“My medical doctor doesn’t think I need chiropractic, and even discourages me to see one, even though I have really bad back pain. What should I do?”

Although we’re well into the 21st century and there has been growing collaboration between allopathic doctors (MD) and “alternatve” practitioners such as chiropractors, acupuncturists, and naturopaths, bias still remains.

In my humble opinion, the main reason why a physician would not refer a patient (assuming the patient’s condition is treatable by chiropractic) to a chiropractor is misinformation. It’s quite likely that the physician formed an adverse opinion of chiropractic or chiropractors by one negative encounter with a chiropractor; or a research article about an adverse effect from chiropractic treatment. Another reason could be plain professional bias; where the MD “feels” that chiropractors aren’t “real” doctors. Never mind the fact that over 100,000 people die each year from adverse drug reactions and medical procedures, and MDs routinely over-prescribe harmful medications like Vioxx and Avandia, which have caused hundreds of deaths since their approval by the Food and Drug administration. Compared to these statistics, even when taking the larger number of physicians into account, chiropractic’s safety record is stellar.

I hope that physicians who hold a grudge against chiropractors regain some humility and acknowlege that they are not perfect, and that allopathic medicine is VERY far from perfect, and that if they have a patient suffering from low back pain who is NOT responding to medications, they should have the decency to refer that patient for chiropractic treatment. Not doing so, to me, is not doing your job as a health care provider– to make sure all available forms of therapeutic intervention are attempted.

So, my bottom line advice on this matter– you as a patient and as a health care consumer have the right and freedom to choose the type of care you feel might help you. With every health care procedure comes risk; some carry more than others. Chiropractic is statistically more safe than taking medicine and undergoing surgery. If your medical doctor doesn’t share this view, you don’t have to listen to him/her. Do what you feel is right.

Dan Perez, DC

(415) 627-9077

“Slipped disc” is the layman’s term for a herniated nucleus pulposus, or simply disc herniation.

Discs are actually tough fibrous ligaments that hold your vertebrae together, forming your spine.  They consist of an outer layer of concentrically arranged fibers called the annulus (like onion rings) encasing an inner, jelly-like material called the nucleus.  The nucleus is designed to absorb and re-distribute weight, and therefore can change shape.

If the annulus weakens in any way, the nucleus could herniate, or puncture through the annulus layers, causing pain.  When viewed from the top, it looks like a bulge, hence the term “disc bulge.”  If the bulge presses against an exiting nerve root, it can send shooting pains down the arm (for discs in the neck) or leg (for discs in the lower back).

If you have a bulging disc in your spine, you may be a candidate for non-surgical spinal decompression. This is a treatment method that utilizes a special table and traction system. In spinal decompression, the lumbar spine is gently pulled and released in cycles, with varying force and patterns. This pumping action can cause a negative pressure to build up in the disc, which draws in the disc bulge. It works well on some patients– but not on all. Various factors such as age of the disc herniation, condition of surrounding ligaments and bone, and general health of the patient all factor in the prognosis. Spinal decompression is worth trying before you opt for spinal surgery.

We offer spinal decompression consultations at our downtown San Francisco chiropractic clinic.  Just call us at the number below, and we’ll fit you in.

Dan Perez, DC

San Francisco Chiropractic

(415) 627-9077

www.sf-chiro.com

First of all, I believe that the term “scoliosis” is being used too liberally by some chiropractors. True, clinical scoliosis refers to an S-curved spine in the lateral plane. It is a congenital (formed during embryonic development) malformation. Persons with scoliosis will exhibit a rotated spine, uneven shoulders, and a protruding scapula (shoulder blade) in some cases. Severe cases can interfere with organ function.

Some chiropractors incorrectly use the term “scoliosis” to describe a subtle sidebending of the lumbar of thoracic spine. This type of lesser curvature is usually acquired; i.e., comes as a result of an external force such as a car accident or sports injury.

Chiropractic treatment cannot “straighten out” a clinical scoliosis. It may, however, provide relief by imparting more movement among the individual spinal vertebrae. Chiropractic is more effective in addressing acquired curvatures. Chiropractic adjustments to the pelvis and spine, combined with exercises targeting a specific muscle group, and sometimes the use of heel lifts has a better chance of straightening out the spine.

Dan Perez, DC

San Francisco Chiropractic

(415) 627-9077

www.sf-chiro.com

Many health insurance plans, particularly the PPO (Preferred Provider Organization) variety, have some chiropractic coverage.   It’s important to remember that it is extremely rare to have 100% coverage, there are restrictions that apply.

Most health insurance plans have a deductible and co-pay. The deductible is the amount that the patient/policy holder has to come up with out of pocket before coverage takes effect. For example, a policy with a $250 annual deductible will cover treatment after the first $250 of charges of a year.   So if you doctor’s bill is $251, you will need to pay $250, and the doctor can bill for the $1 (extreme example).

Then there is the coverage itself, which can be between 50% to 90% depending on the plan you signed up for.  The patient is usually billed the remainder.  Sometimes the plan coverage is 100% with a fixed co-pay, for example $25.  So in this case, if your doctor’s bill is $100, you pay $25 and the doctor bills for the $75.

There is also a maximum number of visits or maximum dollar limit each year limitation for chiropractic coverage; for example, maximum of 12 visits per year allowed or $1,500 maximum coverage per year.

If you would like us to check your benefits, you can request it online by clicking here.  Sometimes we can make arrangements to simplify your out-of-pocket expenses, based on your insurance plan.

Dan Perez, DC

San Francisco Chiropractic

(415) 627-9077

I would advise against it. Such activity can cause joint hypermobility, where the joints lose ligamentous support. This can lead to improper joint movement, and over years, degenerative changes (arthritis).

In chiropractic adjustments, the joints that are manually moved are determined (by X-ray, palpation, or instrumentation) to be already misaligned in some plane, or are already hypomobile. The human spine has 24 moving vertebrae, and not all of them need to be “mobilized” or adjusted. “Self-adjusting”, or cracking your own neck joints is non-specific and does not give you the same benefit as a more targeted adjustment that can not be safely performed by the patient himself /herself.

Dan Perez, DC

San Francisco Chiropractic

(415) 627-9077