Chiropractic Care Offers Faster Back Pain Recovery Than Medical Care

Chiropractic Care Offers Faster Back Pain Recovery Than Medical Care

As a Baltimore Chiropractor that spends the majority of my clinical hours treating patient with back pain, it is not uncommon for patients to see me after they have seen their family medical provider. Typically these patients present for care to their PCPs office with a complaint of back pain. These patients are usually prescribed some combination of rest, activity modification (i.e. no lifting, bending, twisting), pain relievers such as ibuprofen, and maybe some muscle relaxers. When these remedies fail to bring about resolution of the lower back pain, these clients usually present to my office for evaluation and treatment recommendations. In some other instances patients with lower back pain in Baltimore either do not have a primary care doctor to see, or are in so much pain that they do not want to wait several weeks to get into their doctor to see them, so they just come to my office in pain.

Regardless of how a client gets to my office, the vast majority suffer from back pain. Regardless of how they go about feeling better, one thing is true: patients want to feel better quickly and they want to feel better now!

Recent research out of the journal Spine in December 2014 seems to indicate that patients that undergo spinal manipulation therapy had the best outcome compared to patients who either underwent “mechanical assisted manipulation” or “usual medical care.”

This study was a randomized control trial that set to compare to approach of manual-thrust manipulation vs. mechanical assisted manipulation vs. usual medical care to see what impact these approaches had on patient’s pain and disability levels.

Each of the first two groups underwent a series of 8 total treatments (2 visits per week for four weeks) and the medical care group saw their provider a series of 3 times. The study followed participants’ self reported levels of pain and disability at the beginning of the study, immediately after their fourth week of treatment, and then again at three and six months following the termination of their treatment.

While research was quick to point out that all three groups saw improvement in pain an disability levels, it was found that the first group, the manual-thrust manipulation group (aka the chiropractic manipulation group) saw the greatest reduction in pain and disability levels at the end of care.

This study is important to me for two main reasons. First, it backs up what I tell my patients, which is that for mechanical lower back pain chiropractic spinal manipulation is incredibly successful. Secondly, and most importantly, it confirms that healing is a process that takes time. Even though spinal manipulation beat the other methods of back pain relief, notice that it still took 4 weeks of treatment to reach the outcome. Often I see patients who discontinue treatment after 2 or 3 treatments because “it isn’t working” and I assure them that healing is a process that takes time. This study also seems to suggest that patients should expect to see results within about 3-4 weeks. After that period any patient that is not improving may want to consider referrals to other specialists for second opinions and future treatment recommendations.

If you, or someone you know, is suffering from lower back pain, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

What Position is the Best for Sleeping?

As a Baltimore Chiropractor that spends much of my time treating patients with neck and back pain, I commonly get asked questions regarding sleeping posture. Patients want to know which positions they should be sleeping in for optimal spinal health. This makes sense since we spend nearly one-third of our lives in bed.

Best Position: On Your Back

Research seems to suggest that the best position for your spine is sleeping on your back. This preserves the curves of the neck, mid back, and lower back and does not put extra pressure on your spine. For patients that have acute lower back pain that can not lay on their back comfortably, it has been suggested that using one pillow below the knees can help to lessen back tension, allowing for a smoother transition to sleep. Additionally, only one small pillow should be used to not elevate or stress the neck while in this position. While this is the “ideal” sleeping position, it is not the only one.

Second Best Position: Starfish

This position is similar to the first position, with the addition of your arms being placed above your head. This position can cause snoring so if your sleeping partner notices that you snore in this position, take note and be prepared to transition to the best position, on your back.

Third Best Position: Laying On Your Side

Sleeping on the side is considered to be beneficial as it helps to open up the spine during sleep, by elongating the spine. This position helps to open up the spine and to reduce the probability of snoring. Pregnant women are especially encouraged to sleep on their sides (left side, specifically) to optimize uterine blood flow.  There is a difference in health effects depending on which side you lay on. Research has shown that asymmetrical sleeping can lead to facial wrinkles or sagging breast tissues. So, if you choose to sleep on your side, make sure to alternate each side whenever possible.

The Worst Position: Stomach Sleeping

Sleeping on your stomach is considered to be the worst of all of the sleeping positions. The spinal curves are not naturally supported. This can lead to neck pain, mid back pain, and lower back pain. It is the equivalent of standing for 8 hours in a night- given enough time a joint will be painful since the joints will have been “loaded” throughout a night of sleep. Nor surprisingly, the vast majority of my patients that come in with neck and back pain seeking chiropractic care are usually stomach sleepers. Some common symptoms of stomach sleeping include numbness into the hands or legs when they wake up in the morning. A subset of stomach sleeping (of which I am guilty) is known as the “fetal position.” This is someone sleeping on their stomach with one leg flexed up towards their chest to varying degrees of hip flexion. This position should be avoided at all costs, as it can cause hip or knee pain as well.

Sleeping is probably the best way to heal our wounds yet many of us do not get enough sleep, or sleep poorly when we do sleep. Sleeping patterns can be changed over time, but they take time. We should all aim for the optimal sleeping position.

For now, if you develop neck or back pain related to sleeping poorly please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

What Is My Baltimore Car Accident Case Worth?

As I’ve mentioned in many past blog posts, I treat many patients involved in Baltimore car accidents. After taking a thorough past medical history, evaluating chief complaints, and beginning treatment, one of the questions I am most frequently asked is “what is my Baltimore car accident case worth?” When I first started in practice I had no idea how to answer the question. As a medical provider I did not want to give an opinion on the value of a case. That is, I only treat patients and their symptoms. How could I possibly know?

If you look up case values on the internet, attorneys and insurance companies often list a formula to determine the value of a personal injury case. The formula is something like this:

Past Medical Expenses + Future Medical Expenses + Past Lost Wages + Future Lost Wages + Pain and Suffering = Total case value

Although I’ve been in clinical practice for approximately six years I can say that my answer to this question has not changed much at all. I still tell patients that I do not know the value of their case (in dollars) because it does not concern me. I encourage them to not worry too much about the monetary value of their claim either. The only thing that I can control when a patient is under my care is the treatment that I render on any given visit and in some capacity, how a patient heals.

When the question comes up about case value I like to re-direct the conversation back to the topic of activities of daily living. If you remember, these are activities that we either must do, or enjoy doing that can be made more difficult or impossible as a result of musculoskeletal pain. The question should not be what is the case of my value (in dollars) but rather, what is the value of my life and my daily routine? How valuable is it that I can be the person I was before the car accident and that I can “move on” and not be reminded for the rest of my life of this motor vehicle collision?

How much would you enjoy waking up each day if you woke up with searing back pain? How much would you enjoy going to work if bending to get into your car and sitting caused you numbness down a leg? How much would you miss carrying your newborn child if neck pain and looking down caused you hand numbness? How much would you enjoy reading a book to your child if sitting a chair caused back spasms?

Obviously the “quality of life” questions are endless, but it stands to reason that regardless of the monetary value of your personal injury claim, the quality of life interruption that you may be experiencing is way more important.

To be clear, I understand that money “makes the world go ’round” but it is not the most important thing following a Baltimore auto accident. Without a physical and emotional recovery, all the money in the world can not make you “whole” again.

If you really must know the value of your Baltimore auto accident claim, I would recommend contacting one of the many Baltimore auto accident attorneys that can better answer that question. If, on the other hand, you are concerned about making a complete recovery and resuming your life as quickly as possible with as few complications as possible, please contact Mid-Atlantic Spinal Rehab & Chiropractic. We would be happy to help you feel better and go back to living your life, which is the true “value” of a Baltimore auto accident claim.

Dr. Gulitz

Length of Treatment Following a Baltimore Car Accident

As a Baltimore Chiropractor that spends a considerable amount of time treating patients injured in Baltimore car accidents I often get asked by patients how long they should expect to be treating for their injuries. It is a complex question that is often hard, if not impossible, to answer on the first visit. That is, when patients first come into the office for an evaluation it is usually several hours to several days following their injury. Often their conditions will get slightly worse before they get better as their body begins to heal.  Additionally, these patients may be severely medicated if they went to a hospital following their injury, so it is difficult to accurately assess their “true” levels of pain and discomfort. Research suggests that human metrics are way more important in determining injury severity than are vehicle metrics. That is, it stands to reason that all things being equal, a previously healthy 16 year old male may not be injured as much as a 75 year old male with diabetes and heart disease.

I don’t like to set hard and fast parameters for my patients in terms of how much care they need. I let their treatment “do the talking.” If they are making their appointments, if their subjective pain levels are improving within the first 3-4 weeks of care by at least 50 percent, and if they are able to resume their activities of daily living without much interruption, then chances are they will not require much treatment and will be released to home care shortly. Typically for these patients care lasts anywhere from 4-8 weeks, on a declining frequency basis. They may start at 3 visits per week but by the time they are close to being released, they may only be treated in the office about once per week or once every other week as they continue to resume their activities outside of the office.

If, on the other hand, a patient is not making their treatment visits, is not performing the stretches that we have assigned for them to perform at home, and has other comorbidities that delay wound healing (smoking, diabetes, heart disease, etc.) then it stands to reason that the length of care that the injured patient requires would be longer.

The purpose of this blog post is to alert you to the fact that it is impossible to predict, particularly early on following an injury, the exact amount of time that it takes for a patient to be dismissed from therapy. Keep in mind, even once dismissed from treatment in my office, a patient will continue to go on and heal, as healing is a long process.

There are some chiropractic clinics that treat all patients the same. They treat all motor vehicle collision patients with the same therapy, for the same number of visits, without regard to their age, pre-existing health conditions, or restrictions. These clinics will routinely tell their patients that they need 16 visits. How they can predict such a specific number is beyond me. This type of blanket treatment often leads to misdiagnosis, suboptimal care, and disgruntled clients who are left “holding the bag” by remaining in pain and having had their time wasted.

Mid-Atlantic Spinal Rehab & Chiropractic combines both chiropractic care and rehabilitation activities to help facilitate healing in our injured clients. We also work closely alongside Dr. Kevin Carr M.D. of Carr Medical Specialties to co-treat our patients to make sure that they get the best care medically and physically.

If you, or someone you know, has suffered injuries as a result of a Baltimore car accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Top 5 Chiropractic Myths

As a Baltimore Chiropractor that has spent my entire professional life treating patients with chiropractic care and physical therapy modalities it recently dawned on me that although I know and understand what chiropractic care is all about, many of my current and perspective patients may not. There are a lot of mistruths and misunderstandings about Chiropractic care. Typically this is why my office offers a free consultation, to let potential patients ask any questions that they would like in order to determine if they are in the right place. As a result of the success of my last blog post about the Top 5 Whiplash myths, I’ve decided to put together (in no particularly order) what I view to be my Top 5 Chiropractic myths. So here they are.

1) Once you go to the Chiropractor you will “always have to go.” Admittedly many patients feel relief of their neck and back pain symptoms with a short course of therapy and choose to return for additional treatment on a recurring basis, but you do not have. I see many patients who are experiencing an acute bout of neck or back discomfort that is able to become eliminated after only a few visits and then they stop presenting for care until, or unless, they need me again. There are no contracts to sign, no long term treatment plans, and no “guilt” associated with discontinuing treatment. Like a fisherman, we “catch and release” and a patient’s desire to come back after their initial treatment is completely up to them.

2) Chiropractic care is unsafe. There have been many research articles demonstrating both the safety and efficacy of chiropractic care for acute and chronic neck and back pain. And while there are the occasional sensationalistic stories about patients having negative outcomes under chiropractic care, the incidence of cataclysmic injury while under the care of a licensed and trained Chiropractor is so small as to be nearly negligible.

3). Chiropractic care is expensive. Like most health care providers we accept many means of payment for our treatment. These include fee-for-service (cash), health insurance, worker’s compensation payments, and auto insurance for personal injury cases. Typically the costs for services rendered are presented to an insurance company who will pay our bill. The out of pocket cost to a patient is determined by an insurance company’s plan, just like it would be at a family physician’s office. Many of the common insurance plans have chiropractic benefits that you are already paying for when you pay your monthly premiums. Care is not expensive, at least not more than a copay would cost you at your family physician’s office. Additionally, research has shown that for patients experiencing lower back pain care is about 20 percent less expensive than for those initiating care in a traditional medical setting.

4). I can crack my own back, I don’t need to see a chiropractor. Many patients ask me some variety of this statement each day. I remind them that the joints that they are able to cavitate or “crack” on their own are typically joints that are already hypermobile- that its, they are moving too much. Chiropractors are trained to palpate and adjust hypomobile fixated joint segments. So while it may be true that you hear joints cracking on your own, typically these are joints that are already moving appropriately and should not be adjusted. Chiropractors are trained to seek out and manipulate joints that are truly fixated.

5). Chiropractors break bones when they adjust you. Patients are often confused about what the “cracking” sound is. Research tells us that is is the sound of dissolved carbon dioxide and nitrogen gases in synovial joints that rush out of solution with an appropriate joint adjustment. This is similar to the popping sound that a bottle of champagne makes once the cork is popped, or to a can of soda once the top is opened. It is not the sound of bones being broken. While it is theoretically possible to apply enough force to break a bone, instances of broken bones within chiropractic offices are extremely rare and special efforts are made to prevent such outcomes.

I am sure that there are many more chiropractic myths out there. If you would like more information on any of these myths or if you would like me to “debunk” some more, feel free to comment and I would be happy to address any Chiropractic myths that you may have.

In the meantime, if you, or anyone you know requires Chiropractic care for neck pain and back pain please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz