Have you ever wondered what are some of the factors used to determine your supportive care? Dr Hulsebus shares some of the latest research. #healthy815 #icachiropractor #palmerproud
https://chiromt.biomedcentral.com/articles/10.1186/s12998-023-00507-y#citeas
www.rockforddc.com
Have you ever wondered what are some of the factors used to determine your supportive care? Dr Hulsebus shares some of the latest research. #healthy815 #icachiropractor #palmerproud
https://chiromt.biomedcentral.com/articles/10.1186/s12998-023-00507-y#citeas
www.rockforddc.com
- Hello, I'm Dr. Brant Hulsebus. Welcome to another edition of Ask the Chiropractor. Ask the Chiropractor is my little podcast I do where people submit questions about chiropractic care or if a chiropractor can work for them, or how does a chiropractor do this, or how does- should I see a chiropractor for this or that? because all too often people make a common mistake of asking a different healthcare provider, say a physical therapist, or a medical doctor, who is not a chiropractor. I have always felt like if I have a question about my teeth, I'm going to ask a dentist, not a podiatrist. So if you have questions about chiropractic you should ask them here. So, recently, I was asked a question by a younger patient of mine, Hey, you know, I came in, you started me off with this, I had this ankle complaint. I'm feeling a lot better now. What am I supposed to do after we're done with the initial care plan? Basically what is supportive care? How do you determine supportive care? Now many people have heard me talk about wellness or supportive care in the past, and I've always talked about the fact that it's basically based on, um basically based on the overall health of your spine. If you have little arthritis in your spine you have good healthy spine, you're young, you're not a lot of stress, everything looks pretty good. Then we don't need to see you as much as we need to see somebody else with lots of degeneration, or someone who's been in five or six car accidents, or maybe a old professional hockey player, right? Like we take care of the AHL Rockford Ice Hogs. We take care of them as they're playing now so they don't become that old person with aches and pains. So, how do we determine your care plan? What are some of the main factors? And I've talked about how it depends if you have a scoliosis if your disc spaces are healthy you can go back and see all those other ones. But what was exciting to me was a new research paper just came out. This was published August 30th, 2023. It's clinical indicators for recommending continued care to patients with neck pain in a chiropractic practice, a cohort study. So basically, this was published in Chiropractic and Manual Therapies, Article #33 2023. So, let's talk a little bit about this research paper and what they talked about, what makes it different than other things we've talked about in the past? Well, a lot of the stuff we determine is for lower back pain. There's been all kinds of studies about lower back pain supportive care. We've had them coming since chiropractic started, you know, what's going on with this lower back pain? How do we take care of it? How long should we see somebody with lower back pain? What kind of a care plan do we give somebody after they no longer have lower back pain to prevent lower back pain from coming back? Why does lower back pain and neck pain come back? Well, I'll tell you why. One's gravity, right? Gravity's always working against us. And two is stress. Stress is always working against us too. And that stress Dr. Palmer talked about back in the old days about thoughts, traumas, and toxins. Maybe how you, what you're eating, the toxins going in your system, maybe the the stress you're under, mental stress you're under. Then obviously everybody understands the physical stress. That's always been easy for chiropractors to really let you know like the Ice Hogs over here, right? They have a lot of physical stress from getting clobbered against the boards, but maybe they have more stress, actually physical stress, from traveling city to city in the airplanes on the buses. I don't know. But yeah, that's the physical stress and everybody understands that. So, Dr. Palmer from Palmer College of Chiropractic Where I went to school, talked about the three T's, and those again, those have always existed. These books were written back in 1895, his original stuff. And today it's 2023, we're still talking about the three T's. So, they're always undefeated. So, usually what happens when somebody starts care with us, we kind of give them a care plan, help them initially get over what they came in with. We talked a lot about the benefits of chiropractic care, staying adjusted, maintaining it. And they always ask me, well how often do I come? How much more should I do? Because you see, when you start chiropractic care most of our patients don't quit their jobs, start a new lifestyle, change their diet, change everything. They all make better choices. But honestly most of them don't do a full 100% change of everything they're doing. And so sometimes some supportive care is still needed after the fact. And when we found out that when you determine how often someone should come in that they originally came in with neck pain versus lower back pain, there's different determining factors because I've always said when you have lower back pain you can like lay on your back, put your feet up trashing your back, give your back a break. Well if you've ever had neck pain it doesn't matter what you're doing, sitting, standing, laying down, hanging upside down, it always bothers you. So the neck's a whole different thing compared to lower back. So often chiropractors will determine your lower back pain real simple. Hey you know, hey you get a new patient named Tom. Hey Tom, it looks like you have this back pain if we don't see you about every three weeks, so let's get you in every three weeks and let's stay ahead of it. This way he doesn't come back to bother you. So we determined Tom's back pain, the fact that after about three and a half, four weeks, Tom has back pain. So we're going to get Tom in three weeks to try to beat it before it comes. And that's their idea. Because again, Tom hasn't like, created a huge exercise program, or lost a bunch of weight or done a bunch of things he's supposed to do in order to help us help him. Kind of like when someone says to Dr. Hulsebus, they gave me this new heart medication. I don't want to take it. What do you recommend I do? I said, I recommend you start exercising a lot and eating a lot better and think, you know, taking better care of yourself so you earn the right to get off the medicine. You can't just say I don't want to take it. You have to earn the right to get off of it. So when people say to me, how often do I need to come see you? I say, well these are all the things you can do to earn the right to stretch our business out longer or longer or longer. But until you go to try these things, I'm going to see you more frequent, more frequent, more frequent. Not because I'm trying to get you in a lot, just because that's the stress you put yourself. That's the way gravity pulls on you. So those are the things we talk about. And we do reevaluate these in our patients about every year or maybe every 18 months. And we say, you know what? I think that you know, you've been doing this, this and this and you start this, this and this. Let's try to go a little bit longer, a little bit shorter, depending on the case. So that's how we do lower back pain. They commend their lower back pain. They did, they say did. Some of you have heard me talk about stabilization exercises'cause the spinal muscles, you know you can't consciously control them. They only the reflectory muscles. So we give you stabilization exercises to make them stronger. If your back is stronger your back would be harder to throw out. Hence you can go along without needing us. So we do those kinds of things to try to incorporate that. But when it comes to the neck, it's a different ballgame. because when the neck happens, if those of you have had severe neck pain, I have. I've had severe neck pain where I couldn't turn my head for a couple days 'cause I injured my neck so bad. We determine that, not so much in the frequency of the neck pain. Because like I said, when you're, when you're having acute neck pain it doesn't matter what you do, your neck hurts. We took more of our determining factors how often we see you for supportive neck pain based on how bad you were the first day we saw you. Like myself. I was in a boating incident and I got a really bad neck accident afterwards and I couldn't- I could barely move my arms and my neck was locked up. I could barely turn my head and I ran right to my father. Luckily for me, I'd always been under chiropractic care. If you listen to my podcast two weeks ago I talked about how I could adjust right after I was born. So I was able to make a quick, speedy recovery because I'd always been under chiropractic care. But because of the severity of my neck pain, I don't go longer than like two weeks ever without getting my neck checked because of the severity of it. Now do I need to get adjusted every two weeks? Not always, but I always get checked every two weeks. So I make sure of that. So, because mine was very, very severe. Now if somebody comes in and says, you know when I look up, away, to the right, down, go like this, I feel a little pinched right here. But that's completely different than not being able to turn your head for two weeks. So, we determine the care plan based on the severity of how bad you were when you first came in. And this is another reason why when you're really bad and you're really acute, some people are a little scared to go to the chiropractor right away because they want to wait until it feels a little better before they go. Well then we don't really get a true sense of how bad you are, and it's harder for us to make that determining factor for your supportive care from that further on. If you go to the chiropractor, you can barely turn your head and you're in too much pain. The chiropractor- we're trained to tell you you know what, let's give this a few days. Let's give us some time to get some of the information down and let's do A, B, and C before we can help you. Not only that, but we know what to tell you what to do on those A, B, C days, right? Like you go home, ice this, go home, put moist heat on this. Go home and do this. Go home and do that. We know how to tell you how to do those things until you feel like you're more ready to dive into more aggressive chiropractic care. And we also will probably use a more passive technique than our aggressive techniques, on the days you can barely move. Not only that, but we also know the neck muscles end between your shoulder blades around T five, a lot of times we can start adjusting that area pretty aggressively right away and start to restore some of the range of motion. So the day you feel like you're in really really bad neck pain, that's a great day to go with a chiropractor. And if we feel like you're in too much pain and you need to maybe get some other help, we can all make those calls for you. We're trained on that. We're trained to know when to say when, right? That other saying. So we know how to get you the help you need when you need extra help. But again, who's the expert on knowing that? We are. That's what we do. That's what we do all day long. So if you have a question like, you know maybe I'm too acute, maybe I'm too bad to go see the chiropractor. The chiropractor will let you know that, and the chiropractor can make the phone calls you need. In our office if you came in like that, we have friends that are in the other medical realm, and we can call them. They know if we're calling, they know it's a serious thing. So if they hear a phone call from us, you're going to get in a lot quicker than if you just try to walk in on your own. Because they're like, oh, Dr Hulsebus is calling. This person must be bad. They must need me right away. If you try to call on your own, you know you might have to wait a little while for an appointment. That's how it works in my office. I can't promise your chiropractor has those same relationships. But usually all the chiropractors have a friend on the other side that we can call on when we need them. So, there you have it. Determining care plans, supportive plans for neck pain and lower back pain. Lower back pain's going to be more about the frequency of when you have the lower back pain versus neck pain, it's going to be about the intensity of the pain on the first visit. It's going to determine what we do from that point on. You know, we can definitely reevaluate that from time to time. But it seems like the neck, when it goes out, it's just all at once and it seems to replicate itself a lot. So we're going to determine it based on how bad it is, not how frequent it is when it comes to the neck pain. And again, all the other factors I've talked about in the past that are not mentioned in this research paper like your disc space, your posture, your overall alignment, those all come into play too, don't get me wrong. But that's the general rule. It's going to be the frequency for lower back pain. How long can you go between visits? And the other one's going to be for the neck. How bad it was when you first came in. I hope that answered the question about how do we follow up with the chiropractor after we start care? Why do we follow up with the chiropractor after we start care? I addressed that too. It's the fact that gravity always wins and the stresses in our life haven't fully gone away yet. So therefore, we still need the same care. The things that brought you in, you're still doing they're going to happen again, unless you're prepared for 'em. We try to help you stay prepared for them and tell you how to do that. All right, well if you have a question for me, if you have a question you'd like to see me answer or dive deeper into the topic, go to rockforddc.com. That's R-O-C-K-F-O-R-D-D-C.com. And you'll find in my website there, Hey, contact us. I'll get that and I'll answer your question. I'm going to put a link to this paper I referenced everywhere I can. I'm going to share this to a lot of different places. Everywhere I can put a link to this paper, I will put a link to the paper so you can read it yourself. You know me, I try to cite and quote everything I talk about. So I'll cite and quote this one. I'll send the link to to you there too. All right, well, remember, if you have a question about chiropractor or chiropractic care, the best person and the only person you should ask is a chiropractor. Hope that answered your question. Have a great day and we'll talk to you real soon. Bye-bye.