A new look at subluxation: From Dr Robert Maigne

I'm really fond of reading interviews with Dr Robert Maigne, a French rheumatologist and MD.

Without knowing it, he pretty much summed up what chiropractic does, and the mechanism of what we call "subluxation".

Dr Maigne coined the term PMID, or "painful minor intervertebral dysfunction", and he claims this is the cause of most back pain. Brought on my exertion, false movement, or poor posture, he states the best treatment is "manipulation", or what we call, adjusting. He also describes that PMID can go away on its own, become worse, be asymptomatic, or create episodic pain over the years.

Maigne also notes what he calls "neutrophic disturbances" in the distribution of the spinal nerve. He believes that segments at junction areas of the spine (lower neck , midback) become dysfunctional, and can cause pain and these neutrophic disturbances in areas much further away.

Ever felt that? A faulty movement..pain comes and goes for years...doesn't take much to trigger it? Now, imagine what that pain means? Could it mean that, areas that are innervated (supplied) by that nerve from that segment could be not functioning correct, as well?

Chiropractic addresses these segments, corrects them, and lets the nerves go back to normal.

Yes, I'm a Chiropractor. No, I won't crack your back!

I find that people have a funny reaction when I tell them I am a chiropractor.

They turn around and point to something on their back, and so "oooh, can you give me a massage??".

I am not a massage therapist. I am a chiropractor. No, I don't crack backs. I perform adjustments. I forgive you if you didn't understand the difference.

But, lets say I meet Bob, and Bob is a mechanic. I don't say oh, hey Bob, you're a mechanic? What do you say we go change my oil right now? Or, hey Jim, you're a contractor? How about we go build a doghouse?

I would be THRILLED to give you my full time, attention, and an adjustment if need be. Just, not at Starbucks.

What can chiropractic do for me?

Depending on your own experiences , people have varying concepts of what a chiropractor does and what chiropractic can do for you.

Here is a list of common questions and answers regarding chiropractic:

What are your specialties?

Chiropractors are all over the map in what their specialties, which is good, because people are all over the map with their health issues.

I have studied fitness and health for several years, and so naturally, I specialize in working with people trying to lose weight or that are fitness minded. But, I have also studied Webster technique, which is a low force technique used on pregnant women. I also use activator (a low force adjusting tool) for children and people that are hesitant of "cracking noises".

I don't just work on spines; I also adjust extremities (knees, shoulders, wrists, feet) and work on soft tissue rehab, as well.

Woah--pregnant women? Kids?

A common misconception about chiropractic is that its some how going to be too forceful and cause harm. Not true! The recommendations on pregnancy are changing. Where as, the idea used to be that women were delicate little flowers and couldn't do anything while pregnant, the current recommendations are that the more fit you are, the better you can handle labor. Labor is like the biggest marathon you will ever run--getting your body prepped by having your pelvis and spine aligned helps the mechanics of the body.

Kids are the best patients! They move "like buttah". Wear and tear on our bodies accumulates over time; addressing it while its still new helps to prevent damage down the road.

Can you help me lose weight?

Yes, I'd be happy to. I write a fitness column, I have worked for Bally's, and I was a program director for a very large national weight loss chain. I know the in's and outs of weight loss, and I love to help people lose weight because it not only makes a change in your physical health, but in your mental and emotional health as well.

Weight loss isn't chiropractic!

It sure is! Anything that helps take wear and tear off your body (like, losing excess weight) helps with your chiropractic care.

Are you going to make me put my feet in that foot bath thingy?

No. I don't do pedicures. The only detoxification I recommend is the old fashioned way--healthy eating, filtered water, and a functioning liver.


Are you guys really Dr's?

Some people have this bizarre idea that chiropractors get licensed by sending in some card from the back of Men's Fitness. Not true!! The standards in chiropractic education have become increasingly stringent over the years. In addition to completing coursework before attending chiropractic school, we take years of coursework in anatomy, physiology, clinical skills, nutrition, adjusting, and preparing for "worst case patients" (like you wouldn't believe). Then, we take 4 different national board exams in those subjects and apply for a license. They require a lot of preparation, studying, and plenty of people don't pass. No pass, no license, no refund.


I am not having any pain. Why should I go see a chiropractor?

When my dad calls me, he still asks me weekly if I am getting my oil changed. According to dad, taking care of my car now means that I won't end up on the side of a road with empty oil and a ruined engine, with Ted Bundy coming around to offer me a lift. (He's such a dad)

Well, dad is usually right.

Preventing a problem is a lot easier than trying to fix an existing one. Pain is often the last sign that something is not working right in your body. Chiropractic works in various ways: firstly, it helps to maintain alignment in the body to minimize wear and tear on the joints; secondly, it is theorized that by stimulating the nervous sytem via the spinal adjustment, it affects the nerves that exit the spine and go to different tissues away from the spine; third, it keeps motion in the joints to help them move freely, which can help with mobility and athletic performance. By seeing a chiropractor before you have pain, you usually have to come in less often, and avoid problems before they start.

I heard once you go you have to keep going. I just dont have the time for that!

My goal is to see you less. I don't care if you are super charming or bring me pumpkin muffins (they are welcome, though).

Like a lot of healthy habits, chiropractic usually involves some kind of maintenance plan. Your body is always working, and so there is usually no quick fix for anything. Healthy habits, such as exercise and healthy eating require that you continue as part of a habit to see the best results, and chiropractic is no different.

Most people keep seeing a chiropractor after their initial visit because they see the benefit in continuing care. The goal of chiropractic is to get you to a point that your body becomes healthier and better functioning, so that your number of visits decrease over time. It is better to come in once a month for a maintenance visit than to go several months without care and come in for a visit in pain.

I went to a chiropractor before and they told me I had to come 3 times a week and that I was a total mess. What gives?

No one wants to be cornered with something scary like an X ray and told they are all messed up. It's like when you bring your car in for brake pads and find out that you are leaking things, your brakes are destroyed, your engine is going to explode, and things you have never even heard of need to be replaced.

Sometimes, in trying to explain what chiropractic can do for you, people get overzealous and miss the mark. Although everyone is different and the amount of visits recommended will vary by person, I am always willing to work with your budget and schedule to help get you the care you need.

Seeing things on your x-rays or hearing your exam findings can be scary, especially if you felt fine coming in. Rest assured, my goal is to never scare you or make you panic. Relax! I will give you an honest opinion of your current health, and what recommendations I can make.

My doctor gave me exercises to do, and told me to lose weight, and stop drinking and smoking...that hasn't really happened. Are you going to lecture me?

Any kind of doctor/patient relationship involves a partnership for a common goal. That means that we both have to work together to get you the best results. Exercise, diet, and modifications to your lifestyle can help you get to your goal faster and improve the results you get from chiropractic care.

Unless we are married, I am not going to nag you. But, I do want you to get better so I will work with you on small changes over time that will help you get to feeling better.

Have questions for me? Email me at drcatchiro@gmail.com

What is a Doctor?

Many people have the title of Doctor, and there is always debate on what is a "Doctor".

One of the most ignorant and offensive things to assault my eardrums is the misconception that chiropractors are not "real Doctors".

When I ask people why they have this belief, they explain that Doctors can prescribe medicine, and that is what makes them a "real" Doctor.

Many psychologists, professors, Ph.D's, and chiropractors cannot and do not prescribe pharmaceuticals; however, they still have the title of Doctor, for having earned a Doctorate degree.

What is a Doctor?
The word Doctor in latin actually means "teacher". The job of a doctor, long before modern pharmaceuticals, was to educate patients on how to maintain health, treat conditions, and prevent disease. Providing pharmaceuticals is part of providing care, just like a dentist drilling teeth or a chiropractor delivering and adjustment. It has never been the sole purpose of a Doctor, nor the definition of their title.

Thomas Edison once said, "The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease."

Although I believe that pharmaceuticals are necessary, its the responsibility of every Doctor to use their role to educate patients on maintaining health, and preventing disease, before intervention is necessary. As a chiropractor, and certified personal trainer and weight management consultant, my goal is to help my patients and the public through education, and focus on disease prevention.

Lose More Weight (without trying)

It's Sunday night, and you have fully recommitted yourself to your diet and fitness program. Your fridge is full of skim milk, bottled water, and green leafy things. Your sneakers are primed by your bed for that morning spin class and you have your next vacation, bikini sans sarong, on your brain. You are ready!
However, life is stressful and you find yourself laying awake all night stressing instead of slumbering. You think about money, work, and soon your thoughts and worries spiral out further and further. Did you lock your car? What did your mom mean when she said that comment about your hair? Why can't you remember the last name of your high school chemistry teacher?
Monday morning rolls around and groggily you decide to skip the spin class. You wake up with voracious hunger and all you can think about is a sugary frappuccino topped with a glazed donut. You feel out of control, and find yourself hungry long even after you eat, enticed only by greasy, sugary, and starchy "comfort" foods.
You may chalk this up to your willpower, and blame yourself for another failed diet day. But, you should not blame yourself: blame your hormones.
Anyone who still believes that weight loss is a simple equation of calories in versus calories out is not aware of how complex the body truly is. Your body has an innate intelligence, and a strong survival urge, or else we would not survive as a species. If you think that willpower alone will outsmart your primitive human urge to not starve to death in a cave, think again. Each individual is a cumulation of genetic, psychological, and hormonal factors that have more control over your body than simply willpower alone.
The three hormones most responsible for appetite and weight control are Insulin, Ghrelin, and Cortisol. You may have heard of Cortisol being touted as a buzz word for "belly fat", which is partly true, but oversimplified.
Cortisol is not all bad, as it plays an important role in raising your blood sugar during fasting periods, such as sleep. However, when sleep patterns are disrupted, or your body is under stress and starvation, cortisol is over-secreted. High levels of cortisol release more blood sugar and insulin (which will store fat), cause too much "alertness" during sleeping hours, and increase appetite. Other pleasant effects include water retention (bloaty chub), muscle fatigue (crappy workouts), and decreased thyroid function (more chub).
Ghrelin sounds like an evil gnome from Lord of The Rings, and he can be an evil fat little gnome. His primary message to your brain: EAT. Not only does ghrelin cause intense hunger, but it causes cravings for simple to digest, high calorie foods. Ghrelin spikes after a short night of sleep, or after a bout of starvation (unhealthy dieting). This is why dieters tend to have intense binges, and why lack of sleep causes you to reach for the starchiest, fattiest, greasiest things you can find at a 6 am drive through window.
So, how can you control these hormones, and lose more weight without having to try? Hormones are a complicated picture, and vary by person, but one of the most simple things you can do is a no-brainer: Sleep. Adequate sleep (preferably the same time every night, by 10:30 pm) helps your body to wind down naturally and wake up refreshed, energized, and with your metabolism ready for action.
To help your body wind down, avoid sugar, caffeine, and heavy foods after 4pm. Try not to exercise late in the afternoon and overload your system with adrenaline that will end up being counterproductive for your weight loss.
To help your mind wind down, write your stressors in a journal and do not keep it in your bedroom. Take a slow walk, a bath, or simply sit in quiet and try breathing slowly. Also, kick the TV out of your bedroom. Your bedroom should be a peaceful place for two things: Sleep is one of them and TV is not the other!

For more info: To learn more about balancing your hormones for weight loss, look for Katie O'Neill's upcoming book "The Myth of Diets and Willpower: Why Fighting your Body Keeps You Fat".