Daniel: Welcome to “The Future Adjustment,” Chiropractic Economics podcast series on what’s new and notable in the world of chiropractic. I’m Dan Sosnoski, the editor-in-chief of Chiropractic Economics, and our guest today is Dr. Perry Nickelston.
He’s a graduate of Palmer College of Chiropractic and he’s the founder of his practice, Stop Chasing Pain located in New Jersey. His primary focus is on performance enhancement, corrective exercise, metabolic fitness, and nutrition. He’s also an advisor for the American Institute of Medical Laser Application.
He hardly needs an introduction as he’s a frequent lecturer, trainer, writer, and instructor both in the U.S. and abroad. Dr. Nickelston, you’ve been a contributor to Chiropractic Economics and a blogger on our website and we’ve followed your career over the years, so it’s a pleasure to have you with us today.
Dr. Nickelston: Thank you, Dan. It’s an honor to be on the show.
Daniel:All right. Well, let’s just jump right in. You know, you have a kind of interesting backstory. Like so many other doctors of chiropractic, you chose to enter the field as part of a personal journey. Could you tell us what led you to develop your practice in the form that it exists today?
Dr. Nickelston: Sure, absolutely. Yeah well, it’s hard to believe I graduated Palmer College in 1997, time goes by so fast. But probably, like many others, I got hurt and that chiropractic was really the only thing that was able to help me at the time. I was a very hardcore bodybuilder back in the day and you know, I was competitive and I hurt my back squatting like many people do, even today.
And I honestly, I did what most people still do. I just said, “Maybe it’ll go away,” and oddly enough, it does, but it kept coming back. And then, eventually, my training partner at the time said to me, you know, “Enough is enough, I want you to go see my chiropractor,”because I was never seeing one at the time.
And I went into him and you know, I walked out with the significant relief of pain and was hooked ever since. And it wasn’t until maybe four years later that I approached him and said, “You know, I love what you’ve done for me, and I’m really not happy in my current career choice and I’m thinking of going back to school and becoming a chiropractor. Do you think that that’s something I could do?”
And he was very encouraging and he said, “Absolutely.” And just like most people, you’d go where your chiropractor went to chiropractic college. And that’s how I ended up going to Palmer College in Davenport, Iowa. And because I got into it through bodybuilding, all my fitness and chiropractic places are located inside gyms.
So that’s kind of my business model, where I’m inside of gym locations.
Daniel: Okay. Well, you know, I picture you in person and you’re in terrific shape. So you definitely walk the walk.
Dr. Nickelston: Well, thank you very much. I mean, chiropractic definitely allows me to keep doing that. I mean, I turned 51 this year. You know, because of that chiropractic, I’ve been able to keep going all these years.
Daniel: Yeah. You know, located very close to our offices here at Chiropractic Economics magazine, there’s a CrossFit gym. And sometimes I just look through the open door and watch what those guys are doing in there and I think to myself, “Boy, hope all of you guys have access to a good chiropractor.”
Dr. Nickelston: Well, it’s really a testament to the amazing things that the human body can do. And I mean, I work quite closely with a lot of people in the CrossFit community and they do use chiropractic on a regular basis to do what they love harder, faster, stronger, and longer.
Daniel: Got you. You know, one of the things that you’re really well known for is your expertise with laser therapy. You’re, you know, one of the kind of the pioneers, really, of people who are in that specialized modality. And right now, I’ve been seeing there’s kind of a movement now where people are really focusing on what they’re calling Cellular Photobiomodulation.
Can you tell us a little bit about how you discovered laser and began using it in your practice?
Dr. Nickelston: Sure, I’d love to. Yeah, I mean, I guess, you might call me an early adopter of it. I’ve been doing it for well over 10 years now. And, you know, the technology has changed a lot over the years from when it first started, but I got into it personally, for myself because my back had a flare up at the time, and I just wasn’t able to break through that plateau, even through traditional means.
And a friend of mine was using laser and he said, “You should try it. I’m doing it on my back on myself and I’m alone.” And at that at that time, I decided to get one and I started using it on my complicated cases basically for pain, on anything and everything, really. And the results were really astounding. So, like many therapies, I started using it because it helped myself first, and then I started really looking at the technology and then purchased one.
And then, really just seeing the results that my patients and clients were having. And it’s really beautiful to see that the technology itself has come so far over the last decade with much more research going, and it’s really been highlighted a lot in some of the neuroscience books. I think Norman Doidge has The Brain that Heals Itself book or something like that one.
He’s got a couple of them but he has a whole chapter dedicated to how laser therapy is making such a profound impact on people with chronic pain, which is really, really nice to see. So, you know, things are catching up in the research world by things that I’ve been able to see anecdotally and practice for over a decade. So it’s really nice when those two worlds meet. Now, I use it all the time, every single day when I’m in the office for every single client that comes to see me.
That’s one of the biggest things that they seek me out for.
Daniel: Yeah. And to reiterate to our listeners, I’ve heard from a lot of docs that they say that if you really want to be successful offering the modality, be sure to try it on yourself and understand how it works. And so, it’s nice that you’ve kind of been on both ends of the laser, so to speak. I know there are a lot of the way that the laser works is it activates the adenosine triphosphate mechanism and it reduces inflammation, but I’ve also seen that you’re using laser also for mild facial tissue treatment.
And I’m just going to ask you, are there specific conditions where that’s where you want to go with it?
Dr. Nickelston: Yeah. I mean, I pretty much use the laser for any type of muscular or skeletal condition that comes in a monitor [SP] so that’s really what it’s cleared for, at least clinically, in the United States. But because fascia, as we know it, wraps around everything in the body, no matter where you use the laser, you’ve got to deal impact fascia, and it’s such a huge neuro sensory network into the body.
I mean, how far they’ve come in research in fascia over the last decade has been tremendous. But yeah, I’ll follow a line of fascial connection from the side of pain to many other different parts of the body. And one of the things about the laser that’s so helpful is that it massively increases vassal dilation and vascularization in the body, so you’re able to make a big impact on any area that you use the laser to facilitate whatever sequence you’re going to do afterwards.
So, for me, I always laser first and then I do my chiropractic treatments and things post-laser. It’s a really nice combination because you can think of it, and kind of like a layman’s terms, that, “I’m just relaxing things down, loosening the area up so it’s much more malleable for the things that I want to do in relationship to my manual therapy and my chiropractic adjustments.”
Daniel: Would you say that the results that you’re getting that way are comparable to what you might get with Instrument-Assisted Soft Tissue Mobilization?
Dr. Nickelston: Well, they’re really two different animals altogether, honestly. And that they’re really finding that even with the instrument-assisted that they’re really not changing the structure of fascia in and of itself as it takes a tremendous amount of force to have any type of fascial deformation. They’re saying it’s more a neurosensory input at the moment.
So, the tools are very helpful for that. And then, that’s also why the laser that way. Because I have a special adapter for the laser where I can put the laser light in contact with the skin through an optical round massage ball so I can put physical pressure into and around the area that I’m treating with the laser, at the same time, I’m delivering the laser light treatment.
So I kind of get a two for one, where I get the light stimulation treatment but I also get the manual therapy hands-on at the same time, which is really why it’s powerful. So I’ll go in afterwards and do my Instrument-Assisted Soft Tissue Manipulation because I do that as well, but I’ll do that after I do the laser therapy.
So it’s a really sweet combination.
Daniel: Got you. Well, that’s really good to know. Interesting. And because you do a lot of work in the sports area, you’ve developed expertise with Kinesiology Taping, and that’s really been taking off because people have been seeing it in the Olympics and so forth. Where does taping fit into your practice and your patient base?
Dr. Nickelston: I use it every single day. I mean, every single person that comes in to see me gets a laser and then they also get the taping as well. I found it a really fantastic way, honestly, for me, to be able to use the sensory input from the tape on the client’s skin to give them a sensory awareness of where their body is and space and time when they leave.
So it’s really helpful and helping them try to reestablish better ways of movement because now, with the tape on the skin, you feel that feedback to you whenever you move. So it gives you a sense of safety and stability and plus also it does help reduce pain and inflammation in an area because it also gives a little bit of a lift to the skin to increase vascularization and blood flow.
And that’s one of the biggest things that I’m seeing through my work over the last 20 years. There’s been a lot of the pain that people have is from really poor oxygen delivery and blood supply into these areas that are in chronic pain. So, the sense of the tape I kind of jokingly say is it’s like getting a hug from your mom.
I mean, right, when you put your hand on someone, there’s a sense of reassurance from touch. And then now that they’re saying in relationship to pain, pain is really highly sensory-driven so that sensory input into the skin affecting how the brain perceives the environment makes a huge difference in decreasing pain but also helping people establish better movement patterns of things hopefully won’t return in the future, as much, as often or as fast.
Daniel: Yeah. And on that note, right now, as we speak, I’m working on an article about the use of Kinesiology Taping with older populations because exactly as you said, it can be very helpful in improving proprioception and also promoting lymphatic drainage.
Dr. Nickelston: Oh, at any time. Really, that’s a system that’s really overlooked in healthcare today is the lymphatic system, and then also, with the elderly, as you know, one of the biggest causes of mortality is falling. So if you can use tape to give them a better sense of themselves and their environment and safety and stability, you can hopefully reduce the chances that they will be falling.
Daniel:Exactly. You know, and when people look at Kinesiology Taping, at first, they think it has something to do with you know, moving the muscles around and stuff and it can, but actually it’s those secondary effects, I think, is where people are really starting to see the real value in that modality, and products are just taken off across the board.
Dr. Nickelston: Oh, I mean, you know, when stuff works, word spreads, right? And then, nothing gives you more positive feedback than when somebody has a tape on them and they say, “You know what? I mean, I feel better.I feel like I can move further with less pain.” I mean, that’s a good thing. That’s what we want.
Daniel: You know, something that I saw that you’re doing recently, the Core 4 Recovery and Regeneration Program. Could you just give us a really quick overview of what that consists of? I was interested.
Dr. Nickelston: So, well, thank you. Yeah. I mean, this is many of the different strategies that I use but I try to make things simple, and practical, and as fundamental for people when I give them things, you know, that they can do on their own to help get themselves back to being pain-free or more empowered. But also, a system, right?
Because everybody needs a system. If you don’t really have a system, it’s very unlikely that you’ll continue something. So the Core 4 has many different parts to it and there’s different Core 4s, but the fundamental one is really looking at the systems of the body. Over the course of my 20 years, I’ve really begun to integrate many other systems into my care program.
So, the Core 4 basic fundamental top of the food chain stands for the number one Core 4 is what I call emotion/brain nervous system. That’s how you think about yourself, how you think about the world, how you think about the environment because that influences what your brain does, right, and your perception of the sensory environment.
So, that’s number one. And then number two is looking very closely at the lymphatic system. As you mentioned before, the detoxification system of the body. How can it and can it efficiently eliminate the inflammation that somebody is trying to recover from? Then number three is the gut.
Looking at the role of the organs in general, but definitely, the gut, the small intestine and the large intestine, because inflammation in that abdominal region can increase the incidence of lower back pain as well. And then the fourth one that we have in there is vascular circulatory of blood flow and oxygenation. And you know, all of these systems, right, I mean, they work together.
So, I think, with chiropractic, a lot of them talk about the power of the nervous system, but we have to remember as well, all these other systems work in conjunction with that system. And then with the Core 4, I show people key areas, where I call force multiplier areas, where if you work these four areas, you have exponential improvement in whatever modality you’re doing because these multiply and amplify everything else.
So that’s a military term. Force Amplifier is a military term where one intervention could have mastery [SP] over to the success of the operation. So that’s pretty much the basics of Core 4.
Daniel: And, you know, as you’re describing that to me, I can really see in the background, D.D. Palmer’s, Three T’s, you know, thoughts, toxins, and trauma. And it sounds like what you’re doing is a very holistic but completely in line with chiropractic philosophy. No wonder you’re getting good results with it.
Dr. Nickelston: Exactly. Well, you know, it all comes back down to the basics and the fundamentals. And it can’t get any more fundamental than that. I mean, that’s our baseline that we had our training in. You know, thoughts, in my opinion, are the top of the food chain in relationship to pain and discomfort because you know, we’re trained in our profession to help people and help them restore the power in their nervous system by removing these subluxations, right?
But then, we also, our job as doctors is to be able to empower them to feel healthy and take control of their health. And nothing is more powerful than you can help someone get their thought processed right or better in relationship to pain and their own body.
Daniel: You know, from your perspective, being a specialist in treating pain patients who want relief, how do you see chiropractic’s role as being part of the solution to the nation’s opioid crisis that everybody’s talking about right now?
Dr. Nickelston: Well, I mean, I think, I call it the creamy filling, where I mean it’s the best part, right? And what’s been wonderful about how technology is a two-way street, right? Technology can give us wonderful thing but it can also take us back a bit. So, the technology of today, it leads to a lot of musculoskeletals that we have so we don’t move anymore, but it also is empowering.
So nothing can help get rid of pain faster than knowledge and education. And people are looking for answers, I think, when they can come on and investigate and see for themselves how much is happening in the world of traditional medicine with medication, and opioids, and addiction. They’re looking for alternatives, they’re looking for healthy lifestyles. And then now, with things like with your show, and then the internet, and then a lot of the things that you guys put out, people have now education and options to know that chiropractic is and should be a fundamental part of that journey.
Daniel: Absolutely. And on that note, I would just want to say, recently, I was reading a report from an organization that issues guidance to the nation’s hospitals, and they’re being upfront. They’re saying that the MD community is unnoticed to prescribe fewer opioids, give less of them and give them in lower doses for shorter periods of time.
And the message to patients who are looking at surgery is, “This is going to hurt, that we’re not going to promise you a comfortable pain-free outcome during the healing process.” That I think is going to put some real wind in the sails of chiropractic when patients start thinking, you know, “I can avoid a surgery. Maybe I should look at my conservative options first.”
And if you can be right there delivering pain relief and solutions and you know, keeping a patient away from the knife, well, you’re going to have a really satisfied patient base and one that’s very loyal to you.
Dr. Nickelston: Oh, I agree 100%. I mean, it’s a smart consumer base now. I mean, it’s smarter than ever, the resources that are available. And then, I think, you know, based on the current research that’s coming out, getting hooked on opioids, I mean, they’re like gateway drugs to other things.
And you know, it’s an epidemic of today. And you know, pain is actually something that we need. My preferred definition of pain is pain is a request for change, and it’s a request from your body to change something in your life. And to me, it doesn’t mean change what medication you decide to take, it’s changing a habit, it’s a behavior, a lifestyle that you do.
And then once you listen, and then once you have professional guidance from people that can take you down that route, like chiropractic, well, I mean, that’s where the magic is, and that’s where the healing is, and that’s where the empowering is.
Daniel: Absolutely. Well hey, you just find just the right ways of putting things so clearly. Well, Dr. Nickelston, I want to thank you so much for spending this time with us today. This has been incredibly interesting and you’ve given us a fully faceted look at “The Future Adjustment.” I’m Dan Sosnoski and we’ll see you next time.
