FAQ

Common Questions About Chiropractic Care

1. How do I know if I need to see a chiropractor or a medical doctor?

First off, look at our section entitled “Conditions we treat.” If your problem is listed there is a good chance your case can be managed with chiropractic care. You will have a complete history, consultation and physical examination. This will include orthopedic and neurologic evaluation. Dr. Lichter may also feel the need for some x-rays. He will then evaluate your results to determine if yours is a chiropractic case. If it is he will make treatment recommendations. If it is not, he will refer you to the appropriate specialist.

DR. LICHTER ONLY ACCEPTS CASES HE BELIEVES WILL BENEFIT FROM CHIROPRACTIC CARE. ALL OTHERS ARE REFERRED TO A MEDICAL SPECIALIST.

2. I don’t understand how this happened. I didn’t do anything. Why am I hurting?

There are many causes of spinal problems. Obvious causes include accidents, falls and sports injuries. However, MOST spinal problems are from micro trauma – repetitive stress and strain from routine, ORDINARY activities. Examples include sitting, driving, vacuuming, lack of exercise, doing laundry, playing golf or even sneezing. Injuries occur little by little over the course of years and then one day you snap the last straw and you think you have “suddenly” injured yourself.  Lack of spinal maintainence over the years is the number one cause of spinal problems. You probably didn't know that your spine needed maintainence. Nobody told you that it does. Think about what the condition of your mouth and teeth would be if you went 20-30-40 years without any brushing, flossing or dental exams.

3. Why do I need to come for a series of adjustments?

Because chiropractic care corrects the CAUSE of the problem instead of covering up the SYMPTOMS. Correction of spinal misalignment is a PROCESS not an event. Just like when you start an exercise program or put braces on your child’s teeth, results do not happen overnight – it takes time, repetition and commitment, but in the end it is well worth it because you have CORRECTED the problem and not just masked the symptoms with pills.

4. Should I use ice or heat?

This is a very common, but very important question. Here are the guidelines: if you are in acute pain ( first 48-72 hours) following an injury - always use ice. If your problem is chronic ( long term) or if you have morning stiffness and general achiness use moist heat ( hot shower, bath, hot tub or microwavable gel pack). In cases where there is nerve inflammation ( numbness, tingling or burning or shooting pain down your arms or legs - always use ice.

How long you apply ice is also important. On a low back 20 minutes at a time - no more often than once every 2 hours but at least twice per day. On a neck or shoulder - no more than 15 minutes every two hours but at least twice per day.

When in doubt - use ice. If heat isn't helping, use ice.

5. What is the adjustment doing for me?

The purpose of the adjustment is to restore normal alignment and normal movement to the spinal bones. When bones misalign, they do not move properly and the soft discs between them slowly wear and get thin. We call these misalignments SUBLUXATIONS. The end result of long standing subluxation is arthritis of the spine. By correcting subluxations, we are not just helping you feel better. We are also removing interference from your nervous system, which allows your body to function at an optimal level. This makes you more resistant to disease and finally, we are preventing the process of spinal degeneration which occurs with age when subluxation is present.

6. What is the sound?

Often a popping or clicking sound accompanies the adjustment. That sound is the result of gas escaping from the capsules that surround the spinal joints. This is primarily nitrogen gas and is harmless. The sound is neither a good sign nor a bad one. It is not an indicator of how well you are doing. Some people’s spines make a lot of noise, while some spines make little or no noise at all. Although patients seem to feel like they need to hear that sound to get a good adjustment – there really is no correlation between a good adjustment and how loud it is. What makes a good adjustment is that the right bones are moved in the right direction – with or without the noise.

7. Do you have to “crack” my back?

The answer is , "NO." There are a number of different ways to adjust a spine. Not all patients are adjusted in the same way. The doctor chooses which technique he feels is best for you based on your history, exam and x-ray findings. He will choose the technique that he feels will get you the best result in the shortest time possible. Impulse^TMNeuromechanical Technique uses an instrument to do the adjustment. It is very fast, very gentle and very effective. If you have a preference for a particular technique, or if you prefer a low force ( “no cracking”) technique, please inform the doctor and he will gladly accommodate your request

8. What is Vertebral Subluxation Complex ( VSC)

When a bone or bones in the spine misaligns, it will cause irritation to nearby nerve roots and joints. Both the nerves and the joints are potential sources of pain. Nerves control body function by sending signals to muscles and to organs. When nerves are irritated or compressed, pain may result, muscles may tighten or spasm and organs may not function properly. Examples of organ dysfunction include constipation, heartburn or menstrual cramps. Bones that stay misaligned for extended periods of time put pressure on discs and cause those discs to thin and wear out. Eventually the bones adjacent to those discs will lay down calcium deposits called spurs in an attempt to protect the area from further damage. This whole process is referred to as VSC. It is important to note that it is possible to have VSC without pain for a long time. That can be dangerous, because by the time pain appears, the spine may already be permanently degenerated.

9. Why don’t I feel better yet?

Because we are treating the CAUSE of the problem and NOT the symptoms, it takes time to accomplish a change. When you join a gym, you will not see results after your first workout. When you put braces on a child’s teeth, they will not look straight in one week. Restoring proper function and alignment to the spine is a process, not an event. If all you are interested in is temporary relief of pain, then you can do that quicker by popping pain pills. But, if you are interested in achieving lasting relief and preserving the health of your spine, then chiropractic is for you. Most spinal problems become chronic and degenerative if not properly rehabilitated. Yes it takes a little longer, but it is well worth it.

10. Should I take anything for the pain?

That is entirely up to you. We treat the CAUSE of the pain, we do NOT treat the pain itself. Once we have removed irritation to the joints and nerves, you will feel relief. This happens soon in most patients. Some cases take longer. My experience in treating spines for the past 13 years tells me that oral medications such as anti-inflammatory drugs ( NSAIDs) and muscle relaxants are rarely effective in alleviating back pain. Some patients do get some relief. If you wish to try an over the counter anti-inflammatory such as Alleve or Motrin or a pain medication like Tylenol, you do so by your own choice. It is not my job to recommend them. If you do, please remember: do NOT take them on an empty stomach. They are a frequent cause of gastric bleeding and ulcers. They are responsible for over 16,000 deaths in the United States every year. My experience tells me that the proper use of ice, proteolytic enzymes and ginger is just as effective as NSAIDs. Going to your primary care physician will be a waste of your time. He or she will do nothing more than prescribe muscle relaxants and/or NSAIDs in a higher dosage than you get over the counter. With all due respect to the primary physicians, they are not trained or equipped to treat back, neck or joint problems. Just as I am not the best doctor to treat bronchitis or colitis, your primary physician is not the ideal doctor to see for those problems.

11. Do I need an MRI?

An MRI can be helpful in some difficult cases when the patient fails to respond to treatment within 2 to 4 weeks. In certain circumstances, the doctor will order an MRI sooner if he suspects a condition that may not appear on x-ray. Rest assured that if you need an MRI, Dr. Lichter will refer you for one, but understand that he has been treating spines for over 16 years and he will know when it is and when it is not necessary.

12. Why should I continue care when I already feel better?

Restoring proper alignment, movement and function to the the spine takes time, commitment and repetition. Symptoms often go away once we have made the slightest change in the spine. Discontinuing care before the full job of spinal rehabilitation is finished, guarantees that the spine will slowly and often painlessly decay leading to a permanent condition known as degenerative disc disease. Failure to complete the treatment program also makes it extremely likely that your pain will return and will require more care to correct it than it did the first time. Following the doctor’s recommended program of care will, in the long run save you time, money and future suffering. Doing this care once and doing it correctly is a smart thing to do.

13. Why did I feel worse after my last adjustment?

Beginning a program of chiropractic care is comparable to beginning an exercise program at the gym. About 2 out of 10 new patients will experience some degree of soreness in the hours following the first adjustment. This is simply the response of the muscles and connective tissue to being stretched during the adjustment. It is no cause for alarm. 15 or 20 minutes of ice on the area of complaint usually takes care of it. Soreness following the second is adjustment occurs in about one out of ten patients. By the third adjustment, post care soreness is rare. Be sure to mention it to the doctor if you continue to be bothered by it. Usually a slight modification to the adjusting technique will solve the problem. Remember it takes time to get better. Chiropractic is a process, not an event.

14. What about an Epidural Steroid Injection (ESI)?

This is a procedure that is helpful in some of our more challenging cases, especially in patients with lumbar or cervical disc herniation. A combination of a steroid and a numbing agent are injected into the epidural space to reduce inflammation and swelling on the nerve root and the disc. The procedure is done with a simple numbing injection and the patient completely awake. I use a particular specialist to do these on my patients. He utilizes flouroscopic guidance ( similar to an x-ray on a television screen) to guide the needle to exactly the right spot. I can tell you from personal experience that it is not painful and sounds a lot worse than it actually is. Some physicians do this procedure without the flouroscopic guidance. In my experience doing this procedure without the flouroscopic guidance is a waste of time.