Outside The Spine

Photo by Karolina Grabowska: https://www.pexels.com/photo/crop-unrecognizable-chiropractor-examining-arm-of-smiling-female-patient-4506071/

People are often surprised to learn that I, as a chiropractor, treat other parts of the body besides the spine. But I commonly do assess and treat most of the joints of the body and the soft tissues associated with them, including the hands, wrists, elbows, shoulders, hips, knees, ankles, feet, and even the TMJ (jaw).

Now, to be clear, not all chiropractors choose to work on areas other than the spine and the level of training and scope of practice laws regarding “extraspinal” evaluation and treatment can vary considerably from one practitioner and location to another.

That said, assuming that extraspinal care is permitted by the regional scope of practice, many chiropractors are quite adept at treating joints other than those in the spine. Just as joints in the spine can become misaligned and dysfunctional, so too can pretty much any other joint, and the assessment and correction of joint alignment and movement is one of the primary focuses in the education and training of doctors of chiropractic.

In fact, in my experience, chiropractic treatment often offers a more direct and effective way to address certain common musculoskeletal issues in the extremities than is available through other modes of treatment.

For example, a common issue I see in my office is what chiropractors usually call a “dropped metatarsal head.” This is a misalignment of the joint of one or more of the toes in the area of the ball of the foot that becomes quite tender and creates a lot of pain when walking. To my knowledge, there isn’t even a term for this condition in conventional medicine (most often, the medical diagnoses patients receive for it are generalized descriptions such as arthritis).

Many of the patients who present to my office with this issue have been dealing with it for months, and often have had treatments ranging from medication, to physical therapy, to shoe inserts, to steroid injections – usually without much lasting improvement. From a chiropractic standpoint, this is usually an easy fix – just realign the joint – and we can usually get substantial improvement in symptoms within a couple of minutes. There are, of course, cases that are more complicated than others, but people are often amazed at how quickly the pain resolves once the joint alignment is corrected.

Another prime example is wrist pain (which may or may not be part of carpal tunnel syndrome). Here again, a simple re-alignment of the involved joints and some soft tissue release to relax reactive muscles can often bring about better relief in minutes than was achieved with months of medication, bracing, exercises, and other modalities.

Now, some conditions do require more than just a quick joint adjustment/realignment, especially to get long-lasting resolution of symptoms. But on the other hand, restoration of joint alignment may be necessary to get lasting symptom improvement, regardless of what other treatment modalities may be employed.

In other words, treatments like rehabilitative exercise are great in the overall scheme of things, but if the joint(s) being treated are misaligned and are not moving normally, exercises may not just be less effective than they might otherwise be, but they may actually irritate the condition and make symptoms worse!

Anti-inflammatory treatments such as medications, cold packs, electrical stimulation, or even steroid injections may be beneficial, and even necessary to recovery, but they too will be rendered less effective if there is ongoing irritation and undue stress on musculoskeletal structures from abnormal joint alignment and function.

So, while chiropractic treatment of the extra-spinal joints and associated structures is certainly not a cure-all, it can be a very important piece of the treatment puzzle when it comes to getting prompt, lasting symptom relief and functional improvement.

Until next time…

George F. Best, D.C.