San Francisco Chiropractor - Friday, 9:26 PM - September 28, 2007

What is chiropractic?

The American Chiropractic Association defines chiropractic as a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal (i.e., nerves, muscles and joints) complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

This is purposefully is a very broad definition. There are many chiropractic techniques within this definition. Most involve manual therapy; i.e. therapy done by hand. Like the martial arts, these techniques differ in style-- some employ very light force while others use firm force; some utilize a hand-held instrument; and some require special tables to carry out the treatment.

Such a diversity of techniques result in unfair criticism from various chiropractic critics. Granted, on the surface it makes chiropractic appear ambiguous. But to me, the diversity makes perfect sense. It is symbolic of the diversity we see in humanity, from a physiological perspective. For example, large people may respond better to traditional spinal manipulation while more fragile frames may respond to softer force techniques. An analogy that best explains the virtue of the multitudes of chiropractic approaches is that there are many ways to cross the ocean, or prepare a gourmet dish. And not all of them are necessarily the "correct" way, so to speak.

So, if you are a new patient looking for a San Francisco chiropractor, don't be dissuaded upon finding out that there are several kinds of chiropractic styles out there. I recommend that you first ask your friends, relatives or co-workers if they have any referrals. Secondly, you can check the State Board of Chiropractic Examiners website to verify that the chiropractor is in good standing. Lastly, see if you can get a complimentary evaluation at the office so you can get a feel for how the chiropractor runs his or her practice, and how the chiropractor relates to patients.

San Francisco Chiropractor - Saturday, 10:36 AM - September 29, 2007

Is it good to "crack" my neck and back myself?

I would advise against it. Such activity can cause joint hypermobility, where the joints lose ligamentous support. This can lead to improper joint movement, and over years, degenerative changes (arthritis).

In chiropractic adjustments, the joints that are manually moved are determined (by X-ray, palpation, or instrumentation) to be already misaligned in some plane, or are already hypomobile. The human spine has 24 moving vertebrae, and not all of them need to be "mobilized" or adjusted. "Self-adjusting", or cracking your own neck joints is non-specific and does not give you the same benefit as a more targeted adjustment that can not be safely performed by the patient himself /herself.

San Francisco Chiropractor - Sunday, 11:05 AM - September 30, 2007

Is there research to back up chiropractic treatment?

Chiropractic does not only rely on anecdotal evidence. Although chiropractic does not enjoy the huge research funding given to allopathic medicine, courtesy of the pharmaceutical industry, various government and institutional grants enable an ongoing research effort into the effectiveness of chiropractic on selected conditions. Below are a few research studies done over the last ten or so years:

Overwhelming Evidence Shows Chiropractic Effective for Pain Reduction and Restoration of Function

Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustments, is both safe and effective. Many other studies have shown that chiropractic care can be a cost-effective remedy that brings healing in less time than other treatments. The following are excerpts from just a few of these studies:

For Acute Low-Back Problems:
“For patients with acute low-back symptoms without radiculopathy, the scientific evidence suggests spinal manipulation is effective in reducing pain and perhaps speeding recovery within the first month of symptoms.” - Clinical Practice Guidelines, AHCPR (1994)

For Long-Term Low-Back Problems:
“There is strong evidence that manipulation is more effective than a placebo treatment for chronic low-back pain or than usual care by the general practitioner, bed rest, analgesics and massage.” - Spine, Van Tulder and Bouter et al. (1997)

“...improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear.” - British Medical Journal, Meade et al. (1995)

“Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after 12 months.” - British Medical Journal, Koes et al. (1992)

For Pain:
“...patients suffering from back and/or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments, thus reinforcing previous results showing the benefits of chiropractic treatment for back and neck pain.” - Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)

“...for the management of low-back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system.” - The Manga Report (1993)

For Headaches:
“Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.” - Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001)

“The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches...Four weeks after cessation of treatment...the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” - Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)

San Francisco Chiropractor - Wednesday, 8:00 PM - October 3, 2007

Why does computer work cause neck and shoulder pain?

Simply put, the human body really wasn't designed to be sitting sedentary in front of a computer terminal. But, since computers have permeated everyday life at the same level as watching TV, the issue is of major concern.

I treat many cases of chronic and acute shoulder problems. What I notice from gathering information on body mechanics from these patients is that they have their keyboard and mouse too high. And, a distance as small as an inch can mean "too high". This will cause you to subconsciously contract your upper trapezius and neck muscles in order to raise your arm to fit the keyboard. Over time, this contraction can lead to strain. Secondly, the glare of the monitor causes vision fatigue, which causes you to subconsciously bring your head closer to the monitor. When the center of gravity of the head (a 10-12 lb weight) moves forward of the spine, a lever-arm is created. This means that a force is generated at the back of your neck and upper spine to counteract the weight of the head.

So, make sure to keep your keyboard and mouse low enought that you don't have to lift your shoulder in order to type. Keep your upper arm in line with your torso, and your elbow 90-110 degrees. Wrists straight.

Keep your head upright so that your ears are directly over your shoulders. Look away from your monitor and focus on an object at least 20 feet away to prevent lens fatigue. And, visit you chiropractor so that any spinal obstructions to this can be removed.

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