If You’re Not Assessing, You’re Guessing

Laboratory Testing

Laboratory testing is one avenue in healthcare that helps practitioners gain insight to what is going on with a patient chemically and physiologically. One thing that is fairly unknown to the general public is that chiropractors are allowed to do blood work, it just depends on the chiropractic laws in that particular state (which chiropractors in Wisconsin are allowed to do). The chiropractors that typically utilize blood work are ones that deal with functional medicine, in which they use a systems-based, not symptoms-based, model to identify and treatment root causes or any pain or dysfunction.

Getting a look on what’s going on in the inside will often help explain what is going on the outside of a person. Reason why I say that is because there are many reflexes from organs that manifest as musculoskeletal pain and/or dysfunction, which is called a viscerosomatic reflex. The most well-known viscerosomatic reflex is when someone has a heart attack, and there is pain shooting down the patient’s left arm. If someone was to come and see me while they were having a heart attack (which they shouldn’t, they should be going to the emergency room) and they wanted me to work on the pain in their left arm, there’s nothing I can do from a chiropractic standpoint about the pain because the root cause of the pain is the heart and it’s referring pain down the left arm.

Liver Dysfunction

There are two common viscerosomatic reflexes that I see on a daily basis. The first one deals with liver dysfunction that manifests as midback pain/dysfunction, and potentially right shoulder pain/dysfunction. What happens when there is liver dysfunction, that causes the ribs on the right to move as well during every breath (because the liver is suspended in fascia, which attaches underneath the ribs). Since the ribs on the right aren’t moving as well on the right, that refers back to the midback where the ribs attach to the spine, as well as where the sympathetic nerves come from the spine to innervate the liver. Taking that all into consideration, that most commonly presents as a pinch in-between someone’s shoulder blades that just won’t go away, no matter what they do.

As far as treatment for that “pinch in-between the shoulder blades,” I would adjust the spine and ribs to make sure all of that is in proper alignment, as well as utilize some nutritional therapies to improve liver function. Improving liver function takes some time (dependent on the person), but eventually the ribs will move more normal and won’t refer pain/dysfunction into that midback as much until that liver function is improved. Without the nutritional intervention, that entire pattern of the ribs not moving as well would come back, because the root cause of the liver dysfunction was never addressed.

Gastrointestinal Issues

The second common viscerosomatic I see deals with gastrointestinal issues that manifests as a rotated pelvis. There are many conditions that would fall under the category of gastrointestinal issues, including hypochlorhydria, Small Intestinal Bacterial Overgrowth (SIBO), and many other conditions. Those conditions cause certain muscles to contract and spasm, which will cause other muscles to shut down (through reciprocal inhibition). That imbalance in muscles cause the pelvis to rotate, which that in itself can manifest as many different musculoskeletal issues. Common musculoskeletal conditions that are a result of a rotated pelvis include, but aren’t limited to: low back, hip, pelvis, knee, ankle, and foot pain/tightness as well as tight calf and hamstring muscles. There are many different manifestations of both the gastrointestinal condition and rotation of the pelvis, so it is important to have a doctor that understands what goes on the inside can present as something on the outside.

The whole point of identifying those two viscerosomatic reflexes is to show that organ dysfunction can manifest as musculoskeletal conditions, and a great way to pinpoint exactly what is going on with a particular organ is through laboratory testing. Laboratory testing will also help determine courses of treatment to make sure that the patient is getting the best care possible, while not wasting any money. If you’re not assessing, you’re guessing.

About the Author

Dr. Eric Johnson, Doctor of Chiropractic and Diplomate of the American Clinical Board of Nutrition as well as owner of Functional Wellness and Chiropractic Center in Madison, WI, is a functional medicine doctor that identifies root causes of pain and/or dysfunction. His systems-based, not symptoms-based, approach is a comprehensive, holistic approach that helps identify mental, chemical, and physical stressors that are underlying numerous health conditions. If you are in the Madison, Middleton, Verona, Waunakee area and looking to not only feel better, but live better, contact Dr. Eric at (608) 203-9272.

References

Walther DS. Applied Kinesiology Synopsis 2^nd Edition. 1988. Triad of Health Publishing. Shawnee Mission, KS.