This was one of those weeks where I needed to have this conversation a couple of times, while I do have it from time to time, it can sometimes be a bitter pill to swallow for some patients.

When a patient comes in to the office and has a specific complaint, most often than not, it will be something along the lines of neuropathy or radiculopathy is present.  A “pinched nerve,” is what most people will describe it as. Now I make absolutely no promises in our offices as to how many visits it will take to get rid of the pain or symptoms we are able to help with, heck, sometimes we can’t help but we are sure going to try.

I’m about as far from anti-MD as it comes in the chiropractic profession, I have absolutely no problem working with all types of medical professionals.  But there is a general trend when I refer people out for further evaluation.  If there is one pet peeve of mine this is it: we attempt care for a few visits, you get minimal benefit, primary care gets a visit, imaging takes place and then 10-12 visits to a physical therapist follow; possible specialist referral follows.  Pain may or may not still be present but I always kick myself in these cases.

I think there is a statistic to show that 99% of back pain with radicular symptoms are non-surgical cases, basically conservative care is the appropriate course of action.  So the moral of this thinking is: give chiropractic care a chance, it may take more than 2-3 visits, but what we are finding that if you give treatment a try for a week or two with visits that are close together, relief can be found.  We do a lot of the same therapies and exercises that a physical therapist can perform and most of the time imaging is not necessary, this is not intended to be anti-physical therapy, we are just able to accomplish the same results.

Most people would not want to know the statistics of the number of false positives that show up on MRI’s that indicated herniated or bulging discs.  I think research shows something like 30-40% of people are walking around with asymptomatic disc herniations.

I love imaging as much as the next guy but my underlying question for most people with some slight arm or leg numbness, does this actually change the course of action.  That is why most guidelines allow for 10-12 visits of conservative care (physical therapy or chiropractic) before imaging is allowed because as soon as imaging is performed, the odds of medical intervention (injections or surgery) increases.  As I stated before, I’m not opposed to sending people out for medical interventions but I’m getting to a point that conservative care should be given a fair shot before we lead you down that road.

If you walk into an office and the y try to sell a 6-12 month treatment plan that costs thousands of dollars, I would tell you from a personal experience, run.  I will be the first person to tell you that treatment can take several visits but it should not cost a year of your life and a good chunk of your bank account.

So when you come into our office as a new patient or with new symptoms, I may start having the conversation, give us a chance to succeed.  1-2 or even 3 visits is not necessarily a fair shot, but if you give us a couple weeks I can promise that if relief is not being found, we will attempt numerous therapies and stretches, another route will be explored.  Don’t be so quick to dismiss conservative care, it could keep you from going down a rabbit hole that will be far more expensive and painful and often times not that much more successful.