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

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "What to Expect on Your First Visit with Dr. Chan"

So many people have this question when seeing a new Chiropractor or even a Chiropractor for the very fist time. I thought I would write this post so you can get a good understanding of what to expect on your first visit with me.

First off, the first visit will take about 40-45 minutes. We will start off with a history of your complaint(s). A history is your opportunity to tell me what's going on. Along with questions I ask you, the goal is to find out; How did it start? how long has it been going on? has it happened before? what areas are affected? does anything make it better/worse? do you have medical issues that may affect treatment? does it affect your work/activities? and so on.

The idea is asking poignant questions and getting your account of the issue can help with the overall diagnosis. A trained doctor can have a very good idea of the problem based on the history alone. But most importantly, I need to assess if Chiropractic is right for you. If I uncover things in the history that concern me or things that need further investigation, I will recommend you consult your family physician or suggest other therapies like Physiotherapy or massage. If I think that another therapy is more appropriate for you, I will tell you.

If on the other hand, I think that Chiropractic can help you, I will also tell you. More on this later. The next step is the physical exam and orthopedic testing. The physical exam will give me a better idea of your status right off the bat. I will check for; areas of pain, if the pain radiates or travels to other areas, range of motion/stiffness in the affected areas, muscle strength in the affected areas, etc. I will also check for neurological signs that include reflexes, sensation and strength to assess the health of your nervous system.

Finally, I will use a series of orthopedic tests. Orthopedic tests are used in order to narrow down the diagnosis. These tests can be very helpful to distinguish where the problem is really coming from and what structures or tissues are involved.(To give you insight on how Chiropractors or any doctor for that matter thinks, when a patient presents complaining of symptoms or pain, there are probably a few possibilities of causes. So Chiropractors are trained to narrow down the possibilities until we find the most likely cause of your complaint. Kind of like playing a detective. If we can rule out possibilities one by one, we will often be left with the most probable cause)

For an example, here's a video that demonstrates a specific orthopedic tests called; Yeoman's test. This test is used to see if the source of a patient's low back pain is coming from the Sacroiliac joints that make up your pelvis. 

Once we've completed the physical exam. I will explain to you what my diagnosis is and the reasoning behind it. Then I will explain to you how Chiropractic can help you. When you understand the diagnosis and are comfortable with everything discussed, we can begin treatment.

We will then proceed with soft tissue and massage work. This not only feels good but can help to relieve tension in the muscles that almost everyone can relate to. After this, I will use a series of Chiropractic adjustments to correct your complaint, relieve pain, improve mobility and restore function. 

But before the session is over, I will often leave the patient with stretches and exercises they can perform at home to help speed their recovery. NOTE: In my office, this is pretty much a requirement. I believe everyone should be active and along with Chiropractic treatments, you can positively affect your outcome if you set aside some time to stretch and exercise. Although I can't force you to exercise, I know it will definitely help so I strongly recommend it.

I guess that pretty much sums up what to expect from your first visit to my office. But if you have any questions or comments, leave me a note below and perhaps we could get a group discussion going!

As always, if you're in the Commercial Drive neighborhood of East Vancouver stop by my office or go visit my website;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!! 

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Excess Ibuprofen Ups Stroke Risk"

This article is directly related to a study that appeared a few days ago suggesting a link between heavy usage of Ibuprofen (commonly known as Advil) and risk of stroke. The corresponding research was done by a team of scientists from Switzerland. The team looked at 31 clinical trials involving 116,429 patients. They had each taken one of seven commonly-used painkillers. The study, published in the British Medical Journal, found that those who had taken ibuprofen over a long period of time were almost three times as likely to suffer a stroke.

The painkiller was also shown to raise significantly the risk of heart attacks and deaths caused by heart disease.This study also suggested that Ibuprofen carried the same risk of stroke and death from heart disease as a drug called, Vioxx, which was pulled from the market in 2004 amidst serious safety concerns.

Professor Peter Jüni, of the University of Bern, said: ‘We looked at patients taking these drugs three to four times a day. ‘They were mainly being treated for osteoarthritis with a few who had rheumatoid arthritis. A lot of them are elderly who are already have lots of risk factors and these will then be duplicated with these painkillers.

‘In terms of stroke, ibuprofen doesn’t look very good. If I was in chronic pain I would not take it as the risks are just too high. I would look at the different options.’

In my practice, I see lots of patients in acute and chronic pain and lo and behold, many have been taking Advil before they seek my care. In reality, many of these same patients do not wish to continue taking these medications. They arrive at my office looking for a better solution to their ailments that doesn't require medication. Chiropractic has helped many patients not only resolve their acute pain but to also manage and treat chronic pain as well. Now to be thorough it has to be stressed that the dosage of Ibuprofen in these studies was very high. How high you ask? Well the researchers believe people at most risk would have to take 4 pills daily for a matter of months or even years. So take the results with a grain of salt. I think the take home message is to remind people that although painkillers like Advil (Ibuprofen) are available off the shelf and without a prescription, be careful! Advil is not candy and if you need to take it for an extended period of time to manage pain, maybe it's time to look at alternatives!

In the Commercial Drive area of East Vancouver? Want more information? Click the link here;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!!

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "$300 Billion - The Cost of Obesity"

This article I came across is a sobering reminder of the economic impact of a poor lifestyle and lack of exercise. Obesity is a well known social problem that is only becoming more prevalent as time goes on, especially in the western world.The total cost of obesity and being overweight is $270 billion in the US and $30 billion in Canada.

The $300 billion total cost in the United States and Canada is the result of: increased need for medical care ($127 billion); loss of worker productivity due to higher rates of death ($49 billion); loss of productivity due to disability of active workers ($43 billion); and loss of productivity due to total disability ($72 billion), said the Society of Actuaries (SOA).

For more detail, the standard used here is the Body Mass Index or BMI. A person is considered overweight if their BMI score is between 25 - 29.9. Obesity is considered a score of 30 or higher. 

"Overweight and obesity have been shown to increase the rate of several common adverse medical conditions, resulting in this extraordinary economic cost to society," study author Don Behan said in a SOA news release.

The findings are so grim and important to overall society that researchers are strongly urging insurance companies to offer incentives for people to lose weight. Another SOA survey found that 83% of respondents would be willing to follow a healthy lifestyle program if their insurance providers offered such incentives. 


Forgive me but it disappoints me to no end to think that people need 'incentives' to improve their own health. This is a message that I relay to my patients on a daily basis, "you must keep moving!!". Not just because many of my patients recover faster with appropriate activity and exercise but because it's has so many other health benefits.


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

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Who You Calling Fat?........."

I know that this is the time of year where new years resolutions to become healthier and lose weight abound. So I came across this article about our neighbours to the south that I thought would be interesting. It seems that even though countless research has shown that obesity is a huge, and growing problem, only a small percentage of people surveyed would call their diet, "unhealthy". 

Hmmmm, doesn't seem to make sense does it? Well, here's more about the article. The survey conducted by Consumer Reports found that only 1 in 10 people surveyed called their diet, "unhealthy". What's more, while four in 10 admitted being "somewhat overweight," just 11 percent said they were very overweight or obese — a direct contradiction of previous weight measurements taken by researchers at the Centers for Disease Control and Prevention, which show that 68 percent of Americans are overweight or obese.

 "There does seem to be a disconnect," between reality and the answers most of us give when asked questions about our diet, how much exercise we get and our weight", said Molly Kimball, a registered dietitian at Ochshner's Elmwood Fitness Center in New Orleans.

The authors believe the culprit is a disconnect of what we "think" we're doing and what's actually going on. Many advertisers have lead us to believe that we are making healthy choices by choosing "reduced calories" products or eating so called, "healthy choices". However, the secret is to look behind the box and get a real idea of what you're eating. If sugar, corn syrup or the like is listed as one of the first three things in the ingredients list, there's no way it's healthy for you. Regardless of what kind of labeling is on the front of the package. 

Another thing that researchers have found is that we have a poor grasp of portion size. Many people claim to get the recommended 5 or more servings of fruits and vegetables a day. But do  you know what a 'serving' really looks like? Well, to give you an idea, a 'serving' or 'portion' size is about the size of your fist. Hmmmmm. Now be honest with yourself. Are you really consuming 5 'servings' of fruits and vegetables in your day?

The moral of the story is the intention of becoming healthier and losing weight is far more than just will power alone. Anyone can be motivated to exercise and eat healthy for a few weeks but you need more than that. You need to do some research, get a little bit of education and most importantly, be honest with yourself.

In my clinic I stress the importance of a healthy lifestyle including diet and exercise. Most importantly, people need to be reminded that being "healthy" is much more than not feeling pain.

In the Commercial Drive neighbourhood of East Vancouver? Stop by the clinic or visit the website;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!!