How Long to Hold A Correction
Typically one of the first things a patient wants to know when getting evaluated by us is how long it will take to get them to hold a correction and how does it work. To answer this we need to look at the nature of a spinal injury and how it heals. Holding a spinal correction is primarily a result of the stability of the ligaments (connective tissue that holds bones in place) and other supportive/ structural tissues of the spine (muscles, joints, discs, bones). In order for a patient to hold a correction, the tissues around the spine must heal and adapt to the corrected spinal position. The spine must be retrained to stay in place.
It takes a physical injury to damage the ligaments around the spine. Those damaged tissues can no longer hold the spine in a healthy position therefore, the bones shift out of their designed position and begin to compress the brainstem, blood vessels and other nerves. It is essentially a spinal sprain, like a sprained ankle, but more serious because when the spine is sprained it results in pressure on the nervous system which controls and coordinates all body function.
The only way to stabilize the spine is the same way you stabilize an injured ankle-you have to keep the bones in the right position long enough for the supportive tissues to heal. A doctor will set the sprained ankle in the right position and cast it for months giving the tissues the appropriate amount of time to heal and stabilize. One of the challenges with the healing process of the spine is that we cannot cast it after we correct the position of it (body casts are not very functional!). So instead of casting the spine so it can heal we have to keep the spine in alignment as much as possible to allow for healing.
Obviously, the more severely someone has been injured, and the longer they have had that injury the longer it takes them to heal and stabilize.
By monitoring patients closely, we can correct them as soon as they loose the correction and keep them in alignment as much as possible. While the patient is in alignment, the nerves and tissues heal continually until the correction goes back out. Once the spine is out of alignment, it is like cutting the cast off a recently sprained ankle and walking on it, stretching the tissues back out/reinjuring it.
Here are the three most important things that influence a patient’s ability to hold corrections:
- Consistency in Care: By far the most important factor in stabilizing a patient is consistency of care. If a person has been out of alignment for 30, 40, 50 or 60 years, their body is not going to heal instantly. Although their symptoms may feel better quickly, the tissues of their body will require some time to heal. The spine must spend more time in alignment than out of alignment, otherwise it will likely not stabilize as it should.We have found that for most patients this is best achieved by checking and correcting the spine 2 times per week until it is consistently stable for 1 week. For many adults this phase lasts 6-8 weeks. (Children usually require less time). Once the spine holds the correction consistently for 1 week, then we begin checking them 1/week for 6-8 weeks. When the patient stabilizes at that level we move them to 1 visit every 2 weeks for 6-8 weeks. In our experience, by the time this protocol of treatments is finished the majority of patients are able to hold an alignment for 1 month.At this point, if patients can hold for a month, we check them in a month. If they can hold 2 months, we move them out to 2 months. As the patient continues to stabilize, they are moved out to a maximum length of 3 months. Once a patient reaches this level of stability (being checked once every 3 months), they are typically asymptomatic (have no symptoms) but the majority of the time are out of alignment at the 3 month mark. This is most likely due to the various stresses of living in the world. At this point NUCCA care is keeping them out of pain, preventing other conditions from developing and keeping the body from returning to a degenerating condition.In our experience, seeing people once per week is good and does help people get relief, but it often requires years to achieve what can be accomplished in months if people are seen twice a week in the beginning of care.
- Managing Stress Properly: The number one thing that causes a person to come out of alignment sooner than they would otherwise is stress. Stress is a horribly destructive force that works negatively against the mind, will, emotions, and ultimately the body of the person experiencing the stress.Essentially, stress will overwhelm the mind and when it reaches a certain threshold will overwhelm the body’s ability to hold the spinal correction. One reason for this is that stress will lead to abnormal tension in the muscles because of an overexcited nervous system which in turn pulls on the spine making it harder to maintain the correction.As Christian doctors, our advice for how to manage stress is going to be a faith answer. 1 Peter 5:6 states “Humble yourselves under the mighty hand of God, that He may exalt you at the proper time, casting all your anxiety upon Him because He cares for you”. We must realize that we need God’s help and humble ourselves to entrust our problems to His care. Worrying does not do any good and ignores what God says! In fact, all it does is destroy your health. So when a problem or circumstance comes your way, cast it (aggressively and completely) to Jesus and refuse to worry about it anymore.There will always be things that cause stress, it is how we handle it when it comes that determines whether it will knock us out of alignment.
- Fatigue: The third most important factor in stability is when people run themselves down, get too tired and don’t take breaks when they need them. When the spine is corrected, the ligaments will begin to heal. Until the ligaments have healed enough to hold the spine in place, the spine is held in the corrected position by the muscles around the spine. It is important to note that muscle was not originally designed to hold the spine in place, the primary tissues for that are job are ligaments.Muscles, unlike ligaments, can get fatigued. For example, if a person holds a bowling ball straight in front of them, they could hold it until the muscles reach their fatigue point and then they will have to drop the ball. A similar thing happens with your spine; when the muscles reach their fatigue point the correction will be lost because the body cannot hold it in place anymore.So how does a patient overcome this? They first need to recognize the signs that they are fatigued and respond by taking a 15-20 minute break, allowing time for the fatigue to pass, and then they can resume what they were doing. The most common signs of fatigue are feeling weakness, tension, or tightness in the muscles in the neck and spine. The reason the muscles tense up is because they are straining to hold on to the alignment. Patients must learn to resist the temptation to just keep working and ignore the “stop sign” their body is giving them. If caught before it is too late, the patient will hold on to the correction and with time their fatigue point will move out-meaning they will soon be able to go longer before they reach that fatigue point.It is important not to be discouraged if you have to take frequent breaks in the beginning. The more disciplined you become, the more endurance you will get as your body heals. It is also important to note any activity can fatigue the spine if done long enough. Working in the garden, sitting at a computer or even going for a walk can bring you to your fatigue point. Depending on a patient’s type of injuries and what activity they are doing, they will fatigue at different rates. Some days you may be able to work for hours before you get tired and other days it may only take 10 minutes.
The most important thing to remember is that wherever you are and whatever shape you are in, the way to get stronger is to recognize that you are where are, and take breaks when you need them! Don’t get caught up thinking “when I was younger I could work for hours” or “it seems ridiculous that I can’t sit at the computer for more than 30 minutes without tightening up”. Act on our advice and you will soon be getting stronger and stronger.
Contact us at Health & Stability Spinal Care and we can provide you the care you need.
May God bless you with abundant health!
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