Question
Dear Dr. Gillman,
I am a 38 year old female with a history of low back pain.  I do not get radicular symptoms.  My xrays show degeneration and some arthritic changes.  My back most of the time feels out of alignment.  I do not have pain.  But I fell like I can not do things like exercise, or it will worsen.  Frequnently I get very shifted. over the past year the episodes of my back shifting have increased.

I went to a chirpractor: 4X two weeks, 3X one week.  I am definately better. I have also been working with a highly qualified trainer to help correct my poor firing patterns and compensations.


He wants me to continue 3x 8weeks, 2x16 weeks, 1x 28 weeks.  Does this sound right?  It seems like alot to me.

Thank You for your  help,
Louise

Answer
Hi Louise,

Yes, this sounds like a lot to me, too.  I am not clear what you mean by "get very shifted."   If you have no pain, but just feel like there's a glitch (or out of alignment), that's one thing.  Having your spine contort into antalgia is something else.  Antalgia is the contorted lean, with a shifting of your torso to the left or right away from your pelvis.  It is the posture your spine will assume when there is back pain or a disc protrusion, for example.  Is this the shift you're describing?  Often there's pain.  If you contort into antalgia frequently, then you need an MRI, preferrably a seated MRI (see the recent posting were this is discussed).    If you are only describing a FEELING like there is a shifting, and you have no true contortion, and also no pain, then no worries.   As for treatment, it is absolutely absurd to have a canned formula for chiropractic treatment frequency (or any physical medicine treatment for that matter) for such a huge duration of time.  3x/week for 8 weeks?? Am I understanding this correctly?   Ask the DC to explain the purpose of such a plan.  For what purpose?  To accomplish what?? [...make a boat payment?...]  The mild degenerative joints will not change.   Forget about alignment, there's no such thing as putting bones in alignment.   It's all about function.  If you are functioning well, able to perform daily living activities such as sitting, lifting, and recreation, then what's the purpose of obtaining treatment?  If you have mild symptoms, then have them addressed with treatment that occurs in brief intervals, e.g. a few weeks.   If you cannot get your back to feel moderately better in a few weeks of treatment (by anyone), then you must question the treatment protocol.  Regarding back pain, it is well established that general exercise is key.   I'm a fan of strengthening all the muscles you don't see when looking in a mirror, e.g. calves, hams, butt, back, lat's, traps, etc.   

Many folks pop in to their chiropractor when their back pain flares up, get worked on for a visit or two or three, and then go back to business of feeling okay and performing okay for a while.   There's nothing irrational about that approach to healthcare.

'Hope this was helpful.

Dr. G'