It’s really great to be back in the office!  I missed being at work and helping people.  I’m asked all the time how I am doing and if I’m at pre-injury condition.  The great news is that I can do everything I need to do in my physical job as a chiropractor without pain or limits.  I know I have a road ahead of me and it will take up to a year for full recovery.  I won’t be skiing this winter or back on the tennis courts until May or June, which my surgeon, Dr. Brian McKeon, told me prior to my surgery.  I am highly motivated and extremely compliant with my rehabilitation.   Steve Crowell, my PT, says I’m a head of schedule almost 3 months post-surgery

No one ever wants suffer on injury or need surgery. However, injuries happen and when they do knowing the potential outcome and one’s responsibilities in the recovery process is important to manage expectations.

Though I didn’t need to have an injury requiring surgery to know this, this experience has given me better insight and has probably made me an even better chiropractor.  Most of my patients when they call my office are expecting, or at least hoping for a one and done experience.  This does happen, but it is a rarity. Most of my patients present with chronic pain syndromes caused by faulty function in their musculoskeletal system. It could be a nagging long time pain, a recurring pain and at times one than that just manifested.

Our initial history and exam with our new patients are comprehensive to find the cause of the problem.  It only takes millimeters of pressure on or off a nerve to cause pain.  I remind my patients that the pain is there for a reason.  It is your body’s way of saying something is wrong.  That is why the mechanical dysfunction may always be there but the pain is not.  The oil has to go down a certain level in your car before the oil light goes on.  First it may go on intermittently. Then the light stays on constantly and if you ignore the light you may eventually have flames coming out of the engine.

The body reacts the same way.  Often I will see a new patient in pain and they will say they never had pain before in this part of their body. My exam will show poor range of motion and x-rays may show degenerative changes.  I tell those patients that their body has just gotten used to poor function and finally it has gotten to the point that it expresses itself in pain.  Other times a new patient will come in with pain in the elbow.  I’ll do my exam, and yes they have evidence of tennis elbow, but when I check their neck range of motion it is horrible.  When I evaluate the function of the nerves from the neck to the arm there are entrapments.  When this happens and when giving my first treatment I always address the neck before the elbow.  Often after working on the neck when I re-check the positive tennis elbow tests they have lessened or resolved.  If I don’t address both the elbow and the neck the tennis elbow may get better, but will eventually return.  (This is probably why I treat so many tennis players in my office).

So my recommendations to my patients are usually two fold.  The first is to resolve the pain. The second and most important is to optimize their biomechanics. The first part, pain relief is usually quick. The second part, optimizing function takes a lot longer.  First we have to put the fire out and then secondly we need to rebuild.  Otherwise embers remain that can become a fire again.

Just like my surgeon and PT told me what to expect short and long term, I do the same with my patients.  The challenge is that all of us see commercials on TV, and read ads in magazines and newspapers and have been conditioned by drug companies. The drug companies try to convince us if you have pain you are not healthy and need drugs for pain relief. Once the pain is gone you are healthy.  Besides the side-effects and long term dangers of pain medications, what these drugs do is mask symptoms. They do not get to the cause of the problem.  Most pain is mechanical.  Chiropractic care finds the cause of mechanical pain and works to correct it.  That often takes time.  So during my report of findings to my patients I let them know what to expect.  How long it will take, how much will it cost and what can be done at home to quicken their response with care.  Which exercises and stretches to do and what not to do.  Also we discuss how to sit, sleep, bend and lift safely without continually exacerbating their pain. Of course when it is not a situation here chiropractic care is not warranted I refer to the appropriate specialist.

What I have found in 35 years of practice is that many patients don’t get it the first time. I get them out of pain and they often think they are healthy.  They are happy and pleased with their chiropractic experience and then stop care without completing the rehab phase.  Usually they return within a few weeks or months saying their pain came back. I do another exam; explain to them that even though they were feeling better they were not healthy. Their range of motion are still restricted, they still have muscles imbalances/adhesions or nerve entrapments, whatever their individual case may be, and then get them back on track with their chiropractic care. Of course others never return and say that chiropractic doesn’t work.  This is why I try so hard to explain before we start the process so they have realistic expectations.

My experience is that most patients listen to their surgeons and respect their recommendations and understand their outcomes and expectations.  As a chiropractor I have to continue to elevate my communication skills and use analogies that my patients can understand so they understand why they need chiropractic care and what to expect. By doing this I can help my patients get well and stay well so they can enjoy life and the participate in the activities they enjoy for as long as they want!  Life is motion and chiropractic care keeps people moving!

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