Interesting questions that patients ask

“Don’t you have to take an x-ray to know if the bones are misaligned?”

Lately, I’ve gotten this question a lot. It seems that many patients want to be x-rayed to find out if they have “misalignment.” They understand the body as a series of bones that are in alignment and when they have pain, they are out of alignment. The body is not that simple.

Signs of damage to the spine include swelling, muscle spasm, weakness of other muscles, stiffness of the joints, and tenderness.

Ironically, none of these signs are found on an x-ray.

It is common in medical practice to x-ray everyone to simply CYA. A study years ago found that of the thousands of x-rays performed, less than 1% altered the treatment plan for the patient.

“You mean bones don’t “misalign?”

When you get injured, the bones of your spine are NOT popping over to a different location.

Just like a child that witnesses new skin grow underneath a bandaid, and then assumes the bandaid grew new skin, we assume that an adjustment “puts the bone back in” when we hear it pop.

Bones don’t misalign…the soft tissue that supports it gets less elastic and stiff. This restricts the movement of the joints. The adjustment restores normal movement and improves the elasticity of the ligaments and muscles that surround the area.

Because of the risk of radiation, the lack of benefit to the patient, the inability to find the true soft tissue damage, and the success of soft tissue therapies, we very seldom x-ray a patient.

“Why do a get a bill from your office three months after I finished treatment?”

We send out bills every two weeks to the insurance companies. The insurance company has up to 45 working days to respond to our bill. Then they process it sending us a response. Once we get it we send you a bill immediately, but this process can take up to two months at best.

Some insurance companies are faster than others. Medicare for example consistently runs behind whereas blue cross tends to be the fastest.

“I know you told me to put ice on it, but I put heat on it. Is that okay?”

This is always the funniest question I get. Not a week goes by that I’m not asked this. The patient is often trying to get me to buy into the idea that heat was okay.
The answer is that it’s not okay.

I find it fascinating that professional athletic teams used ice for injuries, but the general public is hurting.

Pro athletes are functioning at their peak; the public is hurting and always looking for a miracle. Hmm.

The secret is that in order to heal, you’ve got to know what to do. When you overstretch a ligament, pull a muscle, over exercise, etc you create inflammation.

Ice reduces inflammation. Heat makes more inflammation.

“What about anti-inflammatories?”

That’s always the next question. The research on the subject is that things like aspirin and other anti-inflammatory drugs do reduce inflammation but reduce the collagen formation necessary to properly heal the injury. You’ve reduced the inflammation, but it will take longer to heal.

Again…you’ve seen million dollar per year athletes with their dream-team medical staff, the lawyers, the agent, and the trainers all surrounding them. What do they have on their shoulder after throwing the game winning pitch? An ice pack. Makes you kind of wonder doesn’t it?

Maybe they’re on to something.