Expert: Dr. Victor Dolan, DC, DACBSP - 12/7/2008

Question
I am a 33yr female, x smoker and I have had rib (left top, mid, and bottom) pain along with severe back, shoulder and neck pain that radiates into my left ear 24 hours a day for the past 4 months. It has now moved to the right side as well. Sitting at my desk, driving and sleeping are torture and I fight to get through the day. I have had severe shooting pain under my left breast, left shoulder blade and spine area. When the pain is not a stabbing shooting pain it feels like a severe bruise and my ribs are very tender to the touch. This stabbing pain lasts for about 30 sec. but forces me to cringe and get to the point of tears when it comes on. I have seen a chiropractor for 2 mts. twice a week and there has been no improvement. I have had chest, thoratic, rib, x-rays done and I am still waiting. My primary care doctor prescribed Lyrica and it seemed to work for 2 days and now the pain is back with vengeance. I am at my wits end and just can not deal with the pain anymore. I am struggling to get through each day. Do you have any suggestions or advice for me?

Answer
pinched nerve , back pain , neck pain , shoulder pain , neck pain radiating into head (left ear) , tenderness , sensitivity , Xray results ,

Hello Christine,  

Sorry to hear of your months of pain.

You have had Xrays and are still awaiting results?
Have you had other testing, EMG/ncv, MRI, blood tests?

You have a lot of pain, widespread pain, you need a thorough evaluation.  You have been going to a Doctor of Chiropractic for two months twice a week- and there is no change?, and no further testing has been discussed/ performed?  Could be time to change Doctors, could be time for a new Chiropractor.

My recommendations:

#1)  Communicate with your Doctor of Chiropractic.  What are the Xray results?  What NEW testing to further evaluate can be performed, Different Xrays, MRI, EMG/ncv, blood tests??  What are we going to do here to evaluate why the condition is not responding?  What different, new chiropractic techniques can we do- to make a change?
Do we have an explanation why things are taking so long?  What is the Diagnosis and the complicating, perpetuating factors to this condition?

#2)  If your Doctor does not communicate with you, cannot explain this length of pain (4 months pain, two months treatment, no results on Xrays, no new testing discussed, no changes in condition, no changes in treatment), then it is time to get a new doctor.

Aches and pains, pinched nerves, nerve pain radiating, these conditions usually respond very well to chiropractic care.  Conservative treatment may include an initial evaluation including history, physical examination, perhaps Xrays.  This results in a diagnosis and either treatment, referral, or a combination. After a month of conservative treatment (2- 3x/ weekly), some changes should be noticed; no change?= re-evaluation, re-exam, perhaps more sophisticated testing: MRI, EMG, perhaps referral for consultation with another specialty.  Some conditions can be a 'tough case' taking extra time, but explanation/ discussion should be had with the patient.

With 4 months of pain and 2 months of treatment, time to change, time for a new evaluation, time for a new consult.

I wish you good luck, and Good Health Naturally.

Please do not hesitate to re-contact me here at AllExperts.com if you need to ( http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm ) .

I will attach some information I utilize in my Staten Island Chiropractic office below, for informational/ educational purposes; but I think the above answers your question.

Good Luck,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com        (Email Newsletter)



INFO  HANDOUT  SHEETS :


PAIN   

Pain  is a  ‘red light on the dashboard’.

Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car- -- do you ignore it until the car breaks down, or do you get it checked and correct the problem?  

Pain, pain in your body- -- do you ignore it until your body breaks down, or do you get it checked and correct the problem?   Pain,  do you cover up the pain by taking a painkiller?  Take a painkiller, mask the pain, and allow a problem to progress in your body?

     NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen.


Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.


Vertebral  Subluxation           
(  ‘VSC’ ,    ‘subluxation’   )

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 ‘Subluxation’. 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).  VSC- ‘Subluxation’ – can be the cause of many symptoms and conditions.


Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.


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.

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.


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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‘VSC’-  the    Vertebral  Subluxation  Complex     (aka:  the  “Subluxation”)

Many times a patient will come to the Doctor of Chiropractic – ‘…as a last resort…’,  often  after  ‘….everything else has been tried….’.  This is frustrating to the Doctor (the DC),  yet also satisfying.  Frustrating?, Satisfying?, ,,,why?-  Many times a symptom, an ache a pain, a condition can be caused by the ‘Subluxation’ – the ‘Chiropractic Lesion’.  Just as germs, the Virus or Bacteria- is the ‘medical lesion’ (- the MD looks for germs, the DC looks for subluxation).   Many times an unexplained condition, after exam after exam, blood tests, Xray, MRI, EKG, EMG, etc., etc., --- Chiropractic can help the patient.  Why- because only a Doctor of Chiropractic will check for subluxation- as well as run the ‘traditional’ tests.




           Only a Doctor of Chiropractic will evaluate and treat for VSC, as well as other pathology.




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.

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.
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P.R.I.C.E. =   P  protection.   R rest.   I  ice.   C  compression.   E  elevation.

Hurt  yourself ??  injury/ trauma/  bruise/ not even sure - - a broken bone ??

You should certainly get to the Doctor or trained health professional to be examined  if you think it  is  bad  enough.     BUT  in  the  meantime,  some  simple  steps  may  help.
 
PRICE.

The  PRICE  protocol will usually help just about any musculoskeletal injury.
P = Protection;  protect the area from further injury- stop what you are doing, can you  pad  or bandage the area ? Tape the area? Do something to protect the area !
R = Rest;  rest the area as much as possible, if a part is damaged, give the body time to repair the area
I = Ice;  ice is a potent anti-inflammatory; it will slow swelling, help with pain control  (ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the injured area for 30 minutes; then back on again
C = Compression;  to help prevent swelling compression may be helpful- for example  if it is an ankle, wrap the ankle with an ace bandage and ice the area.  Many body parts may not be applicable to compression.
E = Elevation; again to fight swelling and pain, raising the injured body part above the   heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part


PRICE  may  help :    Sprains,  Strains,  musculo-skeletal injury,  bruise,  contusion
Sometimes  a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain.  Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction).  In the spine, a sprain/strain  is a misalignment,  a ‘kink’ in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation.   Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!
         Spinal = Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)  ;   ( subluxation COULD be any joint )
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.
This 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:
         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.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          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.  For good health- Treat the   Cause,  not just the Symptoms.  Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint.  CORRECT the subluxation !!!!
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