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Woman grimacing with a toothache

Would You Go to Your PCP for a Toothache?

 


 I pose the question, "Would you go to your PCP for a toothache? He or she is trained in all aspects of the human body and has a good understanding of the teeth and gums. He or she knows that healthy teeth play an important part in overall health, so certainly one would think that going to him or her might be a good option. But you don't. Why not? Well, because we all know that a dentist has more specific training, knowledge and experience with teeth and related matters. In fact, even if you did go to your PCP, I bet 99.99% or more would send you to your dentist, and you would thank them and do so without hesitation.


So, who should you see if you are having musculoskeletal problems? To this day about 86% of people would select their primary physician or equivalent medical practice for these issues. Is that any smarter than seeing him or her for your teeth?


Studies in 2004, 2006 and 2007 found that not only were the areas of spinal dysfunction and mechanical back pain not understood by the medical doctors, but most had little if any training in the area and almost no experience treating it. The typical response to treating low back pain is still to provide pain medication, muscle relaxants, order an x-ray and possibly refer to physical therapy. This is the routine in spite of the 1994 U.S. Department of Heath and Human Services, Public Health Service, Agency of Health Care Policy and Research, establishing guidelines that indicated doing x-rays or MRIs is not necessary in most cases unless there are presenting dangerous conditions. They also reported that muscle relaxants and Opioids were of equivocal efficacy and increased the risk of causing drowsiness, debilitation and the potential for dependency. The medical world has not moved since 1994 and is still steering the patients who come to them with low back problems to follow these same regimens which are ineffective.


What the study did recommend was "manipulation (in place of medication) " with the option of adding physical agents or modalities. This is the exact area of training and expertise of the chiropractor. Chiropractic training is very thorough, encompassing at least 4820 hours of training including a very focused education in anatomy and physiology. The colleges are charged by the Council on Chiropractic Education, the Federally recognized accrediting agency for chiropractic colleges, to have a curriculum that enables the students to be proficient in neuromusculoskeletal evaluation, treatment and management.

By contrast, in a 2007 report, 82% of 4th year medical students about to enter internships failed to show basic competency on musculoskeletal examination. It is not that they were not good students, it was perhaps because too little time was given to this in their education. I suspect they might have performed similarly on a dental competency examination.


Studies show that chiropractic care is more effective and cost less than traditional medical care for low back pain.  In 2021, United Healthcare recognized that sending a person with low back pain to a chiropractor first saved them money and had quicker and more satisfactory outcomes.  As a result, they instituted a policy that if a person with acute low back pain went, within the first 3 days of back pain, to a chiropractor first, they would not be required to pay a copay for the first three visits.


So, my question now becomes, "Would you go to your PCP for a backache?"


Acknowledgement is given to an article published in the American Chiropractor October 2015 titled Chiropractic, Chronic Back Pain, and Brain Shrinkage. from which some of the information was extracted.


 

 

 


Healthy Nation

There is a growing need to change the health status of people around the world and even in this country. Health problems abound with more and more concern about the aging population of people who are living longer thanks to medical interventions. While these medications and surgeries are saving their lives, there is the awareness that many of the conditions now being treated are conditions that are the result of life choices and in that sense are preventable. We have to engage everyone in taking an active role in creating a "Healthy Nation."

Redefining "Healthy"

Healthy is the state of all the body systems functioning optimally. Central to normal function is healthy communication in the body, primarily focused on the extensive nerve system that relays information to and from every part of the body. This relates to the brain, spinal cord and all of the myriad of nerves spread throughout the whole body. If this communication is happening and the muscles are getting the right information, the joints are functioning correctly and all of the other systems, (digestive, respiratory, endocrine, circulatory, urogenital and immune), are doing what they should be doing, then we are healthy.

Rethinking Pain

Our society tends to think of healthy in terms of no pain. So, the thought extends to, if you get rid of the pain by taking a painkiller, then you are healthy again. We need to rethink this. Pain is an indicator that something is wrong. It is like a fire alarm in your home. Pulling the battery out of the smoke detector to stop that annoying loud noise and going on about your normal activities is not a realistic plan. Pain is a warning sign that things are not working correctly and need to be attended to in order to correct what is causing the pain. In that sense pain is a friend, particularly if you listen to it when it first presents. Ignored, it becomes like an angry bee, it's going to hurt you.
When someone ignores or medicates the first pains that present themselves, it is not likely that the problem will get better if the cause of the problem is not fixed. After a time, the body will do its best to compensate for the problem to relieve the pain, but if the pain persists, then the brain relegates that pain information into a sub-threshhold category wherein it says this is something we have to live with but we can't do anything about so it is not useful to keep being as aware of it. As the pain gets worse, the ability to ignore it decreases until it becomes the dominant message coming in. Then there is a crisis that is demanding full attention and we reach for, or in the traditional medical setting are prescribed, a pain medication.
The use of a pain medication might be necessary and very useful in some situations, as in following a surgery or a major trauma for short term use. However, many studies and the statistics indicate that pain killers are over-prescribed for conditions for which they provide no meaningful benefit, e.g. low back pain and other musculoskeletal problems.
Use of pain killers gives some relief to the pain in some situations, but does nothing to fix the cause of the pain. While in time the pain will often ease, there can be the continued "need" for some pain relief because the problem is still there and triggers pain again from time to time. This easily leads to physical, chemical and/or psychological addiction to the pain killers.
Pain Killers - Chiropractic in Portland, ME
Chiropractic care gets to the cause of the problem and if that is corrected then the cause of the pain is gone and there is no need for painkillers. Chiropractic is uniquely positioned to assess and correct the functional problems that cause musculoskeletal pains.
For these types of conditions, CHIROPRACTIC CARE SHOULD BE THE FIRST CHOICE OF CARE, only resorting to painkillers if the condition is so severe that some short term pain relief is needed while the correction is being made.
Low Back Pain Statistics - Chiropractors in Portland, ME
When pain medications are used there are often side effects, some short-term, others life-long. If the person has surgery, which sometimes is necessary, there is often significant relief, but the body is compromised and will never be as it was. This is another reason why chiropractic care should be the first route of care for musculoskeletal issues.
Back Injuries Statistics - Chiropractic Physician in Portland, ME
When pain in the musculoskeletal system is ignored and the causative problem is not addressed, there begin to be consequences with degenerative changes in the joint which in time present as arthritis. The muscles compensate and can develop imbalances trying to splint around the painful joint area to prevent irritating movements, and some muscles become over-dominant while others weaken, in the long-run creating an imbalance which becomes harder to fix because of that muscle patterning.

Prevention

There is a saying that an ounce of prevention is worth a pound of cure. How true this is in the health field. There are simple things that we can do to prevent health problems, and the younger we start the better the result. Even when we are older, while we can't prevent everything that is already in motion, the choices we make on a daily basis, can determine the quality and quantity of our life experience in those later years.
The primary areas of self action are nutrition, exercise and rest. Reducing sugars and avoiding artificial foods go a long way to creating better health. Smoking leads to many problems all of which are preventable by finding the way to break the habit. Drinking plenty of water is another cornerstone of better health. The more involved a person is willing to be in their own health care, the more impact they can have. These areas will be explored in further pages.
Chiropractic care also fits into the realm of prevention. Small injuries that are untreated get worse over time and also lead to joint degeneration which when bad enough is diagnosed as "osteoarthritis." It has been documented that within 2 weeks of an injury, there are measurable degenerative changes in those stressed areas. Early intervention with chiropractic care to reduce that joint stress, can allow restoration of healthier joint surfaces and possibly stop but certainly slow the degenerative changes that are happening because of that structural imbalance.

Cost of Care

The old adage that a stitch in time saves nine is so applicable to health care and therefor to healthcare costs. The graphic below shows the difference in cost between traditional medical care and conservative chiropractic care.

Conservative Care Cost Comparison - Chiropractors in Portland, ME
Things happen in life. We lift things or we trip. People, animals or even things bump into us. We overdo in the garden or with sports. These are the things which sometimes cause enough of a problem to require our paying attention and seeking care. But more often these same things cause some pain or discomfort that "goes away" after a few days or weeks and then we think all is well and we never get them checked. It is these uncorrected things that accumulate and create compensations. Then when the system is so compensated and compromised we do one more thing that should never have been enough to cause a big problem, but suddenly there we are on the floor unable to get up without severe pain.

Consider how much lower the cost of care would be if people sought chiropractic care with the first warning signs of discomfort and dys-function, rather than waiting until their "house is on fire." Tending to the small injuries quickly prevents them from becoming big events.
Now this does not mean we need to run to the chiropractor every time anything has a little soreness or pain. There is a mindfulness that is needed to consider what happened, how much impact was involved and what that impact did to our system. If it is just some soreness in the muscles from overusing then and there is no structural compensation happening, then we can just stretch and gently exercise to work it out. If however, a joint was strained and it hurts to where we are limping or having to change how we do things, then care would be very beneficial. If the pain and tightness lingers more that a couple of days, or returns shortly after without specific re-injury or strain, then these are warning signs that something is not right, and early intervention to get things re-balanced and working correctly would be very important.
Caught early something of this nature would take one or two treatments to fix the cause of the discomfort. The longer it is left the more compensation sets in and the longer it will take with more work needed to unravel the knot. Masking the pain with painkillers delays the real work and will ultimately necessitate more work to undo the knots and structural compensations.

In the overall economy there is growing concern about the cost of medical care at all levels. The greatest concern is for the spiraling cost of care for the elderly under the Medicare program. If more people accessed chiropractic care for their spinal issues rather than utilizing the medication and surgical route, it has been estimated that there would be significant savings to the Medicare program of $83.5 million. If they accessed chiropractic care way back when the injuries happened or the pains were first noted, the savings would be multiplied many times over - and people would not have had to endure years of pain, suffering and limitation that could so easily have been relieved.
Reduced Medicare Costs - Chiropractors in Portland, ME

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