The Core policy: introduction of a new standard

September 20, 2011 By

Here at Core Physiatry we are interested in one thing only: helping you.

Now, we know that many clinics will say that, but we are dedicated to making it all about you and making sure that you are being given what you were after. That said it might not always be possible to deliver what you were hoping for, but we do pride ourselves in knowing pretty accurately, and well in advance, what you will be able to expect in terms of outcome measures (results to you and me), time frames and cost frames. We have been using these protocols for long enough now that we can tell you with great confidence that we know how to treat chronic back pain.

That said we have now taking matters one step further! After developing the insurance-backed money-back guarantee (the first of its kind) we now are able to guarantee the cost of care! This means that not only will you know in advance that you will get better or receive a full refund on treatment cost, but you also know the absolute maximum cost of that treatment.

That leaves me only to answer one question many patients have asked me over the years: why do we do it?

Simple: because you deserve to get better in confidence.

Best wishes,

Stefaan Vossen

Filed Under: Chiropractic, For Patients

Myotonic dystrophy Case report Chiropractic Warwick

October 27, 2009 By

Ms. G. a pleasant 42 year old lady who was referred to me, came in presenting with a 3 day history of acute and severe low back pain and sharp pain at between the shoulder blades with shoulder pain radiating across the back of both arms.

As part of her history she discussed the fact that she has been diagnosed with myotonic dystrophy, the most common form of muscular dystrophy.

There were some very clear clinical indicators that this lady was walking with significant gait dysfunction which was exaggerated by the muscular dystrophy. Although it was clear to both myself and Mrs. G. that I would not be treating her for muscular dystrophy I felt that it was worthwhile treating her as it would reduce the overall stresses on her body.

Four weeks into care she is reporting clearly observed changes in her gait, posture and comfort levels. This has been noted by both herself and friends and family.

Chiropractic care was focused on improving her locomotion and her comfort levels. This was achieved by improving muscular balance and timing. You will find other posts on this site which explain how care can improve this but suffice to say that the way we move is down to what our brain perceives our body is doing at any given time, from which it calculates the best way to move from A to B. Care aims to improve the accuracy of that perception, thereby improving the way it calculates and exectues movement.

I hope you found this posting interesting.

Stefaan Vossen, Clinic Director, Chiropractic Warwick

Filed Under: Case Studies, Chiropractic Tagged With: , ,

Not tonight darling, I’ve got a headache

October 12, 2009 By
(if you can remember this picture you are getting old)

(if you can remember this picture you are getting old)

As titles go, this one really is as open-ended as they get. Not that I mind. Strangely enough I will be talking about this issue from an angle probably quite different from what might be expected.

One of the biggest issues I have with the precepts of healthcare is that it is really sickness care. What I mean by that is that we are driven to action by our lack of health rather than our desire to maintain it. Clinically, I don’t mind that, as it is quite interesting to offer people solutions, and it is really quite exciting to offer solutions where others failed. Philosophically I have a great deal of trouble with it as I reckon that it would be far better to deal with the seedling of a problem rather than the fully fledged tree. Two things are really quite nice about dealing with things at seedling stage: it’s easier, cheaper, and in fact there is a third: it avoids or reduces the likelihood for human suffering.

And this is really where the title resonated with me when my wife (of all people) said I should write a piece about chiropractic care and sexual activity. Now it is of course very tempting to discuss what difference feeling great through chiropractic care can do for the patient’s outlook on life, the level of wellbeing and ultimately their very sense of being and how that all obviously links into sexuality. But I shan’t be tempted! For me in the same way as we should address problems in our personal and emotional lives when they are small, and likely to be rooted in misunderstandings, we should deal with our physical niggles and ailments. The real problem with that is that one has to perceive there to be a problem, before finding it valuable use of time to focus on finding, following and sometimes paying for a solution.

Brittain (I am originally Belgian, which is my excuse for liking mayonnaise) has a very interesting relationship with the concept of “putting up with it” aka ”the stiff upper lip”. Brittain has also one of the worst ratings when it comes to quality of living and state of health in the Western world… and somehow I don’t think these two are unrelated. So much then for the stiff upper lip (and don’t get me going on the international “lover ratings” which were published last week-didn’t do too well there either). I know it is a stereotype, but stereotypes are also statistical features and there is a lot of truth in the fact that most people who intended to act proactively and get checked out preventatively really only got round to it when they hurt themselves.

So don’t wait until she has a headache,… instead look after her, cherish her and make sure you’re both up to the job of living the best possible life. (This does not apply for men, as we all know they are far less complicated…) Chiropractors don’t offer you all that, they just contribute to it, but if you invest in yourself, value what you’ve got and understand that unless you do that you will at some point be looking down some abyss  , then you will enjoy a good, unremarkable, steady pleasant physical health.

I know that sounds boring but can’t apologise because although I enjoy a very good reputation and that I am both honoured and flattered when people bestowe me with their care and gratitude , I really hope to one day hear the sentence “I wish I had done something about this earlier” that little bit less often.

Kind regards,

Stefaan Vossen

Clinic Director

Chiropractic Network, offering care to Warwick and Warwickshire, Leamington-Spa, Stratford, Coventry and surrounding villages

Filed Under: Chiropractic Tagged With: ,

The Chiropractic Warwick approach to understanding your pain

October 6, 2009 By

Understanding factors that are contributing to your pain

In one of my blogs I put a lot of emphasis on the concept of “contributing factors” or multi-causality and was asked to explain a little further. So here it is:

When I am talking about a patient’s “problem”, I am NOT talking about a pain. Pain is your problem and is the reason why you come and see me, my problem is what is causing your pain. Firstly it means I must give your pain a name, give it a diagnosis; a tear, a sprain, a disc hernia, sciatica, whiplash, are all just names we give to conditions or situations you find yourself in. Then comes the tricky bit: finding out why you have it. Now, referring to another post you will find that my view on what is causing a pain can be two-fold:

  1. You did something stupid and it makes perfect sense that you’re in pain, but you’ll recover fully without anyone doing anything. 4-6 weeks wait for most conditions is reasonable.
  2. You did something (usually quite mundane) and you are in pain or you did something stupid and it just won’t go away.

The former should be left alone and given a chance to recover naturally (nature is quite good at these things and knows what to do. It has done it for many moons and has learnt some very neat tricks). The latter is where it is worthwhile for you to seek some help. What is needed then, above and beyond a diagnosis is an understanding of what causes you to be unable to recover from whatever is causing your pain. That’s where multi-causality is coming in. It is far from uncommon for people to present to me with two, three or even five different problems which all combine to cause what you perceive as persistent pain. The more different contributory factors are known, the more predictable and successful your treatment and recovery will be. What can they be? A number of things but before I disclose that to you I must point one thing out: they contribute for a reason and some of these reasons are poorly understood.

The first example I will give is that of gait problems, high arches, low arches, poorly healed ankle injuries etc which alter the way you walk and slowly but surely over time will create excessive stress and weaken certain ligaments, tendons and cause repeated unexplained inflammation in the knees, hips and spine.

Another example is that of malocclusion syndromes. This means that your teeth don’t close evenly or correctly causing excessive stress on the jaw-joints (tempero-mandibular joint or TMJ). This one is slightly more complex in that it is currently assumed to be a less direct biomechanical issue like gait problems, but a more neurological one. This means that certain types of TMJ problems are believed to cause interference on the cerebellum, that part of the brain that sits at the back of your skull and whose role it is to balance and coordinate your movements. In fact certain TMJ problems are so intense that they may cause you to feel drunk and unstable in a fashion not dissimilar as inner-ear infections can do. The problem with TMJ issues is that they seem to sometimes be able to interfered with the normal process of “mapping”, which is where your brain receives all information from the senses and effectively draws up a 3-D map of what is where in your body so that it can decide what it needs to do in order to achieve the movement you wish to achieve. Walking, sitting, grabbing your keys, all require your brain to know where your body is in relationship to the environment. That process is “mapping”. Every map has corners and those corners are its limiting parameters. If you imagine that you are looking down at a map which you believe to be a true depiction of the road ahead but something you didn’t know was causing it to skew or warp, then you can easily understand how something that is in fact straight is believed to be bent or something that should in fact be bent looks to the brain like it’s straight. Certain TMJ problems (but in fact I believe there are many other problems that work on a similar basis) can cause such warping, and cause your brain to believe that you are stood straight whilst you are in fact leaning to the right or twisting. Lean or twist for long enough and eventually your muscles will be tired and sore from it…

Because of all this I drew up an assessment protocol which looks at all these and more contributing factors and built them up as part of your treatment process. This means that fewer visits are needed to achieve better results and is part of the reason why I have been able to get the kind of results which meant I could offer my patients a money-back guarantee.

I hope this post has been of interest and if you have any comments, thoughts or questions, don’t hesitate to send me a message.

Stefaan Vossen

Clinic Director, The Chiropractic Network, Warwick

Filed Under: Chiropractic Tagged With:

What’s the difference between chiropractic and osteopathy?

October 6, 2009 By

Another top 5 question and a huge can of worms to boot! Let’s just define what is what here, before I even start to contemplate beginning to answer this one: I appreciate osteopathic techniques as much as chiropractic techniques. My cousin is an osteopath in Switzerland and has shown me some very neat things. I have shown him some he thinks are very neat too. But fundamentally he works with people with different problems than I do. But that is in Switzerland. And now we open the can of worms…

Theoretically chiropractic is a clinical science which BELIEVES that people have problems because they are being obstructed from healing from their injuries. To qualify this it must be made clear that an inflammation from an injury is not a problem (although it is a pain) in itself, not unlike a fever is not a bad thing, in fact it is the best way to get rid of the bugs that are making you ill. Injury and illness are things which happen whether you like it or not. What both chiropractors and osteopath consider a “problem” is that which obstructs you from healing from your illness or injury. So in a nutshell; I am not that bothered by the fact you sprained your back lifting something stupidly heavy or digging the garden up, but I am interested why it is taking you longer than a few weeks to recover from it. Your GP is very good at prescribing medication which will help you go through the natural healing phases in relative comfort. And although there is something to be said for the fact that nature evolved some really good ways to deal with your illness and injuries and it could possibly be ill-advised to suppress these responses too much, I personally won’t stand in the way of anyone wanting to moderate these responses for the purpose of going back to work earlier or being more pleasant company to their wife, husband or children.

So assuming that your back is still hurting after having tried moderate anti-inflammatory, painkilling or muscle-relaxant strategies you may want to see a chiropractor or osteopath as they both know a thing or two about how to help in those circumstances.

So the difference: well in THEORY chiropractors call these obstructions which stop you from healing and returning to normality “subluxations”. Although it should be noted that this term is not used all that much anymore either. Osteopaths on the other hand call them “osteopathic lesions” (at least the ones I spoke to do). And again in THEORY (those of over a hundred years ago) these two are different in that chiropractors BELIEVE that subluxations are caused by nerve pathway interference, whereas osteopaths BELIEVE the lesion to exist in the lymphatic and/or blood circulation. The argument that has been raging for many decades (although nobody seems to care that much these days) is that chiropractors said that the blood lesions are due to nerve interference on those nerves that regulate blood-flow and osteopaths said that nerve interference was caused by poor blood-supply.

So there you have it. A classic chicken-and-egg impasse. Personally I feel there is little merit in it for two reasons: neither chiropractors, nor osteopaths really subscribe to these views anymore, but rather get on with it and use the techniques most appropriate for the presenting problem. There are some other differences, which are both technical and academic but I feel that I can wholeheartedly stand behind a convivial statement: find a good one of either, whom you feel understands your problem and has a good grasp of the needs which must be met, and stick with it. You should get tangible results within 4 to 8 visits and although all may not have been recovered by that point you should know that you are not wasting your time, or your money.

I hope you found this post helpful and if you have any comments, thoughts or questions, don’t hesitate to send me a message.

Stefaan Vossen

Clinic Director, The Chiropractic Network, Warwick

Filed Under: Chiropractic Tagged With:
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