Advanced Health Chiropractic explains what a new patient can experience during their first visit to the chiropractic clinic. A thorough medical history will be taken and any concerns will be discussed as the chiropractor seeks to understand the patient’s long-term goals for their health and wellness.
For a healthy new patient visiting Advanced Health Chiropractic for the first time, what should they bring to the appointment? How long will the appointment take? And what should they expect to happen?
Dr. Luke Stringer: So, obviously a new patient coming to Advanced Health first and foremost you need your ID, to make sure that we’re speaking to the person that we’re speaking to. And then if you have any insurance, bring your insurance card, because obviously if you have insurance, and you want to use it, our team will do a complimentary benefits check for you. Appointments take anywhere from 45 minutes to an hour.
What you can expect is to meet one of our doctors; we then do a really detailed health history, to figure out what’s the reason you came in, and essentially how it’s affecting your life, and your goals of obviously coming to the clinic, what do you want to get out of coming? For example, you have low back pain, you can’t bend over and pick up your kids, so that’s our goal, is to be able to fix that pain, so you can function with your kids for example.
Then we’ll do a really detailed examination. Obviously, each exam is going to depend on each complaint. But if you’re talking about your neuro-musculoskeletal pains, your typical pain, neck pain, lower back pain, for example, we’ll do a functioning examination. So, we are going can evaluate how the joint is moving. We will perform an orthopedic evaluation, see if we can pinpoint any joints, so any structures that aren’t doing their job. So, for example, we are going to show limited range of motion, giving great pain or weakness, and then we’ll do a functional examination. And again, it will depend on what we’re actually evaluating, but it will involve some form of range of motion check. Prerequisite for a healthy joint is full range of motion, so if we haven’t got good range of motion, that’s going to create an issue within the joint and the tissue.
And then we’ll do a functional examination, where we’ll actually watch how that joint performs, through function. So, for example, you have knee pain when running, we are going to watch you lunge, we are going to watch you squat, and we’re going to evaluate how that knee is being loaded. Then based on your case, we’re going to shoot some X-rays. To see is to know; we shoot X-rays in-house, the digital system, and that gives objective findings. And that really allows us to evaluate any degenerative factors, we’ve got any disc issues, what’s the alignment of the spine like. That’s obviously really important when diagnosing and treating.
Then we send you home, and then we evaluate your case. And then when you come back in, on your second visit, we’ll go through everything we found clinically and explain those clinical findings. Then we’ll go through treatment recommendations, and then we’ll get you going with treatment. And obviously each case is going to have different forms of treatment, we’ve discussed that on previous podcasts. But treatment is going to involve adjustments, spinal traction, soft tissue therapy, and rehab in some form or another.
If a new patient has been involved in an auto accident, what can they expect during their first visit?
Dr. Luke Stringer: Yeah, well fortunately we practice in downtown Chicago, but unfortunately there’s so many car accidents, because people in Chicago are quite the drivers. So, we see a lot of people who’ve been in motor vehicle accidents. And everything is going to be similar in terms of what we’ve just discussed, how we process the patient. However, there’s just a few more detailed exams that we need to do, following a car accident.
For example, if we’ve got referral pain, we are going to do specific disc checks within the neck and the lower back. If you’ve got weakness, instability, we’re going to do some muscle grading checks, to evaluate how damaged the issue or the structure is. And then when we shoot x-rays, you have to shoot a specific x-ray for auto accidents, it is called a motion study. When you’ve been involved in a car accident, the velocity lengthens soft tissue really quickly, and that velocity, that force, actually can damage those ligaments.
So essentially those ligaments, you might not be able to find on a basic exam, but on an x-ray, if you’ve moved the joint while the picture is being taken, you can actually show or find ligament instability. And that’s really important to know when treating, it’s also really important for attorneys to know, because if an attorney is litigating a case, and you can unequivocally prove that there’s been ligamentous damage post-accident, that’s obviously something an attorney, and a patient needs to know, because that’s going to benefit that case when litigated.
What can new patients, who are really suffering with back or neck pain expect during their first visit to Advanced Health Chiropractic?
Dr. Luke Stringer: Yeah, great question. And obviously people are in acute pain, which is new onset of pain. Those pain generators are really high, right? Seven, eight, nine, ten out of ten. Usually on their first visit we don’t like to treat patients, just because we don’t guess at what we do, conservative care. It’s just about repetition, and obviously focusing on a specific adjustment, and a specific traction, specific structure within the soft tissue. However, if you’re in a lot of pain, we’re going to do two things. If the pain is referring, so for example, you’ve got neck pain that’s referring to your arm, you’ve got lower back pain that’s referring into your feet, then we’re going to actually get you going through an assessment called a McKenzie assessment. McKenzie is a specific technique that is used for pinched nerves and disc injuries. And there’s a protocol you follow, but it’s going to involve some rehab, that’s done with one of our doctors, and it’s going to involve you doing lots of homework at home.
When you come back at your next visit, the goal is to have reduced those pain levels, improve range of motion, because that’s obviously going to allow us to get more treatment done on that second and third visit. Not everyone warrants a McKenzie examination, but if you’re in acute pain, pain is really quite intense and we’ve got changes in the muscle tone. Those muscles are in spasm. We’ll set you up with something called skin and ice so we use a unit called a TENS unit. We’ll apply an electrical current in and around that nerve, and that tissue, that’s creating the pain. And then we’ll add some ice to it.
The whole design of the TENS unit is to interfere with the nociception which is the sensory signal from the nerve to the brain. And it helps just calm down the pain, improves blood and oxygen into the area, helps calm down that tissue, and then we will send you home with an ice pack, and you’ll do some icing protocols. So again, when you come back and your next visit, hopefully the pain has dissipated a little bit, which will allow for a better treatment at the second visit.
What is a first visit like for a patient who is recovering from a sports injury, or who is looking to get back to playing their sport, as quickly as possible?
Dr. Luke Stringer: Again, working downtown here in Chicago, we treat the corporate athletes, the weekend warriors, they’re pinned to the desk eight to six in the week, and they look to exercise on a weekend. And we’re right down by the lake, so we get a lot of people that run, or do CrossFit.
So again, if it’s a brand new visit, each patient’s case is case specific. So, is it a knee injury? Is it a shoulder injury? Is it a hip injury? And the first thing we need to do is evaluate the mechanism of the injury. How did it happen? Was it acute? Was it a trauma? You slipped and fell? Or you had a contact injury? Or is it repetitive, overtime have you’ve just beaten up that joint and that tissue, which has slowly broken you down. And then same thing we’ll evaluate you for range of motion. A prerequisite for a healthy joint is full range of motion. We will then evaluate the integrity of the structures that are designed to move and stabilize that joint, see if we can find any weakness or any deficiency within those joints.
And then if it warrants, we’ll shoot an x-ray. We want to see if there are any mitigating factors. Is there any shift in the joint? Are there any fractures? And then again, same protocols. First goal for us in the first phase of care, is to decrease inflammation, improve range of motion, and essentially by doing that, we can start people working towards that goal of, you know again, if they’re a runner and they can’t run, working them towards getting back running so they can enjoy the 5 to 10 Ks, or the marathons that they’re going to run this summer.
During the new patient’s first visit, will they get an idea of what would be involved in treating their condition, and what their treatment plan might look like?
Dr. Luke Stringer: Absolutely. Most of our patients are really savvy, when it comes to people looking into healthcare, the majority of patients that we see have done their research, they’ve been online, they checked out our website, they see how we practice. So, most patients have an understanding, but some don’t. If they ask the question: “what is this going to involve?” Then they will be told exactly how we practice, and how we practice is kind of a four-pronged approach. We’re going to look for joint function. Do we have any misalignments or any joints that aren’t moving well, if they aren’t, then those joints need to get moving. We’re going to get them moving via adjusting the spine. We are then going to evaluate the alignment of the spine, because your alignment dictates how much weight and load is being put into that joint in the tissue. So, if we’re out of alignment, and a joint within the spine is just having too much pressure put through it, then it’s obviously not going to function as well as a joint that isn’t having that, then it’s going to break down.
So, we’ll shoot some x-rays. And based on those x-rays, we’ll recommend spinal traction, based on the condition. Soft tissue is really important, the health of the soft tissue; an adhesion is formed in tissue, it is kind of a by-product of repetitive stress or injury, it just kind of acts like glue in a muscle. And it’s not going to allow a joint to move well, it’s not going to move well with stability. So, we’ll take you through our soft tissue protocols, and obviously any muscle imbalances that we found in the functional examination. For example, you want to run, but your hamstrings and your glutes are weak, in comparison to your back, and you have back pain, well that’s an issue that we need to address.
We need to strengthen the hamstrings and glutes, they move you. Your lower back is designed to obviously just stabilize and move the lower back, not move the inside of the entire body. So, we’ll spell it out for them so they have a good idea of kind of what we’ve got going on. We don’t go into exact specifics of how long you need to be here, how many times you need to be here, because obviously clinical findings dictate that. But people leave here with a good understanding of how we’re going to approach their case.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.