Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Chronic Back Pain Sufferers; Beware of Surgery!”

Many sufferers of severe low back pain, especially if it is chronic in nature, have weighed the option of surgery to treat their condition. However, this study is another example of why it is prudent to consider other, more conservative options like Chiropractic more seriously. The study in question focuses on the long term outcomes of patients who have undergone spinal surgery and how it has affected their work specifically.

The conclusion in general is that spinal fusion surgery, an increasingly controversial procedure that has exploded in the last 20 years, leads to HIGHER rates of permanent disability in workers. This is in comparison to those who were treated more conservatively and without the use of surgery.

The researchers in the study randomly selected 725 patients who underwent spinal fusion surgery to treat their chronic low back pain, compared to 725 patients who opted for more conservative treatments. All the patients were chosen from a pool of worker’s compensation claims from the American state of Ohio and all patients suffered from chronic low back pain. The selected cases came from the years 1999 to 2001 and further analysis was done 5 years later in 2006 to see how the patients recovered.

The results will definitely surprise you! When the study ended in 2006, nearly all outcome categories were WORSE in the surgical group. Only about a quarter had returned to work after two years, compared with two-thirds of non-surgical patients. About 11% were considered to be permanently disabled compared to only 2% of those who did not undergo surgery. However, another sobering finding was that the use of prescription pain killers at least 5 years later was at about 85% for those in the surgery group! This compared to 49% in the non-surgical group. As an aside, the researchers also noted that the patients in the surgery group steadily increased their usage of prescription pain killers over the years.

But unfortunately that’s not all, 36 percent of the spinal fusion group had complications from the surgery, including meningitis, kidney failure and death. The re-operation rate was also 27 percent in the surgery group, and included three people who underwent four re-operations. And total days off work was also greater in the spinal fusion group (1140 days vs. 316 days).

“I’m not saying don’t have lumbar fusion surgery . . . but it should be carefully evaluated before it’s done,” said lead study author Dr. Trang H. Nguyen, who practices occupational medicine in Cincinnati and conducted the research while a doctoral candidate at the University of Cincinnati College of Medicine. “The chances are it will have a poor outcome.” However, to be fair surgery may be the best option for certain patients, including those who suffer from an unstable spine or who have suffered severe fractures. The problem is that these patients are a very small percentage of patients who suffer from chronic back pain.

The perplexing side to this story is that these results and results from similar studies have cast doubt on the rationale of surgery for chronic back pain for years now but the rate of surgeries continues to grow exponentially. In spite of continued improvements in surgical equipment and procedures, it seems the long term results for surgery patients is still astonishingly poor.

Now from my own clinical experience I have seen dozens of patients who have seen me because their family doctor or even specialist recommended surgery to treat their back pain. These patients arrive to me looking for another solution that doesn’t require surgery and frankly, often see me as a last resort. This is when I get really honest with the patient. First off I inform them that yes, Chiropractic is a conservative form of therapy that has been successful for other people with the same problem. After a thorough history and exam, I often propose a ‘trial’ run of several sessions to see how the patients respond to care. If they respond well and get relief then everyone is happy and a surgery could be avoided. But, I also inform my patients that they will have to put in significant effort to get better as well, complying with prescribed home stretches and exercises that will help their recovery.

Now what’s my opinion on surgery? I think for some patients, it’s the way to go. In my years of practice I can say I have told three patients that, “yes, I honestly think surgery is your best option”. But for the vast majority, they respond very well to Chiropractic and are very happy with the results. Most importantly, they just avoided a major surgery and everyone wins!

If you have any questions about this post or questions in general, leave them down below. Even better, if you’re in the Commercial Drive neighborhood of East Vancouver, come by and visit or check out the website;COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!

SOURCES: Trang H. Nguyen, M.D., Ph.D., occupational medicine specialist, Cincinnati, Ohio; E. Kano Mayer, M.D., staff physician and physiatrist, Cleveland Clinic for Spine Health; Leah Y. Carreon, M.D., clinical research director, Norton Leatherman Spine Center, Louisville, Ky.; Feb. 15, 2011, Spine

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Does Chiropractic Hurt?”

This is a question I know a lot of people who have never tried Chiropractic have, “…will it hurt?” From my experience dealing with people who have never been to a Chiropractor before on a weekly basis, here’s my honest take on this age old question.

Chiropractic adjustments CAN hurt. Now I placed the emphasis on the “CAN” because there can be a lot of factors to consider when advising someone on pain. What does that mean? Well first off, different people will have different tolerances for pain. What one person calls, ‘pain’, another may call, ‘uncomfortable’. Who’s to say? I guess that’s personal opinion. Now what I focus on when it comes to my patient’s well-being and comfort are the things in my control.

First off, regular treatment sessions in my office are at least 15 minutes long. I never like to rush through a treatment. In addition, all patients in my office will receive massage and soft tissue therapy. I believe working on tension in the muscles that will invariably be present, will lay the path for a more successful treatment.

Secondly, I am adamant about using good technique. In my opinion, I think there are Chiropractors who rely on brute force to adjust a patient and overlook technique. This situation is analogous to the saying, “… why use a sledgehammer when a chisel will do?” I believe focusing on good technique not only makes adjusting the patient easier, but allows the patient to feel better after, likely avoiding the ‘soreness’ people report AFTER treatment. My logic is a patient is already in discomfort when they come see me, so I’ll do everything I can to ensure they feel better when they leave.

Lastly, I would like to say that sometimes pain and discomfort, despite all good intentions, is unavoidable. My patients have reported to me occasionally that they were sore after a treatment. However, this situation happens about 50% of the time, with the rest saying they did not feel sore after wards.

During an adjustments, most patients say they feel a ‘big stretch’, or ‘pressure’ but not usually pain. On the occasions where a patient does report pain during an adjustment, it is likely because they have sought my care during a very acute bout of severe pain. In these instances, many of these patients are unable to do simple things like putting on socks, without pain.

On the other hand, many of these patients are aware of their predicament but feel assured that the momentary pain they feel during an adjustment will be good for them in the long term. With this in mind, I advise them before treatment to expect soreness. I explain that regardless of treatment or not, they are already suffering so it’s better to feel uncomfortable and be on the road to recovery versus suffering and being helpless.

I hope that sheds some light on this question. I know every case/patient will be different but I intended to give a honest account of what I see in my practice when it comes to Chiropractic treatments and pain associated with it.

If you’re in the Commercial Drive neighborhood of East Vancouver, be sure to stop by or contact me at my website; COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN>

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “What Conditions Do Chiropractors Treat?”

In my practice the majority of my patients will see me because of some pain/discomfort or loss of function. By this I mean, the patient definitely notices things they used to do, they are now unable to do or has become really difficult. The majority of times the area in question is centered around the spine. However, it’s not just the lower back that can be treated with a Chiropractic adjustment, but anywhere there’s a joint.

I have successfully treated, mid-back, upper-back, neck, and shoulder pain as well. Now to be up front, not all areas I have found will respond the same to Chiropractic adjustments. It depends on various factors such as stress, working environment, underlying health issues, previous injuries, and even weight. For instance I have seen several patients that have revealed to me during an initial history/interview that they have knee issues, but that’s usually followed by the statement, “….but you probably can’t do anything about that.” Then to their surprise, I will treat and adjust their knee. Many times they will leave a treatment session feeling relief in their knees, and a look of surprise!

Another issue I see a lot is mid-back pain that is often associated with discomfort breathing. This is often accompanied with the comment, “…every time I take a deep breath or cough/sneeze, I feel the pain come back really intensely”. After an examination, the cause is actually a displaced or mis-aligned rib. These types of cases respond really well to a Chiropractic adjustment and patients generally report immediate relief.

Other conditions that I have treated in my office are; Headaches, Shoulder pain/ Rotator cuff injuries, Ankle problems, Wrist pain/Carpal tunnel, Tennis/Golfer’s Elbow and more. As an aside, I have also seen patients who were seeking relief from symptoms associated with Asthma or Digestive problems. Now I tell these patients that research supporting Chiropractic’s effectiveness in treating these kinds of ailments is weak or even non-existent at this point. But I do explain the role that the body’s nervous system has to play in regards to one’s health. I also have informed these patients that we can try a few sessions and see if Chiropractic benefits them in any way, but if they don’t see improvements, we can re-evaluate their case and possibly refer them to other health care providers. These cases even to my surprise, have usually resulted in relief for the patient.

I suppose these cases are a testament to the body’s ability to heal if given some assistance. I think that modern day medicine is amazing in it’s complexity and helps countless people everyday. However, I also feel that there are those people who do not find the relief they are looking for using traditional medicine. For those people I would encourage them to explore different options like, Chiropractic.

If you live by the Commercial Drive area in East Vancouver, stop by and say, hi!.If you want more information, contact YOUR COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “When Your Hip is Not the Cause of Hip Pain – Ask a Chiropractor”

I came across this article that discusses a common cause of hip pain; Bursitis. Bursitis is the inflammation of a fluid filled sack called a Bursa. There is a Bursa at the top of your Femur, which is the long leg bone in your thigh. Where the Femur connects to your hip bone, the bursa is supposed to help cushion the impact of the two bones when you put weight on it ie. standing, walking, running.

Here are the most common symptoms that indicate you might be dealing with Bursitis of the hip;

* Pain that occurs right at the point of the hip.
* Pain that radiates from the hip to the thigh.
* Pain that starts as severe and sharp, and becomes more aching and widespread.
* Pain that gets worse at night or when you lie on the bad hip.
* Pain that gets worse when standing after sitting for a long period.
* Pain that gets worse after prolonged periods of climbing stairs, squatting or walking.

But here’s where the problem lies. These symptoms overlap with a few other causes of hip/ low back pain. So now what do you do? I have had many patients visit my office after they have visited their family doctor or clinic doctor only to leave with a prescription for pain relievers or referral for X-Rays.

After I’ve taken a complete history as well as a physical and specific Orthopaedic exam, many patients comment on how “thorough” my examinations are. I explain that a good history and exam can not only help doctors find out what a problem is, but also, what it isn’t. Hip pain can be a case of Bursitis. But it can also be caused by; ligament sprain, muscle tear/strain, joint dysfunction, muscle imbalance etc. And as you may have guessed, treatment and home care can vary drastically depending on what is causing your hip/low back pain.

So the next time you are suffering from hip/low back pain, check with a Chiropractor first. Doing this can often save you time and needless suffering.

For a Chiropractor in the Commercial Drive neighborhood of East Vancouver contact COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN HERE!!!!!

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Knee Alignment Linked to Osteoarthritis”

This study, funded by the U.S. National Institutes of Health, was released online before being published in an upcoming print issue of the journal Annals of the Rheumatic Diseases.

The study suggested that people who’s knees (Knee caps) point outwards may be at an increased risk of developing Osteoarthritis in the knees later on.

This knee position where the knees point outwards creates a relatively large space between the knees while the ankles are closer together. It resembles a condition commonly referred to as “bow-leggedness” but it’s not as extreme. In anatomical terms, this position of the knees is referred to as the varus alignment.

The study looked at 2713 volunteers between the ages of 50-79 who had arthritis or who were at an increased risk of developing arthritis due to prior trauma or being overweight. As an aside; Osteoathritis is a painful, sometimes disabling condition where the cartilage at the ends of bones, meant to cushion joints, wears down over time. Often associated with ‘wear and tear’, Osteoarthritis will commonly affect major weight bearing joints like the ankles, knees and hips.

Volunteers with the outward facing knees were nearly 1.5 times more likely to develop osteoarthritis than those with a straight-legged stance. There was no increased risk for people with inner-facing knees (valgus alignment), the investigators found.

According to Dr. Leena Sharma of Northwestern University’s Feinberg School of Medicine in Chicago, about 70 percent of the force transmitted to a healthy knee while walking is focused on the inside of the knee. Therefore, when the knee faces outward, as in the varus alignment, there is even greater stress on the inside of the knee, which may increase the risk of osteoarthritis.

I hope this study helps people realize that undue stress of improper alignment in the joints can be harmful to your overall health in the short term and long term.
Now it would not be hard to translate the findings of this study that focused on the knees to other joints in the body like your pelvis or spine. Imagine if the pain and discomfort you are feeling was simply due to unnecessary pressure/strain on your joints due to a slight misalignment? These issues is what Chiropractor specialize in. Finding and treating these joint issues in order to relieve strain and pain. Allowing our patients to return to a healthier, active lifestyle.

Looking for a Chiropractor in the Commercial Drive neighborhood of East Vancouver? Visit the site of YOUR COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Think Twice Before Giving Tylenol to Your Children”

This was a recent study that came out that looked at the relationship between usage of Tylenol in children and rates of Asthma and other allergies. As an aside, some of you may remember a recall that involved Children’s Tylenol a few months back. Although unrelated to this study, it does emphasize the need for parents to practice discretion before they give Tylenol, or any other drugs, to their children.

On to the study. New research from around the world is finding that teens who regularly take acetominophen, better known as Tylenol, for pain and reducing fevers are more than twice as likely to have asthma compared to teens who never take Tylenol. But that’s not all. Taking acetaminophen was also linked to an increased chance of eczema and rhinoconjunctivitis, or allergic nasal congestion, in adolescents.

However, the researchers were quick to point out that this was a retrospective, epidemiological study. Which means that the researchers interviewed teens and asked them to recall their use of Tylenol and how it related to their asthma and symptoms. This method, understandably does not allow the researchers to draw a definitive connection between Tylenol use and causing asthma. But to their credit, the researchers did point out that their sample size was quite large. This was an international study and involved nearly 323,000 children between the ages of 13 and 14.

“Medium” users of acetaminophen were those who had taken the drug at least once during the prior year; “high” users were those who reported taking acetaminophen at least once a month for the past year.

The risk of having asthma was nearly 2.5 times higher among frequent users, and 43 percent higher among medium users than those who never took acetaminophen.

The study will be published Aug. 13 on the American Thoracic Society’s Web site and will later appear in the American Journal of Respiratory and Critical Care Medicine.

Researchers postulate that acetominophen (Tylenol) may interfere with a child’s developing immune system. Others studies have found that Tylenol may lower the levels of Glutathione in the lungs, a substance that is important in detoxification. The idea is that with less Glutathione, increased toxins are allowed to accumulate which prompts the body to respond with an inflammatory response, thus resulting in Asthma or asthma-like symptoms in the sufferer.

This study, although not wholly conclusive regarding a causative relationship between Tylenol use and Asthma, should cause some caution in parents. With the incidence of Asthma in children on the rise, this study is another reminder for parents to think twice before liberally resorting to Tylenol for pain or fever in children.

If you live near the Commercial Drive neighborhood in East Vancouver, find out more about your COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!>

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Prescription Painkiller Abuse is Way Up”

This recent study comes from the US but it’s not hard to see that similar results would apply to Canada as well. Just released a few days ago, the US government has found that substance abuse treatment for non-medical use of prescription pain relievers has increased 400% over 10 years.

That means that more and more people who are being prescribed pain-killers are abusing them and becoming hooked. Addiction to pain-relievers, has never been a hidden fact. In fact, dependency has long been recognized as one of the major side effects of these drugs.

The proportion of admissions for people age 12 and older increased from 2.2 percent in 1998 to 9.8 percent in 2008, and this rise was seen in all age, gender, race and ethnic groups, as well as in people of all education levels and in all regions of the country, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported.

“The non-medical use of prescription pain relievers is now the second most prevalent form of illicit drug use in the nation, and its tragic consequences are seen in substance abuse treatment centers and hospital emergency departments throughout our nation,” SAMHSA Administrator Pamela S. Hyde said in an agency news release.

What bothers me the most about this finding is that over the years, there has been increasing evidence of the efficacy of other forms of therapy for pain relief. Statistics show that musculoskeletal pain (ie. Back Pain) is one of the most common reasons patients will visit a family/clinic doctor. With pain-killers/ muscle relaxants being commonly prescribed for these patients. Imagine, if just a portion of these doctors suggested Chiropractic for these patients? We could see a dramatic improvement in this statistic very quickly. But alas, it seems the onus remains with the patient. So the next time you’re suffering from back or related muscle pain, why not visit your Commercial Drive Chiropractor in East Vancouver?

If you have any questions about what ails you, contact me here at COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!!

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Is Chiropractic Really Effective?”

As time goes on, there is growing evidence that Chiropractic is not only effective at treating musculoskeletal complaints, but also very cost effective as well. Most of the larger studies have focused on Chiropractic effectiveness regarding low back complaints, however Chiropractic has proven helpful with other ailments involving the mid back and neck as well.

If you take a step back, it stands to reason that the same mechanism that gives patients with low back pain relief, can apply to just about every other joint in the body. That is why in my practice, I have had great success with individuals complaining of shoulder, knee, ankle and foot issues as well.

Let’s look at just some of the studies that have investigated the effectiveness of Chiropractic.

The first study I’ll consider is very convincing because it appeared in the journal; The Archives of Internal Medicine. This journal is published by the American Medical Association. This study compared patients that had access to Chiropractic care and those who didn’t. The results were very conclusive. The study concluded that people who had Chiropractic coverage and sought treatment; returned to work faster, had lower claims costs and underwent fewer interventions such as MRI’s compared to patients who did not have access or did not seek Chiropractic care.

Another study published in the British Medical Journal concluded that Chiropractic should be included in “best care” practices in regards to treating back pain patients. They too also found that Chiropractic (Spinal Manipulation) was effective and also reduced costs to the patient and medical system as a whole.

Finally, a very large multi-national research group entitled; The Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders also supported Chiropractic’s effectiveness. They found spinal manipulation to be one of only a handful of treatment options of benefit for neck pain.

In my practice I have seen numerous patients that have never been to a Chiropractor before. In the beginning they are naturally nervous and unsure if Chiropractic will really help them. But often through the encouragement of other patients or the sheer desperation of wanting to try “anything” that will give them relief, they find their way to my office. I can’t tell you how many times I’ve heard after treatment, “Oh that wasn’t so bad” or “Wow, I feel a difference already!”. Usually these statements are followed by the look of relief and satisfaction that they have finally found something that will help.

So if you’re in the Commercial Drive neighborhood of East Vancouver, contact your COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC HERE!!!!

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “What’s That ‘POP’ I Hear During an Adjustment?”

This question comes up very often when patients are treated in my office. Many ask, “Doc, what’s that pop/crack coming from my back?” A few patients that have not visited a Chiropractor have asked, “Is it my bones breaking?”

The simple answer is; the pop is coming from the space between your bones or what is commonly known as the joint. The corresponding picture will make it a lot more clear. When one bone ‘connects’ to another, you get a joint. But what you may not be aware of is the joint is not empty space. In fact, the joint is actually surrounded by connective tissue. Namely; ligaments, tendons and a membrane called a Synovial membrane may surround the joint, forming collectively a ‘joint capsule’. As mentioned before, the space between bones is not empty. It is actually filled with a fluid called; Synovial Fluid. Synovial fluid is very thick and acts to help lubricate movement between the bones. Just think of it like grease making the hinge of a door move without catching or squeeking.

When we take a closer look inside the synovial fluid, we will discover that there is gas suspended in the fluid. When you hear a “pop” during a Chiropractic adjustment, what is happening is that your joints are being stretched. This stretching of the joint momentarily makes the space in the joint bigger. Along with this, the stretching helps to decrease the pressure within the joint. If pressure drops enough, it forces the gases in the synovial fluid to leave the fluid producing a ‘pop’ as it does. (A simpler analogy would be taking a can of any soda. When you first open the can and pull the tab back, what do you hear? That’s right, you will probably hear a “hissing” sound due to you releasing the pressure inside the can by opening the top) A similar phenomenon is happening in the joint, but what you’ll hear is a pop.

Specifically it is known that when you stretch a joint that is stiff and relieve the pressure, you activate a part of your nervous system called the Golgi tendon organs. The stimulation will actually register in your brain as; relief, less pain, more flexibility, lightness etc. That’s exactly what many patients feel after a Chiropractic adjustment and why they get relief.

If you’re in the Commercial Drive neighborhood of East Vancouver, please contact me here; COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC>

Commercial Drive – East Vancouver Chiropractor; Dr. Dominic Chan DC – “Think Twice Before Going to Your Family Doctor for Back/Neck Pain!”

I am fully aware that many will read this headline and feel a degree of skepticism. Perhaps you think that this article is self-serving? Okay let me explain. For years now I have informed patients that Chiropractors are uniquely positioned to diagnose and treat problems involving the Musculoskeletal system (Muscles/Joints/Bones).

In my years of practice I have been able to provide relief for patients that either; wanted a natural, conservative approach to pain relief or were dissatisfied with what traditional medicine could do for them.

Here is a study that will definitely open your eyes and maybe make you think twice about going to your family doctor the next time you have pains in your back, neck or elsewhere!

This survey was published in; Academic Medicine: Journal of the Association of American Medical Colleges. This Survey was conducted at Harvard Medical School, a world famous institution with a stellar reputation. The purpose of this survey was to assess the medical student’s knowledge and clinical confidence in musculoskeletal medicine as well as their attitudes toward the education they receive in this specialty. The survey was given to more than 600 medical students and they were asked about 30 different questions and asked to rate their responses. The results should surprise you!

74% of the students responded and their answers are very sobering. (NOTE: the authors noted that although the survey was conducted at Harvard, they claim the results are consistent with other schools). Medical students rated Musculoskeletal education of major importance (3.8 out of 5) but when asked to rate the amount of time spent learning about the musculoskeletal system, they rated it as poor (2.1 out of 5).

In addition, 3rd year medical students rated their confidence at performing a complete musculoskeletal exam as low to adequate (2.7 out of 5) but when asked to actually perform a competency exam, scored shockingly low with only a 7% pass rate!! (That is not a typo, these 3rd year medical students had a pass rate only in the single digits!!)

When 4th year students were asked the same, they again rated their confidence similarly to their 3rd year classmates (2.7 out of 5). Although, their competency exam results improved (26% pass rate) that still means about 74% of 4th year medical students failed to prove competency in musculoskeletal medicine. Remember, these students are on the brink of earning their MD’s and becoming family doctors!

These results surprised even me. Here is what the authors of this survey concluded;
“These findings, which are consistent with those from other schools, suggest that medical students do not feel adequately prepared in musculoskeletal medicine and lack both clinical confidence and cognitive mastery in the field. Implementing a four-year integrated musculoskeletal curriculum is one way that medical schools can address this concern”.

I will write posts comparing Chiropractic vs Medical school education at a later date but for now, if you’d like more information about this survey, go here;

http://www.ncbi.nlm.nih.gov/pubmed/17457065

So remember the next time you’re having back/neck pain and wondering what to do for relief, consider what you’ve read here!

If your near the Commercial Drive area of East Vancouver, contact your YOUR COMMERCIAL DRIVE – EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN HERE!!!>