Online Health Chat with Andrew Bang, DC
February 7, 2013
Chiropractic physicians offer integrated health care to patients who request further treatment of problems involving the muscles, tendons, ligaments, bones, cartilage and nervous system. Chiropractic physicians can perform soft tissue therapies, prescribe corrective exercises, and provide manipulation of the spine or joints in an effort to help you avoid surgery and medication. 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.
For More Information
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.
At your chiropractic visit, you will be asked for your health history and will have a complete orthopaedic and neurologic exam, to assess the muscles, tendons, ligaments and nerves. Based on this information an individualized treatment plan will be provided. Your chiropractic care will be coordinated with your primary care doctor and other specialists.
On Your Health
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A remote second opinion may also be requested from Cleveland Clinic through the secure Cleveland Clinic MyConsult® website. To request a remote second opinion, visit eclevelandclinic.org/myConsult
To make an appointment with Dr. Bang or any of the other specialists in our Center for Integrative Medicine at Cleveland Clinic, please call 216.448.4325. You can also visit us online at clevelandclinic.org/integrativemedicine
About the Speakers
Andrew Bang, DC joined the staff of the Center for Integrative Medicine in January of 2013. Dr. Bang graduated from Parker College of Chiropractic in Dallas, TX. During his clinical internship in Bogota, Colombia, Dr. Bang treated professional and Olympic athletes. Dr. Bang also served as a team chiropractor for the Texas Wranglers (Semi-pro Basketball team).
Dr. Bang treats back and neck pain, pelvic pain, shoulder, elbow and wrist pain, hip, knee and ankle pain as well as guides patients in diet and lifestyle modification. He has advanced training in muscle work, nutritional therapy and extremity manipulation.
Let's Chat About Chiropractic Care
Philosophy of Chiropractic Practice
brady: What problems (i.e., diseases and conditions) can be treated through chiropractic care?
Dr_Bang: The true philosophy of chiropractic is we never treat specific diseases. Chiropractic removes interferences caused by misalignments in the spine, muscles and other joints, thus allowing the body to heal itself like it was designed to do.
canndo: Can chiropractors prescribe medicine? Is using medication part of the philosophy?
Dr_Bang: It is not in the chiropractic scope of practice to prescribe medicine. Adding or taking away medications should be something discussed with the patient and prescribing physician.
I use diet modification, herbal remedies and supplements to get desired changes in someone’s health.
Choosing a Chiropractor
longtree: How does one go about picking a good chiropractor? I am interested in trying one for my back pain. My friend sees a chiropractor, and swears that the doctor changed her life. However, I have heard bad stories.
Dr_Bang: Unfortunately, there is good and bad in all professions. One of the first things I would do when searching out a chiropractor is ask your friends and family if they have been to a doctor that they have had a good experience with. You could also ask for a short five-minute consultation to meet the chiropractor and see the office. Most chiropractors are willing to take a few minutes of their time to help you know you are in the right place.
What to Expect at Your Chiropractic Visit
brady: How would one know if they need realignment?
Dr_Bang: You might notice pain or stiffness in the muscles or joints. If you have had any falls, sport injuries or auto accidents, you may benefit from being realigned to ensure proper healing. Some other common complaints are headaches and migraines, grinding and clenching of the teeth, and trouble sleeping.
indeed: How does a typical appointment work? You have described different scenarios and reasons for pain—then what would a patient expect? What is the process?
Dr_Bang: A typical appointment works as follows: First, the patient has a consultation and detailed examination with me. I review the patient’s x-ray or MRI, or send the patient out for imaging. Patients typically receive treatment on the first visit, but it is dependent on the condition. Treatments and techniques vary per patient, and no one receives the same treatment. Some things used in the office are chiropractic adjustments, myofascial release, post-isometric relaxation stretches, cranial manipulation, home exercise instructions and nutrition counseling to name a few. Follow-up visits are condition dependent.
Relationship of Chiropractic and Orthopedic Medicine
weed: Do chiropractors work with orthopedic doctors? I thought historically they were at odds. You either went to an orthopedic doctor or a chiropractor.
Dr_Bang: Maybe in the past there was that mindset, but today we strive to work together to help patients get better faster and stay out of pain longer. I refer out to orthopedic doctor when needed, and visa versa.
Chiropractic and Children
tweedledum: What are your thoughts on chiropractic care and children?
Dr_Bang: Chiropractic is safe and effective for children. We treat everything, including conditions related to falls, heavy backpacks and spending too much time on the iPhone®. Neck pain is increasingly more common in young children due to less participation in physical activity and more use of technological gadgets. Chiropractic adjustments are gentle and appropriate for all ages.
Chiropractic Treatment of Neck Pain
WN: Can a chiropractor help neck pain that hasn't responded to physical therapy, nonsteroidal anti-inflammatory drugs or massage. The pain is on the right side of my neck and radiates up toward the base of my head. I do have some arthritic changes and have seen a rheumatologist who sent me to physical therapy. (I am 63 years old and active).
Dr_Bang: I wish I could give you a resounding, “Yes, chiropractic will help!”, but every person is unique and responds differently to care. Many people respond excellently to physical therapy, but you didn't. So, it sounds like your case could be complicated. The good news is that I have been able to help people in your situation. My focus would be working with you to uncover the true nature of your condition. For example, if I just have you come in to my office, massage the tight muscles, and adjust your cervical vertebrae to try and fix your pain, without really questioning you and looking at you as a unique individual, I may miss that you are sitting incorrectly at your computer. Until you change that no treatment will help.
Chiropractic Treatment of Hand and Wrist
mijwstmv: I have a C5-6 pinched nerve with tingling in my left hand thumb and pointing finger, which was diagnosed in May 2012. In October I saw a hand specialist, who performed an electromyogram (EMG) and nerve conduction testing. The results were completely normal. I have participated in physical therapy in November and December for about 12 sessions with hardly any signs of improvement. I am wondering what specific treatment recommendations you would provide. Why would chiropractic, massage therapy and/or physical therapy help resolve my condition?
Dr_Bang: Chiropractic is a great solution for you, especially with all of your test results coming back normal, and physical therapy not being as effective as you would have hoped. You only need the weight of a dime to interfere with a nerve's normal function. There could be a small misalignment of the vertebral bones that could be gently resting on the nerve causing the pain. Chiropractors align vertebral bones to undo the pinch, which will alleviate the pain. Massage will help relax the tight muscles that can pull the vertebral bones out of position. My massotherapist Tracy and I work as a team to figure out what the true cause of your pain is.
songcanary: I was diagnosed with writer's cramp several decades ago. It has cost me a good career because I can't do very much handwriting or typing without stiffness and pain. I use my other hand to get relief, but I can tell it would probably happen on that side if I overdid it. Has chiropractic been used to treat writer's cramp? I was diagnosed by a hand surgeon and had a negative electromyogram...
Dr_Bang: Yes. We work with all muscles and joints of the body.
Chiropractic Treatment of Hip
WN: Can a chiropractor help hip area bursitis?
Dr_Bang: Yes. I use a verity of techniques that alleviate the pain and reduce inflammation. We then will try to uncover the true cause of the bursitis. You may have bad posture that causes excessive use of the bursa, resulting in inflammation, or you my have some weakness in the surrounding muscles that strains the bursa, causing the bursitis.
Chiropractic Treatment of Infertility
hrwright: Do you ever use chiropractic for treatment of infertility?
Dr_Bang: Yes. The spinal nerves come out of the low back and connect to the reproductive organs of both males and females. When there is misalignment of the low back, it can interfere with the nerve transmission from the brain to the reproductive organs. Not every person with infertility is a candidate, so a detailed examination is the first step.
Chiropractic Treatment of the Knee
carolv: I have an iliotibial band injury, and have had knee pain for six years. Nothing helps. I have been visiting an orthopedic doctor. I had several shots and two rounds of physical therapy. I honestly do the exercises. Should I consider chiropractic help? How can they help a ligament injury? I was a runner, but no more. At my last appointment with the orthopedic doctor, I was given some gel inserts for my shoe. We also tried a steroid shot, but the effects didn't last a long time. In the past I've had Sinvisc-One®shots, but they did not last either.
Dr_Bang: It can be very frustrating when you have tried all the things that you have and still have not seen results. Has anyone individually tested the strength of all the muscles that surround your knee? Sometimes I find the problem isn't where the pain is. You may be having a muscle weakness that is causing you to walk or run with your knee slightly out of position. Your iliotibial band then gets strained in the process because of the extra work it has to do.
janet: How does the tape you refer to in a previous question help with inflammation?
Dr_Bang: Kinesio® tape is designed with elastic ridges in the tape and when applied, it retracts and lifts the top layer of skin slightly. This allows better lymphatic drainage.
weed: When I have knee pain from walking, it helps when I lean my upper body to the opposite side. I have to slow down when I do this, but the pain goes away on my knee. I think I might be out of alignment. Please comment.
Dr_Bang: Yes, it sounds like something is off. It is hard to determine where the misalignment is until you are evaluated. I see your type of problem often in my office.
Chiropractic Treatment of Ligament Injuries
weed: How can you help ligament injuries?
Dr_Bang: Ligament injuries can be a tricky beast. Depending on the severity, I have been able to help a patient recover and get back to what they want to do. With ligament injuries, you have to make sure you relax the surrounding muscles, so they don't continue to stress the ligament. I then use special kinds of tape (Kinesio® and Leukotape®) to reduce inflammation and stabilize the area. Kinesio® tape has become very popular because it is used by Olympic and professional athletes.
Assessing Effectiveness of Chiropractic
plastor_of_paris: How long would you suggest continue seeing a chiropractor before judging that it isn’t working?
Dr_Bang: It really depends on how bad or complicated your problem is. Unfortunately, there is no magic number to how many visits someone with neck or back pain need before they get better. My suggestion is to always be open and honest with your chiropractor, so you both can work together to help you get feeling better.
Insurance Coverage of Chiropractic Therapy
sherstol1: Do most major insurance companies help cover the cost of massage therapy?
Dr_Bang: Most do not cover massage therapy when performed by a massotherapist. When certain types of massage are used under chiropractic or a medical doctor's supervision, they can be billed and covered by insurance. Please call your provider for full details because everyone's plan is different.
Cleveland_Clinic_Host: I'm sorry to say that our time with Cleveland Clinic specialist Andrew Bang, DC is over. Thank you, Dr. Bang, for your time today.
Dr_Bang: Thanks for your questions. This was a great chat. I hope this was helpful, and have a great day.
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