King Chiropractic

Don’t believe everything you see on TV…

My husband can tell you how annoyed I get whenever we are watching an action movie or show on TV in which the villain kills a victim by quickly twisting his neck.  Part of me wants to laugh at how rediculous it is, but then I realize that people really believe this stuff. I’ve had so many patients who were terrified to have their necks adjusted because they watched too many of these movies.  Let’s set the record straight: it is not possible to break someone’s neck by simply twisting it.  I did a little research on this, and apparently there are ways to break someone’s neck that are taught in some martial arts and military training, but none of them involve twisting the neck.  Usually it involves some type of headlock and then dropping the person to the ground to use their body weight to force the neck into extreme flexion or extension.  Necks are primarily broken by either compression, such diving accidents and car accidents, or by sudden distraction, such as being hanged. The neck has several very strong muscles that prevent too much twisting.  A forceful twist of the neck is much more likely to cause a muscle strain than a fracture.

So can a chiropractic adjustment break your neck? I don’t see how it would be possible, and I have never heard of it happening. Chiropractic adjustments actually use very little force.  We rely more on speed and positioning to get a good adjustment. This takes years of training, so I don’t recommend people trying this at home. You may not be able to kill someone doing this, but you can give them a very sore neck if you don’t know what you are doing!

All this being said, if my patients are uncomfortable having their necks manipulated in this way, there are other options that do not involve twisting, such as drop-table adjustments, mobilization, Activator, traction, and trigger point release. I always try to tailor my treatment plan to a patient’s comfort level.

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How Safe are Cervical Adjustments?

During their initial consultation, I frequently have patients express concern about having their neck adjusted. They may have heard that cervical manipulation can cause a stroke, or they may have watched too many action movies in which giving a quick twist of the neck is an efficient way to kill someone instantly. (Side note: did you see the episode of Lost where Sayeed snaps a guy’s neck using only his legs? I had to laugh at that one!)

Whatever the reason, I can assure you that chiropractic adjustments are one of the safest forms of treatment for musculoskeletal complaints. In most cases, there are no negative side effects.  In fact, most people report a sense of relief following an adjustment.  Occasionally there may be some soreness at the aadjustment site, similar to post-workout soreness. Severe side effects are very rare, which is why we chiropractors enjoy one of the lowest malpractice rates among physicians.

Probably the most often cited and controversial serious side effect to neck adjustments is vertebal artery dissection. A  very small percentage of the population has a compromised vertebral artery.  With extension and rotation of the neck, this artery can tear, causing a stroke. What is controversial is the timing of the stroke.  Early symptoms of a vertebral artery dissection include neck pain and headache, which may lead someone to a chiropractor. The person may then have a stroke in the hours or days following the adjustment. The question is, did the adjustment actually cause the stroke or would it have happened anyway? It could have just as easily happened by looking up at the stars, turning the head to back up the car, or getting a shampoo at the salon.

With all things considered, the best current evidence indicates that vertebral artery dissection is only associated with chiropractic manipulation in 1 of every 5.85 million adjustments.  To put this in perspective, you are 585 times more likely to be struck by lightning and 58,500 times more likely to die in a car crash. You are more at risk driving to your appointment than you are on the adjusting table!

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Tendinitis or Tendinosis?

In the past, if you went to your doctor complaining of pain in the shoulder, elbow, wrist, etc., it would most likely be diagnosed as “tendinitis” and treated with anti-inflammatories, rest, and maybe a brace of some sort. More recently, doctors are finding that most cases of tendinitis are actually misdiagnosed. As you may remember from high school anatomy, tendons are the fibrous bands that attach your muscles to your bones. They can be injured in one of two ways. Either they can be torn during a traumatic event, such as a skiing accident, or they can accumulate microscopic tears due to repetitive motions, such as typing all day. The traumatic events tend to create a true tendinitis, meaning that the tendon is inflamed (-itis means inflammation). However, repetitive strain injuries are much more common, and these injuries usually do not produce much inflammation at all. Hence, they should be more accurately categorized as “tendinosis” (-osis means degeneration). In fact, one could say there is a lack of inflammation in cases of tendinosis. While you may think of inflammation as a bad thing that needs to be squelched with anti-inflammatories, some amount of inflammation is required for healing to occur. In tendinosis, the injuries occur so slowly that the body doesn’t recognize them as injuries and therefore doesn’t send the required increased blood flow and inflammatory cells to clean up the mess. To steal a phrase from Jim Thornton’s recent article, “Heal the Burn”, tendinotic tissues tend to “languish in a state of near neglect”. The best way to get these injuries to heal is to acually introduce a bit of inflammation. This is why the Graston Technique works so well.  By massaging tendinotic tissues with the patented Graston instruments,  degenerated tissue is broken down, blood flow is increased, and inflammation is temporarily increased. In the days following the treatment, the degenerated tissue is reabsorbed by the body.  With several treatments, the tendon is gradually returned to its normal, healthy state.

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