5 Causes of Sciatica

Sciatic Back Sciatic NerveFirst, let us define what sciatica actually is and is not. Sciatica is, very specifically, pain along the sciatic nerve stemming from irritation of that nerve. The sciatic nerve is formed from a conglomeration of spinal nerves in the low back which binds together into one sheath. This nerve runs under the piriformis muscle in the pelvic area, then runs in between the two parts of the biceps femoris, also known as the hamstrings. It has become common to call any pain in the leg which is suspected to come from the back, sciatica. However, sciatica is a nerve pain which is the same feeling you get when you hit your “funny bone.” Most leg pain, and consequently what most people call sciatica, is actually referred pain. That is a different post. To be a true diagnosis of sciatica, it must be nerve pain that stems from the lumbar spine and runs into the buttock and/or down the backside and middle of the thigh. Now that we have that out of the way, let’s talk about what causes it!

  1. Disc Injury. Disc injuries are the most common back ailment. When a disc bulges or herniates, it can occupy the space where the spinal nerves exit from the vertebral column. If a disc bulges too far it can push against the nerve root causing pain to travel down the sciatic nerve and beyond. Sometimes, the bulge will hit the nerve and then pull back enough so that the sciatic pain is not constant. If the disc is in constant contact with the nerve, one can experience pain, numbness and tingling, weakness, and other symptoms. Chiropractic can help, but these can take a long time to heal and consistency makes the difference. Traction, rehabilitation exercises, physical therapy, and stretching can also help if done properly. If it comes to it, cortisone injections and surgery may be last resort options.
  2. Inflammation. With injury comes inflammation. Though the disc is the most common injury, there are several other structures in the area of the nerves that make the sciatic nerve that can be injured. Inflammation is toxic and can cause its own set of issues. Nerves are especially sensitive to inflammation. Icing, NSAIDs like ibuprofen, Chiropractic, and steroids can all help reduce inflammation. When the inflammation is in check, the back and sciatic pain will diminish. When the area with the sciatic nerve or nerve root is inflamed. The symptoms will remain constant.
  3. Sacro-Iliac (SI) Joint Dysfunction. The sciatic nerve crosses the SI Joint just after it forms the large nerve. If the pelvis shifts or is not working properly, it can irritate the Sciatic Nerve through direct pressure, inflammation, or by causing muscle tightness or spasms from the imbalance. Adjusting the SI joint will help reduce inflammation and muscle guarding, as well as move it away from contact with the nerve if that is the case. Chiropractic is by far the best thing for this case but a clever physical therapist can help, too. Exercise, stretching, and icing may help but can irritate it, as well.
  4. Piriformis Syndrome. This diagnosis has become pretty popular. I find that it is misdiagnosed more often than not. The piriformis is a little pear-shaped muscle (hence the name, piri means pear), that spans the SI joint. The Sciatic Nerve runs underneath it in most individuals. If this muscle tightens, it can compress the sciatic nerve and cause sciatica. The piriformis can tighten for various reasons including any of the above-mentioned maladies. Usually, I find the piriformis is a secondary issue. Sometimes, however, it can take on a life of its own after the other condition has resolved. If it is, truly, piriformis syndrome, the best thing to do is have a specialist perform a muscle release on it. Active release, myofascial release, Bowen, Rolfing, massage, etc. can all help if done right. Be aware that if it only helps for a little while, then there is probably another issue that is still causing the muscle to tighten or guard.
  5. Direct Contact. Because the Sciatic Nerve runs through the buttock and down the back of the leg, the way one sits can cause sciatica. The most common cause is a wallet in the back pocket. Additionally, a seat that curves upward along its lip can put pressure on the legs and irritate the nerve. Unfortunately, I have seen this most often in vehicles.  The solution for these is obvious. The trick is to figure it out before it causes problems more difficult to remedy.

There you have it. Probably not a comprehensive list but definitely the most common causes. Sciatica is actually rarer than it seems. When you have it, however, it is very painful and can be difficult to treat. If you are experiencing sciatica or any type of pain or other symptoms down the leg, chiropractic can help. And, like all conditions, being prompt and consistent makes for better and quicker healing.

5 Things to Do When a Rib “Goes Out”

Rib HeadsRib pain can be miserable. I cannot tell you how many patients have come in to see me after visiting the Emergency Department because they suspected a heart attack or something serious. Pain in the chest, shortness of breath, radiating pain down the arm, nausea, etc. Sounds like a heart attack but all of the tests are negative. So what do you when the emergency docs send you home and tell you it is nothing? Most likely you are dealing with a rib that is either stuck or not moving in the way it is supposed to. Here are five things to do, and not to do, to help.

  1. Heat and Ice. One of the biggest complaints, when a rib is out, is muscle spasming. Heat will help you endure a muscle spasm. There is a caveat, however. Heat brings blood to an area and if that blood is not flushed out, it will cause more inflammation. So, use heat for 20 minutes and then walk around for a while or ice it. Ice drives away inflammation. Ice for 20 minutes maximum. Always end with icing. For more information on heating and icing, go here.
  2. Massage, but be careful. As mentioned, muscles are often tight when a rib is not functioning properly. massage can really help to calm down the muscles. Here again, a word of warning. Often times, the person giving the massage will feel a good sized bump and mistake what is really the head of the rib for a muscle knot. Rubbing this bump will not only be painful but can increase symptoms. Working on the areas around it can be quite helpful. Massaging after the rib is moving again is great.
  3. TENS or Electric Stimulation. A great, non-drug option for killing a spasm and managing pain is to use e-stim, TENS or something similar. These are basically devices that send electrical pulses through wires and patches over muscles. There are several options of machines and can be purchased at various locations or from Amazon. Price and quality range drastically but I have found that the inexpensive units work pretty well.
  4. Get it adjusted! At the end of the day, until the rib starts moving properly it will cause problems. Not all chiropractors are great at adjusting ribs as they can be difficult. Likewise, you really need to have the specific rib adjusted and not just do a general spine adjustment. Even after you get it adjusted it may still feel out. Remember that the muscles have most likely tightened around it and formed a knot. Symptoms can take a while to settle down.
  5. Mind your posture and quit trying to stretch it. Typically, ribs go out because of a forward head and shoulder posture. So, why do we always try and stretch that same way to get it to feel better? Likewise, stretching spasming muscles does not really work. It drives me crazy when I adjust a rib and the first things my patient does is check to see if stretching forward still hurts. That is like separating a wound to see if it has healed yet. If you keep doing it, it will never heal. Instead, look straight ahead and pull your shoulder blades down and back. Here is the vintage YouTube video I created to demonstrate. If you do this exercise and it is still really painful, chances are the rib is out again.

Ribs can definitely be tricky. Sometimes they stay in after one adjustment and sometimes they take several adjustments. Usually, the longer it is out the more adjustments it will take. The rib joints at the front where it connects to the sternum can go out, too. These are also very painful and can be adjusted, although it is a different method. Please remember that although rib pain is brutal, it is not that damaging. Stressing about it will only complicate the healing process. If you have pain to one side of the spine by the shoulder blades, in the front next to the sternum, radiating along the ribs, or all of the above, just come in and we can either help you or, at least, point you in the proper directions.

Decompression and Traction for the Intervertebral Discs

Decompression Vacuum EffectLife tends to be really hard on the discs between the vertebrae in our spines. Discs are made of a flexible cartilage with a thick fluid and a hard nucleus in the middle. Discs are designed to improve motion and provide shock absorption which makes them the most abused structure in the spine. When we bend forward, the disc bulges backward. This can cause weakness due to wear and tear on the inner posterior aspect of the disc. Likewise, placing too much strain on the top can make the disc bulge all the way around. This is seen when someone is overweight, does a lot of high impact exercises, or loads the body with too much weight like with squats.

Each time a disc bulges farther beyond its normal borders, micro-tearing occurs. Tears heal with scar tissue which is, by its nature, not as pliable and can tear again. It is possible to train scar tissue into flexibility and help it act like regular disc tissue but it takes time and training. Too often the more rigid scar tissue will tear and recreate the original problem. This is where traction or decompression comes in.

I may offend some docs who are big into decompression therapy but to me, it and traction are the same thing. I think they started using the fancier word “decompression” because they developed more sophisticated and expensive equipment and needed a word to match. I must confess, though, as a linguist, decompression does portray a clearer and more concise picture of what we are hoping to accomplish. But, I digress. With decompression or traction (and from here I will use the words interchangeably) the goal is to take away pressure from the disc. When pressure on the disc is lessened, the disc can reshape and heal.

Traction can be accomplished in a number of ways. The method I am asked about most is about home-unit to hang upside down. In this case, one straps their ankles into a clamp and then leans backward to a specified angle. Some units will allow a person to hang completely upside down. I recommend 45 degrees to start. That is usually enough to open the disc space without getting a head rush that will shorten the traction time.

There is a host of other traction devices. Most of them can be found on late night infomercials. All of have some legitimacy but some are definitely better than others. The one I have seen a lot recently has the person lying down with their heels resting on a moveable piece that pulls and moves the legs side to side. I am not sure how much traction is occurring but movement is always good. One of the better ones I have seen in the past looks like a big cushy loop that hangs in a doorway. The person is situated so that their upper back is on the ground and their pelvis and legs are parallel with the doorway. Again, the end result is the same and usually positive.

Some providers have very nice decompression machines that are extremely effective in separating the vertebrae thus decompressing the disc. With severe disc bulges and herniations, these machines can be lifesavers. The only downside is the expense which can be significant. In our office, we have available a more hands-on form of traction called flexion-distraction. The table we use flexes at the lumbar level and is spring loaded. The doctor puts one hand on the spine holding a specific level in place and uses the opposite hand to push the table down. The spine separates then accommodates as the spring pushes the table back up. If the chiropractor knows what they are doing, this a very effective form of traction and can make a big difference in the disc.

All of the forms of traction that I mentioned above address the low back. There are, however, various units for the neck, as well. There are three main types of cervical traction. One way uses a harness around the chin and base of the skull attached to a rope and pulley. These units either have a counter-weight, usually a water bag, or a tension spring. The other devices look like a collar between the shoulders and the chin/skull that expand when pumped full of air. Both are effective and mostly utilized at home. The third combines traction with an attempt to restore curvature. This unit is a wedge whereupon a person lies with their head hanging over the tall side of the wedge. Often times there is an elastic strap or a weight that pulls down from the forehead.

Whatever method you choose or whichever method is the most effective for you, the key to success, as with most things, is to apply it consistently over a significant length of time. I have a cervical traction unit that I use when my neck is hurting and I routinely have Dr. Wagnon adjust me on the flexion-distraction table. Discs, just like people, sometimes just need a break from the pressures of everyday life, traction or decompression is a great way to accomplish this.

Humpty Dumpty and Chiropractic

Humpty dumpty falling of the wall with the sky and clouds behind
Humpty dumpty falling of the wall with the sky and clouds behind

Recently, I had a patient ask me if I ever got stressed out about trying to put all of the Humpty Dumptys back together again. I joked that I am not all the king’s horses and all the king’s men so it is not my job to put Humpty Dumpty together again. This exchange brings up an interesting point, though. Several times a day people ask me to fix them. I understand what they want and I always do my best to help them, but somewhere in the back of my mind I am thinking that their expectations are mis-focused.

My job is to adjust the joints of the body. In doing so, the nervous system is stimulated which allows the body to communicate better. Better communication leads to better function. Better function leads to proper healing. Contrast helping the body function better with fixing something and you can appreciate why I am reluctant to claim that I fix or heal anything.

Bear with me while my BA in Linguistics drives the bus for a little while. If you take a very literal definition of the word fix, it means to “fasten (something) securely in a particular place or position.” That is the opposite of what I want to do. My aim is to help joints move. Likewise, it would be the height of hubris to think that I heal people. The body heals itself. Again, my job is to help the body function better so that it can heal properly and, hopefully, quicker.

Finally, giving me the burden of “fixing” someone is an impossible task no matter how willing the participants. That is like asking your exercise equipment to get you in shape. Sure the end goal is for you to get in shape but the responsibility is on you not on the equipment. Focus on improving function and not on getting fixed and you will find that not only are your expectations in line with your goals, but that your care will also be much more effective and productive.

 

The Art of Diagnosis

 

Full confession, I really do not like the word diagnosis. It is a little too limited, definitive, and stodgy for my tastes. I believe that we would be better served just identifying dysfunctional body parts than knowing fancy words that typically just describe symptoms. That saying, understanding symptoms and how they relate to dysfunctional body parts is extremely beneficial when coming up with treatment options. Understanding anatomy, biomechanics,  and physiology can make diagnosing musculo-skeletal injuries so easy it is a wonder why most doctors get it wrong most of the time.

It is important to understand location and type of symptoms to make a proper diagnosis. Location of symptoms does not necessarily indicate location of dysfunction. Many dysfunctional body parts refer symptoms to other parts of the body. Luckily, there are patterns which come is handy for those clever enough to recognize those patterns. The type of symptoms tell a good doctor what kind of structure is dysfunctional.

Embryologically speaking, there are three types of structures: bone, consisting of bones, joints, ligaments, discs, and cartilage; muscle, consisting of muscles, tendons, and organs; and nerve, which encompasses tissues of the brain, spinal cord, cranial nerves, autonomic nerves, nerve roots, and peripheral nerves. Bone symptoms are typically described as a deep dull ache and can refer to other bone-like structures. Muscle is also an ache but feels more like fatigue and soreness. Muscle is more superficial and usually stays within the same structure. Nerve symptoms are more electrical in nature; numbness and tingling, just numbness, burning, shooting, etc. Nerves stay in the network of nerves. Knowing this will get you pretty far.

Consultation is the first step. I ask for location and have the patient describe the symptoms. I also look for the mechanism of injury knowing that some structures are more likely to fail, depending on the stress placed on them, than others. With a good consultation, I have a fairly solid idea of what the problem is.

The second step is to do an exam. Bone structures cannot move themselves. For these tests, I do the movement on the patient checking for instability, pain, and altered movement. When I isolate joint movements, I can narrow down the location of dysfunction. Instability tests will suggest ligament issues (assuming we are not dumb enough to do a stability test on a complete fracture). X-ray is helpful to see fractures and degenerative changes. MRI is helpful to see disc bulges, ligament tears, and pathology. Repetitive movement works great for determining how to reform a bulged disc.

Muscles and tendons move bones. To test a muscle or tendon, resisting the muscle’s movement is an easy way to determine which muscle is injured. Why most doctors do not do this is baffling. Pain with resistance at the end of the muscle is usually tendon related and anywhere else is usually the muscle itself. If the type of pain is described as muscular but cannot be recreated with resisted movement, it could be an organ referring pain. Here again, repetitively resisting movement can really help determine how to help treat the injured structure.

Nerve symptoms require some specialized tests in the form of reflexes and sensation testing. True neurological injuries are very difficult to diagnose and to treat. In addition, any of the above can cause secondary and tertiary issues in other parts of the body, like muscles spasms or nerve pain due to encroachment with a disc herniation, for example.

Finally, one of the best ways to diagnose an issue is to treat the issue and see if it helps. Obviously you cannot do this with everything, but as a chiropractor, I can do this for most injuries. Even a surgeon will tell you that nothing is definitive until they open you up and see it in real life. The point being do not get too caught up with figuring out what something is before trying to treat it. Ruling out conditions is still valuable.

There you have it. Instead of plugging symptoms into WebMD to discover that you have a rare, incurable, terminal illness, just step back and look at the anatomy, physiology, and biomechanics of the body and go from there. Or, see your local chiropractor and let them help you through your issues or point you in the right direction. We spend a tremendous amount of time learning about all aspects of the human body.

 

Tennis Elbow? I Do Not Even Play Tennis!

tennis-elbow-pictureIn a world where we have so much access to information, I find that when it comes to diagnoses, there are some overly-simplified patterns. If there is pain in the foot, it is plantar fascitis, pain down the leg is labeled sciatica, and elbow pain is tennis elbow. Not that these conditions are not common; just not that common. Tennis elbow is particularly over-diagnosed. Pain in the elbow is common. Tennis elbow, however, is specifically pain resulting from injury to the extensor tendons which insert at the lateral epicondyle causing inflammation and dysfunction. Simply put, to be tennis elbow, the pain must be right around the little knob on the outside of the elbow and get worse when trying to extend the wrist with resistance. It is called tennis elbow presumably because repetitive backhand swings in tennis will cause such a condition. Incidentally, pain on the inner knob is known as golfers elbow.

I have found that neither tennis elbow or golfers elbow are more common than just a regular subluxated elbow. As a hinge that rotates and pivots and is made up of three bones and two joints, dysfunction is easy to come by. Often, the radial head will get stuck farther back than it should be. This will cause a strain on the muscles that insert in that area and mimic or create tennis elbow. The good news is that with an adjustment or a few, the condition typically responds quickly. If it is, indeed, tennis elbow, the best thing to do is to make sure the elbow is adjusted and functioning properly, then focus on the tendons with ice, stretching, and myofascial massage or active release. So, the next time somebody complains of tennis elbow, tell them to see their local friendly chiropractor.

 

5 Things To Do When Your Back Goes Out

backpainHave you ever bent over to pick up something only to experience a pain like someone shoved a hot poker into your low back and then started pulling your muscles apart? Yeah, most of us have felt that at some point. Hopefully, it  never happens to you, too, but if it does, here is what you do.

  1. Stop and Breathe. You are probably feeling like your life is about to end. Most of what you are experiencing is muscle spasm. Your back muscles are trying to protect you but they have dramatically overreacted. If you can, stay where you are and do your best to let the muscles settle down. Deep breaths and relaxation will dramatically speed up the process. Have some water and wait it out.
  2. Stretch backwards. Typically, when a back goes “out” there is a disc inbetween the vertebrae that is stuck in a bulging position. Bending backwards will help squish that disc back to the center and will also shorten the spasmimg muscles. Go easy with this. Gently push into a cobra position if you are on the floor. Otherwise, brace yourself with your hands on your backside and carefully arch backwards. Do it several times in a row and often thereafter. Here is an old video for demonstration.
  3. Walk, Lie Down, Do NOT Sit. When the spasm has settled down, walk a bit. Movement will help get the blood moving which helps to settle the muscles and get the disc moving. You do not want to overdo this. Move a bit and then lie down on your back with the knees bent. The firmer the surface, the better. Sitting will be counterproductive. When you sit, you increase the pressure on the disc and stretch the muscles of the lower back.
  4. Ice. Icing helps reduce inflammation. Typically, when a back goes out, there is inflammation. The quicker you can get rid of the inflammation, the better. It is not completely out of the question to use heat. Heat will soften the spasming muscles and allow you to move. However, heat also brings more inflammation. If you decide you cannot move without heat, use it, but then move around for a while and then follow up with ice. Both heat and ice should only be used for a maximum of 20 minutes. For ice, the skin needs to get cold enough to go numb to be successful. Here are the stages of ice, so you know you are doing it right. 
  5. Go See Your Chiropractor. Once the spasms have settled down a bit, the inflammation is under control, and you are able to move, it is time to get the joints working properly and the disc back to a good shape. This is what chiropractors do best. An adjustment will get all of the joints in the area to move correctly which will allow the disc to heal properly. Get in as soon as possible before scar tissue makes that first adjustment a painful one.
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The Cost of Waiting

Abraham Lincoln once said, “You cannot escape the responsibility of tomorrow by evading it today.” The same is true for addressing your health concerns. Several times each day I have patients come in who tell me they have been hurting for days, weeks, months, or even years. The story is usually that they just thought it would get better on its own but it never did. Inevitably, they express their remorse at waiting to come in.

The truth is that with any injury, the body starts the healing process immediately. The concern is whether you will heal correctly. The body will compensate in whichever way it can to stabilize. If muscles are tight or ligaments are overstretched, it will alter the proper movement of joints. Such improper movement causes the nervous system to become confused and ultimately desensitized. Consequently, the body will lay down scar tissue that will promote the new and improper movement patterns which leaves the body susceptible to reinjury or to injury of surrounding tissue.

As a chiropractor, if I can help move the joints in a proper manner before inflammation and scar tissue sets in, then the healing process is a much easier ordeal. If you wait until scar tissue repair has set in when you come in to see me, the first step will be for me to tear down most of that process so the healing can start over. As with remodeling kitchens, the demolition can be ugly. The old adage of getting worse before it gets better is often in play and can lead to a few days of discomfort.

Another caveat to waiting is establishing movement patterns that can be difficult to retrain. Old habits are harder to change than simply making new ones in a fresh environment. Chronic conditions can take years to correct for this very reason. Muscles and joints have memory locked in to the nervous system. In my experience, it typically takes around three months of consistent treatment to change that memory.

Finally, with altered movement, the the body will degenerate quicker. At a joint level that means that tissues will dry up and bone spurs will form. Once a bone spur has formed, everything changes. No amount of adjusting, taking supplements, acupuncture, or whatever is going to remove that. Tissues can be rehydrated but they are never as good as they used to be. This is mortality. However, we can help slow down the degenerative process. At the end of the day, if we just improve the function it is worth it.

All conditions will change over time. The body will strive to compensate but that compensation can lead to issues down the road. If you have an injury or if dysfunction has been brewing for too long, get in! Better yet, come consistently and do your best to maintain good health and function.

 

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Meet Eric Wagnon, DC!

Eric Wagnon Photo

If you have been in the office over the last three weeks, you may have seen a tall gentleman in passing or treating patients. We are happy to welcome Dr. Eric Wagnon!

Dr. Wagnon has relocated his practice from Rocklin to be with us. He brings with him nearly seven years of experience in helping others improve their health through chiropractic care. Dr. Wagnon and his wife, Jackie, are residents of Rocklin along with their children Tucker, Taylor, Tessa, Tyce, and twins, Trey and Talia. Dr. Wagnon was raised in the Sacramento area. His father has been practicing as a successful chiropractor for 30 years. Dr. Wagnon’s undergraduate studies in Biology were completed at Brigham Young University, and his Doctor of Chiropractic degree was attained from Life Chiropractic College West. He is also fluent in Spanish.

Dr. Wagnon plays an active role in the community involved with the Rocklin Chamber of Commerce and speaks regularly to different clubs, groups, schools, and organizations on different Wellness topics to help change the health of our community.

Growing up with chiropractic in the home, Dr. Wagnon possesses a deep passion and personal understanding for what chiropractic can truly do for individual and family health. Nothing gives him more satisfaction than to be able to give that health to the core unit of society, the family.

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How Do I Know If My Chiropractic Treatments Are Helping?

adjustlumbarK

One of the most fulfilling yet difficult aspects of my career is helping people navigate their journey to better health. Healing is a process that can take a lot of time. We tend to think of that process as a straight road from disease or injury to health but that is the exception rather than the rule. Often, things feel worse before they feel better and there are always plateaus and valleys. Helping patients to have faith in the process and continue care inspite of bumps in the road is a worthy challenge.

Everyone comes into the office with disfunction. Not all disfunction is symptomatic but it all has potential to become so. Sometimes people come in with symptoms that are just starting to show but during further examination, I discover that those symptoms are just the tip of a very large disfunctional iceberg. I know that when I start chipping away at the disfuntion below the surface it is going to make those symtoms much more obvious. This can be very alarming. In addition, symptoms can change or move locations. People who are more prone to worry, often need a lot of reassurance to stay the course. There are several signs and symptoms that may cause concern but are actually indicative of progress. Most of these happen in early stages of care.

Pain will often increase with increased movement. Adjustments are designed to move joints that have been stuck or moving improperly for some time. Getting them to move again can cause pain. It is not always pleasant but it is a necessary step. As a rule, the pain should be more of an ache or soreness. Furthermore, pain can centralize and therefore increase in intensity. Centralized pain, or pain that is focalizing on the disfunctional joint, is usually more painful than a broad spread out pain. In this phenomenon, the pain is going back to where it belongs which is a very positive step. The closer your symptoms are to the structure that is actually causing the symptoms, the better the body will be at promoting healing in that area.

Symptoms often change especially when nerves are involved. If a nerve is significantly injured, the worst thing is complete numbness with zero sensation. There is actually no pain. When we lessen the irritation, the sensation is one of pins and needles and achiness. This can be followed by soreness. These symptoms will wax and wane for some time before a complete recovery.

Another change that can happen that will cause a patient mental anguish is when a symptom switches sides. We often see this is disc related injuries. This is not necessarily a bad thing either. It tells me that the disc is not completely stuck in one bulging position and can change or, even better, that it has not degenerated to the point of no return. The ability to change means it can heal.

I find it much better to not focus on symptoms but to look at movement patterns, muscle tone, and inflammation. If range of motion is improving and muscles are calming down, then progress is being made, and it is only a matter of consistency and time before symptoms start to go away for long stretches of time. When people ask if they are getting better, or complain that they are not any better, when I know they are, I usually ask them how they feel after an adjustment. More often than not, they feel significantly better but it just does not last as long as they think it should. As we get better, we also tend to forget how bad the pain was. The contrast of any pain when you have experienced little to no pain promotes the idea that one is not improving. Perspective is the key.

If you feel like chiropractic is not helping you, please take a step back and consider the big picture before you cut your care short, thus nullifying all of the hard work you and your doctor have done to help you become functional again.

 

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