How to Effectively Communicate DJD and DDD

As chiropractors, we see spinal degeneration on a daily basis. We are well acquainted with what it looks like on an x-ray, we know of its progressive nature, and we know of the long-term consequences of leaving the cause uncorrected.

Besides using spine models and x-rays, what are some ways that we can make a practical connection in the innate mind of the patient?

One method I like to use begins in the initial examination, and sets the stage for the report of findings later. I have a chiropractic assistant who does some of the basic examination intake, which includes checking the height and weight of the patient.

When it comes to checking their height, the CA will ask the patient, “How tall were you when you were at your tallest?” The patient responds with their answer, let’s say 5′ 10”. The CA will then measure the patient, and it will typically be less. Sometimes it is considerably less. The CA tells them their actual height, and then says “the reason we ask first, and then check, is because if you have lost height, it’s usually from the spine.”

When I come in to do the examination, I’ll bring this up again about how they have lost height, and point to the spinal degeneration poster, reiterating what the CA had already told them about height loss in the spine.

This sets the stage for what the x-rays will ultimately show, confirming what was suspected.

This all gets reinforced again in the patient education class. A straight piece of wire is bent, and then straightened demonstrating how once it is bent, it is never the same again. It can’t be made perfect, and it is forever weak in that spot where it was bent. Then we take it one step further and ask, “What if this wasn’t a new piece of wire, but rather a piece of wire that had laid out in the grass for about 10 years, what would be different about the wire?” Of course, they are able to say it would be rusty, brittle, etc.

I then take them back to their recollection of their own x-rays and remind them that I had told them they were in a phase of degeneration on a scale of 1 to 4 with 4 being the worst, and to think of that as the rust on the wire. The  level of degeneration determines the time the care will take, the gentleness needed, and the degree to which it can be corrected. All this comes into play when the plan of care is created.

I hope you all find these ideas to be beneficial. I know they have been for me, and for the patients that I serve.

Be blessed.

Dr. Rick Barrows



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