Bringing Chiropractic to You!

Suburban Chiropractic understands that many workplace injuries are caused by repetitive motions or activities, such as sitting or standing too long, improper work station ergonomics and sitting in front of a computer or at a desk for extended periods of time.  Maintaining employee health can be an overwhelming task and it has been shown that chiropractic care can reduce lost work time and improve ones's overall health, as shown by the studies below.  

Utah Study: work days lost under care provided by Doctors of Chiropractic was 10X less than under medical care for identical codes.

Australian Study: The average number of compensation days due to work related lower back pain was approximately 19 less days than regular medical treatment for the same condition.

Oregon study: The median time loss days was an average of 2.5 less for chiropractic cases- suggesting chiropractors are better able to manage injured workers with a history of low back problems and return them more quickly to productive employment.

Have you ever missed your lunch because you had to go to your chiropractic adjustment?  Have you ever had to leave work early to go the chiropractor?  Or maybe missed your appointment because you had to stay late at work?  I understand that life can be busy, and sometimes going to your chiropractor doesn't take precedence over family or work events.  That is why I am determined to make things easier for you! To help combat these aches and pains, Dr. Gregory J. Angermaier, owner and head doctor at Suburban Chiropractic Health and Wellness Center, has created a new Concierge Chiropractic Service!

What is a Concierge Chiropractic Service?

·  Travel to your place of business.

·  Treat your employees interested in obtaining care.

·  Pain Management: Relive back pain, neck pain, fibromyalgia, carpal tunnel, headaches and more!

·  No cost to your company; Patient’s health insurance will be billed.

·  Employees won’t have to miss lunch or leave work early, which leads to increased productivity!

Dr. Angermaier has already incorporated his Chiropractic Concierge Service into several local businesses.  If you’re interested in offering a fabulous service to your employees, while increasing productivity, call 302-261-6346 to lock in your preferred day and time! Don’t get locked out. Schedule your office today before Dr. Angermaier is completely booked!  

Don't "Believe" in Chiropractic? That's Okay. You Don't Have To and Here's Why...

        For years, chiropractors have been treating back pain patients as well as, if not superior to, other health care professions.

        In fact, all of the guidelines published around the world have recommended manipulative care as an initial or first step for the treatment of low back pain and more recently, for neck pain. 

        So why are there still some people who say things like, "I don't believe in chiropractic," "I'm not sure if that works," "if my MD recommends it, maybe I'll think about it."  

        Almost everyone has (or will have) to deal with a sore back that demands some form of health care service. Statistics indicate low back pain affects over 80% of the general population at some time in their lives.  

        Of that number, about 25% seek chiropractic care initially.  

        So, let's look at "the evidence" or research that supports chiropractic care.  Are those who seek chiropractic care truly satisfied?  You be the judge!

1) Consumer Reports May 2009 Consumer Reports Lists Chiropractic Patients As Most Satisfied Consumer Reports ~ May 2009

        A study in the May issue of Consumer Reports shows hands-on therapies were tops among treatments for relief of back pain. The study, which surveyed more than 14,000 consumers, was conducted by the Consumer Reports Health Ratings Center. The report states that, "eighty-eight percent of those who tried chiropractic manipulation said it helped a lot, and 59 percent were 'completely' or 'very' satisfied with their chiropractor."

2) Military Medicine June, 2006 Chiropractic Services in the Canadian Armed Forces: A Pilot Project Military Medicine 2006 (Jun);   171 (6):   572-576

        This article reports on satisfaction associated with the introduction of chiropractic services within a military hospital, through a Canadian Armed Forces Pilot Project. A 27-item survey was distributed that inquired about demographic information and satisfaction with chiropractic services to 102 military personnel presenting for on-site chiropractic services at the Archie McCallum Hospital in Halifax, Nova Scotia. The majority of military personnel (94.2%) and referring physicians (80.0%) expressed satisfaction with chiropractic services.

3) Journal of Manipulative and Physiological Therapeutics July, 2006Factors Associated With Patient Satisfaction With Chiropractic Care: Survey and Review of the Literature J Manipulative Physiol Ther 2006 (Jul);   29 (6):   455-462     

        The results here generally confirm the findings elsewhere in the literature. Of the 23% of the adult population who have ever visited a chiropractor, overall rates of satisfaction are once again found to be quite high (83% satisfied or better) and the number dissatisfied is quite low (less than 10% dissatisfied or very dissatisfied). This is remarkable given the fact that much of the financial burden of the care is borne by patients, and the preponderance of care is for difficult chronic problems of back and neck.

4)  Symptomatic Outcomes and Perceived Satisfaction Levels of Chiropractic Patients with a Primary Diagnosis Involving Acute Neck Pain J Manipulative Physiol Ther 2006 (May);   29 (4):   288-296   

        A total of 115 patients were contacted, of whom 94 became study participants, resulting in 60 women (64%) and 34 men. The mean age was 39.6 years (SD, 15.7). The mean number of visits was 24.5 (SD, 21.2). Pain levels improved significantly from a mean of 7.6 (median, 8.0) before treatment to 1.9 (median, 2.0) after treatment (P < .0001). The overall patient satisfaction rate was 94%.

5)  Patient Satisfaction With Chiropractic Physicians In An Independent Physicians' Association .  J Manipulative Physiol Ther 2001 (Nov);  24 (9):   556-559

        Various aspects of chiropractic care were given a rating of "excellent" by the following percentage of respondents: Length of time to get an appointment (84.9%); convenience of the office (57.7%); access to the office by telephone (77.3%); length of wait at the office (75.7%); time spent with the provider (74.3%); explanation of what was done during the visit (72.8%); technical skills of the chiropractor (83.3%); and the personal manner of the chiropractor (92.4%). The visit overall was rated as excellent by 83.3% of responders, and 95.5% stated they would definitely recommend the provider to others.  

6)  Patient Satisfaction With Chiropractic Care in Los Angeles AHSR FHSR Annu Meet Abstr Book 1994;   11:11     

        This RAND Corporation Study found for overall care, 92% of the patients choose chiropractic care as either excellent or the best .Although the ratings on all the items are high, the highest ratings were given to the more personal qualities of the practitioner: courtesy, politeness, and respect shown to the patient (92%); interest shown in the patient as a person (91%); willingness to listen (89%); ability to put the patient at ease (89%). These results support those of previous studies on chiropractic suggesting the high satisfaction with chiropractic care is a result more of the personal health encounter than the therapeutic outcome. They also suggest other providers could learn much from the interpersonal art of chiropractors.
   
7)  Patient Satisfaction With the Chiropractic Clinical Encounter: Report From a Practice-based Research Program Journal of the Neuromusculoskeletal System 2001:   9 (4):   109-117

       The majority of patients were highly satisfied with their care; 85.0% reported that their chiropractor always listened carefully; 85.3% that the DC explained things understandably; 88.2% that the DC showed respect for what they had to say; and 75.6% that he/she involved them in decisions as much as they wanted. The median proportion of patients, per DC, with a chief complaint who said their doctor always spent enough time with them was 82% (IQR: 19%) and 82.3% reported that their chiropractors never recommended more visits than necessary.

8) Patient Evaluations of Low Back Pain Care From Family Physicians and Chiropractors . West J Med 1989 (Mar);   150 (3):   351-355 ~ FULL TEXT     

        Patients of chiropractors were three times as likely as patients of family physicians to report that they were very satisfied with the care they received for low back pain (66% versus 22%, respectively).Compared with patients of family physicians, patients of chiropractors were much more likely to have been satisfied with the amount of information they were given, to have perceived that their provider was concerned about them, and to have felt that their provider was comfortable and confident dealing with their problem.

Doctored

As I was going through my e-mail today, I noticed I had received a message from my Alma Mater; New York Chiropractic College located in Seneca Falls, NY.  The President of the College had wrote to us explaining that there was a new documentary premiering this weekend in NYC.  Below is an except from that e-mail. 

"An important documentary film entitled "Doctored"  will be premiering in New York City starting on Friday, September 21, 2012.  Advanced previews of the film reveal the candid exploration of a currently compromised American healthcare system replete with big pharma inducements and symptom-centered medical approaches. This is contrasted with accounts of successful patient experiences and positive results with chiropractic and other forms of natural healthcare. The film provides a straightforward look into the history of chiropractic including its struggle for recognition and challenges with anti-competitive practices by the AMA."

I immediately clicked on the link and watched the preview and was very excited by what I saw.  Check out the preview below.

For more information, please go to the film's website.  If you're concerned about your health, or just concerned with the direction of the medical model in this country, this is a must see film! 

How To Explain Chiropractic to Others

We cannot thank our family, friends, patients, and allied health care providers enough for referring patients to our practice.  

        There is no other form of advertising that attracts the quality of patients as those our patients refer to us.

        So, here's some information that may help you tell others about us:
Chiropractic has been around since 1895 and is the third largest healthcare profession in the world:

• The primary focus of treatment includes the neuromusculoskeletal system (nerves, muscles, joints) such as disk herniations (e.g., sciatica, pinched nerves), sprains and strains, sports injuries, neck pain (e.g., whiplash), headaches, and many others.
• The treatment includes a "hands-on" approach where massage, manual traction, joint manipulation and mobilization are commonly utilized.  In general, the treatment typically feels good and patients look forward to the process.
• In many cases (such as low back pain, neck pain, headaches), chiropractic care may function as the primary or only treatment that is needed.  However, when other medical conditions co-exist, the combination of chiropractic and medical treatment is often better than either one by itself (depending on the condition).
• Doctors of chiropractic commonly refer back and forth with medical and osteopathic doctors, creating a "win-win" for the patient and providers.
• Over the last 20-30 years, a significant volume of research has been published finding chiropractic approaches to be either equal or superior to other forms of healthcare provision for low back and neck pain, headaches, and other conditions.
• Many hospitals, medical clinics and VA facilities have integrated chiropractic into their healthcare systems.  Medicare and Medicaid have included chiropractic coverage since the 1970's and most private insurers include chiropractic coverage due to the significant volume of research reporting the benefits, cost savings, and patient satisfaction.

        Your individual story may actually be the most important thing you can share.

        The following are a few of the many websites that include great information about chiropractic that may also be appreciated by the potential "internet savvy" future chiropractic patient:

• https://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=61
• http://www.spineuniverse.com/displayarticle.php/article800.html
• http://www.chiroweb.com/find/whatischiro.html
• http://www.spine-health.com/treatment/chiropractic

Arthritis

Can Chiropractic Prevent
Some Types of Arthritis? 

        This question is asked frequently by patients visiting chiropractors.

        To answer this question, let's first talk about, "what is arthritis?" 

        The word "arthritis" is derived from "arth-" meaning "joint" and "-itis" meaning "inflammation."  

        Hence, arthritis is basically swelling in the joint.  

        Many types of arthritis have been identified - in fact, over 100!

        Some types of arthritis are primary (not caused by anything that can be identified), while others are secondary to a disease or other condition.

        The 9 most common primary forms of arthritis are: osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, juvenile idiopathic arthritis, Still's disease, and ankylosing spondylitis. 

        The most common type that virtually affects everyone sooner or later is osteoarthritis. This is basically the wearing out of the joint, which usually seen in the older person but can be found at any age after trauma or injury occurred or, after an infection in the joint.  

        The next most common is rheumatoid arthritis, which is an autoimmune disease where the person's antibodies attack the joint (and possibly other tissues as well).  This can occur at a young, middle or older age, whenever the body is triggered to produce the joint attacking antibodies.  Crystals deposited in joints can injury the cartilage surface of which the most common is gout- often attacking the base joint of the big toe, and pseudogout.

SO NOW THE QUESTION - CAN CHIROPRACTIC
PREVENT SOME FORMS OF ARTHRITIS? 
 

        The answer is yes.... sometimes.  For example, when a spinal joint is fixated, stuck, or subluxated, the normal biomechanics of the spine are altered because of the faulty movement between the vertebrae.  

        Restoring movement can restore proper function so excess forces are not exerted on the adjacent levels.  

        A good example of this is when 2 or 3 vertebrae are fused together (surgical or congenital), the levels above and below the fusion have to work harder for the spine to move and function and tend to become osteoarthritic sooner than the other non-fused levels. 

        From a more broad approach, lifestyle changes including exercise, weight management, the use of a brace or splint, certain medications and dietary supplements can be helpful as well.  

        Exercise, in particular, can have significant benefits to the joint surface in both pain relief and slowing down or even stopping the degenerative process (osteoarthritis).  

        Diet emphasizing an anti-inflammatory approach includes the paleodiet or caveman diet where grains/glutens are avoided and lean meats, fruits, and vegetables are emphasized (see http://www.paleodiet.com/ and http://www.deflame.com/).

Here is a list of websites that offer additional information: 

1. http://en.wikipedia.org/wiki/Arthritis
2. http://arthritis.about.com/gi/dynamic/offsite.htm?zi=1/XJ/Ya&sdn=arthritis&cdn=health&tm=101&gps=343_379_1196_561&f=00&tt=14&bt=1&bts=1&zu=http%3A//www.chiroweb.com/archives/17/23/04.html
3. http://www.chiropractic.com.sg/arthritis.html
4. http://www.chiropractorguide.com/basics/chiropractors-and-arthritis-pain-relief

Is Chiropractic Dangerous?

 The mission of chiropractic is to help sick people get well, as well as to help healthy people function better in the absence of drugs or surgery.  

        When people are asked, "...what do chiropractors do?" the frequent response is, "...they crack your neck and/or back."  

        Chiropractic spinal manipulation (frequently called an adjustment), often produces an audible popping or cracking noise.

        This sound is known as joint cavitation and it is reported to be caused by the release of pressure created by gases (nitrogen, oxygen, and carbon dioxide) within the joint.

        It is the same noise produced when one cracks their knuckles. One common myth is that cracking or cavitating a joint will produce arthritis in the joint - this is simply not true.

        Several scientific studies of joint cavitation dispel this old wives tale. In fact, studies demonstrated that joint manipulation actually benefits patients with arthritis of the spine.

        There have been a number of studies published on the topic of unwanted reactions to spinal manipulation.  

        In general, side effects, if any, are mild and transient.

        When they do occur, they typically happen shortly after the first or second session of spinal manipulation, similar to the post-exercise soreness that occurs when first introducing a new sport or activity.

        Unpleasant side effects may occur in between 10% and 30% of patients. They occur more often in women than men, and as previously stated, they seem to occur more often after the first session of spinal manipulation.

        The most commonly reported unpleasant reaction is temporary and transient increased pain or stiffness. This reaction usually resolves in 24 hours or less.

        More rare reports of tiredness, light headedness, and occasional nausea have been infrequently reported.

        The type and nature of these reactions may be associated with the severity and nature of the condition being treated.

        It seems self evident that more severe problems have the potential to produce short term increases in symptoms. The use of ice, ultrasound and or other modalities can help to minimize any irritation that may occur due to spinal manipulative treatment.

        SPINAL MANIPULATION HAS BEEN FOUND TO BE SAFE AND EFFECTIVE FOR UNCOMPLICATED SPINAL PAIN SYNDROMES. MORE IMPORTANTLY, IT MAY ALSO BE A VIABLE ALTERNATIVE TO SURGERY FOR LUMBAR OR CERVICAL DISK HERNIATIONS.

        There are many reports on both sides of this subject, with some stating spinal manipulation can increase compression of the spinal nerves in patients with disk herniations as well as the opposite - that it reduces nerve root pressure.

        The good news is that the rate of occurrence is only about 1 in 1- 3 million cases, making spinal manipulation for disk problems an extremely safe treatment option for patient with herniated disks.

        Chiropractors will often use low-force manipulation methods for treating herniated disks that do not require a standard type of manipulation thrust.

        These spinal methods are sometimes preferred over traditional manipulative techniques for the treatment of herniated spinal disks, but this is case dependent.

        To make an educated decision about any type of care you may be considering, you must consider "relative risks". Simply put, relative risks compare the risk of one procedure with the risk of a second procedure for the same condition.

        For example, if you are taking medications to relieve your pain, how do the risks of the medications compare with the risks of an alternative treatment, like chiropractic care?

        An example is chiropractic treatment versus drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin, Aleve and Advil (TM).

        THE RISK FOR SERIOUS SIDE EFFECTS FROM ANTI-INFLAMMATORY DRUG IS FROM 6000-9000 TIMES GREATER THAN THE RISK FOR SERIOUS SIDE EFFECTS FROM SPINAL MANIPULATION, MEANING THAT CHIROPRACTIC CARE IS A MUCH SAFER ALTERNATIVE THAN ASPIRIN OR OTHER NSAID DRUGS FOR TREATING INFLAMMATORY BACK OR NECK PAIN.  

        Further, there is no significant increased risk to add chiropractic care to an existing regime of NSAIDs, thus treating the condition with two different strategies.

        Interestingly, studies have reported that patients receiving chiropractic care were able to reduce their intake of drugs, thus, reducing the risks of drug reactions/interactions.

        If you are trying to avoid surgery for a spine related problem, your condition is more serious and potential side effects of surgery should be compared with chiropractic.

        You should understand any patient who is a potential candidate for spine surgery has a serious medical condition. There is pressure on a nerve and the potential for permanent damage to that nerve exists. Studies show that chiropractic care often can reduce the pressure on a compressed nerve in the lower back or neck, without surgery.

        The following references were utilized in the preparation of this information.  

References 

1. The audible release associated with joint manipulation.  JMPT. 1995 Mar-Apr;18(3):155-64.
2. Does knuckle cracking lead to arthritis of the fingers? Arthritis Rheum. 1998 May;41(5):949-50.
3. Efficacy of treating low back pain and dysfunction secondary to osteoarthritis: chiropractic care compared with moist heat alone. JMPT 2006 Feb;29(2):107-14.
4. Comparison of human lumbar facet joint capsule strains during simulated high velocity, low-amplitude spinal manipulation versus physiological motions. Spine J. 2005 May-Jun;5(3):277-90.
5. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment JMPT. 2004 Mar-Apr;27(3):197-210.
6. Side posture manipulation for lumbar intervertebral disk herniation. JMPT. 1993 Feb;16(2):96-103.
7. Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. JMPT 1996 Nov-Dec;19 (9):597-606.
8. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage. 2001 Mar;21(3):238-42.
9. Risks associated with spinal manipulation. Am J Med. 2002 May;112(7):566-71.
10. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. JMPT 1995 Oct;18(8):530-6.
11. J Side effects of chiropractic treatment: a prospective study. JMPT. 1997 Oct;20(8):511-5.
12. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005 Jul 1;30(13):1477-84.
13. Complications of spinal manipulation: a comprehensive review of the literature. J Fam Pract. 1996 May;42(5):475-80.
14. Dissection of cervical arteries Presse Med 2001 Dec 15;30(38):1882-9
15. Vertebral artery occlusion after acute cervical spine trauma. Spine. 2000 May 1;25(9):1171-7.18. Spine Journal
16. Internal forces sustained by the vertebral artery during spinal manipulative therapy. JMPT 2002 Oct;25(8):504-10

Chiropractic Education

Many people seem surprised to find out that the chiropractic education process is so extensive.           I usually reply, "...whether you're planning to become a chiropractor, medical doctor, or dentist, it takes four years of college followed by and additional 4-5 years of additional education (med school, dental school, chiropractic college) simply because there is that much to learn about the body to become a competent health care provider."           Hence, depending on the area of interest a person has in the health care industry, it takes a similar amount of time to complete the educational program.           DID YOU KNOW...         The initial step is completing a typical "pre-med" undergraduate or college degree.           Courses including biology, inorganic and organic chemistry, physics, psychology, various science labs, as well as all the liberal art requirements needed to graduate are included in the undergraduate education process.           Many states now require 4 years of college in addition to the 4 to 5 academic years of chiropractic education to practice in their particular state.           Once entering a chiropractic university, the same format exists as most health care disciplines.           The basic sciences are covered in the first half of the educational process after which time successful completion of the National Boards Part I examination is required to move into the second half - the clinical sciences.           From there, internships, residency programs, preceptorship programs become available to the chiropractic student.           Once graduated, residence programs including (but not limited to) orthopedics, neurology, pediatrics, radiology, sports medicine, rehabilitation, internal medicine, and others are options.  Many various Masters and doctorate programs in specialty areas are also available.         The following chart shows the similarities between three health care delivery approaches, DC, MD, and DPT (doctor of physiotherapy). Curriculum Requirements For the Doctor of Chiropractic Degree (DC) in comparison to the Doctor of Medicine Degree (MD) and the Doctor of Physical Therapy Degree (DPT):

*Does not include hours attributed to post-graduation residency programs.         AS YOU CAN SEE, THE ACTUAL NUMBER OF AVERAGE CLASSROOM AND CLINICAL STUDY HOURS PRIOR TO GRADUATION IS EVEN HIGHER FOR CHIROPRACTIC COMPARED TO THE MD AND DPT CURRICULUM.           It should be noted that this does not include additional educational training associated with residency programs, which are available in the three disciplines compared here.         At one of the chiropractic colleges, the academic core program or Clinical Practice Curriculum consists of 308 credit hours of course study and includes 4,620 contact hours of lecture, laboratory and clinical education.         There are 10 trimesters of education arranged in a prerequisite sequence.         The degree of Doctor of Chiropractic (D.C.) is awarded upon successful completion of the required course of study.         In order to receive a degree, a student must have satisfied all academic and clinical requirements and must have earned no less than the final 25 percent of the total credits required for the D.C. degree, allowing up to 75 percent of the total credits through advanced standing.         The academic program may be completed in three and one-third calendar years of continuous residency. Graduation, however, is contingent upon completion of the program in accordance with the standards of the College, which meet or exceed those of its accrediting agencies.         In addition to courses included in the core curriculum, a variety of procedure electives are available to the students. These electives are designed to complement the study of adjustive procedures included and facilitate investigation of specialized techniques.