A chiropractor’s role in treating a person is not limited to only addressing their musculoskeletal system. In fact, it is best to use the “triangle of health” concept with patients. There are three equal sides to address: the “physical,” the “emotional,” and the “chemical” aspects of health and well-being. If any ONE of the three sides becomes distorted or out of balance, all three aspects of health are negatively affected. Although chiropractic typically embraces the “physical” aspects of the person, care must also help bring the emotional/spiritual side AND the chemical side into balance. These three aspects of health do not exist by themselves. The triangle of health approach follows the recommended treatment guidelines known as the “biopsychosocial model” of health care. We do not have the luxury of separating these three aspects of health, and each patient who presents with low back pain, neck pain, headaches, a rotator cuff strain, or a knee injury must be managed wholistically in order to obtain optimal and satisfying outcomes/results. Frequently, there are barriers that can block or prevent a person from improving in a timely manner. Since each person is different, there is no way of knowing what barriers (if any) exist that may prevent them from recovering as one would expect. When this occurs, it’s usually because some other aspect of their health is preventing their condition from improving or resolving. The focus today is on the “chemical” side of the triangle of health and the associated chiropractic management strategies.
Using a case study approach, let’s say a patient presents with “typical” localized low back pain (LBP). During the course of the initial evaluation (which includes a “review of systems” that tells us about their general health), in addition to their low back problem, we find out that they have other health issues that include headaches, difficulty sleeping, flushing of the skin, muscle aches, tenderness and weakness, general fatigue, drowsiness, dizziness, nausea or vomiting, abdominal cramping/pain, bloating/gas, diarrhea and/or constipation, and they have a rash. They are also complaining of memory loss, mental confusion, and have high blood sugar (Type II diabetes). This type of patient may NOT improve to a satisfying level because of the other health issues creating a barrier, blocking recovery from their LBP. So HOW do we figure out what’s going on? We sometimes perform blood tests and/or work with other health care providers who do. That may be a good place to start. Also, many times, people have had blood work done recently and we can simply send a signed release and obtain a copy of the records, including their blood work.
We’ll also gather a list of their medications and can look for side effects or drug interactions. This may be important, especially when so many complaints involving multiple systems are present. In this case, we’d look to see if they have elevated LDL’s (“bad” cholesterol), a high HDL level (“good” cholesterol), or are taking a medication like Lipitor (a statin medication that reduces cholesterol). If there is myositis (muscle pain caused by inflammation), we may order a muscle enzyme test (called CPK or creatine phosphokinase) which, if elevated, may determine the reason for nearly ALL the side effects listed above (not just muscle aches and weakness). A dangerous side effect of statin medications is “rhabdomyolysis” (protein breakdown in muscles causing muscle damage). In this case, discontinuing the medication is ABSOLUTELY necessary to stop these side effects before the damage becomes permanent (especially kidney damage!). Through weight management (such as a gluten free diet), proper nutritional counseling, and whole person care, we can NOW find a remedy for that LBP that was not responding and for a good reason. With statins being one of the most prescribed medications on the market (about 17 million users) and 1 in 10,000 developing the rhabdomyolysis as a side effect, it’s NOT an uncommon finding!!!