The practice of Chiropractic Neurology Sydney includes the evaluation, diagnosis and conservative treatment of clinical symptoms or syndromes which are an expression of many temporarily or chronically impaired functions of the central and peripheral nervous systems. It involves the integration of fundamental neuroscience principles, nutrition, pharmacology and a systems-based medicine approach in order to achieve positive adaptations to the nervous system.
What are the things a Chiropractic Diplomate assesses?
- Muscle-tendon reflexes
- Sensory testing
- Gait
- Dynamic pulse oxygen saturation %
- Head, neck, eye and spine coordinative control
- Blood pressure and heart rate reflexes
- Dual tasking and cognitive loading
- Vestibular and visual reflexes
- Dizziness, vertigo and balance disorders
- Gait or ambulation difficulty
- Movement disorders
- Peripheral nerve pain and neuropathy
- Migraine and various headaches
- Musculoskeletal pain
- Functional gastrointestinal disorders
So how does a Chiropractic diplomate differ from a conventional Chiropractor Sydney?
The answer is NOT to do with the types of therapy utilised, but lies in the individualised rehabilitation approach based on the patient’s qualitative and quantitative observations during the neurological examination. For example, a patient with low back pain, nausea and intention tremor on the left hand will be treated very differently to a patient with low back pain, increased heart rate and intention tremor on the left hand. They still have the exact same location and character of neck pain and tremor but a very different autonomic (heart rate) concomitant. Therefore the same rehab strategy across both patients may be optimal for only one of the two.
This is where chiropractic diplomates differ! We look at the nervous system exam findings and triangulate the problem to an area of the neuroaxis – brain hemisphere, basal ganglia, cerebellum, brainstem, spinal cord, and peripheral nerve. We then target certain adjustments and other types of brain-based therapies with a neurological bias. The bias that conventional Best Chiropractor Sydney and osteopaths use involves adjusting a joint through its restrictive barrier to increase range of motion and an attempt to reduce pain. In some patients, having an adjustment at end range motion may be too metabolically demanding and this is where a chiropractic neurologist may use different strategies before, during or after the adjustment to ensure appropriate balance within the nervous system hierarchy.
Most patients who visit their neurologist have a very strong belief that their symptoms must be organic in origin. That is to say, if there is no structural or objectifiable pathology on an MRI, the symptoms therefore must be made up in their heads.
There are two problems with this:
1. The symptoms may be subclinical before imaging findings show up. For example, in Multiple Sclerosis, patients may have double vision and tingling in their hands and feet yet have no evidence of demyelination upon MRI
2. There is no designated treatment that would allow restoration of normal human functioning
Conventional neurologists ignore subtle, more nuanced neurological examination findings, especially those that don’t fit a criterion for a diagnosable pathology or disease. The difference is not in the knowledge or examination domains, but rather in the analysis and interpretation of what those test results mean. From this, Chiropractor Sydney diplomates are able to use more healthy neuronal networks that can have a positive influence on unhealthy neuronal networks. This information is gathered from the neurological examination. This concept is called neuroplasticity and despite the concept making leaps and bounds in the neuroscience literature, conventional neurologists have a difficult time seeing how it would be appropriate in the application of the patient. Yet, the surplus of pharmaceutical prescription seems to predominate, despite having not reached an objectifiable neurological diagnosis from a conventional standpoint. Furthermore, Chiropractic diplomates are appropriately geared to modulate areas of the nervous system with a more refined and personalised approach. Prescription drugs on the other hand often may change all aspects of the nervous system including its neurotransmitters and may actually cause negative changes in different brain networks that are unintended.
The aim of treatment, therefore, is to restore the optimal function within the targeted neurons and neural networks, that are:
A. Firing at a rate too high for the metabolic, vascular and immune systems to tolerate or cope with
OR
B. Firing at a rate too low to drive processes that allow the engagement and repair mechanisms of the body. When neurons are at their resting state, they have other neurons that talk to them by way of inhibition or excitation. The overall summation of the inhibition and excitation to a resting neuron is known as the central integrated state (CIS). Therefore, the CIS is the probability of a neuron to talk to other neuron/s within their neural network. Depending on the environmental, task and internal demands, the CIS is both primed and ready to talk to other neurons in certain brain areas and not so primed in other brain regions.
So what maintains the health of a resting state neuron?
Nutrition and fuel for delivery to the neuron may be in the form of glucose, ketones, oxygen, adequate neurotransmitter and hormonal output in addition to a homeostatically mediated immune response that has neither tipped toward a hypervigilant or suppressed state. In other words, a neuron depends on these metabolic requirements for nerve-to-nerve communication and firing rate. There is also a requirement for an intrinsically mediated system that constantly modulates blood flow perfusion to ensure that the neurons undergoing both metabolic and non-metabolic functions are receiving the right amount of fuel and oxygen in a ratio that would subserve the task at hand to be efficient in its outcome. After all, it would not be in your best intentions to shunt blood to an area of your brain or muscles that have very little do do with the task at hand, for instance, rapidly tapping your index to your thumb should create a reflexogenic response in shunting blood to your hand and not to your legs.
How do your recent lab results influence what we do?
A simple, full blood count with electrolytes can give us general clues into the biochemical environment which the neurons are influenced by. For instance, low haemoglobin levels, elevated sodium and low potassium on a complete blood count may significantly influence the resting state of a neuron, in that it might fire excessively, despite receiving a low stimulus and even continue to fire in the absence of it. For example, shining a light in your eye to examine your light reflex may bring about an acute onset-headache whilst seeing spots in your visual fields. This is why it is essential to evaluate blood biochemistry in conjunction with your neuro-musculoskeletal complaints.
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