Post Treatment Care

Please note: this is a general list of post-treatment care and may not be applicable to all issues. If you are unsure or have any questions, please discuss with Dr. Richard.

Purpose

The following recommendations have been compiled from the insights of many doctors and thousands of clinical observations.  The intent of this material is to make you aware of activities that commonly put the patient at risk for spinal injury.  In addition, the following activities can impede or interfere with your healing and prolong your treatment regimen.  If you have any specific questions not answered below, please ask Dr. Richard.

Exercise During the Initial Intensive Care Period

If you have been exercising at the time of your injury or symptoms occurring, please observe the following recommendations unless directed differently by your doctor.  If you were not involved in an exercise program, beginning one at this time is not recommended.  Recommendations for exercise will be provided once your condition has left the acute phase of your healing process.  Exercise can interfere with the healing of your injury, causing unnecessary inflammation during the acute phase of your injury.

Week 1-2: Light walking

Week 2-4: Walking, light jogging, and low-intensity resistance/weight training

Week 4-6: Moderate intensity running, resistance training, and physical activities

Week 6-8: Full-intensity running, resistance training, and physical activities

General Guidelines

•  Avoid sleeping on your stomach. This position creates sustained twisting of the contents within the spine, including the brainstem and spinal cord.  To help prevent this from happening, put a pillow in front of you so that if, by chance, you do turn toward your stomach, the pillow will feel awkward enough to make you roll back.  For more suggestions, ask the doctor.
•  Do not pop your neck or back or pull on your head.  This could result in the loss of your alignment or cause a new misalignment, thus requiring new X-rays.  Repetitive popping or cracking of your spine or any joint on a daily basis can create spinal instability, arthritis, and ligament damage over a long period of time.
• Choose a pillow with the proper thickness.  When lying on your side, the pillow should support your head and neck so that your nose is aligned with the center of your body.  If you prefer lying on your back, make sure the pillow is placed under your head and neck, not your shoulders. The thickness should support the neck so that the forehead is level with or slightly higher than the chin.
•  Avoid sleeping in an upright position. The muscles of your neck will grow tired of holding the head, leading to sustained stretching of muscles, ligaments, and nerves, as well as abnormal forces to the spinal bones.
• Avoid sleeping in such a manner that the head and neck are not equally supported.  For example, don’t lie on a couch using the armrest as a pillow or lie on your side holding your head up with your hands.  This creates forces that can lead to shifting or misalignment of the spine.
•  Avoid tilting the neck back too far or for long periods of time.  This can overcome the ability for the muscles and ligaments to hold the spine in place.
•  Use the 4-finger rule when reading. Keeping a space of at least 4 fingers between your chin and chest will prevent sustained stress to the muscles of the back of the neck.  This is a good idea for any activities that require the head to be flexed downward for long periods, such as reading or sewing.
• Do not have your hair professionally washed with your head and neck supported backward. Hair salons frequently provide services that require their client to have their neck resting on the lip of a sink,  putting force to the upper neck, especially the bone we adjust (atlas), creating the potential for misalignment.  You can request that your hair be washed with your head and neck freely leaning forward over the sink.
• DO NOT  permit anyone to “Pop or Crack” your Spine. Your spine is a protective cover for your spinal cord.  Chiropractors are highly trained doctors who know when and when not to adjust your spine and any contraindications to manipulation in your particular case.  A well-meaning friend or loved one may want to walk on your back or give you a bear hug to “pop or crack” your back or twist your neck to crack it. Although the sound coming from your back may resemble a chiropractic treatment, it is not. Since your spinal cord is inside your spine and controls every function of your body, a high degree of certainty, expertise, training, and thought must be put into the proper direction, force, and timing of an adjustment. The well-meaning friend or loved one can cause a rib or spine fracture, spinal cord or spinal nerve damage, resulting in serious injury.
•  When visiting a dentist, request to be positioned so that your head and neck are tilted back as little as necessary.
•  Use caution when doing any exercises to avoid pulling/pushing to the head/neck.  When doing sit-ups, cross your arms in front with your hands on opposite shoulders rather than holding the back of the head/neck.
• Never use the head to lift or support the body.  Yoga and Pilates exercises are great, but avoid positions such as headstands or any other position that uses the head or neck to stabilize the body.
•  Pay attention to signs of fatigue.  Muscles and ligaments are responsible for holding the atlas bone in place.  If you overwork these muscles and ligaments, you increase the chance that they will allow the spinal bones to slip out of place.  So, if you notice muscle fatigue, take a 5-10-minute break from what you are doing to allow your muscles to recover.
•  When traveling in a car or plane, make sure the neck is supported. A horseshoe-shaped neck pillow works the best, but a rolled-up towel or cloth will work as well.  The thickness should support the neck so that the forehead is level with or slightly higher than the chin.
• There are no side effects that would prohibit you from driving after an adjustment unless you already have a health issue that limits you.

Possible Reactions to the Initial Correction

There are over 300 trillion nerves in the spinal cord that are responsible for the regulation of every cell, tissue, and organ in the body.  Therefore, there is a wide variation in responses one may experience when interference is removed, and nerves begin to heal and function properly.  These reactions can be a positive sign that healing is taking place.  Since your condition typically involves inflammation, you may not experience significant pain relief after your first couple of treatments.  The alignment of your spine is crucial to the healing process.  Once the spinal segments are properly aligned and the proper nerve supply starts to return to the nerves that were pinched, the inflammation will begin to recede, as will your pain, as your body begins to heal itself.  The longer your spinal misalignment or injury has gone untreated, typically the longer it will take to diminish in pain or correlating symptoms.

The following is a list of possible reactions that you may experience.

1. Cold-like symptoms (runny nose/sinus drainage)
2. Headaches
3. Muscle soreness
4. Popping or cracking in the spine (from spinal reconstruction)
5. Pain in the area of an old injury
6. Diarrhea
7. Fatigue
8. Temporary increase in pain in the treated areas.

As nerves begin to heal, these and many more interesting changes could occur in the body.  Remember, it took a long time for your body to break down to this point, and it will take time for symptom relief, muscle and ligament restructuring, and continued healing of the entire body.

Proper Shoe Guidelines

We request that when you come in for your regular visits, please wear shoes with a secure back.  A dress shoe or sneaker with a thick heel is ideal.  This allows the doctor to accurately perform leg length checks.  We also request that if you wear foot orthotics, you leave them in consistently or leave them out consistently on each visit.  So when the doctor measures your leg length, he will find consistent results.

Heat or Ice????

Immediately following an acute injury, one should never apply heat to that injury.  With any injury, the body will respond with inflammation.  Inflammation is a source of pain and tissue restriction.  Heat will increase this response, leading to more pain and greater motion restriction.  Although heat feels good and soothing at the time, it can trigger a rebound of inflammation after application, causing more pain.  As a result, folks apply more heat to help, which creates a cycle of increased inflammation and pain, further deteriorating their condition. After the first two weeks of an injury, heat may be applied for no more than 10-15 minutes per hour.  Even when heat is appropriate, prolonged use can cause damage or increase pain. A big no-no is to sleep with a heating pad on your condition.  The same goes for ice.  It should be applied for no more than 10-15 minutes per hour.  If ice is applied for too long, the body will respond with inflammation by surging blood to the area to protect the tissues from freezing, which will cause inflammation and, again, more pain.