinetic palpation to effectively determine the level of subluxation and therefore perform manual adjustments accordingly. 

Do you have leg pain that is constant or comes and goes?  Many Americans suffer from leg pain each and every year.  Many conditions may cause leg pain such as but not limited to: varicose veins, artherosclerosis, strain, stress fracture, dehydration, medications, tendinitis, shin splints, blood clots, infections, arthritis, gout, nerve damage, tumors, sciatic nerve pain, Legg-Calve-Perthes disease, and Slipped capital femoral epiphysis.  Home care for acute leg pain caused by strains and overuse consists of the PRICE therapy which stands for protect, rest, ice, compression, and elevation.

 Questions the doctor will ask the patient

Your physician will ask a host of questions like the following: When did your leg pain begin?  Is it one or both legs? What makes the pain better?  What makes the pain worse? Are you able to perform your activities of daily living? Are you suffering from any numbness or tingling and if so how far down does it go?  Are you currently on any medications and/or supplements?  Does your leg pain increase at different times of the day?  Can you describe your pain?  Is it dull,achy,severe/stabbing, etc?

 What to expect at your initial visit

 The physician will first begin to take a through case history and physical examination including range of motion and orthopedic testing.  One or more of the following diagnostic tests may be performed as well such as: Arteriogram, Bone biopsy, Bone scan, Duplex Doppler/ultrasound exam, MRI, or X-ray.

 Leg pain and Chiropractic care

 Depending on the condition at hand, Chiropractic may be able to help with acute or chronic leg pain.  Most of the time, Chiropractors will help facilitate the healing process of strain/sprains by utilizing the PRICE therapy as mentioned above.  They may also perform manual adjustments to the knee, hip, or ankle joint.  In addition, Chiropractors may incorporate physiotherapy modalities such as electrical muscle stimulation, ultrasound, whirlpool bed, cold laser, massage therapy, and acupuncture.

There are many times of fractures, the main categories are displaced, non-displaced, open, and closed.  With displaced and non-displaced fractures, it refers to the way the bone actually breaks.  In a displaced fracture, the bone breaks into two or more segments.  When the bone is broken in many segments the fracture is considered a comminuted fracture.  A non-displaced fracture occurs when the bone cracks part way or all the way through but maintains its normal alignment.  In a closed fracture, there is no puncture or break in the skin; however, in an open fracture the bone actually protrudes through the skin with a visible wound present.  Open fractures are extremely dangerous because of the risk of bone infections due to the skin and bone being exposed to the environment.

Fracture types

There are many different types of fractures including: a Greenstick fracture, Transverse fracture, Oblique fracture, Comminuted fracture, impacted fracture, Pathologic fracture, and stress fracture.  Greenstick fractures mean the bone is bent.  A Transverse fracture means the fracture is at a right angle to the axis of the bone.  In an Oblique fracture, the break is in a curved fashion.  A Comminuted fracture occurs in several pieces.  Impacted fractures occur when the two ends of bones are forced together causing a break.  Pathologic fractures are caused by disease processes or weakened bone.  Finally, stress fractures are caused by injuries such as repetitive stress. 

Treatment

The initial treatment of fractures includes splinting and stabilization of the extremity in the anatomical location, ice, and elevation.  Fractures of the neck and back require the body to be placed on a stiff board or the neck to be placed in a hard collar in acute situations.  This is performed to limit spinal cord involvement and movement.  Some physicians choose to operate on fractures in certain situations depending on where the bone is broke, and the severity of the break.

Chiropractic care

After the bone has healed for the appropriate length of time, Chiropractic care may be beneficial to improve range of motion and joint function.  The attending physician at the time of the fracture injury will recommend when this should be performed.   

Are you a sufferer of Chest Pain?  Chest pain is a dangerous symptom that should not go unnoticed or diagnosed.  It’s especially important whether the pain is acute, chronic, mild or severe in nature as well.  Chest pain can be caused by a number of conditions including but not limited to cardiac conditions such as: angina, myocardial infarctions, aortic dissection, coronary spasm, pericarditis, and other heart-related conditions.  Chest pain can also be due to digestive problems such as: heartburn, esophageal spasm, hiatal hernia, Achalasia, gallbladder or pancreas conditions.  In addition, chest pain may also be due to musculo-skeletal conditions like the following: rib subluxations or fractures, Costochondritis, inflamed muscles or nerves.  Respiratory causes of chest pain could be the following: pulmonary embolism, pleurisy, pneumothorax, and pulmonary hypertension.  Other causes of chest pain could also include panic attacks, shingles, or metastasis (cancer). 

Chest pain due to cardiac conditions

When chest pain is due to a heart attack or other heart problems the patient will experience the following symptoms: pressure and tightness in the chest, a crushing-type of pain that radiates to the arm, back, neck, shoulder, or jaw especially in the left arm, pain that lasts more than a few minutes that goes away or comes back in a different intensity, or shortness of breath, dizziness, sweating, or nausea. 

Chest pain due to non-cardiac conditions

When chest pain is due to a non-cardiac condition the patient will experience the following symptoms: a burning sensation behind the sternum, a sour taste in the mouth, difficulty swallowing, and pain that increases when you cough or breathe deeply, and chest tenderness. 

Diagnosis and treatment

Diagnosis of chest pain is not always clear or straightforward.  Your physician will take a detailed case history, perform a physical examination, and perform possible laboratory tests, x-rays, CT scan, or MRI.  Once a diagnosis is established, the physician will employ a specific treatment program with one or more of the following: pharmaceutical administration, surgery, chemotherapy, diet, exercise, Chiropractic care, acupuncture, or massage treatments.

How it works

MRI is an abbreviation for Magnetic Resonance Image.  It is different from an x-ray because it takes pictures of organs, bones and muscle tissue without using radiation.  Instead of radiation, the MRI uses strong magnetic fields and radio frequency energy that generate images which can be viewed on a computer.  The MRI creates images that allow patients to view a healthy and unhealthy image of the affected area.  Before the test begins, the patient must fill out a medical history information sheet and remove all metal jewelry from their body.  Some things that may affect the test are pacemakers, metal implants, dentures, aneurysm clip, or a neurostimulator.  It is important that the patient tell the doctor if he/she has ever had surgery on involving the heart, eye, ear, brain or blood vessels.  Once he/she is ready they will lie on a narrow bed and the doctor will push them into a machine tube.  It generally takes 20-30 minutes for the procedure, but it depends what the doctor is screening for.  The patient may be asked to wear earplugs because certain scanners may produce loud noises.  The loud noises are completely normal and the patient should not be alarmed.  The MRI is painless and the machine never touches the patient’s body.  Once the images are complete the doctor or radiologist will review them with the patient.  Chiropractors use images from MRI’s to get a better understanding of the medical condition with the patient.  The high quality images are helpful when chiropractors are deciding on which method of treatment to use for the patient. 

Benefits and Risks of an MRI

An MRI is a non-invasive technique that does not expose the patient to harmful radiation.  The images from an MRI are very detailed and can help identify problems with soft tissue structures more accurately than an X-ray.  This is a valuable took when it comes to early diagnoses for serious conditions like tumors or cancer. 

Risks- If a patient has a metal plate in his/her body, it can distort the image.  Patients who have pacemakers or any metal implants near the eyes cannot be scanned by an MRI because the magnet can move the metal around.  Some patients may feel claustrophobic during an exam because they are in a magnetic tube.  Typically, the patient may hold a buzzer while being scanned and if they are not comfortable, they can push the buzzer to let the staff know they feel uncomfortable. 

A CT scan is a computerized tomography scan that takes several x-rays from different angles to get cross-section images of the body. The images appear as slices and the radiologist and primary care physician can look at the individual slices or combine them to get a 3-D image of the bodily structures. Because of the slices and 3-D ability, CT scans are more visually helpful compared to a regular x-ray. A CT scan can provide images of bones and soft tissues to help a physician make a diagnosis while treating a patient. Because a CT scan can provide images of soft tissues, a physician may order these scans for views of the brain and also look for any blockage in arteries and veins using a contrast for better enhancement of the blood flow. If a contrast CT scan is ordered, contrast material is given to the patient either orally, through an intravenous line (IV) or rectally, for the viewing of the intestines. Unlike an MRI or ultrasound, during a CT scan, a patient will be exposed to a higher level of radiation, more than received during an x-ray. Although this exposure is brief, someone who is pregnant is not allowed to receive a CT scan due to the radiation risks to the unborn baby.

A Great Tool for Viewing

CT scans are often ordered by a chiropractic physician when simple x-ray images are not enough. This diagnostic imaging tool helps the chiropractor to see bodily structures that require a more detailed understanding of the dysfunction that is present and causing the patient pain. It is a great tool for viewing spinal structures as well as joints of the extremities. A CT scan allows a good view of fractures found in the spine and other bones of the body and will also show any disc herniation that may be present. Although inferior to an MRI, CT scans are effective enough to be routinely ordered by chiropractors for, most commonly, bony structures. Typically, a chiropractic office does not have a CT unit on site due to the cost of the unit and the amount of space it takes up so therefore a patient who needs a scan will be referred to an imaging clinic for the test. Once a CT scan has been performed, the images are stored in a computer and read by a radiologist. The results are then given to the chiropractic physician who will be able to determine if chiropractic treatment is indicated for future care for the patient or if they need to be referred to a specialist for a different treatment plan.

References Cited in this Article

www.mayoclinic.com

www.spineuniverse.com