Seeing Your Chiropractic Physician via Telemedicine? Absolutely!
I know what you’re thinking. ‘How can you possibly give me an adjustment during a video conference?’ The short answer is I can’t, but when coming to our office for an in-person appointment is difficult or impossible, I can continue to help. As a chiropractic physician, I’ve been working with patients via telemedicine for several years, and it’s become a useful tool in ways I never imagined.
Consider these ideas:
–Chiropractic physicians do more than adjust. While some chiropractic work uses a hands-on approach, this doesn’t represent the sum of our treatment strategies. Patients usually leave my office (physical or virtual) with at least one exercise they can do at home to treat the problem. Also, we often discuss ergonomic changes that can help reduce pain and improve function, such as using a lumbar roll for support while sitting, moving your computer monitor closer to avoid straining your neck, or continuing your weight lifting with a few specific changes in form.
–You can keep progressing even though you can’t get to our office. Checking in with me virtually to ensure you’re performing a therapeutic movement or exercise properly can mean the difference between improving and plateauing or worse, exacerbating the problem.
–You are more than musculoskeletal. During our virtual meeting, we’ll discuss your history and symptoms to help determine the right treatment. If you need lab tests or diagnostic imaging, I can order them for you. I can also recommend supplements and, in case a prescription or specialist opinion is needed, can refer you appropriately.
–Telemedicine empowers our connection. When you’re in pain you can feel powerless. You don’t want to move the wrong way or cause further damage, and sometimes you don’t even want anyone touching you. With a virtual chiropractic visit, we can safely walk through movements and other strategies to help alleviate pain and restore function. It’s the direction musculoskeletal medicine is moving anyway, and I’m pleased to walk you through the patient-specific approaches included in techniques such as McKenzie Method and the Shoulder Symptom Modification Procedure. Techniques like this exist for nearly every musculoskeletal problem and I can help you learn how to make the problem better yourself at home. Doesn’t that feel empowering?
Whether you’re currently a patient of mine or and would just like to talk about a musculoskeletal problem you’ve been dealing with and some strategies to get you started on treatment, I’m ready to see you. I’ll be meeting with new patients and following up with current ones using telemedicine during Covid-19, and I encourage you to use this method of care while we’re all responsibly staying at home.
Call our Patient Services team at 773.296.6700 to set up your visit. We’ll spend a half hour or so together in a virtual consultation room (a little longer if I’ve never met you) and by the time we’re done we’ll have a plan in place to get you feeling better soon. Telemedicine visits can also be submitted to your health insurance.
See below for a case study of how I recently used telemedicine with a patient who had a peculiar problem: When Back Pain isn’t just Back Pain.
Cliff Maurer, DC
Virtual consultation case history: When Back Pain Isn’t Back Pain
Here’s an example of how telemedicine was used to resolve a patient issue that had gone undiagnosed for more than a month.
Jerry (not his real name), the boisterous 46-year-old teacher in my virtual consultation room, had developed pain and burning in his back around his right shoulder blade about five weeks earlier. Having just arrived home after a four-hour plane ride, he attributed the pain to being wedged in a middle seat with both arm rests occupied by his neighbors. His pain didn’t worsen with any particular movement or position, but it kept him awake at night. He was especially frustrated that the pain kept him from going to the gym.
When a massage didn’t relieve his symptoms, he called the physical therapist who’d helped him with a knee injury a few months back. Jerry dutifully went in for a few weeks of expertly-delivered manual therapy, muscle release work, dry needling, and rehabilitative exercises. But he wasn’t getting better. After discovering that his primary care doctor couldn’t see him for a few weeks, he made an appointment on my telemedicine schedule, hoping for some answers.
Obviously with a virtual visit I couldn’t physically examine Jerry, can’t miraculously adjust him through the screen, and can’t do any kind of manual therapy with him. But those things hadn’t helped him, so clearly we needed a different approach in any case. We went through some examination techniques to evaluate his back, neck, and shoulder, but nothing stood out as a musculoskeletal problem.
As any good physician will tell you, the devil’s in the details, and most diagnoses can be made by listening to the history of the problem. A brilliant, thoughtful instructor of mine said years ago, “the patient has the answer – your job is to listen for it.”
In Jerry’s case, she was right. Most musculoskeletal problems get better and get worse with certain movements and positions. Jerry’s pain was there all the time, no matter how he moved. But when I asked him about his general health, lifestyle, and diet, he mentioned that he was on a keto diet (a diet that features specific high-fat content known for – among other things – its ability to promote weight loss), hoping it would help him shed a few pounds.
I asked him if he ever noticed a relationship between his shoulder blade pain and meal time. “You know,” he said, “I almost dread eating because about 30 minutes after I sit down and eat my shoulder blade feels like it’s on fire.”
In my mind, Jerry had solved his own case. Eating high-fat foods causes the gallbladder to contract and release bile, a substance used to break down fats in the small intestine. If the gallbladder were to contract over, say, a large gallstone, the sensation might range from annoying to excruciating. Most problems like this develop of a long period of months or even years. Eating a high healthy-fat diet merely brought the problem to light.
Internal organ pain, known as visceral referred pain, often doesn’t occur specifically where the organ is located. Rather, the pain usually refers elsewhere (a well-known example of this is pain during a heart attack radiating into the arm and jaw, sometimes missing the chest entirely). One of the most common places for gallbladder pain to refer is to the right shoulder blade, and hence, Jerry’s malady became evident.
We agreed that this diagnosis might make sense and I quickly referred Jerry for an ultrasound, which confirmed what the radiologist remarked over the phone: that Jerry’s was the biggest, most inflamed gallbladder he’d ever seen; a condition known as cholecystitis. A general surgeon colleague of mine got Jerry in for a consultation the next day, and his gallbladder was removed by the end of the week. Jerry’s gallbladder inflammation was gone, along with his shoulder blade pain.
It’s worth mentioning that not all gallbladder problems require surgery. Most can be alleviated via dietary changes and nutritional supplements. Our naturopath Dr. Caley Scott and nutritionist Olivia Wagner can help with this, in-office or via telemedicine. Chinese medicine is also helpful for gallbladder pain. Mari Stecker and Sandra Subotich often treat it. Chinese Medicine herbal consultations can also be done via telemedicine.