Question
Hello,

I am 58 years old and in good overall health.  I work at a computer everyday and have recently been noticing some tingling sensation in the left side of my face.  It seems to radiate from my inner ear toward my left cheekbone, eye and jaw, sometimes over the left forehead area as well and seems to come and go.  There is no pain in my neck, face or anywhere else, just this sensation of mild tingling and sometimes a general "tightness" in those areas.  I assume it is probably related to my neck and sitting at a desk for long hours, but since it has become more frequent I thought I should get it checked out.

I would like to see a chiropractor but don't know what I should expect at the initial evaluation/exam, what type of tests would be appropriate for my complaints, if x-rays would be required, the type of treatment, etc.  I've heard so many negative things about the chiropractic field and unscrupulous doctors, that I feel it would be prudent to know ahead of time what to expect, especially as far as the physical exam and subsequent treatment.  

Also, what is your opinion of some of the newer tools being used in the field, such as activators, electronic adjustors, etc.?  Would these be something that would ordinarily be used for treatment in someone with my complaints?  Or, would manual adjustment be a more appropriate protocol?

Thank you for your help.

Answer
iatrogenic,  'overall good health', facial tingling, facial numbness, chiropractic initial examination, staten island chiropractor, activators, electronic adjustors, manual adjustment, staten island chiropractic, most appropriate treatment,




Hello Vanessa,

Thank you for your question.  I am sorry to hear that you have a health complaint.

Let's start at the beginning. You state; "...Hello, I am 58 years old and in good overall health....",  in my Staten Island Chiropractic office I find that lay people (the public) have a very wide/ varied definition of 'good health'  http://www.who.int/about/definition/en/print.html .    I  have  had  people  during  their  initial  consultation  tell  me  they  are  in  'good health',  only  to  elicit  later that they are on cholesterol medications.   I have heard claims of 'good health', and the patient is on anti-hypertensives.  Obviously if someone is on medications, by definition they are NOT in good health.  The crutch of a medication, the need for a chemical shows that the body is NOT functioning properly, hence:  NOT  healthy.  Also, some people claim 'health' because they have not seen a doctor in xxx years, meanwhile they have UNDIAGNOSED diabetes or high blood pressure or cholesterol or arthritis or osteoporosis or some occult condition.
         Any practitioner that you see will take a history and depending upon what verbal questions/ answers accumulate:  physical examination may be a general exam or focused.  Your Doctor of Chiropractic (DC) will do the same thing your family medical doctor (MD) would do: talk/ question/ listen/ look/ touch/ put you through some physical examination;  this will determine how healthy you may be.   

You say, "...I work at a computer everyday and have recently been noticing some tingling sensation in the left side of my face...."; Tingling can have many causes.  Have you suffered any recent trauma?, slip trip fall?, motor vehicle accident?, simple things like waking up with a stiff neck?, did you change work stations?, how long have you had this complaint?, have you ever had anything similar?, Has anyone in your family ever had anything similar?, anyone in your family ever have TMJ syndrome?, anyone ever have a T.I.A. (transient ischemic attack)?, anyone ever have a stroke or heart attack?
         Your Doctor (whether a DC or MD) will TALK, ask questions, evaluate your answers, see if a specific direction is indicated.  Physical Examination will take place regardless of your 'story'  and depending upon the initial consultation the physical exam may flow in that specific direction.  Certainly Xrays will be ordered, perhaps your Chiropractic Doctor (DC) will take them in his(her) office, perhaps you will be referred to a radiology facility.  Depending upon consult and exam results, you may be forwarded for an MRI examination- perhaps of the head (brain), perhaps of the cervical spine (neck).  
         Depending upon the initial clinical exam, EMG or even EEG may be ordered.  Your chiropractor would order the same tests as your family medic.

You say, "...It seems to radiate from my inner ear toward my left cheekbone, eye and jaw, sometimes over the left forehead area as well and seems to come and go.  There is no pain in my neck, face or anywhere else, just this sensation of mild tingling and sometimes a general "tightness" in those areas...."; this kind of verbal description kind of points to a TMJ (temporal mandibular joint) disorder.  Your DC will exam your jaw, look at your TMJ motion, look at your bite, look at the alignment of your jaw joint.   It is possible you have a TMJ condition, which often does respond well to chiropractic treatment http://www.youtube.com/watch?v=lxrMnxYQ6nI&feature=related .
         Along with evaluation for the TMJ, a close inspection of your C-spine mechanics will be performed.  TMJ and the neck are intimately involved, both should be examined given your type of complaint.  Have you had any recent dental work?- this can initiate a TMJ condition.

You further state: "...I assume it is probably related to my neck and sitting at a desk for long hours, but since it has become more frequent I thought I should get it checked out...", should you 'check it out'?, yes, of course.  This may be an innocuous situation or complicated and serious.  Yes, check it out, whether MD ( I would suggest a neurologist MD), or your family DC,  both  will conduct similar examinations.
         Can this be due to prolonged posture, such as sitting at a desk, at a computer?, Yes.  Any prolonged posture can fatigue muscles and joints and affect the nerves.  Have you recently changed the work station?

You ask, "...I would like to see a chiropractor but don't know what I should expect at the initial evaluation/exam, what type of tests would be appropriate for my complaints, if x-rays would be required, the type of treatment, etc. ...", you can expect a similar exam at the chiropractic doctor as you would expect at the medical doctor.   In my office, based upon the little description given here, Xrays would be required,  depending upon history and physical exam; brain and perhaps C-spine MRI could be required.  

You say, "...I've heard so many negative things about the chiropractic field and unscrupulous doctors, that I feel it would be prudent to know ahead of time what to expect, ....", yes, doctors of all disciplines are under heavy scrutiny now-a-days.   From parents questioning the cause of autism (perhaps vaccines?) and MDs 'stonewalling', to questionable treatments, iatrogenic illness and injury,  unnecessary testing and treatment; this is a worthwhile question of any profession.   When I was a child I never thought there were bad clergy or bad policemen,,,, but every profession has their 'rotten apples'.

Any profession should be evaluated upon the facts.  I am always happy to discuss with my Staten Island Chiropractic patients the fact that Chiropractic Doctors (DCs) pay FAR LESS malpractice than ANY other kind of Doctor.   Chiropractic is extra-ordinarily safe  http://www.youtube.com/watch?v=11VN2sGMdbI .


Be careful when approaching any doctor.  Be careful when approaching a Chiropractor; be especially careful when undergoing any allopathic (traditional American medicine) approach, see the research:
         "Death by Medicine" (1)   
is  an  eye-opening  paper  published  as  a  Web  exclusive  in the March 2004 issue of Life Extension, a monthly magazine dedicated to "up-to-date coverage of the latest scientific and medical breakthroughs from around the world." As the grim title suggests, the paper explores the hazards of conventional medicine in the United States, analyzing and combining the complete published literature to date regarding injuries and deaths attributable to medicine.

In their introduction, the authors note: "Never before have the complete statistics on the multiple causes of iatrogenesis been combined in one paper. Medical science amasses tens of thousands of papers annually - each one a tiny fragment of the whole picture. ... Each specialty, each division of medicine, keeps their own records and data on morbidity and mortality like pieces of a puzzle. But the numbers and statistics were always hiding in plain sight. We have now completed the painstaking work of reviewing thousands and thousands of studies. Finally putting the puzzle together, we came up with some disturbing answers."

The "disturbing answers" the five researchers uncover are an indictment of the entire American medical system:
        *   "The total number of deaths caused by
         conventional medicine is an astounding
         783,936 per year."
        * "The number of people having inhospital, adverse drug reactions (ADR) to
         prescribed medicine is 2.2 million."
        * "Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics
         prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now
         refers to tens of millions . of unnecessary antibiotics."
"The number of unnecessary medical and surgical procedures performed
Annually    is 7.5 million."
        * "The number of people exposed to unnecessary hospitalization annually is 8.9
         million."
        * "It is evident that the American medical system is the leading cause of death and
         injury in the United States."

The authors are especially concerned that "(a)s few as 5% and only up to 20% of iatrogenic acts are ever reported."  (It must be noted that these reports on MEDICAL failure are compiled by MEDICAL personnel, and therefore these statistics a probably BIASED in favor of medicine, with poor outcomes being omitted or dismissed from the research.  The statistics are probably LOWER than the reality.)

They also project that the costs associated with deaths caused by medical interventions total approximately $282 billion per year, and estimate that the costs for unnecessary hospitalization and medical procedures total $16.4 billion per year.

As if this information isn't startling enough, the paper goes on to review the drug industry world. The authors discuss the dangers of many types of drugs and how their overuse is affecting our health and our environment, Next, they discuss the dangers of surgical procedures, the lack of error reporting and unnecessary hospitalization. The paper concludes with a discussion of how women are mistreated by medicine, and the dangers awaiting the unsuspecting elderly: "A total of 20% of all deaths from all causes occur in nursing homes."

The complete text of "Death by Medicine" can be found online at www.lef.org/magazine/mag2004/" mar2004_awsi_death_01.html.
More than 150 references and an extensive appendix support the discussions and conclusions presented in this paper. While many will find it quite disturbing, every health care provider and every patient should read this paper.

Reference
1).  Gary Null, PhD,  Carolyn Dean,  MD ND,  Martin Feldman, MD, Debora Rasio, MD, Dorothy Smith, PhD. "Death by Medicine." Life Extension March 2004 (Web exclusive).

Investigative Reporter Gary Null, PhD:  http://www.youtube.com/watch?v=y3XlJB7J5-o

Misconceptions:  http://www.youtube.com/watch?v=Xn_2XrVNlOc

When you aggregate all of the iatrogenic morbidity and mortality  (medical doctor caused illness and death) it would equal a Jumbo Jet Plane crash every day, every year!
         We would certainly investigate the airlines if that was a statistic.  Given that it IS  a statistic with medicine,  I would closely evaluate any profession or any doctor and the recommendations before proceeding.

Whether it is medicine, chiropractic, nutrition, acupuncture, massage, whatever- confidence in the Doctor, confidence in the treatment, motivation, compliance; ALL of these things affect the patient's outcome.

That being said, let me give you some information, websites, and resources which may help you  decide if Chiropractic could be for you.



First, some caution on pain killing medications:

Pain  Killing  medication???  =    16,000  deaths   ( probably  under-reported )
         DEATH ! ? ! ?    better   watch  out  on  those  medications!!!  

PAIN          
Pain  is a  憆ed light on the dashboard?

Pain  is  your  body  telling  you  that  something  is  wrong.
 Think  you  should  listen??
That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?  
Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?   
Pain,  
do you cover up the pain by taking a painkiller?  
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?


         NOTICE  ON  PAIN  RELIEVERS:

Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to  include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

SIXTEEN THOUSAND DEATHS: "Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many chronically painful medical conditions. However, it is estimated that 25% of all serious adverse drug reactions involve NSAIDs, with more than 100,000 hospitalizations and 16,000 deaths occurring annually due to NSAID-induced gastrointestinal (GI) events."----- http://hhc.sagepub.com/cgi/content/abstract/13/6/468   Home Health Care Management & Practice, Vol. 13, No. 6, 468-475 (2001)  Motrin, Advil = NSAIDS

The  American Heart Association issued a scientific statement   recommending medical doctors change the way they prescribe OTC pain relievers from a first choice    to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ).   Many times people take NSAIDS  for  the pain of Arthritis,  not realizing these drugs may make the underlying condition worse.   These medications  cover  up  the  pain,  and  cause  the  problem  to   worsen.

Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation          (  慥SC?,    憇ubluxation?  )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- 慡ubluxation??can be the cause of many symptoms and conditions.



Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.



The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

         A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.

      Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine,  Invited to Colorado Springs (Olympic Training Center) to  Care for USA Olympic Athletes 2010;  Staten Island Sports Hall of Fame 2011;  FIRST Doctor from Staten Island selected to the Medical Staff of the Pan American Games 2011

The above is from an information handout sheet I utilize in my office.



You further state: "...I feel it would be prudent to know ahead of time what to expect, especially as far as the physical exam and subsequent treatment....",  as you can see, your first visit, indeed the first few visits to the Chiropractic Doctor (DC) will be very similar to the first few visits at the Medical Doctor (MD).  The first few visits may be made up of consultation, examination, investigation and 'fact- finding'.  AFTER assessment / diagnosis,
the chiropractor, like his(her) medical colleague, may refer you out to a whole different specialist.  The chiropractor may not even treat you.  The chiropractor may treat you concurrently with an allopathic medical doctor.   Depending upon whether Chiropractic is appropriate for your diagnosis,  then perhaps a regimen of care would be started.
         Depending upon the outcome of this exam process, chiropractic care could be similar to a physical therapy regimen:  PHYSICALLY seeing the patient 3- 4x per week for one or two months, re-evaluation, then perhaps 2x per week for two or three months.  Chiropractors do NOT treat patients EVERY DAY the way MDs do.  The MD can give pills and say- take one a day every day for the next 1- 2- 3 months, and I will see you then.  MDs get to treat long distance, chemically.  DCs need to physically see the patient and treat neurologically in person, up close and personal.

Chiropractic, again like medicine, is NOT monolithic.   There are many approaches.   Some MDs like one medicine, some prefer another medicine, but there are dozens or hundreds of different medicines that could be utilized.   Chirorpactic has many approaches.  Primarily I utilize osseous techniques (my hands, manual manipulation), in certain patients, with certain conditions I may utilize the Activator Technique.  I am not very familiar with the electronic adjustive devices, but no matter how sophistcated a computer and machine is,,, I think I prefer my hands tied into my brain- a pretty fine and SENSITIVE computer.  I know I perefer manual therapists over electronics upon my own spine.
         Your  last paragraph is a question; "Also, what is your opinion of some of the newer tools being used in the field, such as activators, electronic adjustors, etc.?  Would these be something that would ordinarily be used for treatment in someone with my complaints?  Or, would manual adjustment be a more appropriate protocol?"-  this would depend upon the Doctor you choose, the findings you present, and the treatment techniques preferred by the practitioner.   I prefer the manual approach, SOT Technique and then the Activator for myself and my patients.

I hope this helps.   If you need further information from your Staten Island Chiropractor friend, do not hesitate to RE-contact me here at AllExperts.com:  http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm .


Thank you for your question.  I wish you Good Health regardless of the profession you choose as the route, regardless of the technique you prefer!

Dr. Victor Dolan, DC
drvictordolan.net