Need Chiropractic Advice, Please!

[Kate888]

Well, I've been seeing a chiropractor for my back pain for a few weeks now. It's 3 sessions a week and it seems to help ease the pain. My insurance only pays for 26 sessions, but even with insurance coverage, I still have to pay $30 per adjustment (which is less than 5 minutes each, expensive). So my chiropractor asked me to attend a mini seminar on Saturday to learn more about chiropractic and the payment plans he offers.

To my surprise, he said it takes 12-18 months of adjustments for the ligaments to heal. OMG, 3 sessions per week for 12-18 month!!! When I asked why other chiropractors advise intensive treatment for the first few months and then maybe just a few adjustments per month, he said that it's only for pain control, not to "fix" the problem. He said the reason why other chiropractors choose to treat patients this way is that they're afraid to ask patients to pay so much up front. He said "I can tell you from my heart that I can't do this, because it's not the right way to treat the problem". So, here are the payment plans (you pay the money up front):

$1950 for 150 adjustments ($13/adjustment)
$1800 for 100 adjustments ($18/adjustment)
$1150 for 50 adjustments ($23/adjustment)
$300 for 12 adjustments ($25/adjustment)

As you can see, the more adjustments you buy, the cheaper each one is. It's a big commitment, both time and money wise. I'm new to the chiropractic world and need to know if this is really the way to go. Thank you SO much for the help!!


Kate
Mama to Maya 2-17-02

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[JLiebCamm]

I don't know what to tell you about the payment plan, but just wanted to give my 2 cents on my beef with some chiros. There definitely can be a benefit to having your spine adjusted, I don't disagree with that. But when an adjustment is done, some ligaments are really overstretched. And if you keep stretching those ligaments over and over, the spine isn't going to become any more stable and can be prone to malalignment (and thus repeated need to see a chiro). A good chiro should only adjust you until you are aligned, then give you spinal stabilization exercises to strengthen the muscles around the spine to keep the back healthy.

BTW, I'm not sure what he might have meant by the phrase, "for your ligaments to heal." Did you sprain the ligaments of your back? Most back problems are caused either by nerve root impingement or muscle weakness/imbalance.

Sorry if I sound really down on chiros; I know there are some good ones out there. Just make sure that this guy isn't feeding you a line of BS!

[Tondi G]

Seems a little excessive to me... but I only have intermittent pain in my back neck.... I see one more for headaches and such.... my Chiro also adjusts my jaw too! My Husband sees him for his knees adn wrists too! We pay 15 bucks each time we go.... he charges 40 bucks a visit.... bills my insurance, who pays 25 bucks a visit for 12 visits a year.... we pay the balance!

Sometimes he recommends coming more often.... like two or three consecutive weeks (once per week) if there is a problem..... but usually recommends just once a month for maintanence!!!!

Honestly you might want to consider Acupuncture as well as chiropractic for some treatment!!!! My DH sees one in the same office as our Chiro and loves to do both treatments.... really helps with his bad knees and back!

I agree that the Chiro should be giving you daily exercises to do to strengthen your back!!!!

Good Luck

~Tondi and Mason 7/8/01

[Kate888]

Thanks for the reply :) No, I don't think that I sprain the ligaments of my back. According to the X-rays, he says that 2 of my discs are out of alighment. I don't know if there is any ligaments involved. Maybe he uses that statement to stress how long it takes for the spine to heal? He also mentioned that that's why pro-football players can't play for a whole year if they hurt their knees.

According to my chiropractor, he has been having adjustments since he was 8 (due to unknown illness that medical doctors couldn't treat). His symptoms (sudden blindness, headaches, projectile vomitings) went away after having adjustments. That's why he became a chiropractor and also married one. He still has adjustments twice a week. If he was a sick kid before, he surely looks very good now (very muscular and tall, like a body builder). Very convincing indeed!



Kate
Mama to Maya 2-17-02

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[MartiesMom2B]

Kate:

If your disks are that bad, maybe you should see an orthopedic doctor. Neve recently wrote a post regarding what a physician said vs what the chiropractor said. I definitely would seek a second opinion before plunking down all that money.

Sonia
Proud Mommy to Martie 4/6/03

[Rachels]

I'm a chiropractic devotee and find it REALLY helpful, but this sounds bogus to me. The three-times-a-week deal is very common in the beginning as your body regains correct positioning, but it should very quickly drop off to once a week, then less. I have seen chiropractors for years and had Abigail checked out when she was five days old, so I'm all for the benefits of this kind of care. But it sounds like a bit of a scam to me.

-Rachel
Mom to Abigail Rose
5/18/02

[em_jon98]

As one who is currently being treated for disc issues, I can definately say that you should absolutely seek the opinion of your primary care physican or an orthopedic surgeon if the chiropractor told you that you have disc issues. Most of the research I have done suggests that most chiropractors will not aggressively treat patients with disc issues without the patient also being treated by an orthopedic surgeon. Plus, chriopractic adjustments will not promote disc healing unless they are done properly and in conjunction with a comprehensive strengthening program. In these situations, chriopractic medicine is normally used to treat the pain caused by the disc issue, but not to treat the disc itself.

This chiro. really sounds quite fishy to me. I would strongly suggest you at least seek the advice of your primary care physician, who can examine you for signs of disc bulge at the levels the chiro. states you have issues. Your primary care physican can probably also give you some good strengthening exercises or refer you to physical therapy.

[cara1]

Paying up-front for a year's worth of treatment is absurd. Most physicians try to get you better and see if you do get better. If you get better, treatments should trail off. Apparently this chiropracter is too shady for that, since he is telling you before hand how many treatments you need. I'd suggest going for pain control, not tyring to "fix the problem". What problem? Practically everybody has "slipped discs", that doesn't mean they're pathologic or causing you ANY symptoms. Furthermore, you can hardly see discs on a standard Xray. Sounds extremely fishy...

[AngelaS]

I agree! DH had major back troubles and for several weeks went 3 and 4 times a week. But, he only did that for about a month and then tapered off. He hasn't gone in 6 months now and he's doing great!

I'd get either an orthopedic's opinion or another chiro's!

[caleymama]

I agree too. I would be wary of what he is proposing and would seek a second opinion. Dh has chronic back problems and when they flare up he is seen more often at first and then less as it heals/feels better. I don't know an awful lot about chiropractics, but DH has seen several different chiropractors in different states because of our moves and no one has ever mentioned anything like that.

[Kate888]

Thanks everyone for your input :) It's good to know that you really don't need that many adjustments! I got a second opinion today from my sister's boyfriend who is a rehab doctor with spine focus (his sister and BIL are both chiros). He said that if I'm feeling better, there is no need to see the chiro that often. According to research, once a patient's symptom (i.e. pain )disappears after intensive treatment, more adjustments (2-3 times/week) don't show significant benefit. He also asked me if my chiro taught me any back exercise and the answer is no. Well, he said "that's because he wants you to go back to see him".

Now I feel more comfortable saying no to his treatment plan. Thank you everyone for educating me and sharing your experience :D You guys are the best!!


Kate
Mama to Maya 2-17-02

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[caleymama]

After seeing your update I just wanted to add that DH always got exercises to do from the chiropractors he's seen. He received instruction from the chiro and diagrams of what to do. I know that these at-home exercises were/are an integral part of his treatment.

Good luck finding a treatment plan and a caregiver that is more suited to your needs. And kudos to you for seeking a second opinion. Hope your back feels better soon!

[stella]

I am really not familiar with chiropractic care, but my dh have recently opened a 2 person (him and me!) law firm. I would LOVE, LOVE, LOVE to have some guaranteed income - preferably paid up front. $1,950.00 would be great for our bottom line, but $300 would be helpful as well.

I am not saying that he is running a scam - he may be very qualified and skilled at his profession, but with a deal like that he is putting on this seminar and special for the MONEY!!!

Weight watchers does something like this with their specials - it costs less if you buy the "package." They don't care whether you come to the meetings or not - they just want you to pay up front - I love WW, but it is a BUSINESS!!

So I would look at this sceftically and only buy what you think you need - $1,950.00 is a LOT of money when the back may be healed in 6 months! Do you think you'll go 3 times a week for 18 months? Probably not - and your chiropractor doesn't think you will either.

I am not ragging on him - but this business model benefits HIM - and it may or may not be what your family needs!

[tippy]

Hi,

"To my surprise, he said it takes 12-18 months of adjustments for the ligaments to heal."

I am a practicing NYS liscenced massage therapist. I was wondering if he said what specifically was "wrong" with your ligaments?? Which ligaments was he referring to? and what TESTS he performed to determine this??? Did he just take x-rays?....

Ligaments and tendons do not show up on X-rays. An MRI is probably the most accurate test without actually surgically looking into the the specific area. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body. If he only took an x-ray I don't know how he could have diagnosed you with "injured ligaments".

In my opinion the senario you are describing sounds a bit out of line. Once a ligaments is overstretched it won't "go back" to it's normal length so if the injury isn't in an area where the ligament can be surgically shortened the normal course of treatment is usually an aggressive excersise/strength training program to help build up the muscles around the injured area therefore providing more stability to the area.

I agree with the poster who recommended a second opinion particularly with an orthopoedic specialist.

If you did not specifically injure your back (in an auto accident for example) there could be other causes for your back pain. I know for example that often if there are spinal misalignments they can actually be caused by muscular imbalances. The Chiropractor will adjust a patient and if the muscle isn't addressed it is only a matter of time before the overly tight muscle will "pull" the spine out of alignment. It works in reverse as well. I hope all this info doesn't come across as too technical or preachy, I just don't want to see you get taken advantage of by an overly agressive sales pitch!

Please let me know how you make out. Just one more thing...did you happen to check this doctor out with your local better business bureau after attending his "seminar". I would just to be on the safe side.

[tippy]

Hi Me Again,


Re "He also mentioned that that's why pro-football players can't play for a whole year if they hurt their knees."

I don't agree with this statement. It really depends on the severity of the injury and what approach to treatment they take.

This was taken from The Encyclopedia of Sports Medicine and Science

The medial collateral ligament is more easily injured than the lateral collateral ligament. It is most often caused by a blow to the outer side of the knee, which often happens in contact sports like football or hockey, that stretches and tears the ligament on the inner side of the knee.


How Are Collateral Ligament Injuries Treated?

Most sprains of the collateral ligaments will heal if the patient follows a prescribed exercise program. In addition to exercise, the doctor may recommend that the patient apply ice packs to reduce pain and swelling and wear a small sleeve-type brace to protect and stabilize the knee. A sprain may take 2 to 4 weeks to heal.
At the other end of the scale is the athlete at the height of their career who depends on side-stepping activities for their continued economic well-being. A severely sprained or torn collateral ligament may be accompanied by a torn anterior cruciate ligament, which usually requires surgical repair.
The diagnosis having been made, there is little doubt that they should be recommended for early surgery and will be fit to resume full activities within six months.

[Kate888]

Thanks for taking the time to look up the information :) This is interesting. When he uses analogies like those, I automatically thought the situation applys to me, without thinking if the injury is the same as my back problem, LOL. Thanks for the great help, tippy :D


Kate
Mama to Maya 2-17-02

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[Kate888]

Great points (I would have to quote your whole post, LOL)!! Yes, I think he is very skilled at his profession (because my back feels better), but the package obviously benefits HIM!! If I didn't ask you guys first, I might have bought the package, not because I have the money to spend, but because he sounds so caring and convincing. There is a certain rapport that you build with someone who helps ease your pain. When that person told you something that he believes "from the bottom of my heart", it's very hard to say no to it.

Kate
Mama to Maya 2-17-02

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[tippy]

No problem, really. I understand how you feel. Especially being in a "health profession". I have used chiropractors myself and my personal opinion is there are some really good ones out there and some that probably shouldn't be practicing. If you like this guy and he is helping you then you probably have no reason to find someone else. On the other hand, you might want to just check out another one or two chiropractors to compare their treatment approach, their personalities, and their fee schedules. It sounds like his prices are a bit steep unless of course you opt for the pay in advance option he offers. How much does he charge for an individual session? You could call around and see if it is comparible to other chiropractors in your area. Most of the chiropractors I know (and I deal with a lot of them through my profession) are passionate about what they do and generally into the promotion of holistic type healing and lifestyle. Ya never know. You might find someone you like equally as well who is less expensive and spends a bit more time with you. HTH

Teva

[jerseygirl07067]

Hi Kate - I agree with all of the other posts. I am a practicing physical therapist (11 years) and feel that chiropractic CAN have some benefits, ONLY when combined with a GOOD exercise program to prevent the problem from coming back again, and to correct the abnormal stresses on your spine that caused the problem in the first place. This chiropractor definitely seems like he is more into the manipulation for correction approach. Repeated, excessive manipulation can create more ligamentous laxity in your spine, with a resultant increase in muscle tightening or guarding to protect that area of the spine. Over time, a dependence can be created on "needing" a manipulation.

Just to give an example, my dad was seeing a chiropractor and had gone for 18 adjustments, with only temporary relief after each adjustment. The adjustments were being done in his thoracic spine (mid-back area). The chiropractor never gave my dad any exercise instuction. He just handed him a sheet with like 20 exercises on it. Of course my dad wasn't doing most of them, and if he was, the technique and form were incorrect. So I showed him a very basic pectoralis strech, and two specific strengthening exercises for his mid back muscles. I also educated him on proper POSTURE and improving his BODY MECHANICS/ERGONOMICS (which by the way, poor posture and poor body mechanics account for 80% of all back pain). Low and behold, his pain was gone in 3 days and never returned.



Just make sure the chiropractor is addressing these things and weaning you from adjustments over time, to a point where you can be independent, not dependent. One more thing, if he says that he's going to do "physical therapy" and simply gives you hot packs and electrical stimulation and then puts you on that machine with the roller (intersegmental spinal tracton), that is very misleading as to what physical therapy is all about and how they would treat this problem.

Sorry to go on, but this topic is very heated in our profession!

Marcy