Rants from a Chiropractor: Part 1

Written by: Jeffrey Sergent, DC


What is Chiropractic?

I get this several times a week and find it difficult to answer in two minutes.  I know… if you are an expert at something you should be able to define it quickly. Well, I have a hard time with this answer for a few reasons:  

1. People have no idea what a chiropractor is or have a misconception of what a chiropractor is.  
2. There are a variety of different chiropractic techniques, specialties and philosophies.  
3. I love what I do and could talk about it till the cows come home.

I am going to take a stab at answering what a chiropractor is and what they do by addressing these three reasons... and I'm sure I’ll go on further rants.

1. People have no idea what a chiropractor is or have misconceptions of what a chiropractor is.

I want to start this section off with a crazy real story that happened to me. On a normal Thursday afternoon (okay, the day could be wrong) I had a new patient on my schedule and, as I usually do, I was reading through the new patient’s paper work.

Age: 23

Gender: Male

Ethnicity: Caucasian

Complaints: Lower back pain and pain down the leg

Everything seemed normal. I continued to read…

Reason for today's visit: Hit by a car

"Okay!?" I think to myself. Reading on…

Prior Care: Emergency room

Prior Treatment: none

So I sat there assuming in my office (like I know you are not supposed to) that he was cleared and released. I then walked down the hall to the exam room smug thinking I can help this young guy out. As I opened the door, I suddenly became completely overwhelmed with shock.  The 23-year-old male was sitting cocked to the right with a walker. “This is not right," I thought to myself.  Then, as we went through his history he told me about how he was struck by a car going about 25-30 mph as he crossed the street THAT MORNING.  My jaw had to be hanging open, and I must have been looking absolutely dumbfounded. What was this guy doing here?! I asked him what the E.R. did for him.  He responded that they took a bunch of x-rays and CT scans. "I have a cracked pelvis, broken leg and something to my spine," he informed me.  At this point, I began to think this was a prank and I was getting Punkd... haha Ashton Kutcher. But I was wrong. The young gentlemen could not bear any weight on his left side because of the pain in his likely broken pelvis.  In fact, he couldn’t weight bear at all without the walker because of the broken leg and the ‘something to his spine’.  Being blunt I asked, "What would you like me to do? Why did they let you leave the hospital? You need an orthopedic surgeon." Everything spilled out quickly.  His response was priceless: "Well, I know chiropractors break backs and fuse them back together quickly. I thought you could just fuse mine back." My mind drifted… “If only I was that good”... then quickly back to reality "WHAT?!"

Seriously though, I needed an adjustment to realign my jaw...

In the end this young gentlemen left the Emergency Room against medical advice, saying he was going to a chiropractor. (I can’t even imagine what those ER docs thought.)  He was also on street drugs that he didn't want to admit to taking. To add to this insane situation, somehow between the ER and my office he contacted an attorney which he proceeded to threaten me with.  His last words to me as I called an ambulance: "You'll hear from my attorney. I’ll own you!"

From this story I learned that some people believe that chiropractors break bones and put them back together. Luckily, I have never heard this again from anyone and still find it hard to believe.  Now when people ask me what a chiropractor is, I think of this story.  How would I describe what I do so that this guy would have understood?

I like science, research and math. Let’s go through this realm to answer this question:

Chiropractic started out as a science experiment, truly.  D.D. Palmer, "The Father of Chiropractic,” was into the healing arts.  He was, at the time, a magnet healer amongst other things.  One day, while examining a gentleman who was deaf he noticed that he had vertebrae in his upper back that were different than the others. He knew that nerves from the spine supplied energy and communication to the organs and muscles (this was the 1880's, neuroscience had a ways to go).  He hypothesized that this man was deaf due to the malpositions or subluxations in his upper back. D.D. proceeded to do a direct thrust to correct these subluxations and suddenly the man could hear again.  D.D. then went on to create and develop the theory of chiropractic and subluxations.  He went through treating patients by classifying their subluxations and correlating them to conditions. Even to his death he continued to hypothesize and evolve chiropractic.

He also dabbled in charity work on the side, 

annually delivering countless Christmas gifts to deserving children across the world.

Today, chiropractors and researchers continue to clarify some of these first findings and develop better understanding.

As far as education goes, chiropractors today need a Bachelor’s Degree to enter chiropractic school. Some do allow entry with 90 credits, but all states require a Bachelor’s plus a Doctorate of Chiropractic to practice.  Chiropractor school is considered a 5 year post-graduate program.  Most schools are 3.25 years all year round, or 10 trimesters, which create the 5 year credit due to having no breaks. The first 2 years are similar to medical school, physical therapy school and naturopathic school.  Lots of basic sciences; anatomy, neuroscience, biochemistry, physiology, pathology, histology, etc., with some additional clinical classes: basic exam, palpation, soft tissue.  At the end of the 2nd year is when most of the schools of thought diverge: Medical school gets into pharmacology.  PT: exercise, modalities, manual therapy.  Chiro: Manipulation(adjustment), soft tissue, diet/nutrition, exercise, radiology. Naturopath: botanicals, herbs, homeopathy, exercise, pharmacology, manual therapy.  

Medical school then goes on after graduation for residency that can take several years. Residency and fellowship vary based on specialty. Most take at least 2 years. There are specialties in the other fields, but most are done through post graduate or fellow programs, and are not a necessity to practice like MD/DO.

Chiropractic does has evidence for validity, effectiveness and cost savings.  Recently in JAMA, chiropractic was determined to be the best option for patients experiencing neck pain, especially when combined with exercise.

That being said there is not currently evidence for all practices performed by chiropractors.  We are in a field that works a little differently than let’s say pharmacology.  Pharmaceutical companies start with pathology and develop a drug to interact with the known mechanisms.  Then this drug is put into trials, after which it is released into the public via pharmacies when deemed safe. 

On the other hand, chiropractic and other manual therapies start in our clinics.  We start to help more patients get better based off a basic science principles or applied sciences through clinical experience and knowledge. Then, after more clinicians start to use these techniques and they become widely practiced, they will have the funding to start researching. 

Basically it is the opposite way of most research and development.  Also on that note, it is difficult to have a double blind random control trial of exercise or manual therapy.  Even a single bind is difficult to create, because people know when they are moving or being moved.  A sham or placebo group is difficult to create. Right now there are new ways of researching and developing our evidence.

To be continued...

Photo sources: tvtropes.org, www.chiroone.net, sportsmedicinesalary.org

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Dr. Jeffrey Sergent is a certified Clinical Rehab Specialist and Chiropractor. He earned his Bachelor's Degree in 2004 from Michigan State University and his Doctorate Degree from the National University of Health Sciences in 2008. His special interests include Trigger Point Therapy, the Functional Movement System, Developmental Kinesiology, Pain Neuroscience and nutrition for chronic pain. Currently he practices at Goodyear Chiropractic Health Center in Milwaukee, Wisconsin.

The Doctor Behind JFK: A Tribute to Janet Travell, MD

Written by: Jeffrey Sergent, DC

I have been thinking for a few years, I need to start blog posting. (I go on many rants throughout a day, most of which people probably don’t want to hear).  I have started a blog, but I really never got to the posting part.  So, as my dedication to the new year the rest of 2014, I want to give this year to my mentors, role models and influences.  I'm going to start with a person that came way before me, but has had tremendous effect on medicine, chiropractic, manual therapy and movement therapies.  She is not well known outside of those communities by name, but many know the phrases she developed and treatments she created.  Her name is Janet Travell, MD, the founder and author of Myofascial pain syndrome (better known as trigger points) and pioneer of integrated medicine.  

Dr. Janet Travell in the 1920s.

Janet was a fascinating woman from the beginning.  She was way ahead of her time.  First off she was a woman who went to college and onto medical school in a time when that was not popular, graduating in 1929. Her career began as an ambulance surgeon, and then on to a professorship at Cornell. Eventually, she began research on the topic of arterial changes in response to medications.  After her tenure there she relocated to New York to continue her research on arterial conditions at Beth Isareli Hospital. During her time there she began working with the orthopedic surgeons on treating patients with back pain. She would use the work of Dr. Dudley Morton, "father of trigger points" as the basis for her continued work.  This section would define the rest of her life as she used a variety of injections, spray and stretch, and oral medications. In fact, her methods are still used today.

In the 1950's Dr. Janet Travell started to see her most famous patient, John F. Kennedy.  JFK had suffered a significant lower back injury during World War II. His patrol boat was involved in a major collision, fracturing several vertebrae and damaging many of his ligaments and muscles.  After the war he had several surgeries to correct the damage, however, this was a time before MRI and CT scans. They basically did exploratory surgery into his back. 

...As a side note, I have spoken to surgeons and other spine specialists who relayed to me that during that time they would just cut out the multifidi and rotatares because they were thought of as useless.  Today we know that not to be true, and there are even whole therapies based on activating the multifidi... 

Back to our story... JFK continued to have significant back pain after theses surgeries.   The story goes that he was going to give up his political career due to pain and the demands that came with the territory.  He was referred to Dr. Travell based on the results she was getting on these types of cases in New York.  Thus, she began treating him with injections, medications and braces. As a result he was able to go on with his political career, becoming a senator and of course eventually the President of the United States. JFK believed in her so much that he brought her to the White House as his personal physician.  

"President-elect Kennedy and Janet Travell, M.D.

November, 1960 by sea wall, Palm Beach"

Janet became the first woman to serve in this position and one of the few who was non-military, as most often a high-ranking military physician holds this place. During this time she continued to use techniques including spray and stretch, medications and injections. This was also when she prescribed her most famous addition, the JFK rocking chair.  She believed that he needed exercise throughout the day to keep his legs strong and reduce his pain.  In addition, JFK was wearing a lumbar brace most hours of the day.  Today some believe that this brace was the fatal reason that JFK was shot the second time. It is speculated that the brace restricted his movement from falling forward and almost caused him to spring back up into the second shot. 

Dr. Travell's daughter Janet Powell Pinci 

posing in a Kennedy Rocker in 1984.

Dr. Travell went on to serve Lyndon Johnson till the end of his term.  She then dedicated her time to writing and researching Myfascial pain and trigger points.  She wrote both Myfascial Pain Syndrome and Trigger Point Therapy. These are very detailed, in-depth books. Furthermore, there are two volumes that seem to be 500 pages each. In the practice we refer to these beauties as the red books, due to their red binding.

Dr. Travell was a leader and a pioneer in a field that is still innovating and evolving.  Although she created and defined an entire area of medicine, to this day she has yet to be reviled in that arena.

I have to thank Dr. Travell for influencing me on trigger point therapies, soft tissue and manual therapies. She has taught me that we need to integrate therapies; exercise, medication, injections and manual therapy.  Thinking of her also reminds me that as I get older I need to continually keep an open mind to new and evolving treatments, just as she continued to research into her last days. Lastly, she reminds me that we always need to treat people as individuals and find what will work for them specifically, as she did with the rocking chair in JFK's situation, and for the thousands she treated throughout her lifetime. 

Thank you Dr. Travell.

Janet Travell, MD 

1901-1997

Photography source: www.janettravellmd.com 

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Dr. Jeffrey Sergent is a certified Clinical Rehab Specialist and Chiropractor. He earned his Bachelor's Degree in 2004 from Michigan State University and his Doctorate Degree from the National University of Health Sciences in 2008. His special interests include Trigger Point Therapy, the Functional Movement System, Developmental Kinesiology, Pain Neuroscience and nutrition for chronic pain. Currently he practices at Goodyear Chiropractic Health Center in Milwaukee, Wisconsin.

Naturopathic Medicine: The Medicine of the Future

Here in the United States, our medical system is changing. Since the 1960s the focus of healthcare has been progressively shifting from curing diseases to disease prevention. One reason for this is the recent push toward healthier lifestyles, such as eating less fast food, stopping tobacco use and getting regular exercise. In addition, prevention of disease is critical to lowering healthcare costs, as people will spend less time in the hospital and will spend less money on never ending treatments and medications. For example, despite the fact that purchasing a treadmill or a gym membership is not always cheap, and healthy food always seems to be more expensive than processed food, these costs are nothing compared to what it might cost you if you develop Heart Disease or Diabetes later in life. Not only would the financial burden of treatment be difficult, but you could end up paying with time as well.

For years practices like Chiropractic, Acupuncture, Naturopathy and other preventative medicines were labeled as non-credible or fake. This was in large part thanks to John D. Rockefeller's consolidation and monopolization of medical schools and medical practice in the early 20th century. (Further explained in this interesting podcast by James Corbett).

John D. Rockefeller, Sr., seen here in 1930, died at the ripe old age of 97.

Proof that having an abundance of leafy greens in your daily life does wonders for your health.

However, I won't throw all the blame in one place, there have also been countless instances where people claiming to be well versed in trades like Traditional Chinese Medicine and herbal medicines in fact had no idea what they were talking about and made many of the professionals in these fields look bogus. Luckily, today holistic, or non-evasive, practices are once again on the rise as viable options for healthcare seekers. One such practice that many people have never heard of, or have misunderstood, is Naturopathic Medicine.

What is Naturopathy?

Bastyr University, one of the leading natural medicine universities in the United States, describes Naturopathic medicine, sometimes call Naturopathy, as, "a distinct system of primary health care that emphasizes prevention and the self-healing process through the use of natural therapies." Naturopathy is holistic and is based on a combination of traditional herbal home remedies that were passed on through the generations, as well as current research on a wide variety of medicinal sciences and practices, including conventional medicine, homeopathy, clinical nutrition, psychology and more. A Naturopathic Doctor (ND) is trained in primary care and receives education in the same fundamental sciences as a Medical Doctor (MD). In order to become a licensed doctor in a jurisdiction, just like MDs, NDs must pass difficult board exams and complete a lengthy internship in a licensed clinical setting.

According to Dr. Robert Coleman, Goodyear Health Center's Nationally Board Certified Licensed Naturopathic Physician, Naturopathic Medicine is the healthcare of the past and the healthcare of the future. At the core of his Naturopathic beliefs lay the ideals NDs follow: do no harm, stimulate nature's healing powers, address the causes of disease, work to heal the whole person and to teach the fundamentals of a healthy lifestyle. Utilizing this framework, Dr. Coleman specializes in Detoxification, Vitamin & Nutrient therapy, Physical Medicine, Therapeutic Bodywork, Homeopathy & Herbal Supplements and Energy Balancing & Mind-Body Medicine.

Now, I know what this sounds like. It sounds like an episode of Portlandia where all the flower children are trying to sell you their home grown herbs, and convince you that you should take up yoga, change your wardrobe to tie-dye and replace your music collection with The Rolling Sones discography. However, Naturopathic Medicine is based on years of treatment trials, observation and scientific research. But is Naturopathy right for you? Well, for one thing, Naturopathy is a good idea for someone who has seen a Medical Doctor to no avail. For example, if a patient came to Dr. Coleman complaining of acid reflux, rather than hand him a bottle of Tums and a prescription for an acid reducer, he would advise adding an acid found in food to the patient's diet instead (combining homeopathy and nutrition). So basically, Naturopathic Medicine is more than just a prescription to make symptoms better, it is a lifestyle change to make symptoms disappear, whether you suffer from headaches, stomach problems, anxiety, physical pain, insomnia, or more serious issues. It is best for people looking to find long-term solutions to their problems with a minimum amount of medication and a commitment to making the necessary changes. A Naturopathic Doctor will listen to you, will never judge you, and will set you on the right course for treatment based on your lifestyle.

Thomas Edison was not only a fantastic inventor and businessman,

he could also see into the future...

Finally, despite the fact that Naturopathy has come a long way since the reign of Mr. Rockefeller, NDs are still not recognized as licensed doctors in a number of states, including Wisconsin. However, progress is being made, and hopefully the state's legislation will change in 2014.

For more information on Naturopathy visit here: www.naturopathic.org, or contact us here at Goodyear Health Center and we can set up an appointment for you to talk to Dr. Coleman in person.

Acupuncture Phobia?

One of the major excuses people use to explain away trying Acupuncture is that they are afraid of needles.  I have also heard “It is out of date” and “All it’s good for is pain relief, just like Tylenol.”

The truth is most people are just scared to try Acupuncture, and are not sure how it actually works.

Originally a traditional Chinese medicine, Acupuncture is based on the belief that what happens in one part of the body affects the entire body. It works by reestablishing a healthy energy flow (or Qi – pronounced chee) throughout a person’s body. A person’s Qi travels along meridians throughout the body that come in contact with the skin at over 300 different acupuncture points. When these points are obstructed it can cause an imbalance in a person’s body, leading to pain, sleepless nights, stomach problems and more. An Acupuncturist stimulates or directs these blocked points in order to restore the balance. This is done by inserting about 2 - 8 incredibly thin needles into certain points on the body. They are then left in for about 20 to 30 minutes. This is the part that makes everyone so nervous, but don’t worry, these needles are so thin that most people feel nothing at all, if only a slight prick.  They are also sterile and disposable, and have been approved by the FDA. On another note, if you come into the appointment complaining of back pain, don’t be surprised if the Acupuncturist puts a needle in your ankle or somewhere else seemingly unrelated.  As I mentioned, what happens in one part of the body affects the whole body, and the place where pain is being felt might not be the culprit.

Acupuncture is most commonly used for pain relief. People suffering from arthritis, sciatica, fibromyalgia, tennis elbow, knee pain, neck pain, etc., could benefit greatly from this type of therapy. It can also help people who suffer from migraines, digestive issues, insomnia, depression and can help with weight loss. Acupuncture helps these conditions by stimulating the circulatory and the immune system. This then releases endorphins into the body helping to stop the pain and correct chemical imbalances.

Finally, as is the case with all therapy, each person is different and will require a different treatment. This could mean needing acupuncture once or twice a week for a month or two for the best outcome.  Acupuncture is not a replacement for medications, but rather it is a fantastic compliment to your physician’s already prescribed treatments, and can greatly help those little ailments you are sick of dealing with on a daily basis. Our expert Acupuncturist Jaret Sahr will also offer advice on vitamins and supplements that could help restore you and your body to a healthy balance.

Still have questions or don’t know if you can get over your Acupuncture phobia? Visit our website http://www.goodyearhealth.com/health/acupuncture.aspx or feel free to arrange a time to drop by and chat with Jaret!