January 2005

Opening the blinders

by Dr. Chris Akey

My columns are meant to be philosophically based, but this time I want to combine practical with philosophical.

Have you ever had a patient come in and get well, only to develop some pain in the lower back and/or hips a few months later? This has happened to me, and I doubt that I'm the only one.

I have a patient who cleans houses for a living. Her lower back is very spastic, especially on the left. Her surface EMG showed red and black bars on the lower left side of her back. Her chief initial complaint was numbness in her right arm and hand. After the first few adjustments the arm was better, but later, after a series of adjustments, her lower back and hip started hurting.

Stuck on square one

When my patient came back she was perplexed. I could, and did, offer several possible reasons as to why she was feeling pain (work, stress, etc.). She would come in and her left leg would be about a half‑inch shorter than the right, and when I was done adjusting they would be even. Yet, by the time of the next adjustment the imbalance would have returned.

After doing the things I thought were clinically appropriate, and still achieving the same lack of positive, long‑lasting results, I thought about referring her out or just saying, “I don't know how else to help you.” Obviously, I didn't want to do either of these, because we are here to serve our patients the best we can. I didn't think I had done my very best because of the recurring misalignments and pain she was still experiencing.

I thought, what else can I do? My patient feels great when she leaves, but as her day goes on the problem gets worse. Something is wearing out. Is it the adjustment, her body ‑‑ or both? I could see not only a leg‑length difference, but the left foot was also excessively supinated. I know I can adjust the supinated foot, check the knee and the hip, but I needed to find some support that would help keep her body in proper alignment.

Orthotics made the difference

That's when the blinders opened up to custom‑made stabilizing orthotics. I read research studies on foot, knee, and hip misalignments causing problems in the lower back and pelvis. I also discovered how these stabilizing orthotics can help support my adjustment by keeping the foot, knee, hip, and spine more aligned, thereby reducing stress on those joints. This helps limit or reduce health concerns above the ankle.

I recommended and explained the benefits of stabilizing orthotics to my patient, and she was all for trying them. I correctly casted her feet by doing it weight bearing, sent the castings off, and one week later was fitting my patient with her new orthotics.

After about a week of break‑in time, the sensation of pain in her lower back and pelvis was gone, and her feet, knees, and hips felt better. Best of all, her normal lifestyle was returned and she's happy. This happened because I wouldn't give up, but more importantly, because I was able to open up any blinders I had about doing more than just adjusting subluxations on the table.

Staying a step ahead

I have urged and will continue to encourage you to check out custom‑made stabilizing orthotics for yourself and your patients. Open the blinders, help bring exceptional lifestyles back, and help your practice break through to the next level. Utilize the tools that are researched and referenced to help us. Please feel free to e‑mail me with any questions or concerns.

(Dr. Chris L. Akey has been in practice for five years and currently runs Life Family Chiropractic in Farmington, Arkansas. His focus is on educating his community to be subluxation free. He can be contacted at kidschirodoc@msn.com)