For Healthcare Professionals

The standard treatment for most musculoskeletal syndromes in primary care settings is either rest, medication, or physical therapy. Next in line are expensive diagnostic testing or Orthopedic consult if there is no significant improvement.

In certain situations these approaches are proving inefficient, ineffective, costly, time consuming, and resulting in low patient satisfaction. Cost-efficient and evidence-based driven managed-care organizations or patients that want to avoid medications require a better solution.

You may have heard some patients swear by Chiropractic. You may also have heard stories of discontent. Recent evidence demonstrates effectiveness for a limited number of conditions.

But how does a clinician decide when Chiropractic will be effective - especially when there is some overlap with physical therapy methods. The many variables in Chiropractic technique, in education, thoroughness, and skill levels make it even more difficult to confidently consider referring to just any Chiropractor.

Chiropractic is more effective than massage, physical therapy, or rest when the pain source is primarily from a restricted / inflamed joint. The pain is usually reproduced or worsened with movement or direct challenge, better at rest (at least positionally unless really acute), and pathology has been ruled out. Muscle tension, posture and nerve irritation will typically not completely normalize until the joint function has been restored. Restoring paraphysiological joint space is what chiropractic manipulation excels at more than any other discipline.

Chiropractic care is effective for most mechanical / functional musculoskeletal disorders in combination with proper therapeutic / rehabilitative exercise. A comprehensive list of conditions can be viewed at: conditions treated.

The following is a brief list of conditions that Chiropractic is superior to other methods of conservative care:

Conditions that quickly respond to Chiropractic
Sacroiliac Pain Pain is one-sided, present more on weight-bearing or walking. Some dull pain in buttock or thigh but rarely refers below knee unless piriformis is involved.
Rib-cage pain EKG negative, No history of blunt trauma, pain on respiration, pain worse on movement (twisting / reaching). May refer from sternum to shoulder blade even into ipsilateral extremity (dull, negative Neurological signs).
Pain between the shoulder blades EKG negative, No history of blunt trauma. May or may not have pain on respiration, pain worse on movement (twisting). A degree of pressure and tightness can be constant.
Wrist or Ankle pain on extension / Dorsiflexion
There may or may not be recent minor trauma / compression. X-ray negative. Pain is not very acute. There is no inflammation or soft tissue damage / tenderness. Pain / restriction is felt at end range of movement.
Headache The occiput and or upper 2-3 cervical transverse processes are very tender with superimposed muscle fiber spasm. Palpation may or may not reproduce headache. (Vertebral artery screen / BP measures, assessment of risk-factors determine extent of manipulation - non force techniques available).
Uncomplicated neck or back pain, or some radiculopathies. No or intermittent extremity involvement. Sudden / recent onset usually traced to uneven or sudden movement in flexion or to one side. Spinous or transverse tenderness. Moderate ROM restriction in 1 or 2 directions.
Why our office?
We perform thorough evaluations to rule out possible pathology, and always tolerance test initial treatment.
We only use evidence - based techniques appropriate for condition, patient size, age, and risk-factors.
Always perform treatment trial of 4-6 visits to determine if Chiropractic will be effective or not (no needless never ending treatment plans).
Efficient treatment plans focused on patient self-management and clinical progress.
Prompt written or telephone communication as needed on findings and updates.

If you have a question or concern, or just would like to discuss a particular case or condition please do not hesitate to contact us.


Personal Care Chiropractic & Massage, P.C.
© copyright Nicholas Stamoulos, D.C. 2008. All rights reserved.
104 Massachusetts Avenue
Arlington, MA 02474
781 641 4482 fax 781 641 4483