Chiropractic and Physical Therapy

I was asked to write this article by one of my patients. She actually asked me write about chiropractic vs. physical therapy but I feel like there isn’t really a competition. They are different even if the end goal of improving one’s health is the same. There is some overlap but at the very least they are complementary. Nevertheless, here is the comparison.

Chiropractors focus on proper joint motion and nerve flow. Philosophically, we want to make sure that the innate intelligence that flows in each of us through the nervous system is not impeded. Subluxations or altered joint function can be a major cause of altered innate flow. When a chiropractor adjusts, the correct movement of a joint is restored and the nervous system flows as intended.

I don’t believe physical therapists have any such allusions to such a philosophy. Their focus is on mechanics, rehabilitation and improving activities of daily living. Physical therapists are rehabilitation specialists. After major injuries or surgeries, bodies need to be reeducated and strengthened. Exercises, joint mobilization, soft tissue work, and physiotherapy are their tools. They spend a lot more time teaching and pushing the patient.

Although most chiropractors are taught the same rehab techniques techniques as PT’s, the vast majority, including yours truly, have no interest in them. Our tool is the adjustment which can be compared to mobilization that PT’s do but the adjustment is much quicker and thorough. It is technically considered a Grade 5 Mobilization. I think most chiropractors would argue that it is much more than just a mobilization.

We can both teach exercises, do soft tissue work, and physiotherapy (e-stim, ultrasound, heat, ice, etc.). I personally will teach some basic exercises in a course of treatment and will do soft tissue work, if need be. However, physical therapy requires more time each visit. As a chiropractor I don’t spend very much time with each patient. An adjustment only takes a few minutes. Physical therapy appointments are typically at least a half hour.

Both treatments are effective for what they are. Getting joints adjusted is very important and may be all the body needs to heal. Sometimes the patient needs more. I refer to PT when it is more than I can feasibly handle. On the same token, some soft tissue injuries, especially muscle strains, need physical therapy and adjustments don’t really have an affect either way.

Like I said, Physical Therapy and Chiropractic are very complementary. With complicated cases, doing both can be extremely effective.  If a PT or a chiropractor tells you differently it is probably because they are insecure about their own skills.

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“It’s Never Just a Muscle!”

Back Pain

I hear it just about everyday. I don’t know how or why people think it. There is no known conspiracy about it. It may be because it is the only explanation people can think of. It drives me crazy and takes all of my energy to control my emotions when I hear, “I think it’s just a muscle.”

Let me explain why it is never just a muscle when you are talking about back and neck pain. The muscles in the back and neck are slow twitch muscle fibers. They are designed for endurance. They are not fast twitch, speed muscles. In addition, there are three layers of muscles with a ton of overlap amongst the muscles of each layer. For this reason, it is nearly impossible to tear or “pull” one of these muscle without doing damage to a much more susceptible structure first. 

The most common tissue to receive damage in the spine is the disc which can bulge, herniate, mishape, and swell when over worked or over loaded. Then there are the joints and ligaments of the spine which will sprain long before a postural muscle reaches tearing status. Finally, you have the nerve roots which if irritated even slightly will cause a muscle spasm which essentially protects the muscle. Herein lies the issue. 

When a muscle spasms it can be a lot more painful and noticeable than the underlying cause. Don’t be fooled. Muscles don’t just decide to spasm on their own. It is a protective measure. 

There can be occasions where a muscle due to overuse, usually because of postural strains, will form a knot (the technical term being a trigger point). When this happens it is commonly like asking, “which came first the chicken or the egg.” If there is a trigger point it will immediately affect the joints, discs, and nerves. There will also be a good argument that the trigger point only developed because of a lack of motion or subluxation of the joints. Either way, it is never just a muscle. 

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