Pain is often a roadblock on the road to good health, and it must be addressed by the chiropractor even before the patient is adjusted. "The body just shuts down when you're in pain," says Carl Amodio, DC.

But how to address pain is as individual as the patient and the chiropractor's style. Some chiropractors will address it with high technology. Others will prescribe nutritional supplements. The lesson? There is not a single right approach to the treatment of chronic or acute pain. Chiropractors have individualized ways of approaching pain management.

Evidence-Based Care

Anthony Houssain, DC, has built a niche in the pain care business. He and his five colleagues at SpineCare, Huntsville and Madison, Ala, have focused their efforts on treating pain. Their goal is to desensitize the body to pain through rehabilitation and exercise.

The SpineCare chiropractors use the active release technique and use the Lifetimer table, which is specific for soft-tissue treatment. "It is structured in a way to allow us to use our bodies and arms in odd angles," Houssain says.

Among the various modalities the group uses are the Chattanooga Group's Intelect Electrotherapy System. Houssain says the group also uses Chattanooga's ultrasound system for deep-tissue therapy. The group also uses Russian stimulation. "The wave pattern has been shown that it helps to activate the muscle," Houssain says.

But it is not all high technology at SpineCare. The group also uses low-technology devices such as physio balls to develop core stability, the Thera-Band for the upper back, and the FitBALL for deep abdominal core stability.

Houssain and his colleagues work with patients who sit at a desk for long periods during the day. To counteract the pain that can come from long periods of sitting, he prescribes McKenzie Rolls and wedges to help patients avoid the consequences of being static for much of the time.

The key is to create core support systems. "Before you can exercise, you must create stability," Houssain says. "The first battle is to settle the pain."

Taking the Next Step

Ed Harkins, DC, is currently in the process of purchasing the Microlight Laser product for his acute pain patients because "it basically gives good pain relief that appears to be long-lasting," he says.

His interest in adding the laser to his treatment menu stems from personal experience. While attending a conference and in acute pain because of an infected ingrown toenail, Harkins was invited by Mark Anaya, president of MJ Chiropractic Supply, to try the product as a means of relieving his discomfort. Skeptical, Harkins used the laser on his toe for about 7 minutes. The next day, "it was 75% better," he says.

Harkins was sold on the device, but still canvassed colleagues about the efficacy of the laser. "Those who I spoke with love it," he says.

But the laser is not the only pain-fighting method Harkins has relied on or will rely on in the future at his Long Beach, Calif, practice, Marketplace Chiropractic. Fundamentally, he relies on adjusting to stop the pain. He uses diversified and Gonstead techniques, and extremity adjusting, He adjusts the area of complaint through the entire kinetic chain from the back to the hips and down to the feet. He also uses trigger-point therapy, myofascial release, and PNF stretching to help.

Houssain’s group uses Chattanooga’s ultrasound system for deep-tissue therapy.

Once he has adjusted the patient, he leads him through various stretches. He also uses therapy balls and the Thera-Band—in all the colors—to help build strength. He also uses the Precor Stretch Trainer.

He also recommends that his patients take between 2,000 and 3,000 mg of Omega 3 supplements.

Most important, Harkins says he always gives patients home exercises to do so they can take their health into their own hands.

He recommends that all of his patients begin a fitness regimen in consultation with their primary care physician. "Everyone should have good physical fitness," he says.

Whole-Body Approach

Amodio uses applied kinesiology, Activator, SOT blocks, and adjusting instruments to treat his patients at his practice, WholeBody Health Inc, Roswell, Ga. But even before he begins his adjustments, he measures the patient's pain and addresses that. "No matter if pain is acute or chronic, you have to clear the pain before you can do the adjustments," he says. "If the body is in pain … the adjustments won't hold."

Amodio uses three acupressure techniques to treat the patient's pain: set point technique; nociceptor stimulation block (NSB); and location, quality, memory (LQM).

He usually starts with the NSB technique. This is designed for the patient who is in acute pain, and Amodio pinpoints this discomfort through muscle testing with both pressure and range of motion, bringing the patient to the threshold of pain. Once Amodio pinpoints the point of weakness, he works to negate it, using that point as a meridian to clear the pain, tapping that point from 100 to 1,⁰⁰0 times until it is not weak. "I monitor the pain level while I'm tapping, moving the joint [for instance] to make sure the pain is clearing," he says.

But pain is not the only thing he needs to treat. Once the source of pain has been identified and treated, there is also inflammation that needs to be combated. To do that, Amodio offers Dr. Mercola's Krill Oil for Omega 3 and Standard Process' Black Currant Seed Oil for Omega 6 supplementation. He has recently discovered mangosteen juice, which he has found to be helpful for fighting inflammation. Patients sometimes receive a glass of the juice while they're receiving their treatment.

But it is not just techniques and natural remedies that help his patients fight pain and inflammation. Amodio uses the Erchonia cold gas laser as a high-tech way to eliminate inflammation.

Mobile Pain Relief

Kari Crawford, DC, takes her pain-management strategies to her patients, delivering care in the workplace and at home. Crawford's Vernon Hills, Ill-based Mobile Wellness is located wherever the patient needs to be treated. She primarily goes to office settings to treat low back pain. And all of her adjusting equipment goes with her, including her table. Crawford only uses the Activator technique to adjust her patients. "I see amazing results using this technique," she says. "It helps a lot with pain, and it is easier to adjust the patient using it."

Houssain’s group also uses Thera-Band for upper back work.

Another product Crawford uses in treating her patients for chronic and acute pain is the Posture Pump. This spine trainer is for use in treating pain in the neck, low back, and entire body. "It's so amazing," she says. "It helps bring the spine back in the proper curve. Typically, you want the canal of the ear over the shoulder … and the Posture Pump helps put the C-curve back in the patient's spine."

Crawford says the device is easy to use and does not take a lot of time to show results. For instance, if a patient is instructed to use it for neck pain, he simply puts it under his neck. Using a hand pump, he pumps up the air cell and then lets it deflate, increasing the amount of time that it is inflated. Eventually, the patient leaves it inflated for about 15 minutes. "It has really helped my patients maintain their adjustment," Crawford says.

Perhaps one of the most effective pain-relief products Crawford uses is the simplest and most inexpensive. The Posture Right from Neck Orthotic is a simple plastic wedge 4 inches to 5 inches high that is placed under the neck between C–5 and C–6. The patient lies down on the wedge for 1 minute per night. "It's good for patients who have completed their treatment and are still in pain," Crawford says. "It helps to restore the C-curve."

C.A. Wolski is a contributing writer for Chiropractic Products. For more information, contact .