Cianci Chiropractic recorded this webinar of which is one episode. The webinar is produced and recorded for the ear and they were designed to be either watched live on video or listened to via audio. If you are able to, we strongly recommend listening to/watching this episode which will include emotion and emphasis that isn’t obvious when reading a transcript. Our transcripts are generated using a combination of speech recognition software and humans. They may contain errors. Please check the corresponding audio before quoting in print. This is not meant to be chiropractic advice.


Welcome to the webinar. Our topic today is maximizing your results at your chiropractor’s office. This 25 minute webinar, followed by a q&a session promises to be an informative session designed to empower patients, especially those new to chiropractic care. We will share knowledge and strategies to enhance your treatment outcomes. During today’s webinar, you will learn how to communicate effectively with your chiropractors to tailor treatments to your specific needs. We will also cover pre and post visit practices that can amplify the benefits of your sessions. Please type your questions in the chat, and we will get to them at the end of the webinar. And at any time during this presentation. You’re welcome to call our office for an appointment at 410-210-4562 or visit our website at Dr. c&c dot com and click the book and Appointment button at the top right of your screen. With that, I’ll hand the presentation over to Dr. CNC.


Thank you a couple things we’re going to go over here today, which has been kind of our format we’ve done in other webinars we’ve done, we’re going to talk about what what generally happens when a patient comes to our office initially as a brand new patient, we’re also going to cover why we do the things that we do. We’ve been called thoroughly thoroughly in the past. And we’re okay with that. Just this morning, we had a patient come in, and he halfway through his exams like wow, you not attended a couple different other offices. And no one’s been as thorough as you my friend who referred me coworker friend said certainly would be thorough, and boy, was he right. So we’ll explain what what happens, but also why and the meanings behind it. One of the things we do, we have some computerized forums we use here in the office and we can get information from the patient. The reason why we use the ones we do is because they gather information quickly and efficiently. Now, the last thing we want to do is skim over everything. But then we want to get as much information as we can hence the reason why we use some computerized forms for that patients love it because they can answer a lot of questions in a short time, they’re not sitting in a room, writing things down for an hour, but want to be as thorough as we can. So that’s one of the things we do after that generally, at least one of our doctors, maybe as many as two or three would review some of that history prior to going in and speaking with the patient. And there’s some specific topics we talked to face to face with the patient after we’ve had a chance to review everything. But that’s kind of how that situation goes. We’ll touch on some of the things that are important to know certainly want to know if a person had had any fractures or injuries. There’s a number of things we ask that really go further back just in the last few years, we even go back in towards the birth process, and things like that too, as well.


Absolutely. I’m Dr. Julia and one of the doctors in the office. And I wanted to kind of highlight one of the reasons we asked about such a thorough history even all the way back to your birth or sometimes even pre birth. And that’s because a lot of people in the chiropractic profession, consider birth, the first subluxation the first time that their spine is misaligned. And that’s because anyone’s ever seen the birth process. Most babies are brought out by their neck or their base of their head, sometimes twisted, sometimes pulled. And all of that puts a lot of stress on the baby’s spine. And we can see in when we see those babies as they develop later on in chiropractic because they’re developing other issues such as colic or other things like that we can kind of in our profession, we believe that all ties back to possible misalignments at birth. We also need to know about, for example, if a patient was breached or something like that, and they had a really long, difficult labor, all of that can have an impact on the spine moving forward. Another thing we kind of want to highlight is any falls that the patient has had and ended up seeing as he’s going to talk a little bit more about that.


Ya know, we were discussing this earlier in the week and Dr. Dooley and I were talking about how at the hospital babies check their breathing and their blood work and their functioning and Apgar scores and all these things and certainly that needs to be done, but really the spine and nervous system isn’t checked. And hence the reason why we recommend Pete patients do that more and more progressive patients aren’t doing that. Getting back to the falls and injuries. It isn’t just an idea we came up with as far as reaching back into people’s histories and asking about falls. The National Safety Council tells us that 50% of us fall from a significant height in the first five years a life could be off a changing table or rolled off a chair. What we consider usual childhood falls, but again we want to know that these things happened. And usually if you are an adult now you may not be maybe your older brother or sister told you that or maybe your parents told you they dodgy you, you fell off the countertop or you flipped off the changing table, something like that. We want to know about those things. We want to know about any other accidents, injuries that may have happened with regard to childhood growing up, things like that. So we also ask a little bit about a little bit about auto accidents too, as well. And, again, we even ask, even if it’s a minor fender bender, and how many accident car accidents have you had in your life, and even if it’s a minor fender bender, we talked about that too, as well. So yes, we


that’s not just us asking about that there’s research showing that even as slow as the eight mile an hour car crash can have an impact on the person’s spine, very often, Whiplash occurs at as little as eight miles per hour, there may not be a lot of damage to the actual car with the some of these accidents occur, but your body feels those impacts and that force that traveled through the car went somewhere, likely it’s into you. So that’s another big important thing that we like to know about. Because you can see the results on the X ray similar to falls, you can see the result of childhood falls on X ray.


A lot of things we find they’re very often their injuries that happened long ago, the body healed it but a man held healed long. And if it stays there for years and decades, oftentimes we will, we’ll see the ramifications of it years later. And we’ll talk a little bit more about X ray and a little bit. Again,


we’re going to say something. Yeah, I was gonna say in consultation, our main goal is to understand what is what is wrong with you currently? And what are the possible causes of that. So we try to understand the full picture of what’s going on. We want to also understand whatever is going on, say it’s low back pain, we want to know how that is affecting your life. Is it affecting your relationships? Is it affecting your ability to travel to work? All these things are really important. And we think that all of the questions we ask, help us understand the whole picture. And we always like to tell patients, you know, maybe you don’t remember a falling took when you were two years old, what your body does. So


just this morning, we actually had two different new patients. And both of them checked off the fact that they felt like their current condition was affecting relationships. One of them was a 39 year old, he said, You know, I maybe don’t have as much patience as I should with my children. And it’s just I haven’t felt well. And so again, we want to see how that impacts the patient. And again, lifestyle. You mentioned certain activities, like to golf a lot, and I can’t, I’m not able to do that, or I want to take my grandchildren to Disney World. And I don’t think I’ll be able to do that and walk around and do the whole thing that Disney World requires and whatever it is to fill in the blank for what a person’s activity levels being affected, we find that very often, that’s what drives them here. They may or may not have symptoms that drove them here, but it’s affecting, it’s affecting their life and lifestyle. And we want to know what that is. So we can get a person back to living the lifestyle that they want.


It also helps us create goals for the patient, and then we can work with them to achieve those which we really get a lot of enjoyment out of that process,


we get to see people do the things they love. And we love the fact that we’ve had some impact on that. There’s a lot more things that are covered in history. But you can obviously we’re going to know about the family history and mom and dad and are they living or not and have they what have they died of that’ll be covered by the computerized things. And again, the doctors will review all that initially, before speaking to the patient. And then the doctors will get that get together later that night to review it too, as well, at least two doctors, maybe as many as four. So that’s one of the things that happens. We also want to know, are there some chores or activities around the house, you’re not able to do we have a lot of patients love regardless, but we can’t do the things you love us if that ship may even end up affecting your mood because you love to do those sorts of things. So after we’ve gathered that information that we’ll call the history or what we call the consultation with the patients. The next thing we’re going to do is run some tests on the nervous system. And that’s our primary focus, we’re looking for minor misalignments that affect nerve function. And one of the tests we do on our office actually measures nerve interference, if you will, this is kind of a printout of one and without getting into too much detail. When you look at a exam like this, you’re looking for as much white as possible. And you can probably pick up perhaps in a camera, that there’s some white areas, but there’s also a number of other different colors. And I’m not going to get into details too much. I will tell you this. We tell our patients that probably haven’t had a ton of tests done like this locally because we’re not aware of anyone else in the area that has the instruments we have to measure nerve function. But this tells us what’s happening inside of a person’s body and we’re able to monitor it and measure If this is something we can repeat down the road to monitor and measure patient’s progress too, as well. But that’s one of the tests that we end up, end up doing in the office. And that often leads to other things too, as well. Then after that, after that it often leads to after the consultation exam, we also do talking about the ortho neuros.


The next thing patients would get are X rays, we do X rays in house in this office, the other at least two doctors that look over every set of x rays, sometimes more than that, we consider X ray an invaluable way to analyze the spine. When we’re looking at an x ray. We’re looking at it for many different many different lenses, we’re obviously ruling out any red flags. But then there are also other things to consider. We want to see the actual structure of that person, we want to see if there’s any congenital anomalies, we are born with something that’s different in their spine, that may or may not explain some of the issues they are dealing with today. Another thing we want to look at is how much arthritis the spine has. So this is kind of a quick model of an arthritis model. This is a perfectly healthy disc spacing. And then as it goes down, this is the most advanced stage of the generation. And when we see that on a x ray, we may or may not change the way we approach that case, we might choose a different technique, we have many different techniques that we can do in this office, some of the manual techniques that maybe people will have seen before it might associate generally with fair practical, we also have much more like horse techniques using instruments and things like that. And we’ll talk more about that in kind of a next portion of the webinar. But that’s kind of an overview of what we’re looking for in X ray. We also want to make sure that X rays that we do in office, they’re done in gravity, the patient is standing. And we do that because we want to see what the forces of the spine look like our forces on the spine look like when you are standing up. And that is really important because most people want to remain active they want to renewable and that is the only way in our opinion, to measure to see that it’s to see what the patient’s body looks like when they’re standing in gravity.


And with that in mind, we talked about lifestyle and keeping people healthy mobile inactive, we don’t find that it’s good to take an x ray lying down because there’s not a lot of activities that’s involved lying down, we want to see the doctor joining us at the alignment. When a person is in gravity, perhaps in every sport, we know, one line down. And so again, that’s a real important factor too, as well. Another


thing to consider is most people, if they are in pain, when they’re lying down, they’re usually out of pain, or at least the pain is reduced. And so we like to see the spine when it’s in the position that the is causing the most pain because that will help us understand where it’s coming from.


And again, we look at the spine as a as a system, we look at the nervous system, we want to check the entire spine, we don’t want to just look at the bits and pieces of it. We also do some orthopedic and neurological and chiropractic testing, checking reflexes and strength. One of the things we find a lot of is very often a person has weaknesses they’re not aware of sure we have people come in and say you know, I don’t have the strength in my arm maybe like I feel like I should, maybe it’s an athlete that doesn’t feel like they can throw the ball or hit a tennis racquet as strong as they used to do that can happen. Maybe an older person says My legs aren’t as strong as they used to. But we go deeper than that we want to do a variety of different tests. Maybe in the upper extremity, we’re checking the rotator cuff and arms, hands and fingertips. And then below the waist for checkup, hips and legs and feet and toes. And again, we really have realized we know this to be true is that if a person has certain weaknesses, just say it’s in the hips and legs in that area, well, they’re basically out of alignment when they’re asleep, just lying in there. But if there’s a weakness there, it’s going to torque and twist the spine. So although you think you’re not doing anything, when you’re asleep, very often the spine is out of alignment has been in that pattern for many years and leads to other problems. It’s really kind of odd for you to say I just bend over to tie my shoes and I have a big problem. You probably have been out of line for quite some time. And the nice thing is that we’ll kind of prove that by looking at X ray and testing we’ll see how much stress has been on the spine. Hence the reason why we we do all the things that we do. So one


that I just wanted to add is with both of both the X rays and nervous system testing and the physical exam that Dr. CNC was just talking about. We are seeing these weaknesses and these changes in the patient’s find in people as young as you know, five or six years old, in some cases, or we had a patient just this last week, that’s eight years old. And you can already see the changes in his spine. Most likely from like a developmental, maybe he had a big fall something like that. And we were talking about earlier, he


actually had a pretty difficult for his process too, as well. And, and he’s an athlete himself. And again, very often you just remove the pattern and it’s a bad pattern, it’s not a helpful pattern. So thankfully, a lot more progressive parents are bringing their children in earlier earlier because of the because of what we’re seeing. Long term patient so. So we kind of said consultation exam, nerve scans, X rays, orthopedic neurological testing, that’s all part of what we do. And really, we do that to gather information. And we always tell the patient, there’s four questions that we want to work to answer on the first day they’re here, or at least gathered the information to answer those questions. One is, are you in the right place? Can we help you? That’s number one, we’re looking for a lot of different ways for you not to be here so that we quote unquote, prove the fact that you need to be here. But we’re all trained to do that first. So are you in the right place? Yes or no, we tell you that. The next questions are what’s wrong? Can we help? How long will it take? And how much will it cost? So the questions that most people want to know, the information we gather will give us an insight into that. And then after we’ve gathered that information that first day that patients given some recommendations for home, and then their scheduled time to come back generally the next day. And we will tell them for sure that next day, those four questions, what’s wrong? How long will it take? How much will it cost? Is this the right place? We answered, answer those four questions. So that’s kind of part of of the quote unquote, first visit, I told you a little bit about what would happen that following visit when we do the explanation of the findings. And as Dr. Drew was mentioning, before, all that gathered information may give us some insight into how we’re going to lay out the care plan, I’ll tell you this, at least two doctors, maybe as many as four will review your X rays, your history, all the nerve scans, everything we’ve listed here as well. And that may dictate what sort of care plan we use. Dr. Julio alluded to some manual techniques, kind of traditional chiropractic techniques, which were all excellent app and getting really great results with hands on adjusting, we certainly do that. We also have a number of different instruments here. Some cases don’t, don’t require hands on adjustments on old fashioned chiropractic adjustments. We have small instruments in the office that we sometimes use. This is one of them here, it’s kind of a spring loaded, instrument, very gentle, very easy, but it kind of gently Kaspar back in place. And it’s just it’s placed along the spine, and we make an adjustment to the person’s spine, various levels. Maybe you have someone who’s nervous, or maybe you have someone who’s osteoporotic, meaning that osteoporosis, maybe this might be an instrument that you use to make alignments with patients. We also have another instrument here on this show you it’s basically a similar type optic, but it’s more one tonic chord, and it just gently, gently placed against the spine, and then tap back into place. works well for certain conditions works well for patients who maybe enjoy the popping and clicking. Or maybe a particular case, because of the history exam and X rays and you say, you know, one of these instruments is going to be the better way to go. But either way, we have a variety of different techniques and a variety of different doctors with different specialties to go ahead and take care of those things. So that’s kind of you know, one part of our part of our summary, if you will, for that information is our our library, video library. We have a video library, perhaps we find a person who’s had a bad pattern in their body for a long time it needs to change. We have an area we call our spinal rejuvenation center where people do exercises to help change the patterns that were there. And again, to really target the area that we said that we this is an outboard and they work to really target those areas. The average gym workout doesn’t target the things that lead to spinal problems. They have number one, you’d have to find out what they were. And number two, you’d have to target those areas to get that strength back. We have been triathletes come in here together in very good shape. We find weaknesses in them all the time. college athletes doesn’t really matter eight year old have weaknesses the other day, so it can happen really to anybody. Athletes, no athlete or not. I think we’ve covered most of what we generally wanted to cover. Jen, did you have questions come in that you wanted us to answer? We


do. So thank you for the presentation Dr. Cianci and Dr. Julia, we have some questions that have come in. For our audience. You’re welcome to type in your questions in the chat or if you are watching the replay, you’re welcome to contact our office with your questions, and we’d be happy to answer them. 

Audience Questions

  1.  You wear named tags in your office? Why do you do that?


Yeah, we weare these name tags. I’m part of extension faculty for one of the largest chiropractic universities. And part of it requires a training program that will for doctors. And so we have a training program that doctors go through here involving neurology rotation, radiology, rotation, and there’s a management rotation. So we just want patients to know who the doctors are, hence the reason for the name tax. And hence, the reason why there’s multiple doctors here. We also bring in student doctors too, as well, in various stages of their training for the same for the same purpose for we’re training them to get out in the field, and maybe start seeing patients themselves after graduation. So that’s the reason for the name tags.

  1.  My last chiropractor didn’t take X rays were they supposed to? And why do you guys take X rays?


So X rays have been around since about 1895. Yeah, and it’s been using chiropractic offices since the early 1900s. And so we like we said kind of earlier in this presentation, we think is pretty invaluable to get the information that we need, in order to make the best get the best results for our patients. Pretty much any specialist would their first, their first line of imaging would be X ray. And that is kind of where we fall, we’re in that first level of specialty. And that is kind of alarming reasoning for it, but we haven’t need to add to that.


It’s, it’s been around since 1895, it’s been in private practice since early 1900s. It doesn’t matter whether you go see an orthopedic surgeon or neurologist or neurosurgeon, it won’t be very long. If you have spinal type complaints, they’re gonna order x ray, we just want we want it in house. So we didn’t do it right away. We also want to be able to send it meaning if we will have at least two doctors, maybe as many as four review the X rays, but we also want to have the ability to send them if we do need to send them to a radiologist, or we have patients who start maybe care here and they’re relocating to a new state, in about five seconds, we can ship their X rays anywhere we want, right away they want us to, and that’s I say, around the country, it’s really around the world. And we could send them anywhere and get them evaluated by someone else makes it easier for transitioning, should a person relocate or retire to a new area? We’ve already covered the clinical aspect of it. So I, I don’t know why someone maybe wouldn’t use them. I just know that we wouldn’t accept a couple.


We wouldn’t take an x ray of a patient would be if they are pregnant, or if they are very, very young. And there’s no actual trauma that they are dealing. So


we have a patient yesterday, who who’s ready to deliver in about a month, I’d say well, obviously we’re not X ray for and again, children that it was a recent trauma, that might be a reason for it. But you know, we think X rays. It’s imperative at least as far as our analysis goes. Yes,


that helps us otherwise, we have really no idea where along this kind of these different phases of the generation or arthritis, we have no idea without seeing the spine, what someone’s spine looks like here. We had a 15


year old with arthritic arthritis showing up starting to show in the spine. Exactly. Yes. Got it. Got it right, in our opinion. Absolutely.

  1. You mentioned that more often than not spinal problems start in childhood. Will your clinic treat children and what is the youngest age that you will start treatment?


Okay, so, yes, we see children, let’s say we see children, some children, at least every day. I’ve had children. I’ve had parents who maybe have been under chiropractic care. I’ve had them bring their children right from the hospital here. So


Justin, being born, so


the age doesn’t matter. Meaning it doesn’t we don’t shy away from that. It changes the


way you approach it. We are not using the same techniques you’re using an adult in a child but


again, the more more and more. As I said progressive parents are bringing children in younger and younger, younger thankfully And but we start seeing children soon as soon after they’re born really, like I said, we’ve had some bring them right from the right from the hospital here on the on the right home. So sooner, the better because again, the hospital did everything great and wonderful and fantastic and thorough. But again, the nervous system was fine wasn’t checked, we kind of know that.

  1.  Would you be able to explain this part about the first day? There’s a initial evaluation, X rays and nerve testing. But why is there not treatment the first day?


We believe in our process and needing to look over six and time away from the patient in order to believe gather our thoughts and gather our recommendations, we would never want to not put that time in because we think the patient deserves that kind of effort and analysis analysis. Yes,


I would also add that in most doctors offices are very, very busy. I’d rather make important decisions that are going to affect the patient’s life and lifestyle. I rather do it after patients left for the day, after we’ve had time to sit down and look at it. Yes, we take that history very thoroughly computerized portion of it, and then the the verbal portion of it. But our doctors are instructed to to if this is the history to flip it over, and don’t look at it. And then we’ll do an exam. But while you’re not influenced by it that well, you’re not likely to go have we got this third person figured out, we don’t have to, we talked to them, that’s enough. We want to kind of separate it, and often to the doctor, a couple of doctors reviewing things. One of them wasn’t in the exam room and didn’t maybe take the x rays. So you’re kind of coming in with someone who knows the background and details on someone who isn’t, we feel it’s a more thorough way to analyze things. Because again, the doctor who didn’t do the exam and didn’t wasn’t in there on the consultation is coming in totally no influence their mind is clear, we find it’s a great way to combine the person who saw the details and the person who didn’t bring it together. And it’s just a better, more thorough way to would do things. We might make some general recommendations, we might say, hey, use some ice packs at home. That’s pretty regular. We find that to be helpful. But again, we want to be sure we’ve reviewed everything before we go ahead and make recommendations to the patient or really give out any care prior to having a sit down look through it to be thorough about it.

  1. How long should a person set aside for their initial evaluation and X rays?


office we say typically about an hour to start with the paperwork and you finish the exam and X rays can have paperwork sent home beforehand as well. And that can speed that up, but about an hour’s about what we recommend. We see


a lot of family families here. So oftentimes if the husband is a patient, he saw him bring my wife and sit home and see her will say hey, here’s the paperwork and I want you to take this home door. It’ll save a little bit of time in the office. But I wouldn’t say then hours. It’s a good timeframe to set aside for that.


Please. Yeah, that’s all the questions we have for today. But Dr. Cianci and Dr. Julia, do you have any final remarks before we end the webinar?


I don’t think we’ve I’ve covered most everything. We’ve covered pretty much that we plan to. Yep.


Great. Well, thank you everyone for joining us today. This webinar recording will be available to rewatch within one week. Please call our office for an appointment at 410-210 4562 or visit our website at and click the book and Appointment button at the top right. Thank you for joining us today and have a great day.