Frequently Asked Questions
Are the treatments painful?
The treatments we provide are generally not painful with most patients reporting that they actually feel "good". However, as everyone has a different tolerance to pain, we encourage feedback from our patients so that we may modify any given treatment to be as comfortable as possible.
How long do I have to keep coming in?
This really depends on your complaint. Acute problems - problems that started more recently - generally resolve faster than chronic complaints. Most patients respond quickly to the care we provide and are released to "as needed" care after 2-4 weeks of treatment. For patients presenting with conditions that require a longer course of care we normally start with a 4 week treatment trial and continue until the complaint is resolved or they reach "maximum medical improvement". However, if they are not adequately improving after the first 4 weeks (or earlier if appropriate) we discontinue further care and refer them for appropriate further testing and/or alternate care with another provider such as their PCP or an appropriate specialist.
What is "Evidence-Based Care"?
Our office is an "evidence-based" or, when appropriate, an "evidence-guided" practice. This means that we prefer to rely on the best scientific evidence available when determining the type of treatment and treatment protocols we choose for a given condition. Ideally, this would be from well controlled studies that test the effectiveness of various treatment interventions so that we can determine the best course of care for a patient. However, this may not always be available and we must use our best judgement based on things like our experience with similar conditions, case studies, logical assumptions based on what we know about biomechanics, physiology, etc.. Barring "red-flags" (which we look for on a patient's initial visit) a treatment trial to test the effectiveness of a specific treatment for a specific condition is usually appropriate and helpful in determining further care requirements. In every case, we try to provide our patients with the safest and most effective treatments for their presenting conditions and refer them for appropriate further testing and/or alternate care if we find that our treatments are not helping their condition.
Will I need X-Rays?
The need for x-ray examination will depend on the nature of the complaint and history of the condition as well as our findings during our examination of a patient for a presenting complaint. Current scientific evidence does not support x-ray examination for every single patient regardless of presentation and examination findings and most of our patients do not require x-ray examination for a presenting condition. We try to avoid exposing our patients to the ionizing radiation of x-ray examination unless there are "red-flags" that make this appropriate. A patient with acute back pain following trauma with positive orthopedic tests for fracture will likely require x-ray examination (or CT scan and/or other advanced imaging, etc) prior to treatment whereas a patient that woke up with a stiff neck from sleeping in an awkward position may be able to receive care and hold off on x-ray examination unless they fail to improve as expected. Fortunately the treatments we provide are not based on the structural information that can be obtained on x-ray examination but, rather, on functional information obtained from specialized physical examination of the patient. Joints that move freely in the spine will achieve their optimal position and alignment; joints that are "stuck" will not allow this to happen and can cause problems - we try to free-up these joints and restore their function, the aligment will follow to the extent that this is possible based on the condition of the joint (how much degeneration is present, congenital structural factors, etc). With regard to the occasional question of "what if you miss something by not x-raying everybody?", please consider that a plain x-ray examination is not able to "catch" every single problem or "lesion" that a patient may present with. By the logic of that question we should order not just x-ray examination but MRI, EMG, blood work and a multitude of other tests and, even then, we could not ensure that nothing would be missed. A more logical and practical approach is to use clinical judgement to order the appropriate test at the appropriate time given a particular condition. In addition to being less likely to miss something using this approach than to indiscriminantly just plain x-ray every patient, this saves the patient from unnecessary radiation exposure and is more cost-effective for both the patient and our health care system. For those interested in additional information on the topic, the following link gives The American Academy of Family Physicians recommendations regarding imaging for low back pain:
How much will this cost?
This will depend on your insurance coverage. As each policy is different, please feel free to contact our office and we can try to help you determine the chiropractic benefits of your specific policy. For those without insurance, a typical visit may be $40-$50, depending on the type of treatment provided. The cost is generally higher for initial visits (as an examination must be performed) or if additional therapies are required but we do our best to keep our fees as reasonable and affordable as possible so that our patients are able to get the care they need.