The distinct mechanical dysfunctions that affect the muscles, discs, peripheral nerves, and zygapophyseal joints are recognized as the vertebral subluxation complex.
Chiropractors are the only healthcare professionals who can properly identify and treat this condition through adjustment or spinal manipulation. By applying a corrective force to the joints of the body, chiropractic care reconnects the body’s natural process of healing. This same philosophy holds true for many advanced therapeutic modalities, which are quickly becoming a vital part of the practice of chiropractic.
While this trend is startling to some practitioners, advanced therapies are natural extensions of the chiropractic scope. Though the mechanism of action is different, each therapy plays an important role in breaking down the barriers to healing and supporting the restorative potential of chiropractic care.
Therapies such as laser, acoustic compression therapy, electrical stimulation, non-surgical axial spinal decompression, and radial or extracorporeal shockwave therapy are natural means of supplementing chiropractic care.
1. Photobiomodulation
The positive effects of laser therapy are by now well researched.
Regardless of the brand or class of laser, a therapeutic dosage produces a photobiomodulation (PBM) effect at the treated area. Light energy has been shown to increase cellular metabolism and promote tissue repair at an accelerated rate.
Additional effects of PBM include reduction of nociception and spasticity, making laser an effective tool for patients who present with antalgic or post-treatment discomfort. Class 4 lasers also create low-grade heat, which increases blood flow, fostering an environment of healing in the damaged or diseased tissues.
However, chiropractors should obtain advanced certification to provide patients with the highest quality of care. Doctors of all disciplines should be educated on the safety concerns and biphasic response of tissue to light therapy.
2. Spinal decompression
Non-surgical spinal decompression therapy (SDT) is the ideal complement to the care doctors of chiropractic already provide. Whether a patient presents with acute disc bulges or herniation, or chronic disc degeneration, chiropractors play a vital role in the treatment and management of discogenic pain.
While medical doctors attempt to manage symptoms with medication and surgery, chiropractors are facilitating actual physiological change in the discs and facets through manipulation. Chiropractic adjustments help position the vertebrae relative to one another to improve biodynamics. However, true rehydration or physiologic change of the disc tissue is enhanced through SDT.
Research indicates that the rhythmic loading and unloading at key intervals generates rehydration of the nuclear material of an intervertebral disc. SDT creates a vacuum effect to reduce negative pressure within the disc. This cannot be achieved by a mechanical or physical manipulative force alone.
It takes a true decompressive event to facilitate the flow of blood and nutrients into the disc and continue the work of healing started by the chiropractic manual therapy (CMT).
3. Shockwave therapy
Extracorporeal (shockwave) therapy is one of the best adjunctive therapies for chiropractic care. Shockwave therapy includes focused sound waves (acoustic compression therapy) and radial electric impulses (radial shockwave therapy). Both therapies are effective at breaking down adhesions and scar tissue that forms in the joints, tendons, and ligaments.
Research suggests the mechanism of action includes the activation of acute-state healing and angiogenesis. Shockwave therapy has many of the benefits of a mechanical therapy, such as massage or tissue scraping, but without bruising or discomfort from pressure.
Additional research shows this modality offers benefits for tendinopathies of the Achilles tendon, elbow collateral ligaments, and even sacroiliac joint dysfunction. Whether the problem involves longstanding alignment issues or acute soft tissue injury, shockwave therapy can benefit patients in conjunction with chiropractic care.
4. TENS therapy
One of the most familiar adjunctive therapies to chiropractic care includes electric stimulation therapy. Whether interferential or Russian biphasic stimulation, benefits can be seen in the electric-sensitive tissues, such as muscle and nerves.
Electric stimulation therapy reduces nociception by means of pain gating and the reduction of facilitated muscle. Secondary effects are observed in the connective tissue as well. This treatment technology enhances chiropractic care.
You can effectively manage patients with antalgic and spastic presentations through controlling the degree of resistance in the soft tissue, either pre- or post-treatment. This may prove invaluable for patients still suffering with myalgia or acute muscle guarding.
The prevalence of chronic back pain and spinal dysfunction is growing to epidemic levels. The public is seeking an approach that treats the source of their problems rather than the symptoms. Chiropractic care is—and will continue to be—the most effective way to do this.
The holistic and supportive role doctors of chiropractic play in healing through better alignment and functioning uniquely qualifies the profession to treat and manage patients with a wide variety of ailments. Advanced therapeutic modalities are an indispensable part of the chiropractic practice that can meet this growing demand.
Timothy J. Burkhart, DC, BCIM, has successfully treated thousands of patients with acute to chronic neck and back pain since 1984. He is an authority on the integration of NSSD into clinical practice. He is a member of the ACA, MAC, and serves on the Davenport University Health Professionals Advisory Board and is a regent at Sherman College of Chiropractic. He also developed the Hill DT Solutions certification program. He can be contacted through hilldtsolutions.com.
Ryan M. Burkhart , DC is committed to delivering innovative healthcare solutions to maximizing patient quality of life with chiropractic care. He is accomplishing this mission through integrating the latest technologies and rehabilitation protocols into his family practice, Burkhart & Chapp Chiropractic, PLC. He graduated Sum Cum Laude from Sherman College of Chiropractic and is member of the Michigan Association of Chiropractors. He can be contacted through burkhartchappchiropractic.com.
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