Chronic conditions are characterized by mild to moderate pain and discomfort that has lasted anywhere from a month to several years. Chronic conditions can have many periods of acute flare-ups with remissions, or periods of less or no pain. Chronic pain is usually caused by conditions that have not been properly treated, like in the case of a low back injury where strengthening exercises were not given, or due to permanent damage where the body cannot fully recover, like in the case of a very severe injury or operation.
The causes and types of chronic conditions vary, but all share common characteristics.
Chronic conditions can be some of the most difficult cases to manage. Often, these conditions can be present for many, many years. Patients have also usually tried everything possible to get rid of the pain. We often see patients who come to us as a last resort. Often, we can help patients manage their pain and significantly decrease their pain and discomfort, and help them improve their function and ability to perform certain activities. In some cases we can help patients get completely over their condition. Only in very rare cases can nothing be done at all.
Since we cannot possibly predict how very chronic cases will respond (especially if other interventions have failed), they are handled in a specific manner. If it is a condition that may respond to our treatment methods, it is given a 2 week trial of care at 2-3 times per week. At the end of those 2 weeks if there is no progress we will either change the treatment plan for another 2 week trial of care or discharge you at that time. If at the end of those 2 weeks progress is being made, care will be continued as appropriate. This protocol is followed because we feel we owe it to you to give care a chance to help while at the same time not over treating for something that cant be helped. Plus, there is a high reward (if it helps) versus very little risk (small chance of side effects). This is especially true for conditions that have not responded to any other care (drugs, surgery, therapy, etc.).
Our chronic care program consists of the following elements:
The causes and types of chronic conditions vary, but all share common characteristics.
- Usually due to areas of old injuries that never fully healed.
- Joints do not move well, become achy, and develop arthritis.
- Certain muscles become overly tight while others become very weak.
- Posture is affected and head moves forward, shoulder round forward, and upper back becomes slouched (think of the old man with cane crossing the road).
- May have many periods of acute flare ups and remissions.
- Long term loss/change of function and structure scar tissue and adhesions can form in tissues that are damaged. This can lead to chronic joint pain and muscle tightness, as well as an increased chance of re-injury in the future.
- Increases stress pain and discomfort can lead to both psychological and physical stress on the body. People in pain can often be irritable or depressed and physically exhausted (often from not sleeping well because of the pain).
- Most people develop fear that performing certain activities may increase their pain or cause more damage.
Chronic conditions can be some of the most difficult cases to manage. Often, these conditions can be present for many, many years. Patients have also usually tried everything possible to get rid of the pain. We often see patients who come to us as a last resort. Often, we can help patients manage their pain and significantly decrease their pain and discomfort, and help them improve their function and ability to perform certain activities. In some cases we can help patients get completely over their condition. Only in very rare cases can nothing be done at all.
Since we cannot possibly predict how very chronic cases will respond (especially if other interventions have failed), they are handled in a specific manner. If it is a condition that may respond to our treatment methods, it is given a 2 week trial of care at 2-3 times per week. At the end of those 2 weeks if there is no progress we will either change the treatment plan for another 2 week trial of care or discharge you at that time. If at the end of those 2 weeks progress is being made, care will be continued as appropriate. This protocol is followed because we feel we owe it to you to give care a chance to help while at the same time not over treating for something that cant be helped. Plus, there is a high reward (if it helps) versus very little risk (small chance of side effects). This is especially true for conditions that have not responded to any other care (drugs, surgery, therapy, etc.).
Our chronic care program consists of the following elements:
- Intake forms and questionnaires these forms are used to gather information about you, your personal and family health history, and your current complaint. It may seem like a lot to fill out, but it is all very important to for allowing us to give you the best care possible.
- Interview and physical examination once the paperwork is complete, the doctor will review it with you and may ask for additional information. Based on that information, a physical exam will be performed to find out exactly what areas may be causing your problems. This is when the doctor will also rule out problems that may need immediate medical attention.
- Report of findings and consent to treat During the examination and once it is complete, the doctor will make you aware of his findings, let you know what may be causing your problem, and point out areas that must be addressed for a better recovery. He will then discuss treatment options and possible referral options (if MRIs, Xrays, or medical referral is necessary).
- Beginning Care If you agree with his recommendations, treatment may begin immediately, but most of the time you will be let go and asked to return in a few days. Since the problem is chronic and urgent attention is not needed, the doctor would rather take time to review the exam findings and design a thorough treatments plan that will begin on your next visit.
- Acute flare up of chronic condition in many cases, patients will often present with an acute flare up of an ongoing or chronic condition. Pain levels will be from 5-10 out of 10. In this case, our acute care program will be followed until pain levels are more tolerable, approximately 0-4 out of 10.
- Remodeling For the patients that present to us while they are not in an acute flare up, we will start in this stage. This is the part of care where we need to address scar tissue/adhesions, reduced range of motion, joints that do not move well, and overly tight muscles. Care consists of aggressive muscle work, manual therapy, and chiropractic adjustments that aim to break up adhesions and tight scar tissue, and allow muscles and joints to move through their full range of motion. Without this stage, it would be impossible to improve posture and strengthen weak muscles.
- Strengthening, stabilization, and restoring full function Once the tight and restricted muscles and joints are worked out, methods to fully restore range of motion and strengthen and stabilize areas of weakness. Care is only 1-2 times per week for a few weeks to monitor progress and add/change exercises. Chiropractic adjustments and manual therapies may still be provided to clear up any remaining areas of muscle and joint tightness.
- Withdrawl from care and discharge once it is determined that the condition is resolved and you are doing well with your exercises, you will be dismissed to a home exercise program for approximately 4 weeks. At the end of that time the doctor will see you a final time to check on your progress and discharge you completely if there is no longer need for care. If the condition returns, more treatment may be provided and/or your home exercise program may be updated.
- Maintenance care Some people notice that regular chiropractic care and therapeutic massage help them feel great. Keeping the muscles relaxed and joints moving well can reduce stress and discomfort and joint pain and tightness. Some studies even suggest that this may help prevent future injuries and even arthritis. (joints that move well are healthier than those that do not). These people are welcomed to maintain a program where they see us from once every couple weeks to once every couple months. Insurance plans do not pay for this type of care, but we do offer discount plans for these services.