IMPORTANT INFORMATION FOR PATIENTS
The purpose of your first visit is to determine whether you are in the right place, and whether we can help you. We will talk to you, examine you thoroughly, review any imaging studies, and then give you our honest impression.
DO I NEED A REFERRAL?
While most patients do come via referral from their general practitioner or specialist, it is certainly not mandatory. However, The North Wales Spine Clinic is always keen to collaborate with your medical team (where appropriate) to ensure that you get the best care possible.
WHAT WILL HAPPEN ON MY FIRST VISIT?
First and foremost we need to understand your medical and health history. Unfortunately many health problems can mimic disorders of the spine and, as such, we will discuss your history in some detail. This will be followed by a comprehensive examination in order to make the most accurate diagnosis.
The initial consultation will usually take between 40 minutes and 1 hour, depending upon the complexity of your case. Whilst a physical examination is very important, your modesty will be preserved at all times and gowns are provided. Please be assured that if we do not think that we can help you, or if our examination reveals any additional concerns, we will refer you appropriately and liaise with your general practitioner on your behalf.
When you initially attend the clinic we will start with a discussion about you, your health concerns and your health goals. You will be asked for a great deal of information, not just about the pain or complaint that may have brought you, but about your past health history. To ensure that our approach is appropriate for your condition we will need to establish an overall health picture. If we feel that condition warrants it you will be referred to our GP or relevant specialist. Your details will remain confidential at all times.
Once your case history is complete, the Doctor of Chiropractic will examine you thoroughly. The examination will concentrate on your neurological, muscular and skeletal system (nerves, muscles and joints), but it may also be necessary to examine other areas such as your heart, lungs and abdomen to confirm accurate diagnosis; this thorough check up is a normal procedure at The North Wales Spine Clinic. Personal gowns are made available for you to wear for the examination, as well as any consecutive treatments. Following the initial consultation and examination, the Second Visit will consist of the Report of Findings and usually the first treatment.
WHAT WILL HAPPEN ON MY SECOND VISIT?
Before treatment starts, we will tell you, in clear, simple language, what is wrong and what can be done about it. – a Diagnosis and a Prognosis. You will be advised about any particular need for exercise based rehabilitation, or recommended changes to your lifestyle, occupational environment or diet. We encourage you to take an active part in the healing process to speed up the improvements. You will be advised of all costs that relate to your future care. We will also tell you of any likelihood of a recurrence of your problem, and the possible need for any ongoing care.
Following your Report of Findings treatment normally begins. However, treatment may be delayed for a day or two if we need to take or view X-rays, perform urine tests or obtain further information from your GP (for example blood test results) and where appropriate, refer you for an MRI/CT scan.
TREATMENT
Treatment involves safe, often gentle, specific manual adjustments, done by hand, to free joints in the spine or other areas of the body that are not moving properly. Most often, this requires a short, highly skilled thrust to a joint that can result in an audible release, and may bring relief of symptoms as well as an increased feeling of well-being. The audible release is simply the sound of bubbles of gas popping in the fluid of the joint as the pressure is released. Apart from the adjustment, we may use a wide variety of techniques including ice, heat, Acupuncture, Physiotherapy and Osteopathy based techniques and specific rehabilitation exercises. If you have questions about any of these, just ask.
We treat problems with your joints, bones and muscles, and the effects they may have on your nervous system. We work on all the joints of your body, making gentle, specific adjustments to improve the efficiency of your nervous system and decrease the chance of further tissue damage. Our care does not involve the use of any drugs or surgery. Our emphasis is on long-term solutions for muscular and skeletal complaints. In order to fulfil this objective for patients we ask that you work with us as a team and attend our educational workshops and corrective exercise seminars as prescribed by the Doctor of Chiropractic.
WILL I NEED X-RAYS, MRI OR OTHER TESTS?
It is not necessary for you to undergo any X-rays or other tests before consulting with the The North Wales Spine Clinic. Diagnostic imaging such as X-rays, CT and MRI will only be acquired if clinically indicated.
CANCELLATION & RESCHEDULING POLICY
Your appointments and the time allocated for your appointment is very important. Should you wish to cancel or reschedule please allow at least 24 hours notice. Following this policy incurs no charge.
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FREQUENTLY ASKED QUESTIONS
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CAN CHIROPRACTIC TREATMENT HELP?
The spine is an intricate and sophisticated structure. So when things go wrong it requires a unique expertise to diagnose the various conditions that might result.
While there are many fanciful claims made about the spine, no single treatment approach is a panacea. However, it is vital that your clinician is up-to-date with current advances in research. While each profession has its unique attributes and tools, we all share data from a common pool of scientific research, and it is this that directs the state-of-the-art treatment approach.
By first making an accurate diagnosis we can be sure that you are in the right place and that we can give you the best care that science supports.
CAN A SPINAL BONE REALLY 'GO OUT OF PLACE'?
One of the great misconceptions about the spine is that your bones can ‘go out of place’. While true dislocations or sub-luxations (partial dislocations) do occur as a result of trauma, these injuries are serious and often require hospitalisation. Unfortunately there is often confusion regarding the term ‘subluxation’, as chiropractors historically used this word to describe the less severe forms of spinal dysfunction seen on a daily basis. As such, the use of the word ‘subluxation’ to describe most common spinal problems is being used less and less.
So what does happen to the spine?
In truth, there are a myriad of possible forms of spinal problem and each should be treated individually. When the spine becomes painful it may be the result of local tissue damage - perhaps to the lining of a spinal joint, or a tear in the wall of an intervertebral disc. Interestingly, such damage doesn’t usually happen as a result of significant trauma. Rather, our patients often tell us that they suddenly felt pain during some innocuous everyday movement - or that their discomfort crept up on them slowly ‘for no reason’. So what’s going on here?
In many cases spinal problems develop slowly over time without any clues to their existence - a bit like tooth decay or heart disease. But the ‘problem’ might not be what you think. The real reason that a spine might spontaneously become painful has more to do with a loss of spinal control than any loss of strength. The human spine is an incredibly complex and flexible structure that requires precision control if you don’t want to injure it. What’s more, the moment-by-moment regulation of joint alignment is all done unconsciously - just like the beating of your heart. And, in the same way that people might develop problems with their heart rate or rhythm (a control problem), you may also suffer control problems in your spine. If this happens, then you may well injure yourself with a simple movement.
Interestingly, spinal manipulation works directly by stimulating the control centres of your spinal cord and nervous system to help them do their job better and allow you to maintain your own alignment better. We then follow this up with exercises to help you amplify the improvements that we make on your behalf.
IS A COURSE OF TREATMENT NECESSARY?
In many cases you will need a course of treatment. Manipulation of the spine is dose-dependent and its effects are cumulative over time. When manipulation is combined with exercises we can achieve a strong and stable spine that will handle the challenges that you throw at it.
As discussed above, having a pain-free and healthy spine is all about control - and much of the control ‘circuitry’ for your spine resides in the balance centres of your brain. Chronic spinal problems have been shown to involve poor balance and coordination of the spinal muscles. So to help you on your path to recovery we’ll need to identify and address any such issue.
To achieve spinal stability and control is not unlike any other discipline. It takes time to develop, and here at The North Wales Spine Clinic we are experienced in putting together the rehabilitation programs that you need. Furthermore, our dedication to Evidence-Based Practice means that we will measure your progress every step of the way.
IS IT POSSIBLE TO BE OVER-TREATED?
While it is very hard to cause injury through manipulative treatment when performed by a highly trained expert, there must always be an appropriate and rational reason for any clinical recommendation. Manipulation of the spine is a powerful tool and very well supported by the scientific community. However, it needs to be performed by an expert, and the amount must be carefully calculated to match the needs of the individual patient. While we admit that science hasn’t yet found all of the answers, using a scientific approach to your care helps us to fine-tune your treatment and closely monitor it to see what’s working, and what’s not.
Most of the patients referred to The North Wales Spine Clinic have chronic or recurrent problems. In fact, the average length of symptoms prior to seeing us is just over 3 years! As such, we are usually faced with a problem that is ‘multi-layered’. While treating the core diagnosis might be straightforward, such as an intervertebral disc protrusion, dealing with the compensatory changes is not so easy.
Most complex spinal conditions involve the following factors:
• A core diagnosis or injury - such as a disc lesion, joint arthritis or nerve compression
• An abnormal movement pattern to compensate for the original injury - think of this like the limp that develops when you sprain your ankle, but imagine it never going away
• A balance or control deficit that keeps you always on the edge of further injury
Successful treatment and future prevention of your condition involves identifying each of these components and then addressing them all effectively. At The North Wales Spine Clinic, this is our passion and our core expertise.
IS IT SAFE?
Your safety is our first concern, but this involves more than just the way in which you may be treated.
Firstly, your safety depends upon the accuracy of your diagnosis. For this reason we will not compromise in our initial investigation of your case. Our clinical examination and access to state-of-the-art radiology services means that we can be sure that you are being treated in the most appropriate fashion.
Secondly, we work in close co-operation with other medical professionals to ensure that you are appropriately referred if your condition requires another speciality or approach.
Finally, spinal manipulation has proven itself to be remarkably safe when used appropriately. The effectiveness and safety of any tool is only as good as the knowledge that underlies its use, and it is this dedication to knowledge that you can rely upon at The North Wales Spine Clinic.</b<