Chiropractors and Philosophy: A Perfect Match
Written by Dr. Katinka van der Merwe for the RSDSA blog.
Few topics I have discussed in my career have drawn more attention, more praise, and also more criticism than the following one: the medical fallacy of treating chronic pain.
I have treated approximately 560 patients suffering from CRPS as well as Ehlers Danlos Syndrome, and often see success where medical science has failed. These patients have been everywhere in the world, to the most renowned clinics, such as the Cleveland Clinic, CHOPE, and the Mayo Clinic, and yet they have not been able to find answers.
I now consider myself as somewhat of an expert on the topic. I have certainly devoted my life to giving hope to those who feel like they have reached the end of all hope. Allow me to elaborate. First, I need to explain how my growing years shaped my unique approach to chronic pain. I was raised by a chiropractic father whose life was saved by a chiropractor when he was seven years old. Because of his own healing journey, his philosophy in the body’s ability to heal itself was very strong. This philosophy, the deep belief that the body is able to heal from within, even in the face of defying odds, form the very core of chiropractic philosophy. Yet, I often find that people are surprised by the fact that I am a chiropractor.
The fact is, me being a chiropractor is a big reason why we are succeeding where so many others have failed. How is that possible? How can someone who “pops necks and backs” help someone suffering from complicated and horrific neurologic pain? Like I mentioned above, the answer lies in the philosophy that most chiropractors are schooled in. This philosophy is diametrically opposed to allopathic medicine’s philosophy. Medicine believes that the body fails. Chiropractic believes that the body never fails, it was built to survive. Medicine believes that the body must be healed by science, from the outside in. Chiropractic believes that healing occurs from inside out, if the body is assisted to function properly again.
Chiropractic philosophy has taught me to understand the human body and respect the body’s ability to heal, even in the face of the greatest odds. However, my purpose is not to bash or to even minimize medicine, and I want to make that clear. Medicine has a very clear and concise place in health care, but it is my belief and philosophy that medicine best serves us when it is utilized in emergency care, not chronic pain. If you need a new heart, if you need emergency surgery, if you are in a car accident, if you have suffered a fracture, medicine will typically serve us well. My niece, who is thirteen now, had open heart surgery when she was just three weeks old and weighed less than five pounds. She would not have had the ability to be alive today if it were not for the surgeons who worked on her and the science that got them to where they are. I am forever grateful for the surgeons and medical science that saved her life. However, when it comes to conditions where daily chronic pain is your reality, I am here to tell you today that the medical world is not the best place for you to find answers. This may go against everything you have been taught.
So, let me explain further: Chiropractic philosophy is all about how our bodies were masterfully designed. If you ask any member of the public, they will tell you that chiropractors treat neck and back pain. And it is true, a lot of chiropractors do that. But what really makes our profession distinct is the belief that the body was designed to heal itself if the central nervous system and the brain are allowed to do their jobs. We believe that the body is most often capable of healing even the most catastrophic injuries and conditions.
So, let’s talk about the medical approach or what I call the medical fallacy, when it comes to chronic pain. If you suffer from chronic pain, you have seen dozens, if not hundreds of doctors. You have often been to some of the best clinics in the world and you have been offered the standard choices, which are opioids, pain management, Ketamine, Neridronate, or spinal cord stimulators. The medical philosophy is very clear on how we heal or do not heal. Medicine believes that the body makes mistakes. It is not perfect, it is flawed. It is implied that science is more intelligent than your innate intelligence.
What is innate intelligence? Every living creature has an inborn intelligence that was there the moment you were created. No matter what your beliefs are or what your religion is, or if you do not believe – you have to know that a very intelligent force was there the moment you were formed from an egg and sperm cell, which quickly grew within nine months into a tiny human being with two eyes, a heart, and hair and nails that grow, and the ability to heal itself. When we suffer a cut, we do not doubt that our body can heal that cut. (And yet, we believe that CRPS is too monstrous to heal). The intelligence that governed this process is magnificent. However, medicine teaches that science makes the body better, that it needs help from the outside, that your immune system is not strong enough. It needs science to boost it. Modern medicine gives us the message that pain is a mistake to be numbed or suppressed, that we are not supposed to feel pain. Medicine also will also have us believe that your diagnosis is crucial. It is crucial because it determines how the medical world should intervene chemically or surgically to fix your body from the outside in.
Worldwide, 1.5 billion people suffer from chronic pain. 1.5 billion people – wrap your mind around that. One study analyzed 95 suicide notes from random people and found that 67 of those notes listed chronic pain as the reason for choosing suicide. The USA uses more than 50% of the world’s prescription drugs today. Every day, 130 Americans die from prescription overdose. Nearly 70% of those prescription overdoses involve opioids. Opioids do provide relief by blocking pain, but the body will reach the point where it reacts to the pharmaceutical intervention, to the chemicals we are loading into it every day, by increasing the number of receptors to try to get the pain signal noticed again. Your body is crying out, like a baby that is crying for attention because it has a wet diaper or because it is hungry or uncomfortable. It is crying out because it needs attention, it needs help. When you take painkillers, it is as if you have a fire alarm that is going off, but the noise of it is unbearable. And so, you take a wet towel and you put it over the fire alarm so that you cannot hear it anymore. Somewhere, the fire is raging. Your body is trying to communicate something to you. Pain is also a signal to the brain and the nervous system that a body part needs attention, it needs healing.
When the drug that you are taking wears off, a person will experience more pain for about three days afterwards. And if they continue to take opioids, the pills become less and less effective over time. I have noticed that many of my patients have actually reported this in practice. In 1997, Americans took about two and a half billion prescriptions every year. In 2016, that number increased to four and a half billion prescriptions. What that means is that the total number of prescriptions filled by all Americans, including adults and children, have increased by 85 percent over two decades, while the total U.S. population has increased by only 21 percent. Wrap your mind around those numbers. What is going on? If you turn your television on, if you go to your doctor, you are going to see ads for medications. As Americans, we now believe that we cannot gracefully or naturally age without taking one, two, three, four prescription medications. That is considered normal in the USA. The truth is, there is no medication without side effects. It does not exist.
Ketamine is often considered to be a miracle drug for conditions like CRPS. The need for it is understandable, but yet, the journal Addiction noted that long term use of ketamine exposes patients to ulcerative cystitis of the bladder. That literally means that it may cause damage of the bladder wall. Research has also revealed that recreational ketamine abuse damages the bladder irrevocably. In two studies, medical researchers showed that ketamine present in urine causes damage to epithelial lining of the bladder, allowing urine to penetrate into the underlying tissues, which causes inflammation and extreme pain in the bladder, which is something we see very commonly in our patient population – bladder issues, chronic urinary tract infections. The researchers also noted that people who use ketamine on a daily basis demonstrated neuro cognitive impairment, meaning it changes the way your brain thinks. It also showed that patients who took ketamine struggled with memory problems, also documented in a journal called Frontiersmen Psychology, which noted that long term ketamine use can specifically damage memory and understanding of geographical areas, even something as small as the layout of your own house, remembering where the bathroom is or where your bedroom is. It has been found that repeated use of ketamine produces chronic impairments to episodic memory.
I cannot neglect to mention spinal cord stimulators. Let’s look at some of the recognized side effects of spinal cord stimulators: Biologic complications include infection following the implantation, neurologic injury, epidural hematoma, skin erosion, epidural fibrosis, Dural puncture, pain, and allergic reactions to the device. The most significant biologic complication results from actually implanting the device into your body. The leads are typically placed next to your spinal cord, and may cause significant scarring as a result. In most cases, the scarring is so severe that the lead cannot safely be removed.
Medical devices comprise a 400-billion-dollar industry in the U.S. A worldwide investigation by the International Consortium of Investigative Journalists involving 250 journalists from 36 countries was published in 2018. Investigators interviewed patients, doctors, and whistleblowers. They studied millions of records and recall notices. They found 1.7 million injuries and 83,000 deaths were attributed to these devices. Spinal cord stimulators were among the chief culprits, having faced 50 recalls since 2005. The FDA, which is supposed to protect us, is using an outdated system where devices are rushed through after minimal studies and human trials. These devices were meant to be a last resort. Listen to that very closely. A last resort – meaning that they should not be mentioned to a chronic pain patient within the first six months of diagnosis or even the first year. This was meant to be used when all else failed, because they are dangerous. It should be brought onto the table after every other option has been exhausted. Instead, big money has been spent on lobbyists and physician promotion. Today, 160 spinal cord stimulators are being implanted every day in the U.S. alone.
Let’s get back to the amazing human body. You cannot mask symptoms. You cannot treat the body by dividing it into different parts, like a car engine. I knew at a young age that I wanted my life to matter and to make a difference to others. I knew that I had found my purpose when I treated my first Complex Regional Pain Syndrome patient, and he went into remission, not because I healed him, but because I helped his body to function correctly again. How was this possible? How do we support the body so that it can heal from within? While other professions are concerned with changing the environment to suit the weakened body, we are concerned with strengthening the body to suit the environment. When we treat a patient, our goal is not simply to get them out of pain. Our goal is to figure out why this patient started suffering from chronic pain in the first place. Where did it all go wrong? What started interfering with this magnificent body and its ability to thrive?
Our system is very focused on treating the body as a whole organism. I cannot say this enough. If you move through the medical world, you are sent from specialist to specialist. So, let’s say you have severe chronic pain in your spine, but you also have GI dysfunction. It is very rare in the medical world, in my opinion, for doctors to see that one symptom is connected to another, if it affects a separate system or organ. However, often, the same underlying problem is causing multiple seemingly unconnected symptoms. You must treat the body as a whole, where every single cell affects every single other cell. You have to find the root cause and support the body in healing from within. And to that end, you need a multidisciplinary center, all with the same goal: Removing interference to healing and ultimately to strengthen the central nervous system.
Last but not least by any means, you also have to create a loving, healing environment for patients. I think one of the fallacies of medicine today is that it is isolating. It often treats the patient as just a body, and not as a human being sitting in front of the doctor who has stress at home, who has a certain diet that may be good or bad, who may be presenting with emotional stress and/or post-traumatic stress disorder from events that happened in the past.
You have to know what motivates your patient. Do they have children? Do they have grandchildren they cannot hold anymore? Do they feel free when they are on the golf course, and that is where they feel that they are reconnecting with their soul? You have to deeply care about your patient. It is a science that has too often been forgotten in medicine (or chiropractic, for that matter). We are taught not to emotionally connect with our patients because it is too hard on the doctor. However, it is possible to have sympathy with the patient, even if you do not feel empathy with the patient, without destroying your own health and sanity. If you are a physician, you have to have this sympathy. You have to care about the patient in front of you. In our waiting room, we have opened our waiting areas so that our patients can support each other and celebrate each other’s successes. I pick my staff for their passion, not for their skills. Skills can be taught, compassion cannot. Healing is an art. It takes time, it takes practice, and it takes love. It does not come from a device. It does not come out of a bottle.
I have one last quote I want to leave you with by Albert Camus. “In the depths of winter, I finally learned that within me, there lay an Invincible Summer.” Your body is incredible. It was magnificently designed. Please remember that. Hold on to your hope and know that you are not supposed to give up today. Look at your body in a different way. It is not failing you, it is doing its best to survive. Start looking for your own answers. Be your own best advocate and fight for yourself.
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I was diagnosed in 2007 with RSD (now called CRPS). I have been to countless doctors, specialists, acupuncturists, and chiropractors. The only thing I have been told consistently for 13 years is that there is no cure and pain management is my only option. I arrived at The Spero Clinic five weeks ago and for the first time there is someone, in fact an entire community of patients, doctors, and therapists, telling me there is hope. After just 5 weeks of working Dr. Katinka’s treatment plan I have significantly less pain, I am sleeping better, and thinking more clearly. It’s not a linear journey. There have been bad days. But my daughter says I look like I’m glowing. Who can argue with that? Each week is little better than the last. At long last, I have hope that I’ll be back on the trails with my family soon! I cannot be more grateful for Dr. K and her entire staff!