Before your first visit, we have some paperwork for you to fill out. You may click on the previous link and can fill it out online before you come to our office. The paperwork provides us with general information about yourself and the problem you are seeing us for. You can download and fill out the form ahead of time here. Please bring these completed forms with you to your first appointment. Alternately, you may contact our office and we will email them to you before your first appointment, along with any outcome assessment forms that are appropriate.
History & Examination
In order to determine what your problem is, the doctors and physical therapists will first take a patient history, asking questions about your current problem and your overall health history. Next, chiropractic, orthopedic, and functional exams will be performed. Information from the history and examination help determine what structures you have injured, whether chiropractic treatment or physical therapy can help, and what exercises or other home care measures are indicated.
Most problems do not require x-rays or advanced imaging (MRI, CT), but if necessary they will be done at Martha Jefferson Hospital, where a medical radiologist as well as Dr. Spillman will review the films.
Review of Findings
Following the history and examination, we will explain your diagnosis and discuss how chiropractic treatment or physical therapy can help, the role of posture and exercises, the length of treatment, or, when appropriate, referrals to other providers. A treatment plan will be outlined that typically includes a combination of in-office treatment, therapeutic exercises to be done at home, as well as any appropriate ergonomic or activity modifications. Our goal is to release each patient returned to full activity without pain, with the lowest possible chance of re-injury.
Same Day Treatment
Once finished with the history and exam, patients will generally be provided with their first treatment during this same visit. This usually includes spinal adjustments, physical therapies (myofascial release, ultrasound, electric muscle stimulation, heat/cold), and exercises.
Prior to leaving, patients will be given instructions on certain activities or procedures to be conducted at home. This may include ice or heat application, avoidance of certain activities or positions, posture and activity advice, as well as home exercises and/or stretches.
Schedule your Next Appointment
You will be given a convenient appointment time for any necessary follow-up visits. At your second visit, your doctor or physical therapist will review your diagnosis and treatment plan with you.
Typically our patients encounter 3 stages of care. The first stage focuses on symptomatic relief such as reduction of pain and other discomforts. The following stage addresses tissue healing and function normalization. The final stage consists of periodic spinal care to prevent the formation of new injuries, minimize future flare-ups of old injuries, and prevent degenerative spinal processes from occurring.
1. Relief Care
Relief care is the first stage of care for most patients. The primary goal during this initial stage is to provide the individual with symptomatic relief. Treatments focus on those techniques and therapies which most quickly and effectively reduce pain and other discomforts. This will allow the majority of individuals to continue their activities of daily living. Patients are generally recommended to “take it easy” but are encouraged to stay mobile and functional so long as there is not a risk of further injury or tissue damage. Therapies that reduce inflammation and muscle spasm are also used during this stage when present. This stage is composed of acute and subacute care: Acute (first 3 days after injury) Subacute (2-3 weeks after injury, at the end of this stage should have full pain free range of motion).
2. Corrective Care
The second stage of care consists of correcting the problems which caused and contributed to the condition and healing and rehabilitating the injured tissues. Unless these events take place, a favorable outcome is unlikely and future recurrences of the problem are likely. It is extremely important that the patient comply with and follow the instructions given by the doctor or therapist during this stage of care. Tissues and structures that are not fully healed and rehabilitated are prone to future problems. Sticking to appointments, complying with home exercises and instructions and following all other recommendations will help insure this occurs. Patients should also be aware that once pain and discomfort have subsided, tissue healing and functional correction is many times still incomplete and will often require additional treatments. This stage includes lifestyle modification and a home exercise program. Office treatment often include both a manual component as well as exercises. Exercises should be local, regional and global. If it doesn’t heal properly a 65% chance of reinjury is possible, especially of the patient or athlete has functional deficits elsewhere. Our goal is to release each patient pain free at full function without issue.
3. Wellness Care
Once the tissues are healed and the biomechanics and movement patterns have normalized the patient may be recommended to continue with periodic checkups. For some this might mean once per year, for others this may mean once per month or more. For most patients it may not be necessary. It depends entirely on the individual patient and factors that are relevant to them (body type, type of work or athletics etc). Chiropractic checkups provide similar benefits to the spine that dental checkups provide to the teeth. Namely, catching minor problems and disturbances before they have the opportunity to cause pain, discomfort or lead to injury.