Why do I have to come in so often or can’t I just come in once or twice? These are some of the frequent questions that we get asked here at BMC Family Chiropractic. First off, I appreciate the confidence that I am so good it only takes one or two visits to cure what has been going on for years! I tell a lot of patients, I’m good but I’m not God. Secondly, we are missing a big piece of the puzzle if we think we can just do something once or twice and be magically cured of all of our ailments. Don’t get me wrong, I wish it were that easy and if it was I’m sure I’d have a waiting list of people coming from throughout the world to receive this wonderful cure. Alas, in most cases, this is not how things work.
Let’s start with the underlying premise of, “it should only take one or two visits to “cure” you.” There is a wonderful principle of chiropractic (#6 of 33 to be exact) that there is no process that does not require time. This is true in the healing of an injury but it is also very true in the creation of an injury. Most of what we deal with in our office is the concept of the proverbial straw that breaks the camel’s back, something known as repetitive stress. As with everything there are always exceptions, such as a car accident or some other extreme case of trauma, where one can go directly from being healthy and having their body move perfectly to the complete opposite. But most of the time, when patients come in, there is generally a particular small or minor movement or action that doesn’t seem to warrant the level of discomfort that they are experiencing, but it causes it nonetheless. Part of our first appointment is digging into the history and seeing if there wasn’t something previously or perhaps these symptoms have been recurring without us knowing. Most times, we can find a pattern that has been present, which shows this is more than just bending over to pick up a pen causing the low back pain. We help patients connect the dots so that they understand there is a greater underlying cause of their symptoms and it’s not just this new development. It is very easy to think that just because you bent over to pick something up and began to have pain that it should only take a quick session to put you back to where you started. Unfortunately, as we’ve pointed out, it has taken much longer to get you to that place that allowed you to injure yourself with just simply bending over.
Since we live in Colorado, a simple mountain analogy seems to help out with this concept. If you were to drive to the top of Pikes Peak, just outside of Colorado Springs, the road is a gradual one. If it was too steep most cars would be unable to make it, but gradually it gets higher and higher until you reach the peak. Coming down, the road is going to be equally gradual. The roads on Pikes Peak are so steep in fact that there are brake temperature checks along the way. If the roads were any steeper, cars could easily lose their brakes and crashes would occur. Now, if we apply this concept to our above topic, a traumatic injury is like an incredibly steep slope to the top; most injuries though are that slow methodical climb that takes a while to build and build until you reach the peak, or in our story the injury. Once the injury occurs, rarely do we get to the bottom of the mountain immediately, it takes a slow and methodical approach to get us safely to the bottom, or to a stable, healthy place. Just like our mountain example, going from the peak to the bottom wouldn’t be feasible because of the dangerousness of the decline. Every now and then, we have patients that are truly those outliers that need just one or two visits. We have a name for these examples: Miracles! They don’t happen often but when they do we all rejoice and give thanks! They are definitely the exception that proves the rule.
Want another example? Let’s talk about something we can all relate to. If we want to improve our health, the best and most direct way would be to improve our diet. But this does not happen just by eating one or two healthy meals. It occurs from the repetition of making healthier options over and over and eventually you begin to see the results in the way the body looks, feels and also hopefully in better blood work numbers. The same is true if we want to get stronger. We unfortunately can’t just go to the gym once and look like a superhero. We have to, again, make the choice to go over and over repeatedly in order to see results/changes. There is that principle again, there is no process that does not require time. Even from the medical paradigm we can see this play out for those who are on a prescription drug. Most of these drugs have to be taken regularly and some are to be taken for life, such as blood pressure meds or cholesterol meds. Others have to be taken repeatedly for a shorter duration (think antibiotics) but it is rarely a one and one deal. Our teeth are another great, common example. There is a great joke about someone asking their friend who is a dentist about if the daily brushing and flossing is necessary. His dentist friend replies, “No, you only need to do it for the teeth that you want to keep.” Just because we brush or floss once or go to our bi-annual cleanings/check-ups doesn’t mean we get out of the daily, and really twice per day task of keeping those pearly whites shiny and healthy! Why people think that chiropractic should be different from any of these is a mystery. Perhaps it is our profession’s fault for not communicating properly.
Now let’s tackle the nuts and bolts of repetitive visits to your chiropractor. First off, as we saw above, healing takes time. Simple as that. Typically when people come in to see their chiropractor, they are dealing with an injury and if it was a fractured arm it would need 6-8 weeks to heal in a cast. Most mild soft tissue injuries take a minimum of 10-14 days with perfect conditions, more severe cases obviously take longer than that. That concept is similar to what occurs at our office. At BMC, we start patients with a “Corrective Phase” of care. We know the body needs an amount of time for the joints, ligaments, muscles and tendons to heal properly. The primary goal of the corrective phase is to restore normal function to the spine and body. Most instances, a loss of normal function precedes any pain and returning the body to normal function is an absolute must to allow the body to heal properly. The second phase that we move into is the “Stabilization Phase”. The goal of the stabilization phase is to get you to a nice and stable place where you will not have a repeat of the injury and the body will be in a much more resilient place, allowing you to return to the activities that you love.
In some cases, it is as straightforward as that. We love these because people return to their lives quickly! However, in some instances the path of healing isn’t so straight and simple. When a patient comes into the office, we are not only dealing with the injury itself but we are also dealing with the patient’s body’s response to the injury. Most often, the body’s muscles provide a splinting effect to prevent the body from further injuring itself. You have to love the body’s innate intelligence and while these responses create tight and painful muscles, it also prevents something worse from happening. When we deliver that first adjustment, we help restore the body’s normal range of motion. However the muscles are slow to adapt to this and invariably, in the beginning of care, will fight against this and try to return the body to that old baseline to protect itself. In that first adjustment, we might get the patient 80% better range of motion but we are also likely to see the majority of that decrease over the next day. Let’s say after day one, there is a loss of 60% improvement, leaving a 20% improvement from the initial treatment. Each successive visit builds on this improvement, as we slowly retrain the body to return to its normal ranges of motion. This concept is very similar to the gym where over a period of time the body is trained for something new and better.
Next, let us tackle the “Shrek Paradox”, as I like to call it. Much like ogres, many of us are like onions. We have multiple layers. Invariably someone comes into the office for one thing but through the course of treatment we begin to “uncover” other things. As the saying goes the squeaky wheel gets the grease. The brain is very good at listening to the loudest voice and silencing the remaining. In a way, the brain triages all of our injuries and takes the most serious first. As healing begins, those other injuries begin to grow louder in our heads and our brain makes the decision to not listen to the original injury as much and instead begins listening to the other siren calls. This can lead to a longer healing time because the problem might just be bigger than what we originally thought.
So you’re finally in a good place, your body is responding well and you’ve dug through all those layers and then, BOOM, re-injury! Invariably a patient will start to feel better and before they reach that stable phase, they attempt to return to their normal activities. If they aren’t ready, they could just be setting themselves up for failure and unfortunately re-injury. If that happens, it will obviously take a bit longer to help them achieve that stable place.. So a new goal is set and the body begins the healing process again.
As you can see, healing doesn’t take place in a straight, linear line. There are many factors that go into healing and just to repeat it one more time, there is no process that does not include time, especially healing. The good news is, the body knows what to do and regular adjustments, even 1 time per month, keeps it right where you need it to be. I want nothing more than my patients to be healthy and happy as quickly as possible but sometimes we just have to come to a level of acceptance that it won’t happen overnight. Our goal is to help you live the life that you want to live and hopefully you have a better understanding of how we go about that. If you would like to learn more about our treatment plans and how we approach them, give us a call at 303-284-7724 or shoot us an email at firstname.lastname@example.org and we would be happy to discuss this with you.