March 18, 2014
Chiropractic physicians are established members of the mainstream medical team. They treat problems involving the muscles, tendons, ligaments, bones, cartilage and nervous system. Chiropractic physicians can perform soft tissue therapies, prescribe corrective exercises, and safely manipulate the spine or joints to help you avoid surgery and medication. Chiropractic physicians can prescribe home therapy. Additionally, they may offer joint bracing or muscle taping for support or to improve overall function. Nutritional advice may also be offered for weight control to reduce joint pain and improve posture. You may benefit from the chiropractor’s “hands-on” approach to relieve chronic pain from old injuries or for acute pain from new injuries. Take this opportunity to get your questions answered as our expert discusses how to choose a chiropractor, what to expect from your visit, and chiropractic treatment for pain.
About the Speaker
Andrew Bang, DC joined the staff of the Center for Integrative Medicine in January 2013. Dr. Bang earned his Doctor of Chiropractic Medicine from Parker University, in Dallas. Part of his clinical internship was completed in Bogota, Colombia where he treated professional and Olympic athletes. Dr. Bang served as a team chiropractor for the Texas Wranglers semi-professional basketball team.
Let’s Chat About Ask the Chiropractor
Moderator: Welcome to our Online Health Chat with Cleveland Clinic expert Dr. Andrew Bang. We are thrilled to have you here.
Chiropractic Care for Medical Conditions
bugaboo: What conditions can be treated with chiropractic care?
Andrew_C._Bang,_DC: Chiropractic treats all types of muscle and bone pains. I use hands-on therapies, including manipulation, massage, stretching, exercises, supportive tape, and activity modifications. So we can work on all joints and muscles in one way or another. Chiropractors do not prescribe medications, set broken bones or perform surgery.
Chiropractic Care and Arthritis
victoria1102: I have a rather complex question that may not have any relation to chiropractic care. I have mild degenerative disc disease and arthritic progression in my lower lumbar back and neck. I also get this odd pins and needles or numb feeling directly in my mid-back area, when standing, sitting, or positioned a certain way. I have also noticed that some mornings I wake up with a kink in my neck. When I tilt my head a certain way, it feels like a muscle is pulling along the left side of my head above my temple area. I have randomly felt these electric shock-like spasms that seem to start from my spine and radiate outward like wrapping around to my side. Also, at times I'll feel it start in my lower abdominal area and wrap around to my lower lumbar area or near my sternum. When it happens, it seems to take my breath away for a quick moment. Could this odd shock-like spasm be related to any back problem I have?
Andrew_C._Bang,_DC: All of your pain sounds related. Some questions you can ask yourself that will help you know if the shock-like spasms are coming from your spine are as follows: Are you overweight? Do you sit for long periods of time? Are you overactive in sports? If you answer yes to any one of these questions, then there is a great possibility that the pain is coming from your spine. Spinal arthritis can also cause some of these shock-like spasms because the arthritis can pinch adjacent nerves and muscles.
ldsuz: Are chiropractic services beneficial for arthritis, especially in the wrist and fingers?
Andrew_C._Bang,_DC: Personally, I have seen very good success when working with wrist arthritis. I use a combination of adjustments, deep tissue massage to wrist flexor and extensor muscles, and supportive exercises. I have not seen success when working with arthritis in the fingers.
margaret: To follow-up with chiropractic for arthritis—would it specifically be rheumatoid arthritis or osteoarthritis? I am experiencing osteoarthritis in my thumb and down the road I will need a joint replacement. I put my hands in warm water in the morning and evening, and take meloxicam for pain. Would massage or chiropractic help?
Andrew_C._Bang,_DC: Chiropractic is best used with osteoarthritis. Some rheumatoid arthritis patients are high risk and sometimes they are not candidates for chiropractic treatment. For your thumb pain you would have better results with physical therapy. They can teach you exercises stretches and use ultrasound therapy.
Chiropractic Care for Herniated Disc
boopthenight: I do not know what type of chiropractor or who to go to for my chronic tight and painful back. I have had back issues since I was 18 years old. I am now 57 years old, and was diagnosed with fibromyalgia when I was 37 years old. I have managed to live with this and have worked full-time as a nurse for 20 years. Last year I woke up with a herniated lumbar disc. I was out of work for five weeks in so much pain. The pain went from my back to my right leg to the top of my right foot. I was not able to do even the slightest bending without the fear of having my back spasm and lock up. I found out that I have spinal stenosis. (My mom is crippled with arthritis and back issues.) I go to massage therapy bi-weekly, and have for about 15 years. This has been beneficial for my body, but not for my lower back and spine. If I push on my back even a little, it causes spasms bad enough to push my body forward above my waist. I then cannot straighten up for at least 48 hours. When it’s like this I cannot stand for more than a few minutes. It is too painful. I hope you can suggest something that will help!
Andrew_C._Bang,_DC: You are the extreme case where chiropractic care can either really help or not do anything at all. I have hope that chiropractic would be a good treatment for you because you respond well to massage therapy. Besides the hands-on treatment that you would receive in my office, we would see if there are any activities of daily living that you are doing that are aggravating the herniated disc. I often find that my patients with fibromyalgia need to work with one of our integrative physicians to review diet, food allergies and nutrient levels. This way we are working on your pain from multiple angles and that increases our odds of success.
Chiropractic Care and Dislocated Ribs
tanya: One month ago I dislocated a couple of ribs. (I didn't fall or have an accident—I really don't know how it happened). I have had chiropractic adjustments and light touch. I've gotten some relief, but the ribs are not staying in place. I have a rib belt and it helps at times, too. I'm “icing” it. My chiropractor says that there is not much more to do. Do you have other ideas? I have a chronic liver condition, so medications are not an option. I am more interested in ways to get myself back in alignment and ribs in place.
Andrew_C._Bang,_DC: One thing I always focus on is the muscles that support the bones where the pain is. The muscles move bones. You might need to strengthen the muscles that stabilize the dislocated ribs. This will be painful, but as long as the ribs are not broken it will help. You might also have intercostal neuralgia. That is when the nerve in between the ribs is hypersensitive. In that case massage therapy to restore balance to the muscles would be beneficial.
Chiropractic Treatment Protocol
Katydid: What does manipulation do?
Andrew_C._Bang,_DC: Manipulation or adjustments restore range of motion, decrease pain and realign joints.
lilred67: Concerning chiropractic services: is it sufficient enough to receive one treatment for back pack pain or would multiple treatments be necessary to lessen the pain? Or does it depend on what the chiropractor feels necessary after examination?
Andrew_C._Bang,_DC: It definitely depends on the severity of the problem and the professional opinion of the chiropractor. I prefer to use combined therapies when treating patients, including adjustments, massage therapy and home exercises. I have found and research shows that patients recover faster and pain goes away quicker when using combined therapies.
alycen: Are there long-term ramifications to chiropractic care? I feel much better after I have had adjustments, and find I have been easier to adjust over time. What is a good way to evolve out of weekly care?
Andrew_C._Bang,_DC: Long-term ramifications of chiropractic care do exist but the problem is we continue to live, move, and get injured. If you see a chiropractor for an injury and get successful treatment for that specific injury, you may never experience a problem there again. But we often re-injure areas because we continue to do the same activity that caused the injury in the first place. A great example of this is the office worker who comes to my office for neck pain. The way they sit at their job is causing the pain, but they can't quit their job so they continue to have reoccurrences of neck pain. In my office we teach patients what they can do to help themselves in to recover. Our goal is to help them not have to come to the office so much.
Theshaunzy: I have been going to a chiropractor for a couple years. Is it possible for me to adjust myself?
Andrew_C._Bang,_DC: If you feel the need to "crack" your neck or low back multiple times throughout the day that means that you have some really restricted vertebral bones. When you crack yourself you are moving the bones above and below the restricted area. If you find that your neck or low back cracks on its own occasionally, that is normal.
Non-force Activator Chiropractic
ctabialex: What musculoskeletal problems does a non-force activator chiropractor treat? Please explain how the hand-held activator method device works. On what parts of the body can it be safely used? How does it compare to a non-force activator treatment without the use of this instrument?
Andrew_C._Bang,_DC: I use hands-on treatment when working on patients in my office. The activator technique is a very light force that can be used on any age patient or condition. Even though it uses light force, the theory is it is able to adjust the spine because of the high velocity of the spring and hammer. I find that patients who are overly sensitive to manual pressure or who have severe osteoporosis usually prefer using the activator. It becomes a personal preference per the patient if they choose manual or activator adjustments.
Chiropractic Care Risks
Pididle: Is chiropractic care safe?
Andrew_C._Bang,_DC: With every type of medical treatment there are associated risks. I use the best orthopedic tests, imaging and examination to find patients who are high risk and not candidates for chiropractic treatment. I then refer them to the proper doctor. For patients who are not high risk the treatment is very safe. One common side effect to treatment is some soreness similar to the soreness you have after working out. And that soreness only happens when first starting treatment.
Chiropractic Adjustments and Pregnancy
Mommy2b: Is it safe to get chiropractic adjustments while pregnant?
Andrew_C._Bang,_DC: Yes. I find that most pregnant women experience pain during their pregnancy in the mid- and low back. Many women feel pain in their neck after pregnancy due to holding the infant for long periods of time and nursing. With adjustments and massage most of these women feel a lot of relief from their pain. I then teach them some exercises or stretches that will help relieve from their pain while at home.
Sleepygirl: What is the ideal sleeping position? How do I determine the right kind of mattress for sleeping?
Andrew_C._Bang,_DC: I often have patients who show up to my office with pain from sleeping wrong. There is not one position that is best for all but here are some basic guidelines: 1. Avoid sleeping on your stomach because it stresses the neck and low back. 2. Sleeping on your sides and back are the least stressful on the spine. 3. Use a pillow between your knees to help keep your spine in line as you sleep. 4. Avoid using too many pillows under your head. You know you have a thick enough pillow when your neck and mid-back are in line. 5. Avoid sleeping with your pet. Your pet won't move for you, so you end up contorting your body to fit them.
Moderator: I'm sorry to say that our time with Dr. Andrew Bang is now over. Thank you again, Dr. Bang, for taking the time to answer questions today.
Andrew_C._Bang,_DC: Thank you very much for joining me during this chat. Take care.
To make an appointment with Dr. Bang or any of the other specialists in our Center for Integrative Medicine at Cleveland Clinic, please call 216.986.HEAL (4325). You can also visit us online at www.clevelandclinic.org/integrativemedicine.
For More Information
On Chiropractic Physician Services
For further patient education information from the Cleveland Clinic Center for Integrative Medicine on chiropractic care, please read:
On Cleveland Clinic
At the Center for Integrative Medicine, our chiropractic physicians consider the “whole patient” and not just the area that hurts. They receive extra training in exercise prescriptions, corrective exercises, advanced nutrition, and dietary and lifestyle intervention. Wellness chiropractic physicians are specially trained to incorporate chiropractic treatment into complex medical care, working with your primary care doctor and specialists.
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