A. Sometimes they are necessary, but often not. However, if a case poses certain clinical questions, then I may suggest that x-rays be made.
A. In short, no. Change of some sort should be noted within four to six office visits. While some problems are very difficult to correct and may require extended treatment plans, improvement should be noted, even if it is only gradual; otherwise, further diagnostic measures should be taken and the treatment plan amended accordingly.
A. Very often, yes. Sometimes anti-inflammatory or analgesic medication can diminish symptoms and objectives signs, causing the patient and the chiropractor to misjudge improvement. However, if both are aware of the patient's true pain level and activity capacity without medication, such medication may speed recovery along.
The chiropractic scope of practice in this state does not allow commentary or advice of a medical nature to be given to patients by chiropractors but I have successfully referred patients to cooperative MDs who prescribe appropriate medications and returned patients to me for continued chiropractic treatment. The clinical outcomes with this approach have proven quite successful. The difficulty in the mix can be finding the cooperative MD.
A. MRI is a wonderful tool. While it does not replace regular xray films, MRI can certainly reveal a great deal that xray cannot. The bonus of MRI lies in the visualization of soft tissue, which is more limited with xray. MRI is excellent for actually allowing the doctor to see what has happened to spinal discs or to look into the neural canal.
A. If I perform an initial orthopedic/neurological examination and the findings indicate that consultation with either a neurosurgeon or an orthopedic surgeon is warranted (or at least prudent) I will make that recommendation to the patient and call the office of the particular doctor to whom I wish to refer and make the appointment. This I usually do personally to avoid confusion. However, I still conservatively treat the patient to try what relief and correction I may achieve for him or her, because it usually takes a minimum of two weeks to get in to see a neurosurgeon or an orthopod. During the interval, I obtain the requisite xrays and MRI for the referral, for there is no point in the consultation without these diagnostic procedures in hand. If a patient well into a conservative treatment plan with me does not manifest the expected clinical outcome, I may refer for consultation at that protracted interval. Again, xrays and MRI are obtained.
We have plenty of on-site parking, and our new office is at street level.