San Diego, CA – November 19th, 2010 – ChiroTouch™, the nation's leader in chiropractic software, recently posted its latest article in its educational series entitled "Assessing the Need for Foot Orthotics in Chiropractic Patients.
Orthotics have a long history with chiropractic practice, and can greatly enhance the efficacy of chiropractic treatments. As many patient complaints treated with chiropractic care can be tied to improper orthopedic care, it is important for chiropractors to be informed about this branch of medicine and what it can do for their patients.
What can Orthotics do for Chiropractic Patients?
Multiple studies have shown the correlation between orthopedic and chiropractic treatments. It has been proven that orthotic devices can have a great impact on the alignment of bones, particularly in "trouble spots" on the body, such as the lumbrosacral disc, patellas, and other pain-prone joints, and are widely acknowledged to improve the condition of pedal instability in patients. By treating such orthopedic issues, chiropractors can also effectively treat a whole host of chiropractic complaints, including patellar, pelvic, and spinal distortions, pain resulting from poor posture, and stressed joints. Orthotics can even improve joint malfunctions due to dysafferentation, as they relieve some of the strain on the nervous system. The use of flexible stabilizers is often implemented to address many bio-mechanical imbalances and problems that could otherwise require repeated correction or lifelong periodic treatments.
Who Needs Orthotics?
Many types of patients can benefit from orthopedic care, and as is a non-invasive and gentle treatment, it can be used on both old and young patients. Those with chronic back pain can benefit from foot orthotics, as do those with pedal instability, flat feet, and elevated arches. Additionally, athletes can prevent excessive strain on their bodies by using orthotics, and overweight patients can manage discomfort and improve joint function with orthotics. Although they can generally be prescribed for any patient, practitioners must be extremely careful when prescribing foot orthotics for those patients with diabetes, as decreased feeling in the foot can lead to improperly fitted orthotics, which can be harmful. Additionally, orthotics should not be used to treat those patients with "one off" complaints, and cannot be expected to work fully without the accompanying chiropractic treatment.
How to Assess the Need for Orthotics in Chiropractic Patients
In order to determine whether certain patients could benefit from orthotics, chiropractors should check each patient's posture during every visit, as well as performing an assessment of the patient's gait. If a patient is showing an unusual posture or gait, the chiropractor should perform a more in-depth exam that includes checking leg length, possible pelvic imbalances, and in some cases a computerized gait assessment--a function which is rapidly becoming available in the newest chiropractic software. Chiropractors can also spot the need for orthotics by thinking about run of the mill chiropractic complaints more holistically. For instance, rather than simply treating chronic back pain by an adjustment, they should perform a check to see if the issue could be related to tissue damage in the feet or improper balance, both of which are effectively treated with orthotics. In fact, many chiropractic complaints have an underlying or contributing cause, such as an exacerbation of patello-femoral syndrome caused by the patient wearing improper shoes while running.
While all patients can benefit from a basic orthopedic exam during their visit, chiropractors should pay particular attention to those at high risk for orthopedic complaints, particularly, athletes, the severely overweight, and those with damaged or uneven feet or legs. However, chiropractors should still perform basic checks on those patients who appear to be at a low risk. This is easy to accomplish by simply adding a few more questions to the exam routine, such as the types of shoes the patient normally wears, how much they walk or run on a daily basis, whether their job requires them to stand for long periods of time, and whether they experience chronic foot or leg pain.
Remember, patients may be unaware of how orthopedic treatment can enhance their chiropractic treatment, so it is the chiropractor's responsibility to inform the patients of this treatment option. An easy way to bring the topic up is by including it as one of the general checks included in the practice's chiropractic soap notes, to remind both the chiropractor and the patient of this supplementary treatment.
Integrating Orthopedic Services into the Chiropractic Office
Chiropractors can treat those that need orthotics in two ways: either by providing the treatment themselves, or by partnering with a trusted orthopedist. In the first case, there are several steps that should be taken to integrate orthopedic treatments into a chiropractic office. There should be literature made available for patients, and models can be helpful in explaining how an orthopedic complaint can impact a chiropractic one. They must also be equipped with the proper equipment for measuring pedal instability, improper gaits, and mismatched leg lengths. Additionally, the office should invest in chiropractic software that can perform gait analyses, as well as chiropractic software that includes orthopedic treatments on invoices and documentation. Finally, offices should incorporate orthopedic checks into their chiropractic soap notes to allow proper documentation, and to remind the chiropractor and patient of treatment progress.
For those chiropractors wishing to care for patients with orthopedic needs, it is important to find a reputable orthopedist to partner with and develop a longstanding relationship so that one does not end up undoing the other's treatment. It is extremely important for the two practices to keep proper orthopedic and chiropractic documentation, as this will serve to streamline the treatment process. By comparing notes and cooperating with each other, both practices can ensure the best treatment for the patient.
In sum, many chiropractic patients can greatly benefit from orthopedic treatment, whether coming from the chiropractor themselves or from a trusted orthopedist to whom they are referred by their chiropractor. Chiropractors must be educated about this area of medicine and how closely it is tied in to a number of chiropractic complaints. By treating patients in a more holistic manner, chiropractors can improve their patients' physical health and enhance their own treatments.