Backpain Blog

Helpful information about the neck, back, and other musculoskeletal pain and disorders. Tips for a healthy back and neck.

Friday, August 10, 2007

You're hurting. Does your insurance care?

by Dr. Joseph Pigg, D.C.
When insurance first started covering chiropractic back in the 1980’s, they simply paid for everything for as long as the chiropractor and their patient felt it was necessary. Nowadays that is not the case. Chiropractic is still covered on most insurance plans, however, they now require more documentation than ever before showing proof that the patient is getting better overall and that the care is still having an effect.

In a 2007 article in “Dynamic Chiropractic Newspaper” by insurance specialist Samuel Collins, a review of insurance approvals vs. denials of chiropractic care found that further care was allowed when patients’ function improved. That’s right, I said “function” not “pain”. The insurance does not place much value on whether or not you’re feeling better, but only if you’re functioning better. Function has to do with your range of motion, muscle strength, ability to complete daily tasks at home and work with little problem, etc… Pain, though valuable for us as doctors to understand, is not the driving force when they decide whether or not to allow continuance of care. And if you stop for a moment to think about it, if you ARE increasing your range of motion, strength and flexibility, you would be feeling better in most cases anyway!

So I am going to give you some free advice to teach you a way to improve your lower back muscle strength and function. I like to call this the superman exercise. It’s based on strength and proprioceptive training (a big complicated word meaning “position sense of your muscles”) of the Multifidi muscles of the spine. These are the short skinny muscles running up and down each side of your spine which control balance, posture, and stance. If you’ve ever had back pain that caused tightness in your spine, it was likely coming from these deconditioned muscles. These exercises are designed to be done on a gymball. Most people fit comfortably on a 55cm or 22inch gymball which can be purchased through my office or at most sporting good stores.

First laying stomach down on top of the ball. Start by pulling your belly button up towards your spine and allow your hips to rotate slightly forward. This is called a pelvic tilt or abdominal hollowing. From this held position, bring both arms out in front of you and lift your upper body up off the ball slightly so that only your hips and waist are in contact with the ball. Hold for 7-8 seconds. Come down and relax. Then repeat 8 times. Once you get good at it, do the whole exercise with your eyes closed to put more demand for balance on the multifidi muscles of the spine. Once you get even better, try it again with only one foot in contact with the ground behind you.

Keller, MD in the 2004 journal Spine showed that this simple exercise was superior to back surgery.

For help in learning this rehabilitative exercise, ask me to personally teach you this exercise the next time you’re in the office.

1 Comments:

  • At 1:40 PM, Blogger Ryan said…

    I recently read a post from Dr Fred Kahn on the role of the insurance companies in medical practice. http://drkahn.meditech-bioflex.com/2007/06/medicine-and-the-role-of-the-insurance-company.php

    I don't carry a lot of hope for the insurance companies to get their priorities straight, so it's nice to have useful articles like this to give practical advice on how to feel better and prevent pain.

     

Post a Comment

<< Home