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The Best Chiropractic Care in Mesa, Arizona

Chiropractic Care

Should All Patients with a Migraine See a Chiropractor in Mesa?

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Ok..given my bias everyone probably knows my answer here when it comes to chiropractic in Mesa.
It never ceases to amaze me when a patient has had headaches for years or even decades that have never been to a chiropractor.  Given the evidence, it really should be considered malpractice (lack of informed consent) for a neurologist to NOT refer to a doctor of chiropractic for an evaluation of any headache patient.
And yet the referral to a chiropractor who specializes in soft tissue treatment of the neck almost never happens.  It is the migraine sufferer that loses out.
Just how common is neck pain in migraine headache sufferers?  This particular article looks at this question in 113 migraineurs, who had headache frequencies ranging from episodic to chronic migraine.  These headaches sufferers were examined by headache medicine specialists to confirm the diagnosis of migraine and rule out both cervicogenic headache and fibromyalgia.
For each attack over the next few months, sufferers recorded the whether nausea was present as well as the intensity of headache and neck pain (graded as none, mild, moderate, or severe).  Here’s what they found:
  • There were 2411 headache days, 786 of which were migraines.
  • The majority of migraines were in the moderate pain stage.
  • Regardless of the intensity of headache pain, neck pain was a more frequently present than was nausea.
  • Those diagnosed with chronic daily headache were more likely to have neck pain.

So what does this mean?  From a standard migraine approach, this means that, although the presence of nausea is a characteristic of a migraine headache, neck pain (which is not a characteristic) is actually more common.

From my standpoint of almost 20 years of treating migraine patients, we have totally, absolutely missed the ball.  Since most headache specialist do not touch the patient and wouldn’t even know how to treat problems in the neck is he or she found them, these patients are mis-diagnosed.

I can’t tell you how many times I’ve had patients come in with a diagnosis of “migraine” only to have the headaches go away with soft tissue treatment of the neck structures combined with manipulation.  These were NOT migraines.  Migraines generally do not respond as well to manual therapies, but most often need a lifestyle overhaul to manage the headaches.

The bottom line?  Neck pain is strongly associated with headaches.  If you have headaches, it is absolutely essential for you to find a chiropractor competent in soft tissue treatment to see if this will help.

Should I See a Mesa Chiropractor for My Chronic Migraine Headaches?

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Why am I even asking this (it was rhetorical, by the way)?  The answer is unquestionably yes.

It never ceases to amaze me how many new patients come into my office that have been having headaches for years and have never been to a chiropractor in Mesa.  Many of these patients begin to feel better in as little as a week.  The caveat here is that you need to find a Mesa chiropractor who addresses the soft tissue (muscle, ligaments, tendons, fascia) aspect of your problem and not just adjusting.  Many times the soft tissue aspect has been present for so long that just adjusting, just exercising, just ultrasounding, just interferentialling (is that a word??), just strengthening or just adjusting is not going to be enough.

This particular study just supports this link, finding close associations between tenderness in the trapezius muscles and chronic tension headaches as well as migraine headaches that were present only on one side of the head.

Having Orthopedic Surgery? You NEED to Know this Scary Risk

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orthopredic surgery and troponin
lenetsnikolai / Dollar Photo Club

Everyone knows that there are risks associated with any surgery. But the risks that you know about are the obvious ones.

Problems with the anesthesia such as aspiration pneumonitis or respiratory failure.  Problems with the surgery itself such as excessive blood loss, damaging the spinal cord or spinal nerves, infection or blood clots.

But what if there was something more insidious that can occur?  Something that won’t kill you today or tomorrow, but waits in the shadows until years later?

Before I tell you what this scary thing is, I do need to point out that there is a time and a place for orthopedic surgery.  But this should only be considered as an absolute last option.  All too often we THINK something is a last option.

But time and time again research proves that this is just not true.  Some examples:

This list is much longer, but you get the idea.  There are an uncountable number of orthopedic surgeries done every year that were unnecessary.  Which would be fine if there weren’t dangerous risks associated with orthopedic surgery and the chance that you will be no better after the surgery, or worse, in more pain after the surgery.

Side note–these comments do not apply to trauma-induced orthopedic surgeries–in these cases there are usually no options for avoiding an emergency surgery after trauma.

All of this brings me to this particular study.  In it, researchers looked at a scary side effect of orthopedic surgery called myocardial necrosis.  As you may be able to tell from the name, this is a condition were the heart muscle dies as a result of the stress on the heart from the surgery.  This bad effect from surgery is well known and characterized for short term mortality after orthopedic surgery.

What is not as well-known is what happens in the long term.  To get a better idea of how often this happens, researchers looked at levels of troponin (a protein found in the heart; elevated troponin levels are a sign that damage to the heart has occurred) immediately after orthopedic surgery and whether this related to long term death in hip, knee, and spine surgery 3 years later.  Here’s the details:

  • There were 3,050 surgeries with an average age of 60.8 years.
  • Myocardial necrosis occurred in 179 cases (5.9%) and heart attacks in 20 (0.7%).
  • In those patient who experienced myocardial necrosis, 16.8% of them did not survive in the long term (3 years).
  • In those who had normal troponin levels around the time of surgery only 5.8% did not survive.
  • To put it clearer, those orthopedic surgery patients who had higher levels of troponin were 233% more likely to die in the long term evaluation, while those who had a heart attack after the surgerys were 351% more likely to die.

Now certainly, if you had a heart attack just after your orthopedic surgery you’d know about it.  But myocardial necrosis may not have been fully explained to you if it had been identified.  Either way, if you DO end up having orthopedic surgery, it may makes sense to push your surgeon to run troponin levels along with everything else to get an idea about whether or not you’re going to be around in the next 3 years.

Seems simple enough.

 

Narcotics and Your Baby; Not a Good Combo

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opioid use during pregnancy
Maksud /Dollar Photo Club

You’re reading the title of this thinking that this is pretty stupid.  Who on Earth would think that this is a good idea??  Opioids during pregnancy.

I’m sure that if I gave you the true / false question, “Morphine is ok to take while pregnant,” there’d be no hesitation to check the “false” box.  And it wouldn’t surprise you at all to know that the use of morphine and morphine derivatives during pregnancy can lead to scary things like withdrawal symptoms into the newborn.  The technical term for this is Neonatal Abstinence Syndrome (NES).

If you agree that it’s absolutely crazy to take opioids during pregnancy, then you will likely be as shocked at the results from this particular study as I was.  In it, researchers looked at the use of opioids during pregnancy to evaluate just how common it was.  Here’s what they found when they looked at group of 112,029 pregnant women:

  • A shocking 28% (31,354) filled at least one opioid prescription during pregnancy.

How is this possible?  There are probably few people out there who would think that opioid use during pregnancy is ok.  I think I may know why; at least in my office.

From what I’ve seen, not enough of the population understand the drugs that they take.  Top culprits are Percocet and Vicodin.  It seems like a good chunk of my patients do not realize that these drugs are opioids.  Sure, most know that OxyContin and Oxycodone contain morphine derivatives.  But a surprising number of my patients over the years have not been aware that common pain medications that are handed out like candy also contain opioids.

So maybe a good chunk of the 31,000+ pregnant women in this study were written a prescription for hydrocodone-containing drugs like Percocet and Vicodin and just didn’t realize it.

Of course, the real question is how they got the prescription in the first place.  The prescribing physician should darn well know that opioids should not be prescribed in pregnant women.

The researchers then looked at what factors played a role in these pregnant women receiving a prescription for an opioid.  Here are the factors they found:

  1. They were more likely to have depression (5.3% vs 2.7%).
  2. Anxiety disorder (4.3% vs 1.6%)
  3. Smokers (41.8% vs 25.8%)

Looking at the list of these 3 factors, I just can’t understand how these patient-related factors should affect whether or not these women got a prescription for an opioid from her physician.

Overall, I don’t really have a take home message.  I’ve provided this article more for educational purposes rather than providing answers because I can’t understand how these prescriptions are written at this frequency.

In my biased opinion, the best and easiest answer to this prescribing problem is chiropractic care during pregnancy for any pain-related complaints instead of these prescriptions.  Maybe the answer is education for these pregnancy-related-opioid-prescribing physicians on the benefits of chiropractic care for pregnant women…??

Chronic Neck and Low Back Pain – Amazing Procedure Helps in ONE Day

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manipulation under anesthesia
Ded Pixto/Dollar Photo Club

As a practicing chiropractor, I see patients who have had chronic problems improve just about every day.  Despite how successful we are at treatment, there are still patients that we can’t help.

At least not in the office.  And not while the patient’s conscious.

There is a little-known procedure called manipulation under anesthesia (MUA) that involves a team of physicians in a surgical center working in a unique matter to help patients who have lost all hope at responding to any other treatment.  Some of these are surgical candidates who want to avoid the pain, rehab and uncertainty of invasive surgery.  Some of these are not surgical candidates because they don’t have a specific “lesion” to go in and fix surgically.

And, quite frankly, the results from surgery in clinical trials for back and neck pain are not exactly stellar.  The research study results from pain management procedures like epidural injections is even worse.  This from someone who reads a LOT of medical literature.

One anesthesiologist that I worked with called MUA “yoga in a can.”  Which pretty much sums it up.  So much of the problems that I see in my office are linked to poor movement.  Movement at the individual spinal level (let’s say L5-S1 as an example) or movement of the spine as a whole (the entire lumbar spine, for example).  While it is not common, it is rare for me to see someone with good flexibility who is very active to have low back and neck pain.

This is one of the reasons why yoga is so bad for a chiropractic practice.  Because it gets the spine moving.

I’ve been doing MUAs for almost a decade now and have seen some amazing results.  What I have never seen is a negative outcome.  I’m not saying that I haven’t seen patients not respond, but I can honestly say I’ve never had a patient get worse after an MUA.  Try asking a surgeon if he or she has ever had a bad outcome.

Even better, people who have observed or assisted with the procedure (there are any number of videos available on Youtube.com) all state that it looks like it would feel REALLY good after.  Ever heard anyone observing spinal surgery say the same thing??

Some conditions respond better than others.  For neck pain and headaches, the procedure is darn near a miracle (check out one of my patient’s testimonials by clicking here).  Shoulder problems, especially frozen shoulder, respond so well that insurance actually recognizes this as a condition they will pay for.  Low back pain generally relates to how “tight” the patient is in the first place.  Highly flexible patients may not respond as well to manipulation under anesthesia from my experience, but patients who have very little flexibility will do very well.

The problem with MUA is that there is just not enough money to fund good quality clinical studies.  For spine surgery, if a device manufacturer is charging $1,000 for a single screw, they’ve got the money to throw around on a study or two.  That leaves research on MUA in the realm of case studies.

Which brings us to this particular article.  In it, researchers looked at 30 patients with chronic neck and back pain who had failed to respond to conservative therapy underwent a SINGLE MUA by a single chiropractor.  Here’s the details:

  • A mere 2 weeks after the MUA procedure, 52% of the patients reported improvement.
  • At four weeks, this number was 45.5%.

While I would prefer to see this number at 100% response, we all know this isn’t realistic.  But having almost 50% of the patients who were likely at their wit’s end from pain and loss of quality of life respond from a SINGLE session of MUA is nothing to disregard.

At this point I would like to add that many of the MUA protocols recommend 3 sessions of MUA.  It is likely that, while still not 100%, the number of patients who responded to MUA would go up.  In addition, because of my personal background with soft tissue treatments like Graston, I utilize these procedures during the MUA with the hopes that outcomes will be even better.

Make no mistake about it-manipulation under anesthesia IS a surgical procedure, although it is non-invasive.  There are costs involved and risks of anesthesia.  But when balanced against constant pain, loss of quality of life and the risk of surgery, it seems a simple decision.

 

Is Mesa Chiropractic Care Dangerous for Seniors?

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Mesa Chiropractor as your back specialist
Mesa chiropractic care and seniors

This is not the first time I’ve written about Marge, my 80-something severely osteoporotic patient who was told by her PCP not to see a chiropractor in Mesa for her neck pain.

Yep. Don’t see a chiropractor.  Instead, try steroids (which is what destroyed her bones in the first place) or NSAIDs (well known to destroy joints, cause ulcers and greatly increase your risk of a heart attack or stroke).  If those don’t work, then certainly neck surgery is a safer option than those wickedly dangerous chiropractors.

I am sure that there are a large number of people out there, seniors and youngsters alike, that have been steered away from seeing a chiropractor purely out of ignorance for what we do.  I know that in my 15+ years of practice it has been a story I hear occasionally.

With Marge, I’m not sure what exactly her PCP thought I was going to do.  Maybe it involved jumping off of my desk, landing on her unsuspecting mid back region with a loud yell in the hopes of getting bones to move.  The reality is that very, very few of these doctors out there (not just PCPs, but I’ve heard it from neurosurgeons and orthopedic surgeons as well) haven’t the foggiest notion of what we do.

Knock on wood, but in my 15 (almost 16) years of practice, seeing some 5000 patients for a countless number of treatments, I have not had a serious adverse event occur.  Never fractured anything (although there have been a time or two that I really pissed off a rib with thoracic adjusting).  Never caused a stroke.  Never had anyone die from any type of treatment rendered in my office.  And I’ve never heard of it happening to a colleague (although it’s not exactly something you post of Facebook or Twitter).

In general, chiropractic care is incredibly safe.

However, were you a medical journal “title reader,” then the title of this particular article, “Risk of Traumatic Injury Associated with Chiropractic Spinal Manipulation in Medicare Part B Beneficiaries Aged 66-99,” would confirm everything you always thought about chiropractic care.  It’s dangerous and should be avoided at all costs because we are killing and maiming patients left and right.

I have to admit that, even for myself, when I read the title of this article I was instantly pissed off, expecting a research attempt to discredit my beloved profession.  Reading the first paragraph didn’t help much:  “to evaluate risk of injury to the head, neck or trunk following an office visit for chiropractic spinal manipulation, as compared to office visit for evaluation by primary care physician.”

Wow.  Really seems like the authors have it out for us.

Before those of you out there who have never been near mortalty wounded by a chiropractor get too upset, here’s what the researchers found:

  • Those seniors who saw a chiropractor were (are you ready for this???), 76% LESS LIKELY to experience a traumatic injury.  (Yes–that is 76%).

The conclusion is not exactly in line with the title here.  Basically, something occurs with a chiropractic visit that led to a drastically lower risk of a traumatic injury in the 7 days following the visit.

It is highly likely that the work done (stretching, adjusting, exercises) wakes up the nervous system and as a result, these patients have better balance and are therefore less likely to fall and suffer a traumatic injury.  Kind of makes sense.

The bottom line is that Mesa chiropractic care is an incredibly safe option for musculoskeletal complaints; not dangerous like your doctor incorrectly believes.

 

Mesa Chiropractor Vs. Lumbar Disc Herniations Surgery

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HOW CAN WE SAVE MASSIVE AMOUNTS OF $$$ ON LUMBAR DISC HERNIATIONS??

Chiropractic care in Mesa has been shown to be effective in case control and clinical studies to be an effective option for chronic and acute low back pain.  Numerous studies have shown that, if Mesa chiropractic care is the FIRST (rather than the last!!) point of entry for any musculoskeletal complaint, the cost savings are tremendous (upwards of 30%).  Looking at this study, we can begin to see how chiropractic care is a net SAVINGS, not a net expense.  Sometimes legislators have a hard time seeing this.  Researchers looked at the costs for services prior to lumbar discectomy and chiropractic care was a measly 2% of overall costs.  Based on what we know, if more people selected chiropractic care as a point of entry (driving chiropractic costs up to maybe 30%), we’d see a massive savings in the overall amount of money spent.

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Chiropractic Care in the Workplace: Money Extremely Well Spent

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Employers have been getting hip on ways to increase worker productivity and jazz up the workplace.

Some have added full gyms and relaxation areas.  One large, local employer that I’m aware of now has an on-site nurse practitioner.  Overall, the addition of some level of urgent-care-ish care is becoming more and more common.  This saves the employee from having to leave work for routine visits to his or her doctor for things like ongoing prescriptions.

It also means that they don’t have to spend hours going to the doctor for urgent care stuff like sore throats, upper respiratory infections and coughs.  It works out well for everyone involved.  The employer is happy because productivity is preserved and the employee is happy because they waste less time running around to doctors’ offices.

What is notoriously, glaringly absent from these relationships is an on-site chiropractor.

Now maybe my opinion is biased (OK, OK…it’s clearly biased…), but given that the typical office or industrial worker is particularly prone to overuse injuries, it just makes sense to have a provider nearby who can most aptly handle these complaints.  And handle these complaints quickly to get the employees back to working as comfortably as possible.

It is has already been solidly shown that outside of the workplace, whether within an injured workers / worker’s compensation environment or among patients experiencing most types of musculoskeletal pain, chiropractic care is extremely cost-effective, safe and clinically effective.

In this particular study, researchers took a look at what happens when chiropractic care is offered inside of the workplace.  They looks at the claims from a single employer health plan that had employers who received chiropractic care on-site or off-site over the course of two years.  Here’s the details:

  • There were 876 on-site and 759 off-site participants.
  • The off-site group received more radiology services overall (55.5% vs 38.2%) including MRI, ultrasound, and X-rays.
  • The off-site group also had higher outpatient and ER visits.
  • The off-site group also has greater use of chiropractic care and physical therapy.

Given how darn effective chiropractic care is at already reducing imaging, outpatient visits and ER visits, to see that these numbers were EVEN less when a chiropractor was on-site gets me pretty darn excited.

If you happen to be an employer that does not yet have an on-site chiropractor (even if it was just a day or two per week) this should certainly give you cause to think that you’ve been missing an excellent opportunity to do something wonderful for your employees that is going to SAVE you money, not cost money.

So what are you waiting for??