A Conversation with a Chiropractor about Chronic Pain

A Conversation with a Chiropractor about Chronic Pain

Dr. Robert Hayden

Dr. Robert Hayden

Editor’s Note: As we have expanded our chronic pain coverage at the National Pain Report, we realized that we hadn’t covered chiropractic medicine very much. We spoke with the American Chiropractic Association who introduced us to Dr. Robert Hayden.

“The use of narcotics to treat pain is overused and should be a last resort for addressing chronic pain, and too often it isn’t.”

Those comments from Robert Hayden, DC, PhD, FICC, a Griffin, Georgia chiropractor and spokesman for the American Chiropractic Association underscore how his profession views the chronic pain environment.

“The chiropractor should be the first to be consulted,” said Dr. Hayden, who acknowledged that his profession is still only occasionally not perceived as a mainstream provider, “although we have come a long way,” he said.

Hayden’s personal journey to chiropractic treatment is a little different. He was a critical care nurse in the VA for years. The VA, and all of its bureaucracy and ineffectiveness, frustrated him. He thought he could do better. It also taught him something else, the importance of a multi-disciplinary approach to treating patients.

He doesn’t see himself as a standalone solution.

“I grew up in a multi-disciplinary environment,” he said. “We are all cogs in the wheel.”

He thinks any chronic pain treatment should begin with the most conservative approaches, including chiropractic. He said that level of care, which involve cervical spine adjustments, for instance, “are hundreds of times safer than taking an ibuprofen.”

And while he and other try to identify and remedy the source of the pain, he also understands that it’s not always that simple.

“Sometime we will need referral or co-management,” he said, which includes internal medicine, surgeons, family therapists and massage therapists to name a few. “I have a good network, and most of us do.”

For instance, the high incidence of depression that accompanies chronic pain is an area of concern.

“The rate of depression is a big deal and often exacerbates the very pain we are trying to treat,” Dr. Hayden said. “When a patient can start to feel a little hope, we can make steps to regaining health.”

He is past president of the Georgia Chiropractic Association and an unabashed promoter of his profession.

“It’s amazing how much chronic and recurring pain there is,” he said. “My profession simply says that conservative care should be the first act.”

Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, manipulation is receiving more widespread attention.

Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.

It’s about finding the source of the pain which is often found in musculoskeletal origins and an adjustment or realignment can help, but sometimes it’s other things like stress, work, and relationships.

“Our job is to listen and then act, not the other way around.”

Authored by: Ed Coghlan

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Good idea!

I began my journey of pain while undergoing chiropractic adjustments. Had I known at the time that I had Ehlers-Danlos Syndrome ( a collagen disorder that effects the ligaments and tendons), I would not have let a chiropractor near me!

I had kyphosis in my neck, and after adjustments, began having severe migraines. Eventually my neck collapsed, and I had to get a new vertebrae, and some nifty screws and pins.

I also had constant pain in my lower back, and it was also adjusted to the point my sciatic nerve became impinged, and once again, I got a new vertebrae and some nifty screws and pins.

After 5 low back operations and nearly 5 years on disability I felt there was little or no hope for a better and more productive life and I was only 34 years old.

Going to see a Chiropractor was out of desperation and like most pain patients, we try anything if it might help. I never had a medical doctor suggest that I see a Chiropractor and back in the late 80’s and early 90’s most MD’s had nothing good to say about them. Doctors were told: stop bad mouthing Chiropractors and most of them complied.

My first experience was all positive, it wasn’t a quick adjustment and out the door. The treatment took nearly an hour and consisted of hot packs, ultrasound, interferential for muscle spasm, trigger point massage and then a good 10 minutes of intense massage. When I was done my body was soaked in sweat, when I went to stand up I was dizzy and as I started to get dressed I realized - I felt better - not great but better than when I first walked in. After that visit I made appointments for 6 more visits that week and within 6 months I had seen my Chiropractor for over 50 treatments. A short time later I was able to start a part time job and get off of disability. My medication was reduced to Excedrin from Tylenol # 3. For the next 4 years I averaged close to 100 visits a year.

Due to the nature of my back problem I knew my Chiropractor couldn’t cure me but he sure did a great job of getting me back to being a productive member of society, a better husband and a better father. The Chiropractor did what no medical doctor would do; he gave me longer periods of time of feeling better and stronger.

I agree with Dr. Hayden on a lot of his points but I don’t feel that a Chiropractor should be the first ( doctor ) to be seen by a person that just injured their back or neck and is in acute pain and other serious symptoms. Before any kind of manipulation is done I would want to know just how bad my back is, a spinal or cervical manipulation might cause further injury. My own Chiropractor never once did a manipulation of my low back, he had seen the MRI report and the Nerve Study results and he felt that it wasn’t worth the risk of causing more of a problem and making my condition worse.

Its my opinion that most Chiropractors are not trained to make the initial diagnosis on a back or neck injury when symptoms presented involve nerve damage or nerve involvement. Yes most back injuries are muscular in nature but I would feel better if first I was seen by a specialist like a Neurologist. If it does turn out to be muscle / skeletal injury then full speed ahead with the Chiropractor and lots of heat and PT.

Thank you,

John S