Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Warning! Complex Spinal Operations on the Rise. But is it Safe?"

This article caught my attention because of the sheer numbers involved. In addition, I recently saw a patient who's doctor recommended surgery for his chronic low back pain. After coming to me for a second opinion, I suggested a more conservative approach of Chiropractic therapy, stretching, exercise and simple home care. After three weeks, he is already feeling better than he has been in the last two years. Now he's grateful he tried Chiropractic before opting for surgery like his doctor had suggested. (The surgery suggested would have involved a spinal fusion, mentioned in this article, that would have surgically combined two separate vertebrae in his spine into one)

Now on to the article. This piece was published in the Journal of the American Medical Association. In it, it was revealed that the use of complex spinal surgery to treat back pain has exploded in the last six years. Even though these operations are more expensive and riskier than simpler therapy, and not necessarily more effective.

"It was a bit of a surprise to see how big the increase was," said Dr. Richard A. Deyo, professor of family medicine and internal medicine at the Oregon Health and Science University and lead author of a report published April 7 in the Journal of the American Medical Association. "A 15-fold increase over a short period of time was more than we expected." Several possible explanations exist for the increase, money among them, Deyo said. "There are financial influences at play," he said. "You get paid more for complex procedures."

Deyo and his associates looked at a particular problem, Spinal Stenosis. This is when the 'holes' in your back, where nerves travel through get progressively smaller and smaller. Without intervention, the smaller the hole gets, the more irritation and compression it can put on the nerve passing through. Eventually this can be a huge problem not only causing pain but loss or function, muscle wasting and numbness, just to name a few.


Deyo and his team looked at Medicare claims from 2002 to 2007. Over that period, they found that surgery for spinal stenosis actually decreased slightly. However, of the operations that were done, complex surgery rates shot up a staggering 15 times higher! Meaning, in spite of more conservative treatment options, including simpler surgery, doctors were resorting to complicated surgery far more often. Not surprisingly, the study also found related hospital costs over the same time period increased 40%.


The costs of simpler surgical options were reported to be $23, 724 but the costs of more complex spinal fusion surgeries were found to be $80, 888. In addition, patients who underwent complex surgeries spent two more days in hospital and were 3X more likely to encounter a life-threatening complication related to surgery.


Now the big question remains, "...was it worth it?". The surgical literature does not appear to justify the extra cost and hazard of the complex procedures for most people, Deyo said. "Most of the evidence suggests that in terms of pain relief and functional recovery, there is not much advantage in terms of complex procedures," he said. "There is even a possibility that the net benefit of surgery is lessened because of this."

Wow. Now I know many people will counter this study occurred in the states and the results would likely be different in Canada. But the question is, "... are you sure?" With our population aging and the already accepted lifetime incidence of low back pain to be near or above 80%, isn't it likely that doctors will suggest surgery more and more?

I suggest that the answer is Yes. Unless we start looking at other options like Chiropractic. That's right, not only has Chiropractic been proven as both effective and safe but Chiropractic by it's very nature is Preventative!

As everybody knows, an ounce of prevention is worth a pound of cure! So if you've been suffering from back issues, go see a Chiropractor. Not only can you find relief but you can learn strategies and techniques to keep  you back and body in good shape, hopefully avoiding a costly surgery later!


In the Commercial Drive neighborhood of East Vancouver? Drop in and see Dr. Chan or visit his website here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "What's the Difference Between Chiropractic and Physical Therapy?"

This was an article that appeared in the October issue of the BC Chiropractic Association newsletter. The article was written by a physical therapist; Dr. Jacques Beauchamp, PT, DPT, SCS, OCS, ATC, CSCS. It gives a brief insight on the difference between Chiropractors and Physical Therapists. The whole article actually compares the difference between; Chiropractors, Physical Therapists and Medical Doctors but I have decided to just high-light the difference between Chiropractors and Physical therapists here. So the following is a mere excerpt of the entire article.

" A Chiropractor is a health care professional that diagnoses, treats and assists in the prevention of mechanical disorders of the musculoskeletal system, particularly the spine, as theoretically these disorders affect a patient‟s general health via the nervous system. A chiropractor‟s purpose is to restore function and stability to your spine. This is done by realigning the vertebrae in a patient‟s spine using spinal manipulation. Releasing tension in the spine allows for muscles to be relaxed and relieving pain associated with the mis-alignment such as back pain, neck pain, and headaches, to name a few. A chiropractor also affects the patient‟s nervous system. The nervous system consists of the brain and spinal cord. The brain is at the very top of the nervous system. The spinal cord runs through the spine and branches off in pairs at each vertebral level. The nervous system controls every muscle, organ and cell of your body. With correct alignment of the spine, it allows the brain to talk to every part of your body which pro-motes better movement and balance.

A physical therapist, on the other hand, is a health professional that evaluates, diagnoses and provides treatment to individuals to develop, maintain and restore maximum move-ment and function throughout life. This includes providing treatment in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Components of movement and func-tion that are evaluated by a physical therapist include strength, range of motion, flexibility, balance, posture, body mechanics, coordination, endur-ance and general mobility such as walking, stair climbing, and getting in and out of a chair or bed. A physical therapist evaluates the components of movement and develops an individual-ized program to decrease deficits and restore function. Physical therapists help people with orthopedic conditions such as low back pain or osteoporosis; joint and soft tissue injuries such as fractures and dislocations; neurological conditions such as stroke and Park-inson's disease; workplace injuries including repetitive stress disorders and sports injuries. Physical therapy treatment programs consist of educa-tion about the cause of the problem, “hands on” manual techniques and instructions in exercise to improve function."

So I hope this sheds some light on the differences between some of the differences between Chiropractors and Physical Therapists. 

However, I will share some observations that I have seen in my years of practice so far. Any good health care professional that you see to address pain and dysfunction should also be advising you on home care. By that I mean proper stretches and exercises you can do at home or the gym on your own time. Anyone that you see for treatment that lets you leave without advising you on stretches or exercises is probably doing you a disservice. So be wary. If you must, insist on stretches and exercises that you can do to speed your recovery and possibly prevent future problems. But then again, if you have to 'insist', that might be a bad sign alone.

Secondly, I know Physical Therapists are becoming increasingly instructed on 'joint manipulations' to improve function and reduce pain. But I can tell you, Chiropractors learn the technique very early on in their four year education program. Personally, I started adjusting and treating real live people 6 months into my four year program. So I got lots of practice. I'm not sure how long Physical Therapists are trained on manual manipulations but I'm pretty sure it's not as long. 

There are nuances about manipulations or 'adjustments' that take a great level of skill and technique to perform safely. Yes, I do mean safely because you can possibly harm someone if you don't do it correctly. (From my own experience, I remember a classmate of mine actually causing some back pain where there was previously none because I volunteered to be his subject so he could practice Chiropractic adjusting..... Oh well. I suppose, every health care provider should understand what it feels like to be on the 'other side' and appreciate what our patients are dealing with when they seek care.)

So that's it in a nutshell. If I were a patient suffering from back or neck pain or any other musculoskeletal ailment for that matter, I'd want to go to the professionals I knew specialized in the stuff and practiced lots. A whole lot!

If you're in the Commercial Drive neighborhood of East Vancouver come visit Dr. Dominic Chan DC or visit the website;

COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!!

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Ouch! Osteoporosis Drug Linked to Rare Leg Fractures!"

This news story definitely falls into the "Ouch!" category and is yet again a cautionary message to those who take prescription medication. Especially for conditions that can respond well to good old fashion sensible dieting, exercise and a healthy lifestyle.

This story revolves around a popular class of drugs called Bisphosphonates, often prescribed to fight the effects of Osteoporosis and fractures! The common names of these prescribed medications are Boniva and Fosamax. 

Osteoporosis is a progressive 'thinning' of the bones and depletion of bone density due to loss of calcium and bone proteins. Osteoporosis is generally thought of as an elderly problem that more likely targets women. In both instances, this may not always be the case. Especially with society's demographic leaning more towards an 'older' population, Osteoporosis will obviously become a bigger problem as time goes on.

The details of this report involve an unusual and rare form of fracture of the femur (the long leg bone in your thigh). The problem called, "Atypical Femur Fracture" seems to be unreasonably high in patients who are taking Bisphosphonate drugs, especially for longer than five years.
"FDA is warning again about the possible risk of an uncommon form of fracture in patients who take bisphosphonates to treat or prevent osteoporosis," Rear Admiral Sandra Kweder, M.D., deputy director of CDC's Office of New Drugs, Center for Drug Evaluation and Research, said during an afternoon press conference Wednesday.

"Patients taking bisphosphonates who have experienced an atypical fracture are younger than patients experiencing typical osteoporotic fractures," she said. "In some cases people have fractures of both femurs." 

Such fractures occur in the bone just below the hip joint or in the long part of the thigh bone. Over half of the patients who have had these fractures said they had dull aching thigh or groin pain that started weeks or months before there was a complete fracture, Kweder said.

The optimal length of time to take bisphosphonates isn't known, but FDA officials think these fractures may be related to using these drugs for more than five years, Kweder said.

So as I have stated many time in these blog posts, please, please, please! be informed and educated about the potential side effects of the medications that you are taking! Unfortunately, your prescribing doctor may not be informed about all the potential side effects, especially with new research/news coming out daily.

As mentioned earlier in this post, Osteoporosis is a weakening of the bones that can lead to serious health issues. However, as countless studies have proven now, proper exercise, diet and a healthy lifestyle can make a significant difference in maintaining bone density. If you are concerned about Osteoporosis because of what you see on TV or from friends, ask your doctor about lifestyle changes first before resorting to medications like Boniva or Fosamax.

Better yet, if you'd like more information and are in the Commercial Drive area of East Vancouver, come by to see me or visit my website here;  COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Weight Loss Drug Pulled Off the Market"

This news item that came out just last week revolves around a weight loss drug called, Meridia.

The Food and Drug Administration (FDA) in the US approved Meridia in November 1997 for weight loss and maintenance of weight loss in obese people, and in overweight people with other risks for heart disease. At the time, the FDA had concerns about the potential harmful effects of Meridia because it was known to increase both heart rate and blood pressure in some patients. However, the beneficial effects of weight loss, especially for the obese, was considered to be more important. 


Unfortunately, after years of continuing trials and monitoring in the general population, the FDA has now ruled the potential harm to people is too dangerous for continued approval. It was revealed that patients taking Meridia were 16% more likely to suffer a heart attack, stroke or death compared to people taking a placebo.


Late last week, Health Canada reported that Abbott Laboratories, makers of Meridia, would voluntary take it off the market in this country as well.

"Physicians are advised to stop prescribing Meridia to their patients, pharmacists are advised to stop dispensing Meridia, and patients are advised to stop taking this drug and dispose of any remaining product," said Dr. John Jenkins, director of  the office of new drugs in the FDA's Center for Drug Evaluation and Research at a news conference.

I thought this story was particularly poignant because it underscores the need for people to become educated and informed about their own health. Let me say that through my years of experience and countless patients I see, I have always promoted a healthy lifestyle including, proper diet, exercise and healthy habits. 


But I believe it is common sense that when it comes to health and wellness, it will never come in the form of a pill. I think it is natural to look for an 'easy' option. With society the way it is, who wouldn't want more for less? But with anything worth having, health and achieving a healthy weight takes time and a lot of effort. 

I promise you it's not that hard. Chances are, you are already practicing healthy habits. Brushing your teeth everyday and covering your mouth when coughing are just two common examples of things people do regularly to maintain health. This is naturally where Chiropractic comes in. 


I am not completely opposed to resorting to over the counter pain relievers like Advil or Tylenol from time to time. But I would like people to know that there are natural options out there to help with symptom relief and achieve health. 


If you're wondering how Chiropractic could benefit you and you're by the Commercial Drive neighborhood in East Vancouver, come drop by or contact Dr. Chan here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Can Chest Pain Start with Your Back?... Ask a Chiropractor"

The answer to this question is a definite, YES!

This scenario often involves a patient coming to see me complaining of a sharp pain or discomfort in their chest. They usually tell me they can feel a similar discomfort in their back as well. Breathing is labored and can be quite uncomfortable. Sometimes they'll say things like, ".....it feels really sharp when I cough/sneeze." 

So what is going on here? Well let me first say that pain in the chest should be taken very seriously. If you are experiencing chest pain that is unlike anything you've experienced before, go see your family doctor or emergency room by all means. However, if you have experienced this kind of pain before, or have been checked out and serious causes are eliminated, go visit a Chiropractor.

Here's the reason why. I have seen dozens of patients in my years of practice who have complained of chest pain, that was actually originating in their back. The reason is when you visualize your rib cage and the individual ribs, you will realize, a rib is fixed at the two ends. On one end, a rib attaches to your sternum or "breast bone". By in large this end is relative immobile because you have many ribs all connecting to your sternum, a common end point so to speak. However, the other end of any rib is connecting to individual bones in your spine called, Vertebrae. At this end, the rib can only attach to two smaller vertebrae. As you may be aware,  because your spine is made up of well over 20 of these smaller Vertebrae, there's a lot more movement in the back, and thus, more chances for things to go wrong. 


To add a another layer to this explanation, you have nerves called, Intercostal nerves that shoot off from your spinal cord encased in your spine. These nerves follow each rib from the back and often go to the front of your chest. If there is any problem with your spine, a mis-alignment for instance, this can cause radiating pain from your back, that you feel in your chest.


Why does this happen? you may ask. Well in my practice, I have seen it all. Sometimes, trauma is involved. A snowboarder who falls for instance. A hockey player that gets checked into the boards a little too aggressively. Things of that sort. But sometimes the cause is really innocent. I've had patients suffer this type of injury from sneezing or even putting on a sweater in the morning. 


So if you're suffering from this kind of pain and discomfort, come visit my office just off Commercial Drive in East Vancouver and get some relief! You can also visit my site here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC

"Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "What Your Doctor Won't Tell You About Back Pain"

Many people will visit their family doctors when seeking relief for back pain. Of these people, many will be told that they are suffering from "muscle spasms" and told that it should get better with time. To relieve their current condition, many a times doctors will write their patients a prescription for one or all of; pain killers, anti-inflammatories or muscle relaxers.

If the doctor is thorough, they will advise their patients that many of these drugs may have side-effects and to discontinue use if they suffer any unwanted symptoms. But many times, patients are not told these things. 

The majority of the patients I see in  my clinic do not only want symptomatic relief, but they would like to know 'how' they got into trouble in the first place. Here's where I'd like to shed some light. 

Now I will be the first to say that many a times, injury to muscles is a major component to back pain. But as you may have guessed,  it's not the only thing that's going on. Here's a Chiropractor's point of view.

Just imagine for a second and visualize your muscles under your skin. If you think about it carefully, your muscles aren't just 'floating' in space are they? No they're not. They actually serve the very important function of providing movement for your body. Just as the picture above depicts a woman doing a bicep curl, the muscles are what allows her to bring the weight closer to her. As she contracts her biceps muscles, the weight is brought closer to her as her elbow bends. As she relaxes the same muscle, she can move the weight away from her and straighten her arm. This is a very simple description of your muscles at work.

Now just for a moment, think of the muscles in your back. As they contract and relax, you can move your body, twist your body, bend forward, arch backwards and so on. But they do this because the muscles are attached to and move the bones in your spine. Now if you suffered an injury and your muscles went into spasm, unable to relax, how would that affect your spine? 
Well, you would probably feel; pain, soreness, stiff, unable to move and difficulties performing even the simplest of tasks. A general loss of normal function is a very common complaint for back pain sufferers.


This is why Chiropractic works so well. If you can get your joints to move better, taking pressure off these sensitive tissue, you will feel better. But it gets better, not only do you 'feel' better, you are doing something beneficial for your body; restoring motion. Chiropractic can do this in a natural manner without the use of pharmaceutical drugs that can have some very serious side effects. Chiropractors are highly trained to identify and safely restore function for people who suffering. But in my clinic, I don't just stop there. Once I can get my patients to feel relief from discomfort and pain, I will go on to educate them. I will encourage my patients to be active, exercise and to practice the appropriate stretches to help their body work at it's best. 

If you think about it carefully, your body does not become painful because it's lacking Tylenol 3 or Robaxacet. You are just 'masking' the symptoms and tricking your body it into not noticing the pain. However, your doctor won't tell you this. If you want to get to the "CAUSE" of your back, neck or joint pain, a Chiropractor is likely your best option. 


Come visit me if  you're in the Commercial Drive area of East Vancouver or visit my website here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC.