I got a free chiropractic exam from an Earth Day promotion the company had. I got my results this week and the guy said:
- My spine is twisted and needs to be corrected to be straight again (and in the xrays there did seem to be lateral curvature)
- the disks are degenerating due to the curvature (to me the xrays were less clear on that)
And that the only way to stop this regeneration is to a) stop back squating and b) (and this is why I’m super-skeptical) I need pay him $2G and come in 3x a week for corrective back procedures
Personally the only pain I’ve felt in my back is last year my left QL got really tight and hurt during squats and deadlifts. I largely corrected this with foam rolling and strengthening the QL’s synergists (glute medius) and hardly ever feel pain.
Anyone with any expert thoughts on the subject?
How many sessions was he offering for that amount of money? Some Chiros that I have interacted with, from both the patient and clinician aspect, have been amazing and have taught me a great deal. Others have make me want to run face first into a wall and lose all respect for them as clinicians.
The big problem is how chiro’s charge here in the US. You either get the ones who make due with what health insurances cover (which can be pretty meager at times) or the ones who will aim for auto insurance or one who will only accept out of pocket payment (no insurance). Of course there is crossover of which type of billing that chiros do, but those are the 3 ways I have encountered and been described. The out of pocket ones generally will make you purchase sessions in packages as to avoid only getting a few sessions out of you, since most people will find relief after a few or more sessions and stop coming. The chiro you experienced sounds like that kind. Chiros i have worked with and have the utmost respect for have told me that with MOST cases, if they can’t relief the major pain and cause of an issue in 2-3 weeks or less, then they are either going about things the wrong way or there is something more going on that should be referred.
WIth your situation, Mr Stern has already stated most of the points that I would bring up. 1) You are not symptomatic with anything, so you shouldn’t jump to a major financial decision and fork out the money for the services. If you were going to spend the money, I think you would be better off finding somebody who can do a FMS and then find out what muscular imbalances you have and addressing those as preventative measures, instead of what this chiro is offering. 2) X-rays can show curvature and a rough estimate of disc heigh, but there are a lot of factors that can go into this. Is the curvature muscularly caused or is it a skeletal structural issue (scoliosis)? Also, what time of day was the xray taken? Had you been standing or upright for an extended period of time before? Hydration levels of the disc varies and can alter what the disc height looks to be on x-rays. As Mr Stern said, the curvature may have been due to you body positioning during the x-rays. 3) Going back to x-rays/imagining - studies have been done showing MRI studies that show a pathology, but the athlete/patient shows no symptoms. The studies’ results have shown that you cannot just solely rely on imagining to diagnose a problem. It must be a combination of both physical, orthopedic evaluation and imagine and patient history, etc. Here is a link to a recent study on MRIs: http://www.orthosupersite.com/view.aspx?rid=64012
I guess to sum up my long post (sorry), IMO you at this point you don’t need a regular session of chiropractic visits, especially considering you don’t currently have any symptoms. Not saying you can’t/won’t develop any, but I think just focusing on muscular balance, etc will do more than a visit to the chiro.
First off just because something isn’t broke doesn’t mean you shouldn’t take proactive measures to keep it unbroken. You wouldn’t wait to change bald tires until they blew out. Many things in the body can’t be fixed very well once they “break”.
Hopefully you were positioned well for your xrays. If your curvature issues are very minimal then maybe there was a positioning issue. If its pretty significant then it is very unlikely that it would be caused by a tight muscle that day or an issue with positioning. Disc degeneration can be assumed to an extent from x-rays. If you see things like, osteophytes, eburnation, thinning discs, etc.
I would definitely get a second opinion if you feel very skeptical of what this chiropractor has told you. You could get another examination from someone else or have someone else analyze the x rays. Especially since you don’t even feel like you are having any symptoms.
If you are of a proactive health mindset then I would suggest getting the opinions of reputable chiropractors. The medical field can only really treat back problems with drugs or surgery.
I agree with you Radcon in that the OP should be taking proactive measures, and I think everybody else that has commented agrees with that as well. I think the big issue here is what proactive measures should be taken. Personally, from the description that was given about this chiropractor, I wouldn’t feel comfortable with his diagnosis/treatment plan. It just seemed to big of a “money maker” situation - free evaluation to draw in clients, find a problem through x-rays, and suggest a long treatment plan for $2000 (unless I am misinterpreting what the OP meant by $2G).
Definitely agree with you that he should get a second opinion and should continue to be proactive in terms of keeping proper lumbar stability, hip mobility, t-spine mobiity, etc. In either a functional or structural scoliosis case, I do believe that chiropractic work can assist helping decrease pain and mobilize the proper areas, and in conjunction with proper rehab can solve the issue, but this situation just doesn’t seem right to me from the given information.
The OP is asymptomatic and, minus the one QL issue in his past, has had no issues. I am not a fan of “this imaging found xyz, so we need to fix it”, especially if the history and physical exam do not support it. The majority of people walk around with some kind of disc pathology without symptoms and will be fine as long as they continue with proper preventative measures.
You’re absolutely right in that imaging is not the be all end all. A good patient History is generally more important and imaging should be used in conjunction with the history not as a complete diagnostic tool. The OP is obviously skeptical as he should be.
BULLSHIT!!!
Run away from this fu**ing thief and find someone who isn’t going to empty your bank account for some ‘corrective treatment’ that you may not even need from the sounds of it.
Now I’m angry that conmen like this exist and are probably doingverynicelythankyou from a financial perspective - at the cost of their patients.
BBB
the exam was worth what you paid for it.
[quote]jp_dubya wrote:
the exam was worth what you paid for it.[/quote]
In this case you may be right. However I always offer a free initial assesment, just so that I know what I’m dealing with and how effectively I think I can resolve it. I hate to take money but effect no lasting changes in a patient; makes me look like a charlatan.
I will also travel to the houses of those in crippling pain or restriction, for only the cost of my fuel added ontot eh cost of treatment. Why? Because I like to be able to say to myself “I helped that person when there was no other option for them, yet I didn’t take advantage of their situation.”
Find a therapist with a good heart and even if their technical knowledge might not be 100%, you will both be richer for the experience (in a spiritual, if not financial sense, haha).
BBB
Yea I meant $2000 by $2G
Sounds like it’s most likely bullshit but some indication to luck further into my postura, muscle imbalances
I probably should do more posture-related work. I do seem to have slight lordosis, and my lower back starts to hurt when I drive for long distances. Other than that, though, and the QL pain some time back there are no other symptoms of anything.
Outside of foam-rolling my QL and stretching my hip flexors sometimes I don’t really do too much in this department (should I?)
The corrective back procedures seem to involve just pushing the muscles around the spine to straighten it out
LevelHeaded,
What is an FMS? Would you recommend getting one with what I describe?
FMS = Functional Movement Screen. Gray Cook is a big leader in that department and offers seminars/continuing education courses for people to be competent in giving one. The NASM also has a version of a FMS, testing OH squat, SL squat, etc.
I think it is wise for majority of people, especially those with some kind of pathology/pain stemming from a disfunction to get some kind of evaluation, whether it be from an FMS or a qualified chiropractor, DO, PT, ATC, or other therapist.
From you stating you had pain in your low back after sitting for a long period makes me think you have flexion based pathology in your lumbar spine. Not always the case, but usually is. It may be wise to address anti-flexion lumbar stability movements, along with all around “core”/lumbar stability work and increase hip mobility to start.
[quote]TheBlade wrote:
Yea I meant $2000 by $2G
Sounds like it’s most likely bullshit but some indication to luck further into my postura, muscle imbalances
I probably should do more posture-related work. I do seem to have slight lordosis, and my lower back starts to hurt when I drive for long distances. Other than that, though, and the QL pain some time back there are no other symptoms of anything.
Outside of foam-rolling my QL and stretching my hip flexors sometimes I don’t really do too much in this department (should I?)
The corrective back procedures seem to involve just pushing the muscles around the spine to straighten it out
LevelHeaded,
What is an FMS? Would you recommend getting one with what I describe?
[/quote]
Do a functional movement screen for synergistic dominance of the QLs. Basically lie on your side and abduct your thigh. Does the body seem to recruit the glute med and min or the QLs preferentially?
Get someone who knows the correct palpation points to assess whether your erector spinae fire up in preference to your QLs when you do a back extension. Or not.
BBB
LevelHeaded,
My hip mobility should be pretty fine, I can do a full snatch, ATG front squats, etc.
Can you go more detail into this?
bushido,
I’d say the glute med, min and QL are about equally recruited, maybe more the former.
I’d say I did have preferential QL dominance before but per your suggestion 4-5 months ago I had trained my glute med and min and as such the pain has largely gone away
TheBlade,
Have you ever had somebody assess your ATG squat and full snatch? Only reason I ask is that some people can get into the bottom of a full snatch/ATG squat due to compensation with lumbar flexion when they lack full hip mobility. Not saying that is the case with you, but I have worked with athletes in the past that didn’t even realize they were “tailing under”/going into lumbar flexion at the bottom of the squats. Just something to look into if you haven’t already.
I’m a big believer in McGill’s work and largely support the training of abdominal muscles with exercises that stabilize the lumbar spine, rather than advocate movement of the lumbar spine and/or place a huge shearing force on the lumbar spine. Exercises include basic stuff like planks and variations of the planks. Other exercises are Anti-Rotational Palloff Presses, Overhead/Anti-extension Palloff Presses, ab wheel roll outs, bird dogs, etc.
[quote]TheBlade wrote:
I’d say I did have preferential QL dominance before but per your suggestion 4-5 months ago I had trained my glute med and min and as such the pain has largely gone away[/quote]
Bravo sir! I am impressed that you acted on my advice and gratified that I have been able to assist you to help yourself.
I wish all my patients were as full of initiative as you seem to be.
BBB