So, this last week, I have helped 3 people avoid exploratory or corrective Orthopedic surgery, or the consults for surgery. In each case, lower extremity pain was caused not by local pathology, but by misalignments of the upper cervical vertebrae...the top bones in the neck. Come to think of it, all 3 cases involved C2, specifically.
One client was a 43 year old woman, complaining of acute left knee pain. In her late 20's, she had a patellar dislocation while going up a staircase in a pair of high-heeled boots. She was sure the current pain was related to that, and was starting the HMO process of getting referrals for a surgical consult with an Orthopedic Surgeon. As an exam doc and Chiropractic practitioner in an Orthopedic group in Southern California, I have seen a lot of knees come and go through the office that actually needed operations; the presentation is suspiciously different. She had an increased valgus angle of both knees, which her GP had said was the likely cause of not only her patella alta, but also her previous patellar dislocation. Yet, something wasn't right. A cursory active movement review demonstrated an inability to trun freely to the right; in Chiro-speak, that belies a motion fixation on the right side of C2. She also had flat arches, causing her feet to roll inward, placing stress on the knees and GIVING HER the knocked knees. (as an aside, we fitted her for shoe inserts to roll her knees back to normal, and she doesn't have knocked knees anymore. Hm...mebbe "Chiropractic miracles" are just using your brain to help reverse engineer structural problems that are "off plumb", and figuring out how to correct them? Naw. Can't be that easy).
In Upper Cervical circles, misalignments of the top 2 or 3 vertebrae cause an imbalance in the nervous system, and an imbalance in the center of balance of the body. This causes the body to lean more weight on one side than the other. For lots of knee pain, this would explain the lack of findings on MRI. After all...if both knees have the same number of miles on them, why would one give out before the other? Wouldn't all the tires of your car show similar tread wear if wear and tear alone was truly the problem?
In adjusting her C2 on the right (correcting it towards the midline, from it's rightward displacement), we "put the head on straight", and allowed the body a chance to find a new balance. The knee she came in complaining about was symptom free after one treatment. Interestingly, and predictably, the other knee started developing symptoms. It was the first time that knee has had to carry its share of her weight in quite some time, making it "new" to that knee. She has since cancelled the surgical consult. She is having some new aches and pains as her body gets used to being straight, but is pleased with all o fthe little differences she notices. How she sits in her car; what she does with her arms as she sleeps at night; the lack of difficulty going uphill or upstairs; the ability to exercise without pain; etc.
Another patient -- a 59 year old contractor -- called complaining of acute pain in the popliteal fossa (backside of the knee), sure he needed knee replacements, and not clear on why he was calling a Chiropractor. He asked if I could fix it; I said we need to do a history and exam to determine if it was the sort of problem that would be amenable to Chiropractic care, but since it pretty much "came out of nowhere", I bet I could. After ruling out some of the scary monstors it could be (vascular problems, etc.), we next went to orthopedic causes, for which surgery would have been an appropriate course of care. Major provocative tests were all negative; his knees were fine, even though they were in a lot of pain. My initial suspicion was a Bakers cyst. However, he resonded so well to mild Activator correction of a "C2 Right" subluxation, that I followed with some medium-intensity myofascial release of the plantaris muscle, medial hamstring, and gastro-soleus tendons. After 10 minutes of working on it, he stood and walked pain free. He was also able to squat down on that knee...something he had not been able to do in nearly 5 years. Some of his discomfort has since returned, but nothing like the levels it was at when he called. He has a follow-up appointment next week, and has also cancelled the appointment he made with his GP, at which he was going to push for a referral to an orthopedic surgeon.
3rd patient this week is a woman in her early 60's, complaining of chronic, slow onset hip pain. One of her co-workers had the same symptoms, and recently had a hip replacement surgery. I asked if it helped...she reported that her friend was, in fact, worse off than before the surgery. I recalled a plaque that used to hang in the office of the Chiropractor who helped me out as a young man: "If it's not a Chiropractic probmen, Chiropractic care won't help. If it is a Chiropractic problem, nothing else will". After a consultation, history and physical, a series of neurological challenges determined that she was "out" at both C1 and C2. Since (in my own clinical experience) C1 won't stay corrected if C2 is fixated or displaced, I worked on it first. The next day, she returned to the office for follow-up. Her C2 adjustment had held, so we adjusted her C1.
In a follow-up contact, she revealed her hip pain was resolved, and the headaches which had bothered her since childhood as a regular part of her day (so that she didn't know she was having them regularly until she all at once stopped having them for the first time in over 50 years) had also subsided. She is referring several friends who have also been talking about needing surgery for their backs, hips, knees, and shoulders.
Many nagging back and joint symptoms we get are due to imbalances in the structure of the body; like what a car might get if we drove it around for a lifetime with the tires misaligned. With the head on crooked (the top bones in your neck misaligned), the rest of your body has to do some pretty clever gymnastics to keep your eyes looking straight ahead. Over a short period of time, no problem. After 20 years of this, however, the imbalances lead to inflammatory processes in overloaded joints and overworked muscles. The symptom is generally pain. Rather than finding out the cause and correcting it, however, most folks just hide it with over-the-counter or prescription meds: After all, a bottle of Advil is a lot cheaper than a visit to the local Chiropractor.
So, we cover the pain for a few more years, until the Advil alone just doesn't cut it anymore. So we either hit stronger meds, or hit up our General Practitioner up for a Physical Therapy prescription. PT works in many cases; don't get me wrong. But stretching out and strengthening structures that are under an imbalanced load does not do the same thing as removing the imbalance. Morevoer, with so many PT's struggling to make overhead, sessions often consist of doing the bare minimum possible and still getting paid by insurance companies for services rendered. A hot water bottle, some coaching on home exercises, and you're sent away. Not surprising that it doesn't work, and a year later, we are back in the doctors office for what's next...signing up for surgery. More meds get followed by x-rays or MRI's trying to find something to shake a stick at. In lots of cases, something can be found to be operated on. This isn't a surprise: The lifelong battle against gravity always leaves effects. I can find "degenerative arthritis" on the x-rays of pretty much anybody over 30 who has ever done more in life than be a couch potato. It doesn't mean a thing, but I can still find it. And I I don't know any better, tell you it matters an awful lot. But then we go to the next step.
We get surgery, go through rehab, and are completely fixed, 100-percent pleased with the outcomes of surgery and gald we did it! OK. I'm being facetious. How many people do you know who have had surgery, and are pleased as punch with the outcomes; better off than they were? So...why not try something different, and see if you get a different result?
If you think you need surgery, you might. You also might not. Medical doctors are not trained to look at the body the same way Chiropractors are. And to be honest, not all Chiropractors are good at what they do, or ego-invested in getting you well. Neither are all Medical doctors. Some guys in both groups just have boat payments to make, and aren't looking out for your best interests. So, if you're thinking about surgery for a joint problem anywhere in your body, give us a try first. There are people who I cannot help, and I'm honest with them to avoid wasting their time and money. If I can't help you, I'll send you to someone who can....someone who cares. I maintain relationships with some of the top Orthopedic Surgeons and Neurosurgeons in the area for just that reason. But, if you don't need one, why get one? Surgery is an insult AND an injury to the body. And, more commonly than anyone likes to admit, it's an unnecessary insult. So call us. The initial consultation is free. Bring your films if you have any; reports if another doctor has written them, and I'll review them and give you my best guestimate. And if it looks like Chiropractic might help, we can go to the next step of an examination and trial course of treatment.
Keep your parts: They were put there for a reason. And remember, "If it's not a Chiropractic problem, Chiropractic care won't help. If it IS a Chiropractic problem, nothing else will."
Best Regards,
Dr. C
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