Question
Hi Doctor Dolan,

A few days ago I started experiencing pain in my middle left back when breathing. I thought it might be pleurisy since I had been dealings with some allergies but it continued to get worse, to the point where I couldn't sleep because of the pain. It became quite severe the next day so I had an exam at my local chiropractor.

He said my left leg was shorter than my right, noticed swelling to the left of my spine and diagnosed 3 ribs being out of place. This shocked me since I had done nothing that I knew of that could of misplaced ribs. He did some minor adjustments, couldn't do much since I was so swollen and in so much pain; it was all I could do to get on of and off of the adjustment table. He hooked me up for some electrical stimulus, put a cold pack and my back and told me to go home and alternate heat with cold.

His explanation of my ribs being out of place was based on the fact that I've been having pain in my left hip joint for over a year now. It has been sporadic but very painful when it hits. The pain will radiate down the front of my left leg and, at times, will wake me up several times during the night.  His thought is that, since I haven't had the hip corrected, my spine was way out of alignment already so it wouldn't have taken much to move the ribs out of place.

I did go see him the next morning and was feeling somewhat better, but that might have been because I was taking some pain relievers. He was able to make a more normal adjustment that morning and, once again, did the electrical therapy and cold pack.

Does any of this make sense? I like this doctor but, I have to admit, he is very young, straight out of school so I guess I'm not real confident in his ability to diagnose.

I look forward to your reply. Thank you for being available.

Answer
Hello Renee,

Sorry to hear of your aches and pains.

"...Does any of this make sense?...", yes, from a purely straight Chiropractic point of view.

Chiropractors are licensed Doctors in all fifty states.  That license gives us many responsibilities.  The Doctor of Chiropractic must evaluate from a Chiropractic perspective- looking for neuro-musculo-skeletal aberrant function.  The 'thing' that makes us different from Medical Doctors and physical therapists-- is the Vertebral Subluxation Complex, the 'kink' in the spine that can cause so many symptoms and problems.  In my Staten Island Chiropractic office I utilize an informational handout to help explain this condition:

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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).   

Only a Doctor of Chiropractic will evaluate and treat for VSC.

  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.

         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
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.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

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;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, 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

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Along with evaluation for this 'specialized' condition (Vertebral Subluxation Complex, VSC, subluxation), the DOCTOR of Chiropractic has
responsibility to rule out conditions that are more 'medical' in nature.

Pleurisy, cancer, pneumonia, a heart attack,,,,  all of these things could have caused your aches and pains or similar aches and pains.
I assume your Doctor of Chiropractic took a full case history in consultation with you, performed a physical examination; particularly of your area(s) of complaint as well as a general survey of your health.  Once the big, >bad<, 'emergency', medical type conditions are evaluated for and eliminated or considered remote, then we move into the chiropractic evaluation.  

In 25+ years of practice, at the same place, I have sent many patients to the Medical Doctor for 1) evaluation, 2) evaluation and treatment, 3) evaluation and concurrent treatment.  Your examination should have been thorough enough to set your mind at ease that other causes of your complaints were considered, evaluated for, and ruled out.

In 25+ years of practice, I must admit, there are times I have been 'stumped' by a patient's presentation.  When that happens, I try to narrow the complaint/ condition to an appropriate medical specialty, and I send the patient for evaluation at a medical colleague's office.  Sometimes I do not expect the patient to return, and I tell them so, sometimes I expect the patient to get a combination of medical care (at the MD's office) AND chiropractic (my office)('concurrent care'), sometimes I just want confirmation of what I suspect, and I expect to treat the patient entirely with chiropractic- but I just want a second set of eyes to evaluate the patient.

Personally, I do think some type of Chiropractic care is appropriate for everyone with a spine.  Chiropractic care and removal of the Vertebral Subluxation Complex allow our nervous system, and our body to function better.  However,,, if I was in the middle of a Heart Attack --- give me the TPA, give me the drug to break up the clot,,, give me immediate medical attention not a visit to the chiropractor.  Critical care, emergent care, is excellent in the American Allopathic Medical Approach.  That said, chronic care, or 'builiding health', or preventive care-- it seems as if approaches such as nutrition, acupuncture, chiropractic help the body towards homeostasis and balance- naturally, safely, effectively and cost effectively.

Okay, I am giving a long answer, but your question opens up many issues.  Going from  - 'mid-back pain,,,,  trouble breathing,,,, pleurisy....' to a short leg syndrome sounds silly, UNTIL we are properly informed.  As long as the medically urgent possibilities, medical pathologies, were evaluated for and ruled out; the jump from breathing dysfunction to spinal dysfunction is NOT a big jump.

Your DOCTOR of Chiropractic, after careful examination and evaluation apparently ruled out those medical pathologies that would require medical intervention.  Your Doctor of Chiropractic then came to an assessment that yours was a chiropractic case, appropriate for chiropractic intervention.  The young Doctor should have communicated more clearly with you to calm your fears.

Remember:  You- the patient- EMPLOY the Doctor.  Regardless of doctor type --- Ph.D., DC, MD, DDS, OD,  we doctors work for you.  Do not be afraid to ask questions.  If something does not 'hit you right', leave that office, go to a different doctor.  Feel comfortable and confident with your doctor.

Your question; 'Does any of this make sense?', yes it does, yes it can; as long as thorough evaluation was given, medical pathology eliminated, and chiropractic pathology (VSC) found to be the cause of your problem/ complaints.

I wish you good luck and good health naturally. This is your Staten Island Chiropractor friend signing off,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com      (email newsletter)
http://www.GoodHealthNaturally.info
http://www.DocDolan.net