Patients should have the right to understand what is happening with them. My job is to educate them about their condition and help them understand why they’re having their symptoms. For many, if not most people, the symptoms are not what should be treated. If symptoms alone are treated then they will continuously return unless you treat the root of it. If you think of it as a cause and effect. If you treat the effect then nothing has changed the cause so the effects will return. The trick is to treat the cause not the effect.
To treat the cause, first the cause needs to be found. That comes from the History and Exam. I believe that we should be thorough with this part of the first visit. After a thorough History and Exam, there comes the diagnosis. For some people, the diagnosis is relatively straightforward so we go directly to treating the cause. Granted, if a Patient does not want to treat the cause then I am happy to treat the symptoms.
If a Patient has a complicated issue then it becomes more a challenge to find the answer. I have to admit that I often enjoy this challenge. I look for the correct cause and therefore treatment through the treatment and rechecking the exam. Sometimes, I will send the patient out for more testing. Typically, the correct diagnosis and therefore the correct treatment will bring about relief for the patient. I usually will want to see a reduction in symptoms by at least 25% within two to three weeks. Some conditions take longer and sometimes the Patient’s schedule will slow things down.
I often will treat Patients with chronic pain and have had the issue for many years. In that case, the diagnosis is often a bit more complicated simply because if it was a simple solution, they would not still have the same issue. In some cases, once those issues are correctly diagnosed and correctly treated then the issue starts to go away. In some cases, I can’t do anything about the cause, but I can lead the Patient to a better outcome by finding ways to try to stabilize the condition. The most common example I have for this are people with spondylolisthesis (it’s where a vertebrae slips forward relative to another vertebrae). I can’t reverse the spondylolisthesis but I can help the Patient have less pain and have fewer episodes of pain through strengthening around the slipped vertebrae.
I am a firm believer in Occum’s Razor. The simplest explanation is usually the correct one. The same is true for diagnosis. Furthermore, the explanation has to follow physical principles because the body is governed by physics and chemistry.
Many people do not understand that there are conditions that can be reduced or eliminated. A good example of this are Migraines. Migraines always have a trigger. The trick is to find the trigger. The trigger is easier to treat then the Migraine. Often a Chiropractic adjustment will reduce a migraine, but if we can reduce the likelihood of the Migraine in totality, that is a much better solution. If the trigger can be found and successfully treated then the Migraine should not form. Similar to the Butterfly Effect, if there is no initial butterfly then there is also no eventual effect.
There are multiple ways to accomplish the same thing. So, if a Patient prefers one type of treatment over another, that Patient should be able to choose what they like and dislike for the treatment.
