We like our patients to be well informed. To that end we'll walk you through how a typical first visit will go, how a standard visit will proceed, how we tell what is going on, and the big one, how often to come in.
When you first come in we ask that you come about ten minutes before your scheduled appointment. This is to fill out some forms. The first form tells us who you are and a bit about your past and current health. The second form will be a diagram of a person. On that you'll be asked to mark where the pain you are experiencing is at, what type of pain it is, and how intense it is. Yes this is redundant to a point but it's for legal purposes. At that same time you will be given a brochure on HIPPA guidelines and policies (HIPPA guidelines and policies linked to privacy page). You will need to sign a paper saying you have received this. Lastly you will receive a paper that must be signed saying that you consent to getting care from us. We try to maintain procedures that are as easy and stress free as possible so don't worry too much about the forms.
Next you'll be sent into a treatment room. The first thing to expect is for us to go over your information with you to get a few more specifics that give us a little better of an idea of who you are and what is going on. See, taking the time to fill out the forms wasn't a waste! Next we will go through some short quick physical and motor exams. There are no procedures that will require special clothing so wear whatever clothing you feel comfortable wearing. For ladies who arrive wearing dresses rest assured that your modesty is foremost in our minds as well. In any situation where you will be horizontal, such as lying on the table for the adjustment, a heavy bath towel will be placed over your lower legs. The exams that we do will include ranges of motion, general muscle strength, reflexes, blood pressure, and a few orthopedic exams focusing on things that may be wrong you might not be aware of. The most common of these things we will check for is disc bulge or herniation. Depending on what your complaint area is we may also do some other more location specific orthopedic tests.
Now that all of that has been completed you are all set for the adjustment. We usually keep a running commentary going explaining what we're doing and how we are finding what we are finding. Keep in mind that we expect questions so if you have any please ask!
We typically use one of two methods to find what needs to be adjusted.
One of them is palpation. This means we gently press on places in your back to feel where the bones are at. If we are using this method we usually will lightly press on the bone in order to make it move. We do this to check if it is moving through its normal ranges freely. If it isn't where it is supposed to be and if it doesn't move like it is supposed to then is when we'd adjust. Since we are trying to explain things in writing here it's hard to distinguish for you the difference between that and how we press when we are going to adjust something. When we are just checking things it is a slow light pressure that is more broadly distributed. During an actual adjustment the pressure will still be as light as we can be but the pressure will be more tightly focused and much quicker (generally adjustments require the total pressure to be applied within .18 seconds).
The second method we may use is called reflex muscle testing. The way this works is we will have you resist a light pressure that we will place on one of your limbs. We are not checking the strength of the muscle. What we are checking for is how long it takes for your muscles to respond and resist that pressure. That very tiny time gap is the same in your body for every kind of pressure stimulus. That is because that time gap is your reflex response. How we use that information is quite simple actually. When your body is required to respond to a pressure but there is a pain signal being sent simultaneously the response is slightly slowed down. The pain signal, if present, will come from when we lightly press on places in your back. If there is nothing wrong then no pain signal is sent and the reflex response happens without an added delay. Keep in mind that your body will receive pain signals that do not break the threshold to be consciously painful.
NOTE: This is for informational purposes only and should NOT be used for "home diagnosis".
When we have located the problems (these problems are termed subluxations pronounced sub-lucks-a-shuns) we will adjust them to return them to where they should be. This is done by exerting a focused pressure to the area of the problem. The pressure will be fast and gentle.
For various reasons a delivered force may not get the bone to move. In this case, or for some other potential reasons, we may decide to use the "drop piece" mechanism of our table. What this means is that a section of the table will be lifted roughly 1/2 inch from where it was while you are on the table. Next we will change the pressure sensor on that section of the table so that it won't quite hold the pressure your body is exerting on it. When that happens the section will "drop" the 1/2 inch to its original position. We then slightly increase the amount of pressure that the section can hold so that it will accommodate the slight pre-adjustment pressure that will be added to it when we place our hand or hands on the problematic area. We then lift the section again. It's now set for the adjustment. The way this actually works is that when we press on your back, overcoming the amount of pressure the section can withstand, the section "drops". When the piece stops at its original position your body is still slightly in motion. When your body stops that force change allows the joint we were working on to move into place.
Please keep in mind there are many ways we can do something so if anything make you uncomfortable let us know right then so we can offer alternatives.
After the adjustment is over you can head out to the reception area to deal with any charges that there may be.
After the first visit if it has been several years since you've seen a chiropractor or if it was your first time ever you may (roughly 15% of patients) be a little sore or tender. This is because your body was going through motions it isn't used to. Very much like when you do a physical activity that you don't normally do. In this case it is usually best to apply ice to the area for 20 minutes to fight off any inflammation. If you are still having some soreness wait one hour then reapply the ice. If you ever experience sever pain after an adjustment please call us or come back in so we may determine the reason for the pain.
To begin each visit after the initial visit we will first take you into our massage and relaxation room. We will have you lie down on a table that slowly and gently rolls up and down your back relaxing and loosening your muscle. The table also gently vibrates. We have soft lighting, a tricking fountain, and some relaxing music playing. The vibration part of the table can be turned down or off at your discretion. The experience is there to help a person calm down from all the stresses of everyday life and relax the muscles to make adjusting easier on both you and us. This is free and optional so if you do not want this or are in too big of a hurry to use it on a particular visit just let us know and we'll skip that part.
We will have you come into the treatment room and lie down. We will then check to find out what we need to adjust. If at any time you have questions feel free to ask.
This is a big one and a question of much debate. We have two answers to this question and of course there are exceptions to this but here our exceptions are the exception and not the rule.
Our policy that we stand by for how often a patient should come to see us is this: when you decide you need to. You live in you body, not us, so you know when something is hurting, when you've been injured, or when you've stressed your body beyond the limits it wants to accept. When you need us we're there for you.
Now that you know our policy here's what else we think about that topic. If a person wanted to take complete care of their body they would get checked once every two weeks. The reason for this is called Wolff's Law. Wolff's Law states that every change in form and function of a bone, or in its function alone, is followed by certain definite changes in its internal architecture and equally definite secondary alteration in its mathematical laws (Morton's Medical Bibliography). In short that means that bone is deposited or reshaped because of the stresses on it. This is thought to start after two weeks of a stress on a bone. That means that your body tries to reshape itself to be OUT of place. Being checked every two weeks keeps that possible reshaping of the bone from happening. We realize that we do not live in a perfect chiropractic world and that it is hard to find time in our busy lives. Several patients choose to schedule an appointment every three weeks to a month.
The exception: In cases where you have just had some kind of accident or trauma you may need a slightly increased schedule of visits. In the few cases we've had that fall into this category we STRONGLY try to keep the number of visits to three or less in a two week period.