Type of Therapy: Electrotherapy

Because the body's nerves are electrical conductors, medical professionals have long held that stimulating nerve endings with small electrical current can produce beneficial results.

The theory behind electrotherapy as part of Chiropractic Care is that such stimulation to affected nerves and muscles encourages the body to release pain-killing chemicals, such as opiates and endorphins, and blocks pain signals from being transmitted to the brain.

Electrotherapy is a Pain Management technique, and as such, is part of an overall chiropractic treatment regimen. Electrotherapy is usually involved in the early treatment stages, especially right after an injury. Ice and heat therapy may be combined with electrotherapy to boost its pain-killing powers.

Electrotherapy normally involves placing small adhesive pads on the skin at various points on the body. Electrotherapy is generally not painful. The adhesive pads may cause a minor skin irritation after being removed, and in some instances, patients may feel a mild stinging after therapy.

Common types of electrotherapy include:

• Galvanic stimulation (GS) - High voltage pulsed galvanic stimulation has been used in acute low back pain to reduce muscle spasm and soft tissue edema (swelling). It is commonly used despite the lack of hard scientific evidence for its efficacy. Its effect on muscle spasm and pain is felt to occur by its counter-irritant effect, effect on nerve conduction, and a reduction in muscle contractility.
• Radiofrequency rhizotomy - Normally used for chronic cases of facet joint syndrome, a degenerative condition in which joint cartilage wears thin, causing stiffness, inflammation, muscle spasms, and later osteoarthritis. This procedure applies heated radio-frequency waves to the joint's nerves that carry painful impulses.
• Transcutaneous Electrical Nerve Stimulation (TENS) - This is the most common type of electrical stimulation used today. TENS therapy is normally used to treat chronic, or long-term pain in the lower back. Small electrodes are placed inside an elastic-type belt worn around the lumbar region. Percutaneous electrical nerve stimulation (PENS), an enhanced and newer type of pain management therapy, makes use of very thin needles (much like those in acupuncture), which are inserted in the lower back by the chiropractor. Small, battery-powered TENS units also are available for use at home, work, or other activities. The patient is able to control the level and frequency of stimulation, and self-administer impulses during episodes of pain.
• Interferential current (IFC) - This is a kind of TENS therapy in which high-frequency electrical impulses are introduced deep into the tissues near the center of the pain.

Your First Visit

Be ready to provide your medical history, which will be essential for preparing a course of treatment for you.

Medical records, such as diagnostic test results, or imaging results, such as X-rays and MRIs, also will provide important information about your condition.

Certain things in your health history are particularly vital to a Chiropractor. This information could provide important clues that will allow your chiropractor to properly diagnose your problem. Such clues include whether you have or have had:

• Bone disorders such as osteoporosis
• Circulatory problems (poor circulation could be a sign that you have a subluxation, for example)
• Dizziness or blurred vision
• Heart conditions such as hypertension or high blood pressure
• Infections, especially those affecting your spine
• Injuries, such as bone fractures, muscle sprains, or disc injuries
• Joint disorders such as arthritis
• Sleep apnea

Be prepared to answer such questions as:

• Did the onset of your pain immediately follow an injury?
• Is there anything you do that improves or worsens the pain?
• When and how did your pain start?
• Where is the pain centered?

The physical exam 

Here's what to expect:

The first order of business is checking your vital signs, reflexes, and blood pressure. Sometimes, measurements will be taken to determine arm and leg length. Next, you will be asked to do a series of simple and easy activities or exercises. These exercises will provide information about your motor skills, balance, and gait, among others. These tests also help determine your range of motion, muscle tone and strength, and integrity of your nervous system. Any abnormalities could provide clues about a condition. You may be asked to:

• Bend forward, sideways, or backwards - Misaligned spinal vertebrae can sometimes be detected during this exercise.
• Flex and extend your leg - This is a test for signs of sprain and helps determine the integrity of your joints (also called the "Yeoman's Test").
• Grip something such as a rubber ball - Your grip strength is vital for showing signs of muscular or nerve damage.
• Lie down and raise one leg - This is often referred to as the "Thomas Test," in which the Chiropractor gently pushes on your raised leg to check for hip joint mobility.
• Stand and raise one leg - This test can sometimes show whether you have sciatica, a nerve disorder in your lower back. Another test may involve pushing on your raised leg to determine whether you have pain, inflammation, or imbalance in the joints between your spinal vertebrae. (This is also called the "Psoas Muscle Test.")
• Stand or sit - Posture can sometimes show whether you have misalignments in your spine.
• Walk a straight line - This test measures your gait, and helps to determine if you have a normal walking pattern.
• Walk in place - Abnormalities in the way your pelvis and spine coordinate can be seen during this test.

Next, a short physical exam by the chiropractor will involve palpation, or use of the hands, to explore the alignment of your spine and other structures, as well as provide information on any stimuli that may cause pain.

Depending on your condition, a series of diagnostic tests may follow. These tests may include MRIs, CT scans, X-rays, blood work, and other laboratory tests.

The chiropractor may also consult with you about making important lifestyle changes, such as exercise, nutrition, and smoking cessation, to improve you chances of healing faster, or preventing further injury.

Treatments - Doctor in San Antonio TX

Chiropractors diagnose and treat a broad range of physical conditions in patients with muscular, nervous, and skeletal problems, especially the spine.

Chiropractors make use of conventional diagnostic tests, such as X-rays, MRIs, and lab work, as well as specific procedures that involve manipulation by hand of various parts of the body. Chiropractors are best known for their ability to correct misalignments of the spine, which are called Subluxations. But spinal manipulation is only a small part of what chiropractors do as part of an overall plan to manage and relieve pain and many kinds of ailments. Other kinds of treatments chiropractors are capable of providing include:

• Electrotherapy
• Therapeutic exercise
• Ice/heat therapy, including therapeutic ultrasound
• Lifestyle and nutrition counseling
• Massage Therapy
• Physical rehabilitation
• Stress management

Common Myths

In spite of its long recognition by the medical community and the government as a safe, proven and effective treatment, many people today still have misconceptions about chiropractic care.

Daniel David Palmer, who is known as the father of Chiropractic, bore the brunt of criticism for creating this branch of medicine's healing arts. Despite Palmer's early successes in treating patients with a myriad of ailments through spinal manipulation, chiropractic adjustments were not readily accepted by the medical community. In fact, the established medical community back in the late 19th century worked hard to discredit him, and had a hand in convincing authorities to indict Palmer for practicing medicine without a license. He was sentenced to 105 days in jail and ordered to pay a $350 fine.

The established medical community's assault on the chiropractic profession continued even as late as the 1970s, when a group of chiropractors sued the American Medical Association and several other medical organizations for disseminating untrue and damaging information about their profession. The plaintiffs alleged that the AMA and others deliberately lied in order to destroy the chiropractic field because they viewed it as a threat, or competition, for their health care dollars. The court agreed with the chiropractors and called the AMA's actions "lawless" and unfounded. The case was eventually heard in the United States Supreme Court, which upheld the original verdict against the AMA.

Much has changed since that landmark decision, and today, the medical community has come to recognize the value of chiropractic care. Today, more than a century later, hundreds of thousands of patients routinely receive competent care-and relief from their suffering-from the nation's more than 60,000 doctors of chiropractic.

Here's a look at some of the more common misconceptions about chiropractic care.

Chiropractors treat back pain and little else.

Nothing could be further from the truth. While chiropractic adjustments can be especially helpful in relieving pain for facet joint injuries, osteoarthritis, and sacroiliac joint dysfunction, scores of patients with chronic headaches, sinus problems, high blood pressure, ear infections, leg pain, arthritis, and many other illnesses have reported significant relief after chiropractic therapy. Chiropractors do more than manipulate the musculoskeletal parts of the body, and are capable of providing a myriad of services that include acupuncture, electric muscle stimulation, exercise programs and instruction, heat/cold therapy, herbal therapy, lifestyle and nutrition counseling, manipulation under anesthesia, massage, physical rehabilitation, physiotherapy, stress management, traction, and ultrasound.

Chiropractors prescribe medications to Relieve Pain and perform surgery, when needed.

Chiropractors believe that many ailments can be corrected if the body's interrelated bone, nerve and vascular systems are in balance, allowing the body to heal itself. A branch of the healing arts concerned with disease processes, chiropractic care is a recognized form of therapy that focuses on improving your overall health and well-being-without the use of drugs or surgery.

Those who undergo spinal manipulation are at high risk of injury.
In general, proper chiropractic treatment of your body's lumbar, or lower back, region, involves very little risk, and the rewards can be significant. In fact, a recent study by the Rand Corporation found that a serious adverse reaction from cervical (neck) manipulation may occur less than once in 1 million treatments. The American Chiropractic Association believes those odds are even greater-about one in every 2 million treatments-the same odds of dying in a commercial airline crash. A more recent article in the Canadian Medical Association Journal found only a 1-in-5.85-million risk that a chiropractic adjustment of the neck may result in vertebral artery dissection.

Chiropractors are not viewed as being in the medical mainstream.

The medical community today formally recognizes the value of Chiropractic Care, and medical doctors routinely acknowledge chiropractic care as a conservative treatment option for patients with lower back pain. Moreover, many medical doctors recognize a chiropractic diagnosis and accept it as the first line of treatment for functional disorders of the entire musculoskeletal system. The prestigious Texas Back Institute (TBI), the largest freestanding spine specialty clinic in the country, once included only surgeons and other medical doctors among its staff. In the late 1980s, the Institute hired its first doctor of chiropractic. Today, close to half of the Institute's patients see a chiropractor first when beginning their treatment. The National Naval Medical Center in Bethesda, Maryland, and the successful Complementary and Alternative Medicine Center at the National Institutes of Health have established chiropractic internship programs.

Chiropractic care is generally unsafe and ineffective. 

Numerous studies throughout the world have shown that Chiropractic Treatment, including manipulative therapy and spinal adjustment, is both safe and effective for back pain. In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy (nerve roots exit the spine and enter the body; if one of these roots is sick or injured in the area where it leaves the spine, it is called a radiculopathy). A 1996 study in the journal Spine echoed that study, and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical doctors.

Cervical manipulation can cause a stroke. 

A 2003 study published in the journal Neurology asserted that chiropractic treatments were the culprit in a patient's stroke, claiming that a cervical adjustment led to a vertebral artery dissection (VAD). According to the American Chiropractic Association, the study is fraught with design flaws and needlessly alarms the public about a safe and effective form of treatment for Neck Pain and headaches. The ACA claims that VAD is a rare type of stroke associated with many other commonplace activities such as talking on the telephone, swimming, stargazing, overhead work, hair shampooing, and even sleeping. In fact, according to the ACA, a recent biomechanical study found that the forces transmitted to the artery during cervical manipulation are less than one-ninth the force necessary to stretch or otherwise damage a normal vertebral artery. "Based upon this study and other recent evidence, many experts now believe that it is physically impossible for a competently performed neck manipulation or adjustment, as provided by a trained doctor of chiropractic, to cause a vertebral artery dissection unless the artery already has a significant pre-existing weakness," according to the ACA.

Benefits of Chiropractic Care

One of the main causes of pain and disease in the human body can be traced to improper alignment of the vertebrae in your spinal column. This is called a subluxation. Through carefully applied pressure, massage, and manual manipulation of the vertebrae and joints, pressure and irritation on the nerves is relieved and joint mobility is restored, allowing your body to return to its natural state of balance, called homeostasis. Put another way, when the bones in your spine are allowed to go back to their proper positions, the nerve energy can resume its normal flow and your body's natural healing processes can function properly.

In general, proper Chiropractic Treatment of your body's lumbar, or lower back, region, involves very little risk, and the rewards can be significant.

Chiropractic or osteopathic manipulations can be especially helpful in relieving pain for facet joint injuries, osteoarthritis, and sacroiliac joint dysfunction, because such conditions respond well to mobilization. Moreover, scores of patients with chronic headaches, sinus problems, high blood pressure, ear infections, leg pain, arthritis, and many other illnesses have reported significant relief after chiropractic therapy.

Increasingly over the past few decades, the medical community has come to accept and recognize chiropractic care as a valid form of treatment for a variety of neuro-musculoskeletal conditions, and as a conservative treatment option for patients with lower back pain. Moreover, many medical doctors recognize a chiropractic diagnosis and accept it as the first line of treatment for functional disorders of the entire musculoskeletal system.

Studies by leading medical journals in recent years have confirmed the benefits of chiropractic care:
A 1993 report by the Ontario Ministry of Health concluded that Chiropractic Care was the most effective treatment for lower back pain. The agency also recommended that chiropractic care be fully integrated in the Canadian government's health care system.

In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy.

A 1996 New England Journal of Medicine study of outcomes and costs for acute low back pain found that patients treated by Chiropractors were significantly more satisfied than those who saw primary care, orthopedic or managed care practitioners.

A 1996 study in the journal Spine echoed that study, and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical doctors.

In 2001, the Center for Clinical Health Policy Research at Duke University concluded in a study that spinal manipulation resulted in almost immediate improvement for cervicogenic headaches, or those that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

What is a Chiropractor?

The word chiropractic comes from the Greek words, "chiro," meaning hand, and "practic," meaning practice, or treatment. Thus, "treatment by hand" is an appropriate definition since chiropractors typically use their hands to manipulate different parts of the body in an effort to promote healing and wellness.

A Chiropractor, also known as a doctor of chiropractic ("D.C."), diagnoses and treats a broad range of physical conditions in patients with muscular, nervous, and skeletal problems, especially the spine.

A branch of the healing arts concerned with disease processes, Chiropractic Care is a recognized form of therapy that focuses on improving your overall health and well-being�without the use of drugs or surgery.

Chiropractors make use of conventional diagnostic tests, such as X-rays, MRIs, and lab work, as well as specific procedures that involve manipulation by hand of various parts of the body. Chiropractors are best known for their ability to correct misalignments of the spine, which are called subluxations. But spinal manipulation is only a small part of what chiropractors do as part of an overall plan to relieve pain and mitigate many kinds of ailments. Other kinds of treatments chiropractors are capable of providing include:

• Acupuncture
• Electric muscle stimulation
• Exercise programs and instruction
• Heat/cold therapy
• Herbal therapy
• Lifestyle and nutrition counseling
• Manipulation under anesthesia
• Massage
• Physical rehabilitation
• Physiotherapy
• Stress management
• Traction
• Ultrasound

Best known for their treatment of back and neck pain, chiropractors sometimes specialize in areas such as sports medicine, orthopedics, neurology, nutrition, internal disorders, and diagnostic imaging. Many back specialists consider chiropractic an integral part of an overall care plan toward treating injury and disease.

History of Chiropractic

For centuries, scientists, physicians-even philosophers-have long believed that the body's spinal cord is at the root of many ailments that have nothing to do with back or Neck Pain.

But the birth of the Chiropractic profession was not to occur until the late 19th century -September 18, 1895, to be exact-in the small offices of the Palmer Cure & Infirmary in Davenport, Iowa. Late that day, Canadian-born Daniel David Palmer was in his office, trying to have a conversation with the building's janitor, Harvey Lillard.

Palmer noticed that Lillard was nearly deaf, and asked the man what caused him to lose his hearing. Lillard didn't know, but told Palmer his hearing began diminishing after a back injury he sustained while stooping in a cramped position. Lillard remembered hearing a "pop" in his back, and suffered hearing loss for years after that.

It was a revelation that capped what Palmer had long suspected-an indubitable connection between the spine and disease--that misalignment of the spinal column interferes with normal nerve function, and thus, leads to a host of maladies. Palmer suspected that if he were able to return the popped vertebrae in Lillard's back to its original position, it would also restore his hearing. Using a technique called the "spinous process," Palmer gently repositioned the vertebra with a firm thrust.

Lillard's hearing began to return. Over the next week, Palmer continued his spinal manipulation treatment on Lillard; each day, his hearing gradually improved. Palmer coined a term for his new technique-chiropractic (from the Greek words, "chiro," meaning hand, and "practic," meaning practice-and dedicated his practice from that point forward to use of the new therapy.

In the ensuing months, Palmer treated flu, sciatica, migraine headaches, stomach complaints, epilepsy and heart trouble with adjustments he called "hand treatments"-all without the use of drugs, medications, or surgery.

Despite Palmer's early successes, chiropractic adjustments were not readily accepted by the medical community. Palmer was later indicted for practicing medicine without a license and was sentenced to 105 days in jail and ordered to pay a $350 fine.

Palmer is the author of two well-known books-The Science of Chiropractic and The Chiropractors Adjuster. He died at the age of 68 in Los Angeles.

His son, Bartlett Joshua, carried on his father's work and was instrumental in getting chiropractic recognized as a licensed profession.

In the 20th century, the chiropractic profession has grown into a respected branch of the healing arts-largely through research and recognition by the government and medical community. Here are some milestones:

• In 1944, the Chiropractic Research Foundation (CRF) was created by the National Chiropractic Association to promote and obtain research funding.
• In the 1960s, the National Chiropractic Association became the American Chiropractic Association (ACA) and the CRF became the Foundation for Accredited Chiropractic Education, whose main purpose was to assist chiropractic colleges in gaining accreditation.
• In 1974, the U.S. Department of Health, Education and Welfare recognized the Council on Chiropractic Education (CCE), and the Foundation for Accredited Chiropractic Education was reorganized as the Foundation of Chiropractic Education and Research (FCER).
• In 1975, the U.S. Department of Health Education and Welfare sponsored a research conference on spinal manipulation, an event that raised awareness of the need for research. Out of that, the Chiropractic Research Council (CRC) was born to assimilate research directors from the nation's chiropractic colleges.
• In 1979, the Foundation of Chiropractic Education and Research expanded its research program and established a competitive scientific review process for submitted proposals.
• Today, 14 English peer-reviewed chiropractic journals routinely publish the results of chiropractic research.