Expert: Dr. J. Shawn Leatherman - 3/22/2007

Question
Dear Dr. Leatherman

I spoke to you a few weeks ago regarding endless pressure on both sides of my head, neck pain and face tightness. I took your advise and went to see a chiropractor. I already saw him 4 times and every time I go, I feel that my neck hurts more at first, and then at the end of the day releases, however the following day my symptoms as a whole become worse. I wanted to know if what I am experiencing is normal during treatment? The doctor believes that my pelvis is misaligned, also that I have TMJ symptoms on my left side which is what is giving me head pressure, does that sound like something that would be giving me endless pressure? Also what I am experiencing may sound like tension headaches, however tension in tension headaches is supposed to go away at some point, hour, two, three. However with me, the tension is always there, only at certain times of the day it is accompanied by a headache. Muscles of my face seem so tight, and pulling at different times of the day. Please advise me on what to do and what this can be? Thank you

Answer
Dear Maria,

It is common to have some increases in pain when you start chiropractic treatment due to the fact that the doctor is dealing with tissue that are inflamed and tight, but within 4-6 adjustments of the spine you should start to see improvements.  

If your pain levels are not changing, incorporating massage or myofacial release along with the adjustments would be a good option.  We frequently do this in our clinic for quicker resolution.  Not to mention if the muscle are that tight, they need to be vigorously stretched and massage to help alleviate the stress on the spine...otherwise the adjustment will only temporarily help the fixated segment in the spinal column.  There are some prominent techniques you should read about:

www.grastontechnique.com
www.activerelease.com

You say that the doctor believes that your pelvis is misaligned.  Why does he not know for sure?  Did he take x-rays of it?  Did he find an anatomical short leg on x-ray?Do you have a significantly abnormal posture that he checked and documented?  There needs to be some objective proof of this belief.  Not to mention what about the neck and upper back?  That is where most of the exam should have occurred.

TMJ problems can be contributory to headaches, but how was the TMJ analyzed?  Do you have pain there, because technically you have to have pain to have TMJ dysfunction diagnosis, not just abnormal movement or clicking. These are all questions to think about.

Unfortunately, not all chiropractors are created equally, so make sure that you question his diagnosis and treatment.  He may be right, but make sure that he can explain it to you fully and that he can back up his impressions with some scientific evidence.  He should be explaining things to you in much more detail than I am...he is the treating doctor and responsible for your education.  Ultimately if he cannot clearly explain the problem and a sensible course of action you may need to find a better chiropractic physician.  If this is the case and you need some help, I would be more than happy to help you find one in your area with good credentials.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net