Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC: "FYI: How Long Will it Take Until You Get Better?"

This is a typical question that many patients have before they begin treatment at my office. Now I can't speak for other Chiropractors but I hope to shed some light about how I come up with a treatment plan for my patients. I must stress that every patient is considered individually and it's hard to apply generalizations when it comes to care but I hope this post helps to clarify what to expect in my office. 

It all begins with the first visit. Here I take a thorough history and get a chance to 'see' what we're dealing with. I want to get a sense not only for the nature of the discomfort/pain but I also need to assess how the injury is affecting your function. For example, is it keeping you from work? everyday activities? sports? hobbies? etc. This gives me an idea of the severity or acuteness of the situation. If there was some serious trauma involved, ie. a motor vehicle accident, I generally will recommend three sessions a week for at least the first two weeks. If the injury is moderate, I might recommend a plan of sessions twice a week for two weeks. I inform my patients that the first two weeks of care is very important because from my experience, patients should respond fairly quickly to Chiropractic care. At the end of two weeks, we perform a re-evaluation on the patient. The re-evaluation allows us to monitor and mark the progress we are making. It also serves as 'checkpoints' to ensure that we are reaching our treatment goals and that everybody is satisfied with the progress. At the end of the re-evaluation, I generally like to discuss the treatment frequency again. The goal in my office is to use less and less office visits and encourage the patient to become more active in the recovery process by participating in more home care.

That is another key component in a patient's progress, home care. From nearly the beginning of treatment in my office, patients will be shown and encouraged to practice exercises and stretches at home. I believe that patients can do a lot to further their progress at home if given the right instruction and guidance. But I make it very clear, "If you can do these exercises and stretches at home, you will get better faster!"

Here is obviously where a huge variation in recovery times comes in to play. Some patients are very good at following my home care instructions, they understand the importance of active home care and they participate diligently. It's no wonder that they respond faster and require fewer office visits. However, other patients do not follow home care advice quite as consistently and they tend to take longer to progress. It's really not rocket science but it is up to you.

As time goes on and the patient feels better and better, I strive to spread out the frequency of office visits as much a possible. One of the goals of treatment is to get a patient to the point where they are returning for maintenance care or 'tune-ups' only rarely. Some of my patients have achieved a state of health where they feel they benefit from Chiropractic once a month, others only a couple times a year! 

I hope this sheds some light to the question, " How long will it take until I get better?". If you still have questions, please leave a comment here or visit my website; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC- " FDA Moves to Lower Levels of Acetominophen in Painkillers Over Concerns"

The Food and Drug Administration (FDA) in the US has recently lowered the acceptable levels of acetaminophen in prescription pain killers over health concerns. Acetaminophen is more commonly known by it's brand name; Tylenol. Tylenol is a commonly used pain reliever and is also often used to reduce fevers. However, the FDA is focusing on prescription drugs that contain acetaminophen to deal with pain. The drugs in question include Vicodin and Percocet. These drugs may be familiar to some who have gone to their family doctor to treat very severe, intense pain. The problem with the drugs in question is that they have been linked to severe liver damage.

"We're taking a major step in the agency's overall strategy to reduce the risk of intentional and unintentional liver damage that can occur if a patient takes too much of the common painkiller acetaminophen," said Dr. Sandra Kweder, deputy director of the Office of New Drugs in the Center for Drug Evaluation and Research (CDER) at the U.S. Food and Drug Administration.
"[But] let me also be clear that, when taken as directed, acetaminophen is a very safe product. Our goal is to make it even safer."

Currently, over the counter acetaminophen is available in pills up to 500mg. But note, the recommended dosage is no more than 4 in a 24 hour period. This is very important to follow because if you look at the packaging closely, the risk of liver damage is stated on the box as well. 


Here's my concern with this issue. In a perfect world everyone would be very cautious of any medication they are putting into their bodies. This would also mean reading the label including potential side effects very closely. But I'm certain not everybody may be heeding this warning. I have no doubt that there are some people out there who are taking more than the recommended dose because they are desperate to find some measure of relief from their pain. 


But let's be clear, acetaminophen (Tylenol) will not cure your pain. The way it works is to trick your brain into not recognizing the pain as easily for the time being. However, this effect can only last a short while, a few hours if you're lucky. Afterwards the pain will return, often unchanged. 


If you find yourself in a situation where you are resorting to regular doses of acetaminophen (Tylenol) to manage pain and discomfort (or any other pain reliever for that matter), please know that there are options out there. Chiropractic has helped many patients address the actual cause of their pain and discomfort naturally. Along with some simple exercises and lifestyle changes, a Chiropractor can help find a more sustainable solution to your pain.

Although many people think about over the counter pain relief to address their complaints, not as many people think of the potential side effects. This is one of the major reasons that many patients come to see me. They are looking for a natural alternative to addressing  and treating their pain. Not only that, they are looking for a solution that gets to the cause of the pain, not just the symptoms. 

Chiropractic is a well established form of health care in the western world and it's acceptance is only increasing with time. Some would argue that using manual therapy to address health concerns has been practiced, in various forms, for thousands of years in other cultures, namely in the east. If you're still wondering about how Chiropractic can help you, leave a comment or visit the website here;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Many Acute Low Back Pain Patients Don't Need X-Rays"

This is the message being promoted by a major physicians group from the US. The American College of Physicians is claiming that X-rays, CT scans and MRI's are routinely ordered for patients with acute low back pain, but may be unnecessary. What's more, the college is reminding people that these scans are not without risks. All of the above mentioned imaging techniques expose patients to radiation.

Another concern brought up this doctors group is the presence of 'false positives'. What that means is that using these scans whether it be X-rays, CT scans or MRI's, can expose findings that may be completely unrelated to a patient's symptoms. For example, it is possible to see what appears to be abnormalities in scans, such as bulging discs, while the patient reports no symptoms at all. However, once such abnormalities are uncovered, they may be treated, potentially with an unneeded surgery, experts say.

This of course, brings up the problem of cost. "Health-care costs are increasing unsustainably, and a crucial concern for everyone is how do we maintain or improve the quality of care without increasing costs? One way is for physicians to stop ordering tests that may not be beneficial," said Dr. Amir Qaseem, one of the authors of the back pain guidelines, and director of clinical policy in the medical education division of the American College of Physicians (ACP) in Philadelphia.

The new guidelines on diagnostic imaging for people with low back pain are published in the Feb. 1 issue of the Annals of Internal Medicine.

Here is some more sobering information about imaging and back pain. Low back pain is very common in society today. In fact just about everyone will suffer a severe bout of low back pain in their lives according to the U.S. National Institute for Neurological Disorders and Stroke. Data from the ACP states that about $90 billion a year is spent on treating low back pain in the US alone. In 1997, the average cost of treating a low back pain patient was reported at $4,795. By 2005, this cost had ballooned to $6,096!!

Unfortunately, for patients increasing cost does not seem to be resulting in better outcomes. The ACP cites findings from six different studies that conclude that patients with spine problems that got radiological studies did not significantly benefit. To be more precise, these patients reported similar or WORSE scores on quality of life and physical assessments scores compared to people who did not undergo scans. The ACP went on to add that abnormal findings often do not change treatment plans for patients. In addition, it is very difficult to say with certainty that an abnormal finding on a scan is indeed the cause of the patient's pain. To shine a spotlight on this point,  a study conducted on patients over the age of 60 who did NOT have back pain was surprising. The study found that about 90% of these subjects showed signs of spinal degeneration or bulging discs on scans, even though they did not complain of any symptoms.

Now as an aside, I am not one promoting the idea of forgoing scans altogether. I think in certain situations an X-ray, CT scan or MRI is absolutely crucial to the proper diagnosis and treatment of a patient's complaint. However, in my practice I have encountered dozens of patients who's doctors ordered an X-ray only to come back negative of any findings at all. As one can see, this can be very frustrating to patients because they truly are having pain and dysfunction but seem no closer to an answer.

In my practice, I use a series of physical exam procedures and orthopedic tests to reach a diagnosis. This method is like working backwards, so instead of trying to find out where a problem is coming from, I try to rule out possibilities so I know what it isn't. Admittedly, this process is not 100%. In fact it's nearly impossible to name a test/procedure/protocol that is 100%. But I can say, the results I have seen in my clinic have been very good for my patients and no radiation required!

If you're in the Commercial Drive area of East Vancouver, stop by the office or visit the website;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR;DR. DOMINIC CHAN DC.


Amir Qaseem, M.D., Ph.D., director, clinical policy, medical education division, American College of Physicians, Philadelphia; Anders Cohen, M.D., chief, neurosurgery and spine surgery, The Brooklyn Hospital Center, New York City; Feb. 1, 2011, Annals of Internal Medicine