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The chiropractor explained the treatment options to Carlos. She explained treatment
would comprise a trial course of non-surgical, conservative care consisting
of a protocol of gentle spinal distraction, physiotherapy, exercises, and home
care. A "trial" meant that conservative measures would be used for one-month
and then Carlos would be re-evaluated. If Carlos' condition was not improved
by 50% after a month of treatment, he would be referred to a spine surgeon for
evaluation. If during the treatment month Carlos' symptoms increased and examination
findings showed his condition worsening, the referral would also occur.
Carlos's chiropractor had developed a reciprocal relationship with a spine
surgeon. The spine surgeon referred patients to the chiropractor who he felt
might benefit from conservative care. The chiropractor referred patients to
the spine surgeon who she felt were either outside the scope of conservative
care or who were not responding to conservative treatment.
Carlos decided to pursue a program of chiropractic care. Treatment consisted
of a gentle distraction technique and a type of spinal stretching therapy. The
goal of spinal stretching therapy is to draw the disc away from the nerve root.
This treatment was augmented with electrotherapies, cold and hot packs, muscle
techniques, and other non-forceful procedures.
Carlos did reach the 50% improvement goal after a month and continued treatment
for another two months. He was eventually given exercises to strengthen his
neck muscles and flexibility exercises to maintain the increased spinal joint
motion achieved by his chiropractic care. He was stable without neck or arm
pain at the end of three months.
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