Innova Pain Clinic
Why Do I have to Come Back?
There is a long and short answer to this very common chiropractic question. Let me paint for you this image. A 35 year old mother of 4 kids, comes into my office with neck stiffness, pain in the neck and right shoulder, and she can’t turn her head to the right side. The only reason why she came in is because she has a hard time checking her blind spot while driving. This has been going on for 4 days. She has no idea how it started; it just showed up one morning. She has been taking pain meds but they only help for a few hours.
This situation is pretty common; every chiropractor in St George has seen it a hundred times. We all know how to fix it. It will take from 5-8 treatments to get it resolved. After a consultation and exam, when I visit with patients and provide a report of my findings, I describe for them something called a Therapeutic Treatment Trial. It is the time period for their treatment sessions. Quite often I tell them it will take more than one visit to get them better. Most of the time, people understand that it takes time for the body to heal. Sometimes I hear the question “Why do I have to come back?”
The brain maps nerve pathways to all the muscles of the body. The more often those pathways are called, the easier it is to call them.
The answer is Neurologic Entrainment. This is the process that the brain uses to make nerve connections faster and more efficient. It is used for memory, muscle patterns, and pattern recognition and associations. The more frequently a pattern is called the more easily it can be called. It’s kinda like speed-dial for your brain. Quick, say aloud your Social Security Number. Now say your spouses number. You might have some difficulty recalling your spouses number, and your excuse is “I never need to use it.” That’s it exactly. You use your own pattern frequently so it is easier to recall that pattern.
This entrainment is not limited to memory. Try this experiment: take a sheet of paper and sign your name on it. Note how much effort is required by your muscles and your brain to make those movement patterns. Now just under that, sign the name George Washington. Unless your name happens to be George Washington, you will find that it takes significantly more effort to make that pattern of muscle movements. Your own signature is a pattern that is recalled often, so it is easy to recall. The other pattern is much more difficult because it is uncommon. For fun try signing the name George Washington backwards. Even the micro-patterns (like ‘wash’ and ‘ing’) have brain pathways. When we try to sign Egroeg Notgnihsaw, it takes even more effort.
Our brain creates connections between nerves and maps routes to get a desired effect. With repeated use, those pathways get easier to call. This happens with muscle spasms. The longer a muscle spasm remains sustained, the easier it is for the brain to maintain that spasm. It takes less neurogenic effort to get the same result. So for my patient described above, she has had this muscle spasm for 4 days. I can treat the imbalance, but it will return in a few hours. After repeated corrections, her brain will unlearn the pattern and she will return to normal.
How long it takes depends on each individual. But the sooner a person seeks care the faster they heal. It takes time for the brain to dismantle the machine of inflammation and spasm. It takes even longer when that machine has been entrenched over several days or weeks.
Some look for muscle relaxers to fix the problem. But that approach does not actually retrain the brain. All it does is block the signal after it has left the brain. The brain is still firing the signals and calling the pathway, but that signal is not reaching the destination.
So back to our question, “Why Do I Have to Come Back?” It takes time for the neurologic entrainment to unwind. How long is difficult to say. It’s like predicting the weather, the further out you go, the less reliable the prediction will be. If your chiropractor is predicting 15 to 18 or even 20 visits to fix your complaint, find a new chiropractor fast. I don’t care how smart he is or what school he went to. No one is able to predict a correction with certainty at 20 visits. A safe and realistic plan would be less than 8 treatments with this key: we can do a reassessment after that. Some people get better faster, some slower. Treatment plans that contain more than 12 treatments are too unreliable. If your current chiropractor says something like “we will treat your condition every other day for two weeks then take another look at you and recheck,” keep that guy. He is being realistic and honest.
This cake is not quite done. Let’s give it 2 more minutes then recheck it.
It’s like baking a cake. You put it in the oven for 18 minutes, just like the recipe says. After 18 minutes you check it. It might take a few more minutes to finish baking. So set the timer for 2 more minutes. Some times you might check the cake 3 or 4 times, adjusting the cooking time by adding 2 minutes each check. We all do this. Aim short then re-evaluate. Our plans are fluid and dynamic. Don’t over-estimate and burn the cake!
Neurologic entrainment is a relearning of undesired brain patterns and wind-down of the established pathways. In the chiropractic world, this is one of the reasons why you need to come back. Remember your good chiropractor will have short treatment plans and frequent re-evaluations. By the way, the mother above, with the 4 kids and neck pain only needed 3 treatments and she fully recovered.
Dr. Andrew White | St George Chiropractor
Featured image courtesy of FreeDigitalPhotos.net and Mr Lightman