How Long Will This Take?

By: Erin E. Ducat DC, CSCS, FIAMA, CKTP

Sometimes there isn’t a quick fix.

Regardless of the initial complaint, every patient asks me the same question during their examination — “How long will I need treatment to fix my problem?” I look at them in the eye and tell them that given their symptoms, how long it’s been bothering them, their age and other complicating factors I would estimate that their treatment will take an “x” amount of visits over an “y” period of time.

The “x” and “y” values can be highly variable, but most likely will be an accurate indicator of the amount of TLC your body needs to not only remove the symptoms (such as pain) that you are complaining about, but the cause of the problem as well. When a patient has complicating factors (such as age, obesity, diabetes or a sedentary lifestyle), or if they have had the symptoms for an extended period of time, it requires more effort and a longer treatment plan to help them fully heal from the condition.

Most conditions that are treated by Chiropractic Physicians are those of a musculoskeletal nature. In other words, the majority of cases that I see each day are of various aches and pains of differing joints, muscles and nerves. Many musculoskeletal injuries are due to repetitive stress on a certain body part that occurs over time. Although many individuals feel as though it was “sleeping wrong that one night” or “picking up my 3 year old” that caused their acute pain, it is usually a condition that had been incubating for years waiting for the straw to break the camel’s back (pun intended).

Take this patient case for example. Mr. Joe Jones (name is changed for privacy) came to my office with a complaint of low back pain for the last 2 days. It started after he stood on his feet for about 4 hours at a summer outdoor festival as a volunteer. He has never had low back pain before and is eager to remove this pain as soon as possible. Mr. Jones is 45 years old, about 30 pounds overweight, works in an office setting and walks his dog every day for exercise.

During the examination of Mr. Jones, we found that he has extremely flat feet. The lack of support in his arches is causing the hamstring muscles at the back of his thigh to shorten. Combine this fact with his long work hours, sitting at his desk with his knees bent — no wonder Mr. Jones can’t touch his toes!

It’s at this point that most patients ask, “So what if my hamstrings are tight. What does that have to do with my low back pain?” Ah! What a wonderful question. Hamstrings have a lot to do with the way your low back functions. The hamstring muscle extends from the back of your knee to the base of your pelvis. On the top of your pelvis, sits your lumbar spine, or low back. If the hamstring muscle is shortened, every step you take tugs at the pelvis and therefore pulls on the lumbar spine. With repetitive pulling on the spine, irritation of the joints and degeneration of the discs begins.

Now that those hamstrings have been shortened for the past 3-5 years, you have a slightly irritated low back that is just barely keeping up with the challenges thrown its way during regular activities. On that particular day, Mr. Jones added the challenge of standing on his feet for 4 hours. The additional pressure on the feet, hamstrings and low back was simply too much and the joints of the lower back yelled out in protest, or in this case severe low back pain.

Did standing on his feet for 4 hours cause Mr. Jones’ low back pain? No. Not really. It was a process of wear and tear over time that brought Mr. Jones into our office. We can remove the pain in his low back relatively quickly using adjustments and massage to take away the inflammation of the low back. However, until we’re able to support his flat feet, lengthen his hamstrings and fix the degeneration of his low back, he’ll have trouble with occasional low back pain that will get worse as repetitive injuries continue to occur.

To fully rehabilitate muscles, joints and nerves, it generally takes a treatment plan of 6-12 weeks depending on the many factors as we previously discussed. For some of my patients, they choose to take the short route of simply eliminating the current symptom and not to treat the underlying cause. We usually will see them back in our office in 4-6 months with the same symptoms and we’ll get them back on their feet again. What I, as a chiropractic physician and you as a chiropractic patient, should strive to be serious of getting rid of the problem for good and be dedicated to fully strengthening all of the structures involved…rather than just seeking a quick fix.

So the next time you ask “How long will this take…” think about the reasoning behind a comprehensive treatment plan and make a conscious effort to fix the real problem, not just make the pain temporarily “go away!”

Published 09/01/2008.