Chiropractic Coalface

Case histories of interest

Chiropractic coalface has real case histories taken from the clinic.


There is a temptation in such a file to list cases that make the chiropractor seem like a demigod, able to diagnose and treat all mysterious conditions! Such is not my intention. Each patient in the chiropractic clinic is individual, his or her condition unique, and the treatment is almost always a challenge.

Some people respond very quickly, almost miraculously, but many require hard work on the part of your chiropractor. After all the condition often relates to something that happened many, many years ago. Hard work, a conscientious approach and honest cooperation is what makes for successful outcomes.


UPDATE: Because of the enormous interest in our Coalface anecdotes this page is now full. Instead of deleting anecdotes, you can continue to find new anecdotes at:

Anecdote of the Jar ... 

Short anecdote ...

Chiropractic coalface 2  - what makes a good doctor?



Interesting case of the week

Never trust a negative X-ray report, or blood test for that matter, when your instincts tell you: "there is something wrong." Get a second opinion.

Mr S fell three metres with immediate onset of ankle pain. Severe pain and swelling. X-rays on plain film were negative. He consulted me a year later, still with severe pain, limp and oedema. I couldn't see a fracture on the X-ray either but my instincts said otherwise.

Today the report of the CT scan I recommended. Two fractures, bad ones, right through the talus bone. And now?

Going back to the original X-ray, I can now see a suspicious line, but I would have missed it too.


This week a lady with pain, tingling and numbness in all her toes on the right foot. Two years ago she had an operation for a Mortons neuroma which did bring some relief for about six months. Then the pain returned with a vengeance.

On examination, the tests for a neuroma are negative, and I suspect there are two processes going on: metatarsalgia with possible irritation of the interdigital nerves, AND a peripheral neuropathy.

For twenty four hours she had almost complete relief of the pain after the chiropractic adjustment of the fixated medial cuneiform bone and the metatarsals, and then it returned. That tells us we are working in the right domain, otherwise there would have been no change.

I feel reasonably comfortable that she will get consistently 60-80% better after 5-10 treatments and a course of rehab exercises. Thereafter, maintenance care treatment is unavoidable, otherwise it is likely to slowly worsen again.

We watch with interest.

Update: The arrival of a grandchild has brought a hiatus in the treatment. Significant short term relief, but after two weeks, back to square one. One interesting feature: She is in the menopause and experiencing hot flushes - they increase the tingling in the feet!

Update 2: Alas, Chiropractic treatment hasn't helped significantly either. She's beside herself, another op is not one of the options. I recommend, as with all difficult conditions, an occasional, but regular treatment. Perhaps once a month.



"The biggest mistake people make in life is NOT making a living at doing what they most enjoy."

- Malcolm S. Forbes


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Chiropractic Coalface  - Buttock pain

Mrs G, a 72 year old woman came yesterday for her seventh Chiropractic Help treatment. A great encouragement. For nine months she has had severe L buttock pain. Walking was difficult, she had severely disturbed nights and was constantly taking anti inflammatory drugs. She assumed the worst: cancer or a hip replacement.

Fortunately, neither. The key sign: Kemp's test and a fixation at the corresponding level, L5 are pathognomic of a degenerative lumbar facet. She's a very large lady and, so certain was I of the diagnosis, that I suggested five treatments before taking X-rays, sometimes the wrong decision.

Yesterday she beamed. One mildly bad night, completely off the medication, and able to walk again. And she's lost 7 pounds. A large lady, I strongly warned her that something much worse than cancer or a hip operation is on the way. She's taking me seriously. With a Body Mass Index of 37 she's high risk...


  • Chiropractic Conditions is a central page at Chiropractic Help. It provides you simply and easily with the sorts of conditions that the average chiropractor would be treating.
  • Healthy Living Tips is another vital page at Chiropractic Help. Sparkling good health is not just about having your subluxations adjusted. Our healthy living tips page gives you some insights into different foods you could and perhaps should be eating.


Chiropractic Coalface  Warning signs

It's fairly uncommon for the body to suddenly produce severe conditions without prior warning signs that somethings is about to happen. A heart attack and stroke are exceptions perhaps, but even there raised blood pressure and cholesterol, and homosysteine levels are usually the precursors. But with backs there are usually warning signs. Mr T broke several rules. And is paying for it. He first consulted me a year ago with a severe slipped disc in the lower back; he had regularly had lower back pain for several years. Fortunately he took my advice seriously, came for the treatment, slowed down, did the exercises, and recovered completely.

Mistake 1: After several months of relatively little trouble, he missed his 6 week, "onder controle" maintainance care treatment, vital as in any serious disease process. Diabetes, kidney disease...

Mistake 2 (mine): I never phoned him to remind of the missed appointment.

Mistake 3: He stopped doing his exercises EVERY day.

Mistake 4: When his back started to niggle, for two weeks he did nothing, trying to up the exercises, but still not EVERY day.

Bang! Severe lower back pain, again in an antalgic posture. The Slump test was again strongly positive but he came quickly, the same day, so there was no tingling in arms and hands and feet. Fortunately for Mr T several factors are in his favour. His weight is perfect, he is extremely fit, and his chiropractor has now got his back figured. Adjusting L5 with a spinous push technique, whilst lying on his right side, does the trick. But for six weeks it's going to be weak again. Virtually every back that goes for surgery follows a pattern something like that above. In short, lack of attention to detail, essential in any severe conditions. Want to avoid surgery? Follow the slipped disc rules ...

Chiropractic Coalface  - SHOULDER PAIN

I'm afraid that every profession has its bandits. Highwaymen in white coats. Mrs M is a 32 year old woman with two years of shoulder pain. Surgeon told her she has an acromial spur and needs an operation. I thought it unusual, young folk don't usually get spurs, and sure enough none to be seen on X-ray. After only two treatments she declares her shoulder is 80% better. Miracles we do at once, the impossible takes a little longer.

Her problem is a complication of a cervical rib that is affecting the " inter scalene triangle " through which the artery and nerves to the shoulder pass. More difficult is going to be her hips. Both granny and her mother have had hip replacements, and she is already getting groin pain. X-rays reveal a hereditary condition that you can read about at this Femoro Acetabular Impingement syndrome case file - an ounce of prevention is worth a pound of cure. Can Chiropractic help with hip arthritis? Certainly, though not always. Nothing works all the time.

Missed diagnosis

A missed diagnosis is the dread of every doctor including chiropractors; there's not one of us that escapes. Right now I have a good friend, one of the best, who is dying from five metastases from prostate cancer to his spine; for five months he was just given painkillers by his medical doctor. I'm glad to say he was not treated by a chiropractor; living overseas he never consulted me either.

One of medicine's big beefs with chiropractic is that, by consulting an alternative or complementary practitioner, an important diagnosis may be missed. And I have to admit, it's true. But, this week, I've had two interesting cases.

The first a woman with pain in the groin and front of the thigh. Because she has a history of cancer, for three months her doctors have turned her upside down, taken her through the wringer, as they say in Holland, looking for the villain. No one thought to examine her back.

The second, a man with severe upper lumbar pain, also radiating to the front of the leg. Again, no one thought to examine his spine. Exhaustive tests found nothing wrong with his kidneys. Both have disc injuries in the upper lumbar spine, impinging on the Femoral nerve, giving pain in the groin and anterior thigh. A visit FIRST to a chiropractor would have saved them both a lot of pain, and unnecessary expense. Now to fix them!

Update:

The first case got better very quickly, luckily, a doctor's wife! The second decided, when he wasn't fixed after two treatments, to go elsewhere. Sigh, was Rome built in a day? I hope all is well with him. Perhaps I should call.


Prostate cancer

Speaking of my friend's prostate cancer, there is so much we can do to prevent this very painful and disabling condition; impotence is one of the first indignities.

Did you know that men who eat a tomato a day have half the prostate cancer of men who eat very few? It's in the red colouring; a phytochemical called lycopene.

Add to that the scientifically proven benefit of capsaicin in the chili family, lignans in 100% whole wheat flour, and your greens and you give yourself excellent protection against the most common non-skin cancer of men.

You can get all this is in one meal by enjoying eight colours eggs Florentine every morning for breakfast; I do without fail, seven days a week. That's why my urologist was astounded to find my PSA was less than 1.0. Amazing in a man of 68. 


Failed back surgery

Failed back surgery is not a chiropractic diagnosis; it's in medicine's own backyard. I must confess failed back chiropractic exists too, but the consequences are rarely so common.

This month in Holland it's been difficult sciaticas after back surgery. Yesterday a young man with nasty pain down the leg, and no back pain, after three surgeries when he was less than 30 years old. I wonder if we can help. A woman who had a severe foot drop after surgery and couldn't walk without a walker for two months (in her lower fifties), a top financier with nasty leg pain. And several more... Each of these cases have to be handled with care and consideration. None are ever easy. So far we are winning with all of them, oh except one. The pain in his leg was completely gone, then a shower of sneezes... back to square one. I won't pretend that chiropractic wins with all these cases, but before going for yet another surgery...

BACK SURGERY ALTERNATIVES



Chiropractic Coalface  - CAN'T WALK

It was only today, after three months of care, that Mr A finally admitted his greatest fear: That his sacroiliac condition would have meant he couldn't walk again. At 82, he was an extremely fit man, playing bowls and golf every week. Until his back struck! Months of struggle to no avail with medical treatment which brought no improvement and finally (though he didn't tell me) he had accepted that his sporting days were finally over. Even a short walk around the garden was agony. It proved to be no simple case. There was slow but steady improvement at the Chiropractic Coalface - and then he shook out the bedcovers, and did a mischief to his lower back all over again. Depression set it. Perhaps cortisone (his doctor refused), perhaps surgery, but finally common sense prevailed. Continuing with Chiropractic Help wasn't throwing good money after bad. Within two weeks he was up and about again. Now he comes once a month for a 'grease-and-spray', does his exercises faithfully and has been playing bowls and golf again for the last six weeks. EXERCISES FOR SACROILIAC JOINT PAIN ...



Chiropractic Coalface  : SEVERE HEADACHE

J is a beautiful thirteen year old girl with a severe problem. Nine months ago, for no known reason, severe headaches began for no apparent reason. She's been examined from stem to stern by the doctors to no avail. Nothing helped.

Three things were interesting in the consultation: Bruxism - she grinds her teeth at night. She has the pain on the side of her head and forehead. She has upper neck pain. On examination, a fixated jaw joints, a red hot Lateral Pterygoid muscle in the mouth radiated pain to her forehead, the left side of her face was actually numb, and an Occipital fixation in her upper neck.

There have been no miracle cures for this young lady. After eight treatments, she declared this morning that her headaches are about 40% less. I have asked her dentist to supply a plate to be worn at night. What is good is that the numbness on her face has gone. I'm thinking of a very nasty condition called Trigeminal Neuralgia... TMJ Ear pain … Her mother starts tomorrow as a new patient. She is taking 10 painkillers a day, 70 per week she assures me for lower back pain and headaches. That will kill her quite soon ...

Go to DUAL ANTIINFLAMMATORY DRUGS …


Chiropractic Coalface  : SCOLIOSIS ...

My first patient yesterday was an 82-year old lady with the worst scoliosis I have ever personally seen. She was returning for her second consultation. Mrs M is well acquainted with chiropractic. In fact she was treated by my mother Dr Unity Lewis DC, until her death in 1992, and my father Dr Dick Lewis, DC before that. Since then she has seen a variety of chiropractors whom she said were too afraid to adjust her, medical specialists, physiotherapists but for two years she has had unremitting low back pain radiating to the posterior right thigh.

Touching her toes (not recommended) relieved the pain, and bending backwards caused excruciating pain. Sitting relieved the pain. Walking was very difficult, and she arrived in a stooped, forward bent position.

These are signs of a horror condition: Lumbar Spine Stenosis LSS. Happily, I was able to adjust her back with ease, and she reported the pain was 20% less. Extension was markedly better. I'll be making a webpage of this case in the future.


"Action is the antidote to despair."

Joan Baez



Chiropractic Coalface  : Osteoporosis ...

My first four patients yesterday were aged 63, 79, 86 and 77. All four (three women) were osteoporotic to one degree or another... Medical sites give tacit support to Chiropractic now that researchers have proved that manipulation is more effective than what Medicine has to offer for many joint conditions. But uniformly they state that osteoporotic patients should stay away from chiropractors. I will admit to having contused about six ribs in thirty years in practice... but how many osteoporotic patients have been helped? The most difficult of the four interestingly was the youngest, and certainly the fittest. She walks regularly but ever since a slipped disc was poorly managed two years ago she has suffered from low back and leg pain.

Mrs P had a very stiff neck for six months and was told she had arthritis and there was nothing to be done. Only one treatment brought a 50% improvement in the cervical facet syndrome and after 3-4 treatments she has almost no neck pain. Yesterday she stepped in a hole unexpectedly, and now has low back pain...

Mr B the eldest of the group is one of those miracles-we-do-at-once, the-impossible-takes-a-little-longer cases. He has had carpal tunnel bilaterally and for a year hasn't been able to do up buttons or sign his name. After only one treatment he could do buttons again, and after the second could sign his name for the first time in a year.

Mrs T fell on a rock 8 years ago and has sacral pain ever since. She's a new patient so we won't do any boasting! MY point? We adjust our techniques and power with the elderly. Very occasionally it does go awry. But if one was to apply the same logic, then nobody would ever be taking anti-inflammatories. Just last week a friend had a severe stomach bleed after taking voltaren daily for six months. 14 000 patients per year DIE in the USA from gastro-intestinal bleeds directly caused by anti inflammatory drugs. Have NSAIDs been banned? No sir! CAUSES OF OSTEOPOROSIS ...

Chiropractic Coalface 
: Pulled hamstring ...

Mr A is a 34-year old Fitness Fred. He'a a triathlete, but two weeks ago he pulled a hamstring, or so he said. Why was I concerned? Because pain in the posterior thigh on bending can be caused both by a sciatica AND a hamstring. Which was it? Fortunately there are some simple orthopaedic tests to distinguish between them, and indeed he was right. Braggard's test was negative, though Straight Leg raise was strongly positive, and what clinched it was a test called a Resisted Isometric Muscle contraction: clearly a hamstring.

What was interesting was an extremely fixated sacroiliac joint on the same side. So, some basic chiropractic and by the end of the session the Straight Leg raise was nearly normal, and more important he could walk without pain. After the second session he reported no pain with ordinary activities, though I haven't yet allowed him to run. He's going crazy...! Stick to swimming and cycling meantime, Mr A whilst we're busy with sacroiliac joint treatment and Active Release of that hamstring. Next session we'll start with rehab. SACROILIAC JOINT TREATMENT ...


Chiropractic Coalface  : Whiplash Chiropractic

A new patient, a young woman of 32, in the practice this morning is typical of what happens in a whiplash. Six months ago they were hit from behind on an MVA. She had no inkling, and had no time to tighten her neck muscles, as her husband had - he saw the speeding car in the mirror.

She had immediate pain in her neck, but not severe. She was examined the next day by her doctor who found nothing. The pijn gradually diminished, but 4 weeks ago it became very severe, radiating down her left arm which had a very "heavy, tingly" feeling.

A hernia was quickly ruled out: The Upper Limb Tension Test was negative and compression tests were negative. But... pinwheel testing revealed that her whole arm was 30% more sensitive than her right arm. And "Adson's" test for a Thoracic Outlet Syndrome was positive. What's that?



Chiropractic Coalface  : Colic Chiropractic ...

Little Damian first came three months ago. He was 9 months old, and had been screaming his head off for four months. It all started when he was five months old, suddenly he wouldn't sleep normally, and yelled like a stuck pig. Their doctor said it would go away with no treatment - but in Damian's case the Infantile Colic was getting worse and worse. The cause? A subluxation in his lower neck.

Taking a shirt off his head made him scream in pain. What I love about treating children is how quickly the respond. Just one treatment and Mama swore he was 50% better. Now he's scampering around the clinic, full of beans, only he doesn't like his chiropractor any more. The moment he saw the activator, he thought an injection in the bum was coming, and screamed his head off! Next consult: 4 months. And still medicine is dubious. None so blind as those who WILL not SEE. CHIROPRACTIC HELP baby colic cures ...

Chiropractic Coalface  : Headache Chiropractic ...

It was good to see Shaniqua yesterday. What a beautiful child, only 10. Two years ago she started getting terrible headaches for no obvious reason. First her mother came for treatment for a nasty case of Tietzes syndrome since being viciously attacked (ten years previously) and kicked in the rib cage.

Shaniqua had a simple straightfoward subluxation in her upper neck. I've now discharged her for two months. Such a bright face... I love treating children. She doesn't love me though. She's one of those kids who is anxious about being adjusted. She's happy about having no headaches, though.


Chiropractic Coalface  : Headache - could it be coming from your jaw joint?

It's not every day that I have a referral from a pediatrician. Anja, aged 15 was referred to me some 6 months ago with severe headaches. EVERYTHING, but everything had been tried. Finally, in desperation Dr X shall we call her, said to Anja's parents: "Try a Chiropractor". I happened to be the nearest. It was a pleasant surprise to get a very nice letter of referral from her pediatrician.

The long and the short of it, is that just touching the right Tempero mandibular joint, the temporalis muscle and the external pterygoid muscle were red hot. I won't pretend the treatment was fun, but Anja was much improved within weeks. She now comes for treatment every two months - today was one of those days. She has absolutely no headaches anymore. Update: Anja came in for her 2 monthly adjustment this week. It's been so good we have made her next appointment in three months. It's now two years down the road - quite a dishy young woman in the making! The change in her demeanor without headaches is really quite amazing. CHIROPRACTIC COALFACE

Chiropractic Coalface

Neck pain - do you know the SIX MONTH RULE?

If you've had neck pain and headaches for more than six months, research shows that it will probably never go completely away, no matter what you do. So, you have a six month window to deal with your neck pain.

We don't in chiropractic promote the idea that you must run off to your doctor for every snivel, or your chiro for every little pain. But, if you neck pain hasn't subsided after a decent period of time, please don't wait 6 months and then expect a miracle from your chiropractor. You probably won't have it.

Miss P a very attractive 23 year old young woman consulted me three months ago with headaches and suboccipital neck pain of about six months duration. Fortunately just in time. She had an atlas subluxation from an an old fall off her bicycle. She came in this morning for her 5 week follow up, and has had no headaches at all. So we are spacing the treatments further out.

Miracles we do at once. The impossible takes a little longer ...! Neck pain anatomy >>

Chiropractic Coalface  :

MERALGIA PARESTHETICA - pain or numbness in the upper thigh

It's not often I get really mad, but this week I was cross. And sad, because it was all so needless. About 6 months ago, in the same week, two women, we'll for convenenience call them Mrs A and Mrs Z, consulted me with the same problem, one of the less common conditions, called Meralgia Paresthetica. A pinched nerve in the groin that can either cause just plain numbness on the side of the upper thigh, and sometimes on the anterior thigh, and frequently a severe tingly nerve pain. Electic shocks. It belongs to what we call a "double-crush" syndrome - almost invariably the nerve is affected in both the high lumbar spine and the groin. Now that I understand it, it's become a condition that I treat with great confidence. More about UPPER THIGH PAIN, MERALGIA PARESTHETICA ... CHIROPRACTIC COALFACE

Both responded well in the first week with much reduced pain in the leg, but the family of one of the women, Mrs Z, persuaded her that she ought also to consult her doctor. I had no good reason to disagree as Meralgia Paresthetica is (rarely) also caused by a tumour or abscess lying deep in the pelvis. Mrs Z stopped coming - her doctor said it was far too serious a condition for a Chiropractor, and in any case "no treatment medical or otherwise has been scientifically proved to work". That in fact is so.

Mrs A continued to respond well. She has no pain any longer and now comes in every two months for maintenance care.

But Mrs Z phoned yesterday to inform us she's having a back operation next week. Sigh, so needless.

  • My two oldest patients are unbelievable women. Mrs S plays tennis four days a week, just because it's so lonely at home. She is 87. All her friends have either died or lost their marbles. She has a 2-monthly adjustment of her low back which is sometimes troublesome. Read more about the Lumbar Facet syndrome …

    Mrs van P is a new patient this month. At 86 she was just as amazing until she sprained her left ankle quite badly two years ago. Since then she could hardly walk, and it was getting worse. After only six treatments she reports that the pain is all but gone, and all that remains is stiffness. I love treating feet! CHIROPRACTIC COALFACE Read more about Ankle exercises …

Chiropractic Coalface

POSTERO MEDIAL DISK HERNIATION - look like the Leaning tower of Pisa?

Dutch men are the tallest in the world. An oft used expression is: Tall trees catch much wind. Mr S is a very tall man and has a horrid back. He regularly goes into an antalgic posture.

There are two main kinds of lumbar disc antalgias:

  • Leaning towards the pain.
  • Lean away from the pain.

The first, the so-called Postero-medial disc protrusion is much easier to manage from a chiropractic standpoint, but both types take 6 weeks to heal. This P-M type is thus prone to relapse.

Mr S has the PM type, leaning towards the pain, and responds very quickly, often coming up straight after one or two adjustments of his spine and sacrum. He thinks I have golden hands! He then has minimal pain for several weeks until the next relapse occurs. He is very thorough with his exercises, is careful, does every thing right, cannot be faulted, except ... he is a heavy smoker.

New research from the NY University Medical Centre Hospital reveals that patients with Rheumatoid Arthritis who stop smoking have fewer swollen and painful joints, and lower CRP; this is a marker found in the serum of patients with acute inflammation. Every chiropractor knows that treating smokers with acute joint conditions is far more difficult. Read more about Postero Medial disk herniation …

Update to CHIROPRACTIC COALFACE: Two months ago Mr S took the brave decision to quit the weed. That, together with a heel lift for a short leg, have made a dramatic difference. He's now coming in every six weeks.

  • Six weeks ago a 49 year old woman, Mrs Z. consulted me with acute bilateral pijn on the soles of both feet. It was so bad that she had been on crutches for the last 4 months. It is a complex case, so I won't bore you with all the details, but let's just say that treatment of the fixations in her feet, and the sacro-iliac joint, painful crossfriction of the plantar myofascia and the soleus muscle. We are now in the rehab phase with plenty of exercises to prevent what the Dutch call a 'fall-back'. Quite expressive. Quite clearly she suffers from Polymyalgia Rheumatica. Touching almost any muscle causes radiating pain, what we call an Active Trigger Point. Within two weeks she was off the crutches, and now after 6 weeks she declares she is 80% better. We are both well pleased. Read more about Chiropractic treatment of Foot Pain ...
  • Leg length has long been known to be an important factor in low back pain, and the development of hip and knee arthritis. This week I have decided to reassess two patients with neck pain that was not responding as expected. X-rays show a significant curvature, starting in the pelvis, and progressing up into the neck. Recent research suggests that a simple heel lift may also help with neck pain. I'll keep you informed on how they progress. CHIROPRACTIC COALFACE Read more: NECK PAIN ...



By golly. What, again? Mrs Debets is a vivacious young woman who consulted me three weeks ago with a very sore low thoracic spine after her company took the whole management team for an outing. To a golf pro for a fun day. She had never played golf in her life. What she didn't tell me was that she and her husband had been trying for over a year without success to have a child. The low thoracic spine is a vulnerable area, being what we call a transitional area from the very stable thoracic spine (because of the ribs) to the highly mobile lumbar spine. It's a common area of complaint for a condition known as Maignes syndrome ...

Chiropractic Coalface

Such excursions are in my opinion foolish. Over the years I have seen so many injuries to persons completely unused to a particular activity. In any event, Mrs Debets developed an acute facet joint injury in her lower mid-back. In my first years in practice I tended to treat only the presenting complaint, until one day I read a research project revealing that the degree to which patients were healed of other "medical" conditions by chiropractic was dependent on how many areas of the body the chiropractor treats. On finding a profound sacral subluxation, Mrs Debets admitted to a nagging stiff low pelvic are of some years duration. She could remember no specific injury, and it was never bad enough to do anything about it. The long and the short of it is that Mrs Debets gleefully told me this morning that she is pregnant. Working back, we calculated that conception occurred the night after her second sacral adjustment. INFERTILITY CHIROPRACTIC ...

An aside. I always address smoking and obesity ONCE, AND ONCE ONLY, firmly, at the first consultation. And then hold my tongue. Happily she told me this morning that after she and hubby had repeated the home preg test three times, unable to believe their good fortune, they had both decided to quit. Smoking will knock the last ten years off your life. More if you are unlucky, and the end will be S-H-one-T.



Chiropractic Coalface

Mr Hardeman is an inspiration to me. At 87, fifty years a diabetic on insulin, he is extremely fit and healthy. Except for one thing. A very nasty foot, with a condition called Charcot Foot, which fortunately at present is not active. He has kept healthy so long because of his commitment to the WALKING benefits .

Really the pain in his foot was not coming from the degenerative joints and soft bones, but from a severe plantar myofascitis. He is responding magnificently to chiropractic care of the foot.


Chiropractic Coalface
Mrs de Witt has been unable to sleep properly for the last three months because of a miserable neck. And anybody without sleep is truly miserable.

Suffering from a routine Cervical Facet Syndrome, a condition that usually responds magnificently to chiropractic adjustments, her husband says she is now back to her old ebullient self.

A nasty hip bursitis that has been troubling her for six months is proving more stubborn, but we will get there. Rome wasn't built in a day. A new patient less than a month ago, she is a very happy lady.


Mrs Joure confided in me that the night after the fourth consultation she would never again consult a chiropractor. During the first three consultations of a ten-year long struggle with low back pain, I adjusted only the sacro-iliac joints. With little effect, neither good nor bad. Having cleared out the fixations in the pelvis, at the fourth I adjusted her spine for the first time for a lumbar facet syndrome .

That night she could barely walk up the stairs to bed, and the next day was pretty miserable. By the fourth day? A miracle! 80% less pain than she has been having for ten years. While this is only the beginning, with our rehab program looming,

I have realised over the years that a strong reaction to treatment is not a reason to stop consulting a chiropractor. In fact there is some research suggesting that if you don't have some reaction, you may have little benefit from the treatment.


Mrs In het Veldt: I have been treating for some months first a young woman, and then her 7 year old daughter. Mum I suspected was a very attractive woman, but it was buried beneath 20 odd kilograms of fat. As a divorcee, her prospects I thought at any rate were poor, but now with considerable badgering, and the guidelines provided in our safe free weight loss programs she has lost 14 kg, and hey presto, the ugly duckling is indeed a very graceful swan!


Her little daughter was an altogether tougher nut. A fall from a swing one year ago resulted in constant headaches and neck pain. The real problem was not her neck but gaining her confidence to let me do something about it. Fortunately, and it's a big fortunately, she responded very quickly, and after three or four visits she has no pain, and no fixations. I didn't have to treat her today which was a relief to us both. The treatments have been a drama to say the least.


Treating even children against their will raises many ethical questions, and I didn't like tricking her into letting me adjust her. In any case, she was too smart after the first couple adjustments.


In thirty years in practice I have come to appreciate the trust of parents who let you adjust their children. Kids don't bounce - many of those childhood injuries result in a life time of pain.


Chiropractic Coalface

There are not many more scary conditions that one called a Spina Bifida. They come into two types. "Occulta" which you ignore completely, it has no clinical significance, and "Vera" the true one. Mr Andeweg has the true one, I must say the first I have treated in 30 years. If I pressed just a little harder I could touch is spinal cord. The bone protecting it never formed. Could I help him?

Fortunately for him he was treated by an obviously excellent surgeon, fifty years ago. He has no neurological complications which so often accompany spina bifida vera. But he has constant low back pain for ten years. After the examination I concluded that his pain had nothing to do with the spinal bifida and, while there were risks, it was worth taking on his case. We started gently, and are now manipulating his back quite forcefully. He (and I!) are very pleased. He is responding quite nicely, and playing golf without much difficulty.


CHIROPRACTIC COALFACE:

Today a new patient presented with what is likely to be a very tough nut. This 17 year old girl fell 1.5m straight onto her head at 4 years of age. She has had constant neck pain for five years, and now also low back pain. The real problem is not the original injury, but the fact that someone taught her to manipulate her own spine, which she does 2-3 times a day. Now she has developed quite serious neurological signs in the neck and lower back. She is also a tum-sleeper. There are no real guidelines for chiropractors, but I am personally reluctant to manipulate a joint more than 25 times a year, and that may too much. She has been doing it about 1000 times per year. Self manipulation in my experience leads inevitably to neurological complications.

Illness is cumulative. Injury + self-manipulation + tum-sleeper = serious problems. The first challenge is to get her to change her habits. The next to fix the problem. Watch this space!


Chiropractic Coalface

This week I was very pleased. Yes, with myself! A little pat on the back. Five months ago whilst successfully treating Mrs Deynoot's sacroiliac joint treatment she asked me if I could treat her grandson's bedwetting. Vincent is 15 years old. I hesitated having failed before with bedwetting. But that was before I attended a congress, and learnt some new stuff about adjusting the sacrum. What struck me yesterday, oddly, was not that Vincent, after only one adjustment, was totally cured. What blew me over was that I didn't recognise him.

Five months ago he was a miserable, almost shrunken, fearful human being. In five months, Vincent is transformed, a new person. There has been an explosion of growth, and a complete personality change. There are few things more humiliating and painful for a teenager. I literally did not recognise him. The good wife has warned me. Apparently I am on the verge of becoming a smug jackanapes!

Yesterday that was true. Today I was brought back firmly to planet Earth when a patient with a very serious sciatica with a footdrop, one that I thought we were winning with, took his surgeon's advice. He's scheduled for the knife on Monday.


Chiropractic Coalface

In similar vein, baby Jason arrived this week for his three month check up. Four months ago Jason's mother brought the mewling, unhappy little mite to see if chiropractic had a solution to what the Dutch call a 'huilbaby' - infantile colic. The laddy was shrunken and miserable. In three months he is utterly transformed. Hours of cyring, caused by a subluxation in his low back, were really retarding his growth. A smiling, hugely healthy baby reminded me again of the power of chiropractic. And the negative power of subluxations, perhaps more obvious in children. For more about the chiropractic care of infantile colic, click here. COLIC CHIROPRACTIC ...


"Most people live...in a very restricted circle of their potential being.

They make very small use of their possible consciousness, and of their soul's resources in general, much like a man who, out of his whole bodily organism, should get into a habit of using and moving only his little finger."

- William James, psychologist.



Chiropractic Coalface

  • Mr Tom Prooi consulted me this week with pain in the neck running down his right arm. The pain began about six weeks ago after he carried his son on his neck at a musical concert. Six weeks of PT reduced the pain by about 40% but he noted that his arm was becoming weak. What was significant was that rotation of his head to the right, and particularly looking up, immediately provoked pain down his right arm to the first and second fingers. A neurological tension test for the brachial plexus of nerves was postive, and there was the beginning of weakness in a shoulder muscle.
  • Carrying a child on the neck thus frequently overstrains the neck. My tentative diagnosis was a facet syndrome, though a disc injury is possible. He has never had neck pain before, no trauma, so my thoughts were that a slipped disc is unlikely. Watch this space! Two weeks later: Tom has no pain in his arm now, he is sleeping well but, worryingly, on right rotation and extension, he immediately gets tingling in his arm. He is well satisfied, but I must confess I am less happy. I am thinking a disc protrusion is a distinct possibility.
  •  Pain in the arm, a true brachial neuralgia, ARM PAIN ... pinched nerve in the neck, is probably the most challenging condition that a chiropractor faces. Four weeks later: Tom continues to improve. Ten week update: Tom has no pain, and I have discharged him, recommending he come back in two months for a grease and spray.
  • Chiropractic Coalface  Mr Fred Smitshoek took early retirement this year, and helps his brother on his farm. Last year he had sudden low back pain after driving a tractor, which radiated down the leg. His thigh muscle became severely wasted, but gradually the pain lessened. Suddenly, two weeks ago he had a severe spasm in the back, with tingling in the leg. In terror that another such attack was imminent, he made an appointment. Yesterday, after only one treatment, he is 70% better, and to my horror back on the tractor. I stressed: rehab is essential, and the altho the pain has receded, he had better work on a minimum of six weeks before healing is complete. The worst backs are those which get half better, and then a setback before healing is complete.
  •  My advice. Never take an acute low back for granted. They can be bastards. Do the exercises faithfully, and don't play silly buggers until your chiropractor gives you the green light. 
  • An analogy. Twice recently in the European Football Cup, Turkey one a seemingly lost match in injury time. The opposition relaxed, thinking the match won. Don't let the surgeon score any goals in injury time! It happens. The acute low back is vulnerable for six weeks or more after injury. Update: Six weeks has passed and he is having little trouble. The apple and pear picking season is about to begin in Holland. Dutch pears are the best I have ever tasted! His next appointment is scheduled for two months time. I wonder if he will survive the picking season ... it's heavy work. For more information about the so-called slipped disk , click here: SLIPPED DISK ...


Chiropractic Coalface

  • Mr John Mayer reported today that the pain in his chest - actually the joints right adjacent to his breastbone - has completely gone. He's had the pain for nearly two years. His doctor thought at first he had a heart condition, but extensive tests proved negative. Then it must be a gastric ulcer. A gastroscopy and other tests proved negative. He was referred to me for headaches actually, but chiropractors mostly do, and certainly should, do a full examination of the whole musculo-skeletal system. It wasn't rocket science to diagnose a case of Tietzes Syndrome ...
  • CHIROPRACTIC COALFACE: The headaches I must confess are being more difficult, but then he's had dreadful headaches for twenty years. For ten days after an adjustment he has no headaches, and then they start up again. The good news is that he is using half the headache medication he was three months ago. I was hoping for better ... it can be difficult at the chiropractic coalface.
  • Mr Laflamme consulted me a nastly little problem. Two years ago he fell down the stairs, on his buttocks, from top to bottom. For two weeks he was black and blue, but now for two years, sitting remains very awkward. He has injured his coccyx. The coccyx was very tender (deep down in the crease between the buttocks) and interestingly a very marked Sacro-Iliac fixation. Nobody was more astonished than I, when he reported yesterday that just one adjustment of the SI joint, and an external manipulation of the coccyx, has decreased the pain by 50%. Miracles we do at once, the impossible takes a little longer! This is rather unusual, a chronic problem like that often requires a proper course of treatment at the Chiropractic Coalface, then rehab, followed by an occasional treatment. Update. Jan is back riding his bike with no problems. I have scheduled him for a two months review. For more about chiropractic management of the coccyx, click here CHIROPRACTIC and a COCCYX PILLOW …



    Needless to say, the Chiropractic Coalface is an extremely interesting place to work. How many people, with their 60th staring them in the face, are TOTALLY satisfied with their career path! Update: 60th! Now 63rd coming up! Still at it, every day, marvellous.

Chiropractic Coalface

  • Mrs van Dieren is a very happy lady. She can enjoy intimacy in her marriage again. During the last trimester of her last pregnancy (the child is now 13 months old) she started to develop severe pubic pain. Told by her gynae that it is a normal part of pregnancy, that there was no treatment, and it would resolve after the birth, she quite naturally accepted it. But the pain didn't resolve, and started to spread into the groin and down the inner thigh. Spreading her legs was very painful, and the pain woke her every night. Walking for more than twenty minutes, particularly shopping, was very awkward. There was only marginal improvement for the first two weeks of treatment (and the treatment of the groin is very painful), but she stuck it out and yesterday she reported that the condition is 70% better. After only one month of treatment. This is not an unusual complaint, and it's not only related to pregnancy, though pregnant women seem more prone. For more information about this very awkward syndrome, click here. LEG PAIN DURING PREGNANCY ...

    Like good music? Go to this link " Lay your hands on me ". /watch?v=EwuibLq25qU

    Chiropractic Coalface
  • Whilst it may seem from this little chiropractic coalface list that every patient has unique and interesting problems, probably 70% of every chiropractor's life is taken up with the humdrum - routine maintenance of the body. There is lots of research showing that an occasional regular treatment helps prevent gradual deterioration again. So we have heaps of people coming in every two or three months for an adjustment. We chiropractors are roundly criticised for this, and I confess to having struggled conceptually with maintenance care for many years.
  • I have gradually come round to the opinion that those folk who have an occasional, regular treatment, have fewer problems, and generally less treatment (and it costs less money) than those who wait until it is painful again. Having said that, there are a good many people who, after a course of treatment, and a faithfully done set of home exercises, have no more troubles for years. They are the exception though. So you see, it was a wonderful week at the chiropractic coalface. True, some patients with whom it was not going so well.
  • Not yet, Aachen and Cologne weren't built in a day, as they say in Holland, nor does chiropractic fix thirty years of damage in a few short weeks. Been to Rome, Aachen and Cologne? If not, and you love to travel, add them to your next holiday in Europe. You won't be disappointed. Apologies for all the "CHIROPRACTIC COALFACE" signs. Google demands it so the page gets Brownie points!
  • From Coalface back to why chiropractic help?
  • Inspirational stories

» Chiropractic coalface


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.