Chiropractic BioPhysics® method of rehabilitation?

[Rudy Pohl]

Hi Mark and Maria:

Thanks for both your thoughtful replies. I am still in the process of deciding what to do. The year-long chiro program consists of 90 visits which include manual adjustments, posture-correcting traction and posture-correcting exercises. If you pay for the full program in advance the cost goes from $4,000 to $3000. I live far from the clinic so my transporatation costs would be about another $1000, bringing my total cost to $4000.

I have no insurance or any other kind of coverage, so I am trying to weigh the cost-benefits of this treatment as opposed to just working out at home like a little beaver (hey, I'm Canadian!) to strenthen my core and doing some passive traction using a simple foam lumbar device.

I have spent about 40 hours so far researching this chiropractic treatment and somehow think that I could do almost as well on my own working on my core and doing some passive lumbar traction. My sense is that even if I were to do the year-lomg program, a great deal of my improvement would be as a result of me diligently doing core-strengthening exercises.

Any final thoughts?

Thanks again,
Rudy

[Maria]

Hi Rudy,
I guess I'm cheap. Wouldn't want to spend that much $ on chiropractic treatment if I could get the same benefit from some of the same work out at home. The adjustments are something a few of my friends that frequent the chiro's offices seem hooked on. I think it is very similar to when I was getting very frequent osteopathic manipulations/soft tissue work. Since I worked at an Osteopathic Hosp. and was the Family Practice/OB-GYN director at one time I was the best guinea pig for the students, residents and even fellows. I think truly this is part of why I was able to hold off so long on my first spine surgery (diagnosed in '82 and first surgery in '89).

Also I was very motivated to work on my spinal situation myself with exercise such as light gym work out regularly, swimming 5x/week and so forth. I called it a "Minnie Mouse" workout tho it worked for me to keep me in at least as decent a shape clinically and physically as I am over the years. I'm never been much of an athlete though just your average "I'd like to stay in shape female."

If I was able to start chiropractic treatment on a pay as you go type of plan or if funds could be returned if not all treatment plan was utilized I might consider it if I were so inclined tho again in my case I've never considered using a chiro for my spinal probs esp. because I had medical insurance that covered my care and utilized Work Comp benefits mostly which would have likely either denied chiro care or tried to make it look like that further screwed up my injured area to get out of paying for my care.

Now I trust Mark will give you a reply that makes more clinical sense. My reply has to do with what I didnt' want to do or spend. Good luck either way!

[mmglobal]

IMHO, the most important thought expressed in this thread is:

Originally Posted by Rudy Pohl

My sense is that even if I were to do the year-long program, a great deal of my improvement would be as a result of me diligently doing core-strengthening exercises.

Yes... you can do the program and if you do not follow through on your part, the program will fail.

Yes... you can set up a self-directed program and be disciplined and generate the same results as the full program.

You might consider doing a mix... getting professional help in setting up the self-directed program and then periodically checkpoint with the professional to monitor your progress and tweak the program accordingly. If they are not willing to participate in this way, screw them... they should be about helping you within your budget. None of them hold the magic feather. (But you do need to be careful...IMHO, too many "no pain, no gain" therapists hurt the average spine patient. We are not professional athletes. Finding the good therapist is an independent issue from the $$$. Many expensive PT's suck, and many more reasonable PT's are angels in disguise.

Sadly, you can do everything perfectly and still continue to spiral towards surgery. IMHO, you owe it to yourself to do everything you can to avoid surgery. You also have to consider the financial implications. If you blow your wad on therapy or less invasive procedures, AND still need bigger surgery… if you can’t afford to get it then, you are screwed. IMHO, less invasive surgeries should be pursued before the more invasive ones, but only for the good candidates. (OK… morphing into another discussion here…)

Whatever you do.. .GOOD LUCK! Please keep us posted. Thanks for participating in the iSpine community!

All the best,

Mark

[Rudy Pohl]

Hi guys:

Thanks once again for your thoughtful responses. I have decided to forgoe signing up for any kind of long-term, meg-dollar treatment program, chiro or otherwise. I have spent about 40 hours researching the scholarly literature about conservative chiro treatments of spinal issues and I feel that the evidence is simply not sufficient to merit spending $4,000 on the first year of a chiro-traction-exercise treatment program and then spend $1000-$1500 a year on maintenance after that.

I have decided to try another route. I have discovered something in the literature called the McKenzie Method developed and improved by Robin Mckenzie of New Zealand since 1956. After an initial assessment by a trained McKenzie certified clinician the patient is immediately trained in the particular set of McKenzie exercises suitable for his/her condition. The patient then does a self-directed healing and recovery program at home. For those who are good candidates for this form of conservative treatment the results have been quite impressive, with a lot of supportive evidence in credible, peer-reviewed clinical journals.

There are a number of clinics here in Ottawa who are McKenzie certified and this week I will be looking for one to get an assessment from. As well, I just had my family doctor make a referral for me to a Rheumatologist who specializes in back assessments, so he'll do a complete set of x-rays and range of motion tests and give me his prognosis and recommendations regarding when surgery might become an option and what conservative treatment(s) I should pursue until then.

Anyway, I am hoping that by taking these steps I will be making some good and cost-effective moves.

One last thing I should mention regarding the health care system up here in the "Great White North" is that while chiropractic and physiotherapy are not covered by our national or provincial health care systems, all hospitalization and all surgeries are. That's pretty awesome. Therefore, money is not an issue when it comes to surgery, but rather the big issues are what are the chances of post-operative complications and surgury "failures," and does one want to risks those. I guess that's where the importance of assessments come in as there are some folks whose pain is so high and function is so low that they really have no alternative than to get surgery done.

Anyways, that's all for now. Thanks again for you valuable input.

Take care,
Rudy in Ottawa

[Maria]

This was part of my early PT rehabilitation re my failed spine surgery back in '92. Very good. Helpful. Though at the time more helpful would have probably been right pain meds prescribed. Had to wait another 10 years for that nearly plus the lumbar ESIs.

Good luck Rudy! Please keep us posted on your progress or status~ Maria