Question
QUESTION: My wife is only 23 years old and she suffers from chronic back and neck pain.  We've had her seeing chiropractors since last august, and while the adjustments provide temporary relief, they don't appear to be doing anything to cure the source.

Starting from the neck down:
1) She gets extreme muscle soreness in the neck and jaw.  The connection points of her neck muscles get swollen at the back of her head and are rock hard (when I feel back there I have trouble distinguishing muscle from bone).

2) Her ribs between her shoulder blades are constantly subluxated, and once adjusted they pop back out relatively easily.  

3) Her mid back has a slight lateral curvature.

4)  She has constant problems with her lower back and hip due to a transitional vertebra.

I am 27 years old and I'm somewhat a believer in holistic      medicine and the body's ability to heal itself, but now I'm worried that perhaps chiropractic is not the solution for her, or perhaps she has a condition that her body cannot heal without help.  

Please help!!

ANSWER: Dear Jonathan,

Your wife is not alone in this.  There are many people that suffer with chronic spine pain.  My initial thoughts are that she may only be recieving one mode of care for her spine: joint manipulation.  Is she exercising?  Is she getting any form of soft tissue therapy, e.g. active myofascial release, Graston Technique, or some other form of deep tissue work?   Has she had a TMJ evaluation by a dental TMJ expert?  Has she obtained an opinion by a physiatrist?  If the answer to all of these is "no," then she must pursue these other avenues.  It has nothing to do with holistic it has more to do with being comprehensive and should not involve belief...  [By the way, I am not a fan of how the term "holistic" is used.  While it literally means taking a whole perspective on the body as opposed to looking at one isolated part {reductionistic}, the folks that define themselves as holistic really should be called "esoteric."  There's a difference.]   While the body has the ability to heal itself - if the barriers to healing are removed - popping bones and hoping for healing may be blind faith.   Failure to refer for 2nd opinions while providing endless treatment that does not benefit the patient is blind faith and clinical negligence.   Your wife must decide where she stands in all this.   

Hope this helps.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Sorry about the nomenclature, I tend to use terms loosely.  Properly put, I believe with proper attention the human body is capable of healing nearly any condition.

Answers to the questions:

1) Exercise - yes she is.  The clinic she goes to right now has a rehab room where an attendant enforces exercise routines.  She also does traction on her neck and sometimes e-stimulation on her back.  

Soft tissue therapy:  The chiro does repetitions where she presses hard near the rear of the jaw for five seconds and releases.  I don't believe she does any of the other tissue work.

Part of the reason we haven't pursued other avenues is lack of insurance but that is going to be changing soon. The main reason for the post is to hear from an independent what our next steps should be in isolating the source of her condition.

Do you have any additional recommendations not listed in your previous post?

Answer
My thoughts:  get more thorough and comprehensive soft tissue treatment - the best avenues being Active Release Technique and Graston Technique.  They have web sites to look up providers.  I'm a big fan of Graston Technique (www.grastontechnique.com).  Also, get a TMJ evaluation by a TMJ expert.  Traction and e-stim will not affect ribs or change a TMJ situation.  There are manual methods for dealing with TMJ disorders and if the DC has not been trained in it she may not know what to do.  Dental TMJ eval is paramount, however, since she could have malocclusion driving neck and upper back symptoms and the only way to change this is to deal with dentition.  

Dr. G