Dr. Nathaniel Luke Puyau, D.C.

With any type of chronic pain, one must do a deep dive to see what has happened or is happening to contribute to this condition. In the case of joint pain, previous injury history and a full biomechanical workup are essential. Is the joint pain due to a physical restriction of movement from arthritic changes, or perhaps it is restricted due to a tight or non-engaging muscle. The supporting muscles around or near the joint may be overloaded or deconditioned, thereby transferring more stress onto the joint itself. So as you can see, there is no simple answer to your question. You may require flexibility and/or stability work in and around the ankle. If there is arthritic changes to an ankle joint that is causing physical grinding or impingement, no amount of stretching will reverse those changes. Certain type of injections may be beneficial, such as PRP, cortisone, or ozone (beyond my scope so I defer to the appropriate providers). There are other therapeutic modalities that may be of benefit such as laser, shockwave, Graston or even custom foot orthotics. TL;DR - you need to get an evaluation to determine what or who can help your chronic ankle pain. This may or may not be within the scope of a Chiropractor. Good luck!

For most situations, BOTH work (together) the best with an edge given to Chiropractic. Sciatica is basically a symptom of nerve irritation somewhere in the body. Chiropractors are more equipped/trained to diagnose the cause of the sciatica and treat accordingly. Massage may be recommended by the Chiropractor, especially in cases where the sciatica symptoms are brought on by a spasm of the piriformis muscle, which is in the hip/gluteal region. I hope this helps and you find relief soon. Good luck!

This seems like a question that should be asked BEFORE an adjustment. Regardless of that, yes it is okay for a chiropractor to adjust (not "crack") your spine; that's what we do. Now if they were checking your teeth for cavities, then your worry is warranted. Otherwise, you will be fine; enjoy the adjustments and better health. Good luck!

Short answer: yes. The long answer requires more information about the herniation (which disc, how and when it happened, imaging results, presence of neurological symptoms, etc). This should be discussed with your Chiropractor. If necessary, they may refer you for additional testing (e.g. nerve conduction studies) and/or consultations with other providers (neurologists, physiatrists, etc). I hope you find the answers you were looking for and get better soon. Good luck!

Best case scenario: the herniation heals on its own and you may be fine for an indeterminate amount of time. Worst case scenario: the herniation worsens and begins to cause neurologic symptoms such as tingling/numbness and/or muscle weakness in the extremities or other parts of the body (depending on where the herniation is in the spine).
With that being said, it is always the better choice to AT MINIMUM get evaluated by a trained provider, whether that provider is a Chiropractor, Neurologist, or even your Primary Care doctor. Whether or not you follow their advice is up to you, but at least you will be better informed.
My advice is to get treated by a Chiropractor to not only speed the healing of the herniation, but also to rehab the area and surrounding structures so that any future issues the herniation may cause are minimized. Best of luck to you.

Chiropractic adjustments help to decrease nerve irritation, which may be causing your muscle pains. In addition to adjustments, most Chiropractors use a variety of other therapies to decrease muscle spasms, trigger points and overall tightness. A few examples of such therapies are electric muscle stimulation, ultrasound, laser, Graston, ART, or even massage therapy. Most Chiropractors will have the therapies they use listed on their websites, so this is a good way to research the doctor that best fits your needs. Good luck!

You may wear what makes you feel comfortable. It is advised to remove the bra and all other metal-containing garments/accessories for x-rays, but this can be done at that time. I would recommend you wear comfortable clothing that you can move freely in; no skirts or dresses. During an evaluation you may be asked to raise your leg(s) or other movements that shouldn't be restricted by clothing. Best of luck to you.

I suppose it depends what you mean as a "real doctor". Yes, we do exist, even if you don't believe in us. Yes, we are doctors. All chiropractors received a Doctor of Chiropractic degree upon graduation. It is a different degree than what a medical doctor has (MD), or an osteopathic doctor (DO), or even a dentist (DMD). One difference for Chiropractic Physicians is we are not able to prescribe medications; we try to help the body repair itself through natural means. I hope this helps to answer your question.

Risks for any therapeutic procedure range from zero to serious harm, with the caveat that most procedures very rarely, if ever, get to the serious end of the spectrum. This is usually the result of negligence, undisclosed pre-existing condition or perhaps just really unfortunate luck. Now back to answering your specific question. The "risks" of a chiropractic adjustment to the neck range from mild temporary soreness in the neck to severe pain in the neck and arm with possible headaches. Some will tell you that a stroke and/or paralysis can be an outcome of an adjustment. These are the super rare cases where there was an unknown pre-existing condition that was not properly screened (or perhaps screened properly but still undetected) prior to an adjustment. Research has shown that one is more likely to suffer a cerebrovascular accident while washing your hair at the salon than receiving a chiropractic adjustment. Chiropractic adjustments are inherently safe for people of all ages, provided they are properly examined prior to the adjustment. Your daughter will do fine with her care plan and I applaud you for being proactive in taking her to see a chiropractor after her soccer injury. Best of luck to the two of you.

Chiropractic has been found to be beneficial to pregnant and post partem women. During pregnancy your body produces hormones to help relax certain ligaments in your body to get ready for labor. After labor, there is a transition period where you have lost a good bit of weight (from giving birth, congrats!) but your ligaments are still somewhat lax. This can cause one to "feel off" as you put it. Add to it the new positions you find yourself in while holding/feeding your newborn and you have can develop what we call "new mom neck"; pain and tightness in your neck and sometimes upper back. This is just an example. The bottom line is that it is almost always recommended to see a chiropractor during and/or after a pregnancy. Most of your energy will be going into taking care of your new bundle, but remember it is also important to take care of yourself so you can continue to care for your child. Congratulations, and good luck!

The quick answer is: both. Everyone responds differently to various treatment options. Why do you have muscle pain? Was it from a certain movement/activity? Is it a recurring issue that you've dealt with before? Is it more than just "muscle pain", perhaps stemming from a movement deficiency or other pathology? These are questions that should be investigated by a chiropractor to make sure you do in fact receive the best treatment for your condition, whether it be chiropractic, massage, both, or something else entirely. Good luck.

Yes, chiropractors do treat muscle pain. However, it is more important to do a comprehensive evaluation to determine if your arm and back pain is in fact muscle pain versus some other pathology such as an injured disc in your spine. They can then determine the best course of treatment for your injuries and/or refer to other providers if necessary. I hope you feel better soon.

Fractured vertebrae can be very serious and is a strong contraindication for chiropractic adjustments. If you suspect you have a fractured vertebrae you should get it checked out immediately. The location of the fracture as well as which vertebra is fractured are factors that doctors will consider when triaging you. While a chiropractor can help to determine whether or not you do in fact have a fracture, we do not specifically treat the fracture.

Good question. Technically speaking, the window of change for scoliosis is typically open until you reach "skeletal maturity"; that is, until the growth plates in your bones close. In boys, this typically occurs anywhere from 18-22 years old. Everyone grows at different rates, hence the age range. Your 17 year old bones may be fully matured, or it may be later down the road. So your next question may be "how much worse will my scoliosis get before my bones stop growing?" Well that also depends on a few things. What has been the rate of change in your scoliosis since being diagnosed? Fast? Slow? No change at all? Is your scoliosis mild, moderate, or severe? Do you wear a brace? Did you have surgery? Do you perform any scoliosis-specific rehab exercises or stretches? All of this matters. But as long as your rate of change hasn't been excessive/rapid over the last year or so, your scoliosis shouldn't change much more (if at all) before you reach skeletal maturity (if you aren't already there). After your 20s, your scoliosis is relatively stable. However, there are certain things that may cause it to worsen in your "golden years", such as trauma/injuries or poor posture. But at the end of the day, you're 17. Do some stretches, maintain good posture, and have a good life.

This is a tricky question, as it depends on a variety of factors such as severity of the curve (mild/moderate/severe), location of curve(s) (mid back, low back, or both), occupation, etc. Many people with mild to moderate forms of scoliosis do little to nothing as far as treatment and rarely, if ever, have issues directly related to the scoliotic curve(s). Other less lucky people may have constant pain/tightness in their back and surrounding areas. My advice is to find out where you are in terms of severity (if you don't already know) and go from there. And if you are already experiencing problems you think are related to your scoliosis, get an evaluation by a chiropractor with specific training in treating patients with scoliosis. Typically, chiropractors with "Pettibon" training are very good at treating scoliosis. Good luck!

The answer to your question depends on a variety of factors. What do you define as "work"? What is the condition you need the adjustments to "work" on? How long have you had the condition? Most chiropractic treatment plans will consist of an initial two-week trial of care to see if certain short term goals are met. If these goals are not reached, further assessment and/or referral to another provider is warranted.
Good luck!

A chiropractic adjustment is perfectly safe. The sound that you may hear is simply the equalizing of pressure that is built up in the joints of your spine. If you have ever "popped" your knuckles then you know what this sounds like. The neck is just a more sensitive area to some people and the sound is perceived to be louder due to your ears being closer to the site of the adjustment. If you truly do not feel comfortable with any type of chiropractic adjustment, let your doctor know. There are a variety of techniques to adjust the spine, many of which do not require the "cracking" sound to happen. If this sounds like something you would be interested in, ask your chiropractor about "instrument adjusting". However you get adjusted, you will feel better.
Good luck.

Technically, yes. But honestly, you have a better chance of winning the Powerball AND the Mega Million Jackpot. The unlucky start REALLY have to align in order for this rare and unfortunate outcome to occur. These cases that you may have heard of include people that already had risk factors for serious conditions such as vertebral artery dissections before seeing a chiropractor, and they symptoms were indirectly or directly worsened in the short (or long) term following a chiropractic adjustment. As chiropractors we were all trained in recognizing these risk factors and taking appropriate action when identified. We do not adjust people with these risk factors. That is the standard of care. Do the occasional rarities happen where a chiropractor adjusts someone that may have risk factors for artery dissection? Unfortunately, yes. Just as it is in any profession, mistakes can happen. Secretaries accidentaly hang up on an important client. Chefs unknowingly handle food with a small cut on their finger. Surgeons leave a piece of gauze where an appendix used to be.
To wrap this all up, let me just reiterate that chiropractic adjustments are safe. If they weren't, malpractice insurance for chiropractors would be very high. Currently, chiropractors have some of the lowest malpractice insurance rates when compared to surgeons, neurologists, etc.
If you are still worried, express your concern with your chiropractor. I'm sure he or she will be happen to talk with you more on this subject. Good luck.

An initial visit to a Chiropractor can vary based on what is done that day. Some new patient appointments can be completed in under 30 minutes, while other appointments can be over 90 minutes. The length of time is dependent on a few factors such as: whether or not paperwork was completed online before the actual appointment; the complexity of the new patient's case/injury; and whether or not treatment is done on that first visit. To find out more specifics, you would need to call and talk to that specific office you plan to go to. I hope that helps and good luck with the back pain.

Firstly, I want to commend you for taking your child to get evaluated by a chiropractor even after a "minor" car accident. It is always better to err on the side of caution when dealing with car accidents, especially when a still-growing/developing child is involved. With that being said, the risks of Chiropractic treatment for your 14 year old is the same as it would be with you; very low. Chiropractors treat people from all age groups. Technique and treatment protocols may be different from 6lb baby versus a 140lb adult, but the safety (and efficacy) of treatment is the same. Best of luck to you and your child.