3 Things I Talk About With Every Patient
I recognize that most individuals come and see me because of back or neck pain, and I make clear that their symptoms are important to me. However, to get beyond ‘putting out fires’, it is important to have conversations that go beyond pain and into the realm of improving long term spinal health. I believe that there are three main pillars to improving long term outcomes with regards to many spinal conditions.
1. Mobility
Joints need to move in the way they were designed in order to become or stay healthy. Nearly every joint in the human body requires proper motion to exchange nutrients, water, and flush out waste products. Spinal discs have a limited circulatory system, so they depend on a pumping action that occurs with regular movement to carry out this exchange. This is when I discuss home stretching programs to improve specific objectives for the patient’s condition. This is also why exercise in general is good for the spine. I also discuss at this time how therapy, chiropractic adjustments and mobilization techniques might help with improving this aspect of spinal health.
2. Support
The spine is a weight-bearing column that exists in a gravity environment. In order to reduce excessive wear and tear we have to examine how to make it more efficient. The spine is a column that should be straight from side to side but is unique because it has three important curves front to back that act as shock absorbers. If posture is the window to the spine, a complete postural analysis is important to assessing the patient’s unique biomechanical concerns. The importance of proper posture is discussed and related to their own patterns. Discussions ranging from how they sleep, work, play, carry their children, to their sitting position at the computer can be discussed depending on their unique condition. An example that I use frequently is related to the common forward head posture. For every inch that the head moves beyond neutral, the effective weight of the head on the neck and upper back is doubled. This and similar postural distortions place more stress on the joints and musculature in the region and can lead to pain and various types of spinal conditions. Home exercise programs that include postural exercises and ergonomic changes are often sufficient at minimizing the long term consequences that poor posture can have on the spine. In-office postural correction programs can also be discussed, if needed.
3. Stability
Lastly, if you obtain perfect mobility and posture, and then proceed to throw your back out while picking up a penny, then all that hard work is for nothing. Shortly after a back injury (like a motor vehicle accident or something as small as picking up a penny) , the region goes through a de-conditioning syndrome. Spinal stabilizer muscles become weaker and atrophy as the patient avoids moving their spine in certain directions due to pain. For this reason, a core strengthening and stability program is eventually phased in. In the early stages following injury this may be difficult, but as soon as the individual is physically able, a program is carefully started. In our office, we provide the instructions but it will be the client’s responsibility to do the exercises at home to the best of their ability. To optimize performance or to integrate the exercise program into a gym routine, consultations with our athletic therapist will be recommended. While strength and stability is important, other goals include improving coordination and balance.
While every patient has unique circumstances, these are the three areas that I discuss the most. In our office we strive to see the big picture and try to do everything that we can to help our clients. There are plenty of effective treatment options that we provide, but ultimately in order to achieve optimal spinal health, we have to be good coaches.
I’d love to hear your comments! Please contact us if you have any questions.
Dr. Chris Enns, B.Sc., D.C. has been a Winnipeg chiropractor since 2005. He is the owner of Balance Chiropractic and Wellness Centre, located at 121 St. Anne’s Rd in Winnipeg, Manitoba. Services include: chiropractic, massage therapy, athletic therapy, orthotics, spinal decompression therapy, laser therapy, x-ray services, and health and fitness consulting.