Structure and Function

I had a new patient today, a teenage girl with back pain. Cervical, thoracic and lumbar, but especially thoracic (right below her shoulder blades). I'm so excited, finally a BACK to work on. So far I've dealt mainly with extremities, although I shouldn't complain, people are finally realizing that chiropractic extends beyond the spine! But this situation got me thinking about the competing philosophies in chiropractic.

This girl has a scoliosis. She also has weak core musculature and weak serratus anterior musculature - muscles that keep your scapula lying flat against your rib cage. (She's also a chronic self adjuster, as well as recipient of "adjustments" from her brother. I'll write another blog on this.) Several weeks of a few treatments a week and exercises and she'll regain the strength and stability she's lost and she'll be back to life, pain-free. Fixed?

This brings us to chiropractic philosophy. There are several people at school who call themselves "function people." By this they mean they look at how the body physically functions. Can you perform this test? If not, there's a muscular imbalance for which you'll receive exercises to do and if you perform those exercises and get adjusted along the way to restore motion where it doesn't currently exist you'll reduce your current symptoms.

I don't consider myself a function person per se. When I think of body function I don't think it ends with physical movement. It includes our digestive system, allergies, asthma, colds and flus, everything that our body actually does. What does this have to do with chiropractic? Well, as I said in an earlier post, every function of your body is controlled by our nervous system. With something like a scoliosis, there stands to be a lot of nervous system interference. How does this affect her optimal health? Should her back pain be her primary concern? Am I doing this patient a disservice by not attempting to restore normal spinal curvature?

I understand how strongly what I just said differs from everything you've ever been taught about health (if it ain't broke, it don't need fixin). So I understand that hearing this for the first time, you might be a bit skeptical. This is where I really need to shine. The word "doctor" means "educator." At this point I believe I owe it to patients to explain both sides of the coin and let them decide what they want to do (how will they ever be compliant if they don't agree to the treatment as well?). If they only want to fix the scapula, I do that, but I need to constantly educate my patients on the importance of chiropractic until they finally get it and enter into a world of prevention through maintenance care.