So I was out last night playing a card game at a card shop called Cool Stuff (geeky, yes) and I met a really cool guy, lets call him Allen. After Allen kicked my butt in Magic the Gathering (thoroughly) we got to talking and it became known that I was a chiropractor.

"Really? Wow, I wouldn't have thought that. Ya know, I don't really believe in Chiropractic."

Having heard this many times before I simply said "that's okay, do you have any questions?" Allen asked me why I'd chosen to become a chiropractor. Well, I hurt myself when I was younger, my next door neighbor who was a Chiro helped me to get better and the rest was history. Simple enough.

Then unexpectedly Allen really opened up to me and shared an awful ordeal he recently had. Being a real-estate agent in FL around the time the market crashed Allen started experiencing facial spasms and sought help. The doctor he was seeing ordered a brain MRI where alarmingly 3 lesions were present. His doctor suspected Multiple Sclerosis (MS) and ordered a Spinal Tap to be performed. Allen didn't quite understand why this was being done, but being very concerned he did it anyway.

I explained to him that during MS brain cells are destroyed and they can sometimes be found in the body's cerebral spinal fluid (CSF). So by taking a sample of the CSF, if cell bodies are found it can be inferred that they are coming from your lesions which are "active." I was waiting for him to tell me whether or not they found cell bodies, but he didn't even know thats what they were looking for.

"Wow, see, no one even told me any of that."

He said the results of the spinal tap were vague, but his doctor prescribed medication anyway. Allen had read about MS and didn't think he was having MS symptoms. Unfortunately the spinal tap was very traumatic for him. He was told that there was some nerve damage during the procedure, which he later learned is very common. Now he has back pain which affects him daily. Admittedly, spinal taps are very invasive procedures.

Now Allen is pretty upset with his experience and his doctors. He refused to follow through with the MS diagnosis or medication. Whats more, is that his original complaint of facial spasms have resolved on their own. He asked for my "two cents," he wanted to understand what happened, and he was curious to see what a Chiropractor would have to say.

I told him that it is hard for me to give my full opinion because I haven't seen his reports or done any examination myself and also I meant no disrespect by contradicting his other doctors. He wasn't concerned about any of that, there was no love lost between him and his doctors.

I told him theres really no way of knowing exactly why those lesions that showed up on his MRI were there. It is possible they've always been there, it is a congenital anomaly (there since birth) and has nothing to do with what he was experiencing. A lot of times MS can be abused as a diagnosis. I see it used a lot when physicians really don't understand what his happening; they use this diagnosis as a "catch-all" because the disease itself can be vague.

Occam's Razor teaches us that usually the simplest explanation is the correct one. I told him that what I thought was more likely was that the stress from having his real-estate market crash was the cause. "How could this happen?" Stress can be so utterly devastating. There are multiple mechanisms.

1. Stress can lower the threshold by which muscles are activated. Stress puts you in "fight or flight" mode, in which your body not knowing the difference between a real-estate crash and a physical threat, prepares you to respond. By making your muscles easier to contract, you are better able to fight something to the death, or run away for your life. Smaller muscles, like muscles of the face are more affected because they require less stimulus to contract.

2. Stress can also increase the demand for resources like vitamins and minerals, and thereby make you more prone to deficiency. For instance, Potassium is used to keep muscles from contracting by returning neurons to rest. If because of stress you have used too much potassium, you might be more prone to spasms. Again smaller muscles like those of the face are more easily affected.

3. By increasing the demand for energy, Stress will speed up your metabolism to provide it. As is always the case with metabolism, you get destructive free radicals. Increased metabolism means increased free radicals, means increased destruction. This is why when you are under stress it is ultra-important to also increase your anti-oxidant intake. Anti-oxidants are one of the first places I would look to for treatment for Allen's ordeal.
   

We could go on and on, but you probably already agree Stress is the most likely mechanism.

Finally I told Allen that Chiropractic is different from other professions in that we are often guided by a philosophy. Our philosophy teaches us to take the most conservative and least invasive approach in any situation. I'm not condemning your doctors approach, but if it was me, I might first have treated you conservatively with nutrition (to increase antioxidants) and adjustments (to inhibit the sympathetic nervous system and decrease the stress response) while co-managing with your other doctors of course, to see how you responded, before ordering a spinal tap.

And with that I think my new-found friend had a new-found perspective of chiropractic and chiropractors. He was really happy with our conversation and glad to get some insight into his problem. I also really like this approach to skeptics. Skeptics are not enemies of chiropractic, they are just friends waiting for someone to listen and try to be helpful.

Mad Chiro Luv,

-Darren, DC