The Respine Way

What is funnelled diagnosis?

An effective diagnostic approach allows the healthcare provider to narrow and pin-point the root cause of the problem. At Respine, we combine patient history, full spine examination and nerve scan to funnelled down our differential diagnosis

1. Patient History

The beginning to solving any problems is to figure out what the problem is. We take tremendous pride when it comes to our diagnostic protocol. Dr. Lai will take a detailed consultation upon your first visit, not only to understand your condition and chief complaint but also your medical history, past and present medication usage, surgical history etc. History taking is often overlooked as your past injuries and conditions can be helpful when narrowing down the root cause of your problem.

2. Complete Spinal Examination

After understanding your condition verbally, Dr. Lai will begin to complete a full spine examination. Our examination is referenced by the Gonstead Methodology. Patients will be gowned with an open-back to allow a more thorough visual inspection of the spine for signs of inflammation and swelling. Static and motion palpation with range of motion will be tested along with any appropriate orthopedic tests for further evaluation.

3. Nerve Scan

Inflammation is a key indicator for nerve irritation and tissue damage; as Gonstead chiropractors, we utilize the Nervoscope which scans the spine for presence of inflammation.

What is a Nervoscope?

Nervoscope is a nerve scanning device that Gonstead chiropractors use to detect inflammation in the spine. It serves as a objective measuring tool when examining a patient as well as assessing progress.

Our spine not only provides support to the body, it also protects our nervous system. The central nervous system or spinal cord resides inside the spinal canal where the peripheral nervous system or nerve roots exit through the spinal foramen.

Inflammation of a spinal segment indicates potential irritation to the nerves that exits at that level. Nerve scans aid the doctor to further narrow down possible problematic areas.

Why do we gown?

There are three major reasons why we gown.

1. As previously mentioned, we pride ourselves on the specificity of both diagnosis and treatment. Open-back gowns allow the doctor to be as precise as possible when it comes to examination and treatment.
2. Nervoscope scanning requires the device to be on the patient’s skin in order to obtain an accurate reading.
3. According to Hilton’s Law of anatomy, the nerve supplying the muscles extending directly across and acting at a given joint not only supplies the muscle but also innervates the joint and the skin overlying the muscle. In simple terms, when a nerve is irritated, it not only affects the muscle and joint but the skin overlying it as well. Open-back gowning allows the doctor to thoroughly analysis all three components.

After completing an initial evaluation, depending on the patient’s condition, Dr. Lai may refer out for a full spine X-ray imaging. In the X-ray, Dr. Lai is able to calculate;

• Vertebrae wedge
• Weight shift
• Lateral curvature angle
• Cobb’s angle and apex
• Vertebrae disc bearing
• Spinal stress loading
• Sacral base angle
• Lordosis/ Kyphosis, etc…

Combining “Step 1” and “Step 2”, Dr. Lai is able to precisely diagnosis the problem causing vertebrae thus propose the most appropriate treatment plan and case management for the patient.

What is a chronic pain cycle?

A chronic pain cycle is a cycle where a patient is stuck in the relief phase of recovery. A series of relief- based therapies are employed to provide temporary relief only. Patient eventually becomes reliant on the relief-based therapies and the condition worsens over time.

The Respine Way aims to break the chronic pain cycle and correct the root cause to allow the patient to pass the relief phase of recovery and into condition stability and wellness.

It is important to note that temporary relief does not correct the root cause of the problem, rather it allows the condition to manifest and worsen over time. If your condition is persistent or worsens, please seek medical advice immediately.

After a series of funneled diagnosis, Dr. Lai will design a specific treatment plan and case management for the patient. Targeted treatment and planning are just as important as proper diagnosis.

Journey to recovery is divided into three basic phases:

1. Pain and inflammation control
2. Structural stability of the spine
3. Supportive care and wellness assessment

As mentioned above, the absence of a systematic treatment plan will often result in a chronic pain cycle. Structural stability and correction of the spine are paramount when pain and inflammation are under control.

In “Step 2”, the extensive analysis of X-ray imaging allows the doctor to evaluate areas of spinal instability thus providing correction to those segments. In principle, we are not focused on temporary pain relief but rather the longevity of the patient’s spinal health and wellness.

*在下面的健脊四部曲（四）中，我們會提及到更多有關定期檢查及輔助治療。

Needless to say, prevention trumps therapy. Supportive care are a series of wellness care in the form of rehabilitative devices and/ or exercises to ensure the spinal health of our patients, even after treatment. It is important to note that “The Respine Way” is a protocol that ensures the progress of our patients, proper assessment is required before a patient can advance to further treatment and therapies. Applying supportive care to the patient during an acute phase (pain and inflammation) will worsen the condition. “Right tools, right order” is often overlooked. Regular progress assessment is necessary to provide the most up-to-date information about our patient’s condition.

Acute and Chronic Conditions

Spinal conditions can generally be categorized into acute and chronic.

Acute injuries are sudden accidents or onsets that often cause pain or discomfort within days or weeks. Depending on the severity, recovery is usually shorter and treatment is less complicated. Chronic conditions are developed over time. Repetitive motions or improper posture can lead to degeneration and anatomical changes to the spine.

Onset is slow and recovery is usually longer with a much more complicated treatment plan. “Waiting it out” is often unwise as the condition can worsen over time, Dr. Lai recommends consulting with a healthcare provider if a symptom has been persistent for over a week. A simple condition can be resolved by simple treatments if detected early.

At Respine, our rehabilitation program includes rehabilitation exercises, curvature-corrective Denneroll® and prescription height adjustable heel lift. Our doctor will prescribe different supportive methods according to the patient’s progress to further strengthen and stabilize the spine.

When patients inherit incorrect daily habits, it can contribute to relapse and pain cycle. In order to ensure a full and complete recovery, it is important to follow our doctor’s at-home recommendations and rehabilitation instructions.