Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Can the Right Foods Reduce Pain?"

This is a topic that I think is necessary for all doctors to be considering with their patients. Regardless if you're a family doctor, dentist, specialist or chiropractor. Obesity is a growing problem in our society today. With overall obesity rates in the US alone hovering around 30%, it's clear that our diets could be way better. 

Now from a clinical aspect, I see patients who are in varying degrees of discomfort and distress. In the majority of cases I have the opportunity to not only help a patient deal with pain but I also have the chance to educate people on their overall health. This is a fundamental role of a doctor. He or she must be invested in the well being of their patients and if they can impart good advice on healthy diet or lifestyle habits, they should be doing it.

So the topic today is, "... can eating the right foods actually help to reduce pain?". I believe that, yes! it can definitely make a difference. Now everybody has heard the age old adage, "...you are what you eat." Now if that's true, than it stands to reason that eating the wrong things can have a detrimental effect on your overall health. As more and more research is done on chronic health issues that plague humans, a lot of scientists are realizing that inflammation is a major concern.
“Fats in foods can have the greatest effects on the inflammatory process,” says Charles Friedman, DO, pain management specialist of Pain Relief Centers in Pinellas Park.

So what's the solution?  Well a good place to start is with the big "O". No not Oprah, but with Omega fats. By now lots of people have at least heard of Omega fatty acids, but you may not realize where to get them and that there are different kinds.


Omega-3 fatty acids are great to help reduce inflammation and calm stress. Fish, flax seeds and walnuts are common sources of Omega-3's. Omega-6 fatty acids are also essential however too much of it is actually harmful to your health. Omega-6 can be found in packaged convenience foods, meats such as pork, beef and chicken as well as in egg yolk. In western diets it is very easy to overload on Omega-6 and not get enough Omega-3's. In fact is you have brittle nails or suffer from fatigue, it may be an indication you need more Omega-3 fatty acids in your diet!


Another nutrient to consider is Omega-9 fats. This can be found in foods such as; olive oil, pecans, almonds, sesame oil and macadamia nuts. Omega-9 fats are known to help reduce inflammation ,which in turn can help patients suffering from pain. 


Finally, remember when your mom told you to, "....eat your vegetables!". Well, she may have been on to something. Vegetables are known to carry anti-oxidants and these factors can actually help to stop the inflammation process from even starting! Now there's something to chew on. So the next time you're in pain, consider all the natural ways that you could be helping to reduce your discomfort. If you're going to eat anyways, isn't it better to eat smart?


If you like this article, leave a comment and if you're in the Commercial Drive neighborhood of East Vancouver, come visit the clinic. You can also visit my website at; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC: "FYI: Back Pain a Leading Reason for ER Visits"

Did you know that 'back pain' is one of the leading reasons why people visit an Emergency Room? Also among the leading reasons for ER visits include; fever, chest pain, abdominal pain, childhood earaches and injuries involving trauma.

This is concerning because some sources indicate that the average time a patient with a, 'routine' case will wait in the ER is between 3-5 hours. Remember this is an AVERAGE wait time because I know from personal experience that it can be much longer than that. Understandably, people with back pain who visit the ER are in dire straits. In the majority of cases, the pain they are suffering from is severe. On another level, the pain is also extremely worrisome because most of these patients have no idea of what's wrong. They have sought care at the emergency looking for answers and most importantly, relief. 

Well according to Benjamin W. Friedman, M.D., of the Albert Einstein College of Medicine in Bronx, N.Y., colleagues conducted a retrospective analysis of data from the National Hospital Ambulatory Medical Care Survey, an annual survey of nationally representative emergency department visits in the United States, from 2002 to 2006. And their findings may or may not surprise you.


For patients that present to the ER with significant back pain, the chances are good the treatment they will receive is a prescription for drugs. Opioids were given to 61.0% of patients, with nonsteroidal anti-inflammatory drugs given to 49.9%  and muscle relaxants to 43.1%.For those who are not aware, Opioids are pain killers. 

In my clinic I consider it essential that patients seeking care for back or spine related issues gain an understanding of the cause of their pain, not just masking the pain. Many spine related issues can be traced back to strains, sprains and mis-alignments of some sort. But which is which? Patients who present to my clinic all receive a thorough physical and orthopedic exam. The purpose for this is so we can identify the most probable cause of the problem. Starting here, we can devise a sensible, organic and conservative plan to address the issues, not just simply masking the pain.


If you're in the Commercial Drive area of East Vancouver, come visit the clinic or check the website here;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC !!!!

Commercial Drive - East Vancouver; Dr. Dominic Chan DC - "FYI: Torn Meniscus - A Common Misdiagnosis"

I thought I would write this post today because lots of people are gearing up for the Vancouver Marathon coming up in May. In the last 2 weeks I have noticed a handful of patients coming in complaining of knee pain. They are aware the likely cause is increased running as they train harder for the upcoming marathon. However, two of these patients have presented in my office saying their family doctor diagnosed them with a "torn meniscus". Their doctor has gone on to say that this type of injury is very common in runners and they will have to stop running in order to relieve their pain and allow their knee to heal, if not surgery is the answer. 

Misdiagnosis in both cases! The patients in question were understandably concerned about the news their doctors gave them and came to me to see if I could offer any assistance. As with any patient who visits my office, I perform a thorough physical exam including orthopedic tests. Orthopedic tests are tests designed to specifically rule out possible causes for a patient's pain. For the knee in these cases, I performed what is known as Ober's test. The result of Ober's test in both these patients revealed injury to the Iliotibial (IT) Band. This is a long band of connective tissue that runs from the side of your hip, down your thigh to the side of your knee. If overused, it can come under stress and become injured or inflammed. Often times causing pain on the outside of the knee. 

The common course of care in a medical clinic is to order an MRI for these patients. However, an MRI is so sensitive that a majority of the time, it will reveal tears in the meniscus (a cartilage lining within your knee joint). But the catch is, the tears may not be the reason for pain. "Nine times out of 10, it's normal wear and not the source of the pain," says Ronald Grelsamer, M.D., an orthopedic surgeon at Mt. Sinai Hospital of New York. Surgical treatment "will lead away from the real problem."

So what's the solution? After suggesting a slight change to the patients' training routine, home stretches and Chiropractic adjustments, they saw improvements in a short amount of time. The recommendations included interval training such as running for a minute, walking for two. Icing the affected IT band as soon as training was over to limit the amount of inflammation training induced. Appropriate stretches to alleviate tension on the IT band. Finally, we also used Chiropractic adjustments to re-align and stabilize the pelvis and knees. This was done because both patients noticed pain more on one side compared to the other side. This in turn affected their running motion or 'gait' which only made the problem worse. I explain it like riding a bike. Imagine if one of the wheels was severely bent and warped. How well do you think you could ride that bike? Probably not very well, but even if you could, I bet your ride would be very uncomfortable. Now think of your pelvis and two legs/hips. Same idea.


Moral of the story is, Chiropractors don't just treat your back. I'm routinely encountered by patients who see me for issues separate from their backs and they get great results! Not only that but they are so relieved that there are other options for them. So the next time you are suffering from problems with your joints, whether it be in the neck, shoulder, knees, ankles or back, ask a Chiropractor!


Even better, if you're in the Commercial Drive area of East Vancouver, come visit the clinic or check out the website here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!

Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Chronic Back Pain Sufferers; Beware of Surgery!"

Many sufferers of severe low back pain, especially if it is chronic in nature, have weighed the option of surgery to treat their condition. However, this study is another example of why it is prudent to consider other, more conservative options like Chiropractic more seriously. The study in question focuses on the long term outcomes of patients who have undergone spinal surgery and how it has affected their work specifically. 

The conclusion in general is that spinal fusion surgery, an increasingly controversial procedure that has exploded in the last 20 years, leads to HIGHER rates of permanent disability in workers. This is in comparison to those who were treated more conservatively and without the use of surgery.

The researchers in the study randomly selected 725 patients who underwent spinal fusion surgery to treat their chronic low back pain, compared to 725 patients who opted for more conservative treatments. All the patients were chosen from a pool of worker's compensation claims from the American state of Ohio and all patients suffered from chronic low back pain. The selected cases came from the years 1999 to 2001 and further analysis was done 5 years later in 2006 to see how the patients recovered.

The results will definitely surprise you! When the study ended in 2006, nearly all outcome categories were WORSE in the surgical group. Only about a quarter had returned to work after two years, compared with two-thirds of non-surgical patients. About 11% were considered to be permanently disabled compared to only 2% of those who did not undergo surgery. However, another sobering finding was that the use of prescription pain killers at least 5 years later was at about 85% for those in the surgery group! This compared to 49% in the non-surgical group. As an aside,  the researchers also noted that the patients in the surgery group steadily increased their usage of prescription pain killers over the years.


But unfortunately that's not all,  36 percent of the spinal fusion group had complications from the surgery, including meningitis, kidney failure and death. The re-operation rate was also 27 percent in the surgery group, and included three people who underwent four re-operations. And total days off work was also greater in the spinal fusion group (1140 days vs. 316 days).

 "I'm not saying don't have lumbar fusion surgery . . . but it should be carefully evaluated before it's done," said lead study author Dr. Trang H. Nguyen, who practices occupational medicine in Cincinnati and conducted the research while a doctoral candidate at the University of Cincinnati College of Medicine. "The chances are it will have a poor outcome." However, to be fair surgery may be the best option for certain patients, including those who suffer from an unstable spine or who have suffered severe fractures. The problem is that these patients are a very small percentage of patients who suffer from chronic back pain. 

The perplexing side to this story is that these results and results from similar studies have cast doubt on the rationale of surgery for chronic back pain for years now but the rate of surgeries continues to grow exponentially. In spite of continued improvements in surgical equipment and procedures, it seems the long term results for surgery patients is still astonishingly poor.

Now from my own clinical experience I have seen dozens of patients who have seen me because their family doctor or even specialist recommended surgery to treat their back pain. These patients arrive to me looking for another solution that doesn't require surgery and frankly, often see me as a last resort. This is when I get really honest with the patient. First off I inform them that yes, Chiropractic is a conservative form of therapy that has been successful for other people with the same problem. After a thorough history and exam, I often propose a 'trial' run of several sessions to see how the patients respond to care. If they respond well and get relief then everyone is happy and a surgery could be avoided. But, I also inform my patients that they will have to put in significant effort to get better as well, complying with prescribed home stretches and exercises that will help their recovery. 

Now what's my opinion on surgery? I think for some patients, it's the way to go. In my years of practice I can say I have told three patients that, "yes, I honestly think surgery is your best option". But for the vast majority, they respond very well to Chiropractic and are very happy with the results. Most importantly, they just avoided a major surgery and everyone wins!

If you have any questions about this post or questions in general, leave them down below. Even better, if you're in the Commercial Drive neighborhood of East Vancouver, come by and visit or check out the website;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!

SOURCES: Trang H. Nguyen, M.D., Ph.D., occupational medicine specialist, Cincinnati, Ohio; E. Kano Mayer, M.D., staff physician and physiatrist, Cleveland Clinic for Spine Health; Leah Y. Carreon, M.D., clinical research director, Norton Leatherman Spine Center, Louisville, Ky.; Feb. 15, 2011, Spine. 

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