Dr. Charschan's Blog

Dr. Charschan's Blog
Specializing in runners

Sunday, November 21, 2010

Study Favors Chiropractic over Surgical Discectomy for Sciatica

 I recently came across a study in the JMPT (Journal of Manipulative Therapeutics) regarding Maniopulation (mostly done by chiropractors) Vs. Microdiscectomy (micro dissection surgery) that is becoming very common and has quick recovery times.  There are many times I see patients going to their doctor and having tests such as MRI done and then waiting for the dreaded decision.  As many of you know, we often resolve back problems before MRI is required and before a referral is ever needed. The fact is, often, our care costs less than the MRI.  The reality is that the way we walk (gait) determines the way we function and also determines our likelihood in developing a herniated disc requring surgery in the first place.  Even though the study shows outcomes are similar between manipulation and microdiscectomy, the overall management of the gait issue assures a much better outcome thant manipulation or surgery.
    I have had many people avoid surgery with our approach.  I often see people who are in severe pain make rash decisions when they are irritable and scared like visiting the emergency room for back pain or immediately undergoing an MRI and taking pills that do not improve function.  For Sciatica, see us first.  You will get better faster, more safely, with less intervention with care centered on long term resolution of your problem, rather than just the symptom of back pain.

Monday, November 01, 2010

Macro vs.Micro - Getting to the source of your problems

     Do you see your problems with your body as the big picture or from a small point of view.  This is something I have discussed with many of our patients because it is how we are able to get superior results in solving many peoples problems.  Many doctors see the micro, meaning your elbow hurts while playing tennis, so lets look at the elbow and treat it, or the person who has knee pain and your doctor as well as you are obsessed with treating that problem.  Over the years, I have learned never to take things at face value when it comes to mechanical problems in the body.  Doing so assures expensive care that frankly is usually ineffective. Looking at the micro makes us miss what is really happening in your body.  Obsessing about the herniated disc and treating it as if it created itself because things just happen is fooling ourselves and setting you up for years of exacerbations and even surgeries.
    I look at the macro or the big picture because this is where you find the cause of peoples problems, looking past the obvious.  A great example of this is a tennis player I saw this weekend.  We started with some elbow, shoulder and flexibility issues which have markedly improved.  This weekend, she said she still felt some elbow pain however,   the ball is hitting the net alot.  Looking at the micro, she suggested it was her shoulder.  Looking at the macro, the left side was tight, recruiting into the left oblique restricting motion in the right shoulder, aggravating the elbow.  After properly treating the problematic core muscles, she notices a marked improvement in the way her shoulder worked on the right side.  She should notice her power return during this weeks game and the ball will be going over the net. 
    The majic sauce in our approach is looking at you, not just the symptoms you arrived with.  We do this for you, your family, friends and co workers who are only aware of the elbow or body part hurting, and are likely visiting doctors who also see things that way. The only way to get a better diagnosis, and consequently, more cost effective and appropriate care is to get it right on diagnosis, which yields more appropriate care.  Things are rarely what they seem at first glance in the human body which is why I look beyond your symptoms and think about function. I also dig deeper and ask the right questions to uncover those valuable clues which help me solve the equation of why you hurt. Think of me as the Sherlock Holmes of the musculoskeletal system. My goal is to get it right the first time, fix your true mechanical problem and as many of our patients already know, a number of other chronic problems that are affiliated with that complaint go away too. 
     It is all about finding the cause and fixing that, and the symptoms and the future exacerbations are much less likely.  Its not majic, its getting healthcare right.