Chiropractic BioPhysics® method of rehabilitation?

[Rudy Pohl]

Hi There:

My name is Rudy and I'm from Ottawa, Canada. I am 60 years old and have had serious lower back issues for most of my adult life that I've always managed with exercise.

I am now considering seeing a local chiropractor who is part of a North American group of chiropractors that follows the Chiropractic BioPhysics® method of rehabilitation founded by a Dr. Don Harrison in 1980 in Tacoma, WA.

This approach to chiropractic therapy focuses on rehabilitation and postural correction through adjustments, exercises and traction. Their website is found here: Chiropractic Biophysics Online a.k.a. Clinical Biomechanics of Posture, Developed by Don Harrison, DC PhD, MSE, and Deed Harrision, DC.

Question: Does anyone here have any knowledge or experience of this technique and these folks? Good, bad, ugly?

Thanks,
Rudy

[mmglobal]

Like most of the conservative treatments I've seen, chiropractic has been successful in many people I've known. While I do believe that there are specific instances where chiropractic adjustments are useful, for most of the spine patients I know, they may provide some short-term relief. The likelyhood of getting real, long-term benefit is very low for spine problems that relate to structural issues, degenerated joints, osteophytes that compress nerves, tissues that should not be innervated that have become highly innervated, etc...

IMHO, the peopl who get better are the ones who would have gotten better with time anyway, or the people who will benefit from a powerful placebo. The risk of doing chiropractic adjustments in people who have a problem that may be exacerbated by a crunch is very real.

Rudy, I wish I had more positive things to say. I don't think I addressed the specific question you answered about an improved version of chiropractic. I don't have any specific experience with that method. I'm simply expressing a high degree of skepticism about chiropractic in general.

I hope you get some more positive answers.

All the best,

Mark

[Rudy Pohl]

Hi Mark:

Thanks for the speedy repsonse. I have begun reading your other sites, and your story and your work is quite remarkable. I look forward to spending a lot of time learning from your experiences and your knowledge. Thanks for providing this invaluable service to us back suffers.

Mark, in your opinion, if so-called "rehabiliative" chiropractor therapy holds very little promise of any real long-term benefits for serious spinal issues, what conservative treament can you recommend that I investigate instead? I have degenerative disc disease in the bottom 3 lumbar discs, have had persistant back pain most of my adult life, and 2 months ago my left leg when numb and my pain level went off the charts.

I saw the Chiropractor I mentioned in my previous post on a short-term basis and am now wondering whether to start a long-term program. A few weeks ago was able to begin an increasingly rigorous exercise program and have had significant improvement since then.

Thanks,
Rudy

[mmglobal]

Rudy, thanks for the opportunity to turn my knee-jerk, "I don't believe much in Chiropractic" reaction into a more meaningful discussion.

I clicked through the link you posted to the referral page. I'm not sure if this is generic referrals to chiropractors or if this is specifically for those who practice chiropractic biophysics. In any case, I recognized the name of a friend who I haven't seen in decades. He was in chiropractic school back when I was a teenager. I sent him a message. I hope to get together and discuss these new techniques with him. I’ll post when I do.

IMHO, we all have a level of core strength, flexibility and fitness that is based on who we are. (Wherever I write core fitness; read core strength, flexibility, aerobic fitness, and lose weight if you are overweight.) After an injury or surgery, everyone gets the recommendation to increase core strength and fitness. More of us did PT in the past, but as co-pays and deductibles have increased so dramatically, fewer and fewer of us get through PT programs.

Walking back from my "I don't believe much in chiropractic", I do believe that ALL spine patients can improve their situation by increasing core fitness. I believe that chiropractic, PT, pilates, gyrotonics, etc... ALL have the potential of helping us to achieve greater core fitness if they motivate us to work towards that in our lives. These programs are VERY useful if they get us on an intellegently thought out program that allows us to work at levels we can reasonably do. We must be able to dial up the program when we are doing better and dial it back when we are not.

I do believe that this program will be beneficial to all who can turn it into a self-directed program that will allow you to continue to increase or maintain core fitness. I hope to learn that there is something here that is different from the other programs, but as I said earlier… whatever works for you is great.

I really like gyrotonics, but gyrotonic studios are still hard to find. You might want to look for that in your area. At the AlphaKlinik, they had a superior gyrotonic program. I believe that the benefit from these programs has much, much more do to with the therapist than with the style of workout.

For the worst of us, the battle is nearly impossible. We struggle to make it through each day and all activities seem to make us worse. We would benefit from increased core fitness, but can’t seem to take the steps necessary to get there.

All the best,

Mark

[Maria]

Rudy,
I can't say that I know the type of treatment my friends are receiving other than "adjustments" however I have several friends that only go to Chiropractors and have long standing back problems that are probably a mix of DDD and discogenic types of problems. They've not had any back surgery altho as I mentioned had long standing problems/complaints with pain and needing to do some of the same things I've done for pain relief in terms of types of exercise, rest, Nsaids, muscle relaxers but they do not want to enter into the realm of lumbar ESIs, surgeries if can be avoided and so forth.

These people have seen chiropractors almost exclusively for their ongoing treatment with exception of some diagnostics ordered by Orthopedic spine surgeons and some PT ordered by OSS.

They seem to be "believers" in terms of chiropractic care/managment however I know that they have had to find a practitioner that best met their needs in terms of pain alleviation thru their form of treatment.

I hope if you're going this route that you will have success that is if you have nothing that would contraindicate treatment by a Chiropractor.

Myself personally I've never utilized one however earlier in my spine care I saw Osteopathic doctors for soft tissue work and low velocity manipulations. Finding a really good DO is probably like finding a really good chiropractor and one of the best that I've been to is actually an 87 y.o. Osteopath who last I heard still was practicing (he started the Osteopathic school in Pomona CA).

Again, good luck. Please let us know how you do with this line treatment should you pursue it. Editing to add that I just read Mark's latest reply to you and wanted to add that I've done numerous PT stints for my low back and my knees altho would have to say that after I had my 2nd spine surgery and it failed my ability to exercise on various equipment was very limited. What I found the most helpful was core exercises with use of the stability ball. What I'm most able to do on a very regular basis however are some exercises (core strengthening included) that doesn't flare my back up and walking~ esp. walking.

In fact now it seems that if I don't walk regularly my low back stiffens and aches and walking seems to work this out (arthritic changes).

I'd be interested to hear or read about what you might find should you visit this chiropractic practice and what their style of treatment offers (or if Mark speaks with his friend in this practice and writes something more about it). Good luck!

[Rudy Pohl]

Hi Mark and Maria:

Thanks for both your thoughtful replies. I am still in the process of deciding what to do. The year-long chiro program consists of 90 visits which include manual adjustments, posture-correcting traction and posture-correcting exercises. If you pay for the full program in advance the cost goes from $4,000 to $3000. I live far from the clinic so my transporatation costs would be about another $1000, bringing my total cost to $4000.

I have no insurance or any other kind of coverage, so I am trying to weigh the cost-benefits of this treatment as opposed to just working out at home like a little beaver (hey, I'm Canadian!) to strenthen my core and doing some passive traction using a simple foam lumbar device.

I have spent about 40 hours so far researching this chiropractic treatment and somehow think that I could do almost as well on my own working on my core and doing some passive lumbar traction. My sense is that even if I were to do the year-lomg program, a great deal of my improvement would be as a result of me diligently doing core-strengthening exercises.

Any final thoughts?

Thanks again,
Rudy

[Maria]

Hi Rudy,
I guess I'm cheap. Wouldn't want to spend that much $ on chiropractic treatment if I could get the same benefit from some of the same work out at home. The adjustments are something a few of my friends that frequent the chiro's offices seem hooked on. I think it is very similar to when I was getting very frequent osteopathic manipulations/soft tissue work. Since I worked at an Osteopathic Hosp. and was the Family Practice/OB-GYN director at one time I was the best guinea pig for the students, residents and even fellows. I think truly this is part of why I was able to hold off so long on my first spine surgery (diagnosed in '82 and first surgery in '89).

Also I was very motivated to work on my spinal situation myself with exercise such as light gym work out regularly, swimming 5x/week and so forth. I called it a "Minnie Mouse" workout tho it worked for me to keep me in at least as decent a shape clinically and physically as I am over the years. I'm never been much of an athlete though just your average "I'd like to stay in shape female."

If I was able to start chiropractic treatment on a pay as you go type of plan or if funds could be returned if not all treatment plan was utilized I might consider it if I were so inclined tho again in my case I've never considered using a chiro for my spinal probs esp. because I had medical insurance that covered my care and utilized Work Comp benefits mostly which would have likely either denied chiro care or tried to make it look like that further screwed up my injured area to get out of paying for my care.

Now I trust Mark will give you a reply that makes more clinical sense. My reply has to do with what I didnt' want to do or spend. Good luck either way!

[mmglobal]

IMHO, the most important thought expressed in this thread is:

Originally Posted by Rudy Pohl

My sense is that even if I were to do the year-long program, a great deal of my improvement would be as a result of me diligently doing core-strengthening exercises.

Yes... you can do the program and if you do not follow through on your part, the program will fail.

Yes... you can set up a self-directed program and be disciplined and generate the same results as the full program.

You might consider doing a mix... getting professional help in setting up the self-directed program and then periodically checkpoint with the professional to monitor your progress and tweak the program accordingly. If they are not willing to participate in this way, screw them... they should be about helping you within your budget. None of them hold the magic feather. (But you do need to be careful...IMHO, too many "no pain, no gain" therapists hurt the average spine patient. We are not professional athletes. Finding the good therapist is an independent issue from the $$$. Many expensive PT's suck, and many more reasonable PT's are angels in disguise.

Sadly, you can do everything perfectly and still continue to spiral towards surgery. IMHO, you owe it to yourself to do everything you can to avoid surgery. You also have to consider the financial implications. If you blow your wad on therapy or less invasive procedures, AND still need bigger surgery… if you can’t afford to get it then, you are screwed. IMHO, less invasive surgeries should be pursued before the more invasive ones, but only for the good candidates. (OK… morphing into another discussion here…)

Whatever you do.. .GOOD LUCK! Please keep us posted. Thanks for participating in the iSpine community!

All the best,

Mark

[Rudy Pohl]

Hi guys:

Thanks once again for your thoughtful responses. I have decided to forgoe signing up for any kind of long-term, meg-dollar treatment program, chiro or otherwise. I have spent about 40 hours researching the scholarly literature about conservative chiro treatments of spinal issues and I feel that the evidence is simply not sufficient to merit spending $4,000 on the first year of a chiro-traction-exercise treatment program and then spend $1000-$1500 a year on maintenance after that.

I have decided to try another route. I have discovered something in the literature called the McKenzie Method developed and improved by Robin Mckenzie of New Zealand since 1956. After an initial assessment by a trained McKenzie certified clinician the patient is immediately trained in the particular set of McKenzie exercises suitable for his/her condition. The patient then does a self-directed healing and recovery program at home. For those who are good candidates for this form of conservative treatment the results have been quite impressive, with a lot of supportive evidence in credible, peer-reviewed clinical journals.

There are a number of clinics here in Ottawa who are McKenzie certified and this week I will be looking for one to get an assessment from. As well, I just had my family doctor make a referral for me to a Rheumatologist who specializes in back assessments, so he'll do a complete set of x-rays and range of motion tests and give me his prognosis and recommendations regarding when surgery might become an option and what conservative treatment(s) I should pursue until then.

Anyway, I am hoping that by taking these steps I will be making some good and cost-effective moves.

One last thing I should mention regarding the health care system up here in the "Great White North" is that while chiropractic and physiotherapy are not covered by our national or provincial health care systems, all hospitalization and all surgeries are. That's pretty awesome. Therefore, money is not an issue when it comes to surgery, but rather the big issues are what are the chances of post-operative complications and surgury "failures," and does one want to risks those. I guess that's where the importance of assessments come in as there are some folks whose pain is so high and function is so low that they really have no alternative than to get surgery done.

Anyways, that's all for now. Thanks again for you valuable input.

Take care,
Rudy in Ottawa

[Maria]

This was part of my early PT rehabilitation re my failed spine surgery back in '92. Very good. Helpful. Though at the time more helpful would have probably been right pain meds prescribed. Had to wait another 10 years for that nearly plus the lumbar ESIs.

Good luck Rudy! Please keep us posted on your progress or status~ Maria

[pauljackson]

Never in the history of chiropractic have we been able to provide the level of help and expertise that now exists. These newer correction methods are even safer, more comfortable and more effective than ever before. it is a safe and effective method still i would say you should suggest an expert first for all the information.


Chiropractor Lawrenceville GA

[Maria]

I think you meant to say one should "consult an expert" vs. suggest however what you've done here seems to be advertise your business. I do agree with the idea that one should consult an expert which seems to be what the person entertaining the thought of enrolling in some form of treatment is considering.

[dshobbies]

Paul,

Thank you for being honest in what you do even if you are advertising. And I also agree that chiropractic care has reached new levels. Unfortunately, many, if not most, still use the twisting method of adjusting and those who do new treatments want to sell it through an expensive package. Also, as with all professions, quality counts.

Just for the telling, chiropractic care landed me in both my 1st and 2nd surgeries.

Dale