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Your First Appoinment with the Chiropractor

Lowrie Bell

You've got back pain or neck pain. You can't move as well as you once did.

Your shoulders,knees or hips are aching. You have headaches. (Hopefully, not all at the same time!)

You’ve decided that you need some help and would to see a chiropractor.

There are few chiropractors near you, how do you choose?


·         Reading online reviews is a great way of seeing if people in a similar situation to you have been helped by the clinic.

·         Check out the social media platforms and watch videos and posts they have made to see how they work.

·         Go to the website, there’s usually lots of information about the clinic on there and the conditions they can help with. You can also see if theyre registered with the General Chiropractic Council (GCC), which is a legal requirement for the chiropractor.


Your chiropractor should be registered with the GCC. Pembroke Chiropractic Clinic chiropractors are all registered and insured.
Your chiropractor should be registered with the GCC. Pembroke Chiropractic Clinic chiropractors are all registered and insured.

·         Getting recommendations off friends, family members and colleagues.

·         Calling the clinic or dropping them an Email for a chat about your aches, pains or difficulties before you book.


If you have done this and chosen to come to Pembroke Chiropractic Clinic, we thank you! The following information should be of great help to you before you book in, or before you attend your already booked appointment.

 

How do I book an appointment at Pembroke Chiropractic Clinic?

You can call the clinic and speaking to one of our lovely reception team; Mandy, Lorraine or Aly, who will find an appointment that best suits you. Ever mindful of how busy life can be, we can offer you a lot of flexibility with timings to account for those of us who prefer early morning, daytime or early evening slots.

If you prefer to be in complete control, you can book an appointment online at any time.

Once booked we will send you a confirmation email containing a form to fill out some details before you come in. This allows us to start thinking about how to help you and saves you a little time when you arrive at the clinic for the first time.  

We know not everyone wants to complete online forms, so we also have paper copies in the clinic if you prefer. You will just need to arrive a little earlier than your appointment time to complete these.  Whichever way you book with us, our reception team will give you a consent to examination and treatment form to sign in person before you see your clinician.


The confirmation email also contains information about what to bring to your appointment, for example:

·         Copies of any X-Rays or Scans

·         Copy of prescriptions

·         Clothing that is loose/comfortable and easy to move around in. We provide gowns to change into, which may be necessary for some of the examination.

·         A hair bobble if you have long hair is always a good idea.

·         Your glasses, if you need them for reading.

 

 

The Purpose of the consultation.

As a valued new patient of ours, the initial consultation is a vital element of us helping and treating you to the best of our expertise.  We pride ourselves on being a strongly person-centred and empathetic practice. By spending an hour’s initial appointment with you, we have the time and environment to really connect with and learn about you as a person, and how your condition is impacting your life. We need to decide whether chiropractic treatment is appropriate for you, and if the condition is musculoskeletal (MSK) and if so, give you the best possible treatment and plan for your individual needs and situation.

 

 We also decide at this point whether we need to refer you to a more appropriate intervention or investigation.

 

Medications and other health issues

Certain medications and health problems people have can affect the prognosis of recovery from pain and injury. It may be that certain treatment modalities cannot be used due to risk of adverse effects.

Some examples of this would be patients who are taking Warfarin. We wouldn’t use acupuncture, very deep soft tissue work or manipulate these patients. But that doesn’t mean we can’t do anything to help you.  It just may require a more “hands off” approach, very gentle techniques and more self-management. Even then, we can help you find the right things to do and having regular contact with the chiropractor allows us to monitor progress.

Patients who have osteoporosis  wouldn’t have spinal manipulation due to the increased risk of fracturing the bones and we would have to think carefully about what rehab exercises they were given. If during the consultation, it comes up that the patient is osteoporotic, it would allow us to be directed to the possibility that the pain is coming from a fracture and would guide the examination to ruling this out.

 

Why do you need to know about my medical history or my family medical history?

We need a broad range of information about you in order to make effective and ethical clinical judgements. Asking about your medication, diet, exercise and smoking status allows us to calculate the risk of certain problems and the probability of you responding well to care.

Certain conditions can be hereditary or have a strong familial link and we need to be aware of these while making our prognosis.

 

Getting to know you

Our mission to meet and hopefully exceed your expectations in terms of how you will feel after receiving chiropractic.  Knowing what you enjoy doing, your hobbies and lifestyle, your family and your independence help us design a treatment plan bespoke to your unique self and circumstances.

Some of the information we ask for included:

Work-related: What job do you do? Is your pain affecting your work? Does the fact that you sit for hours per day contribute to your back pain? Have you had to take time off work because of pain? Is that stressing you out?

Family-related:  Who do you have that depends on you? Do you have a little one that needs lifting and carrying in and out of the car, up and down stairs etc? Are you a carer for a family member?

Friendships:  Are you able to be social and do the things that you want to do?

Previous treatments:  What have you tried before? What has worked and what hasn’t?

Diet and supplements: Are you getting good fuel in, to get good output? Without any judgement, smoking and alcohol intake can affect healing and prognosis.

Sleep: Are you sleeping well at the moment or is the pain waking you? Are you a poor sleeper and not getting the rest and recovery you need through sleep, leaving you more likely to injure yourself?

Your goals in seeking treatment:  For example: Do you want to be able to walk your dog, or lift your grandchildren up when they visit? Do you want to run a marathon next year? As you can see, different goals will require very different treatment paths.


Jas during her Ironman 70.3 in Swansea. Will she do Ironman Tenby?
Jas during her Ironman 70.3 in Swansea. Will she do Ironman Tenby?

 

Examination

The examination is thorough and includes assessing the area of pain, as well as other parts of the body. It is common for pain in one region to affect other parts (referred pain). If you present to us with knee pain for example, we would check the lower back, hip and ankle. Knee pain can be caused by referred pain from the lower back or hip joints and having knee pain can impact the ankle and hip joints due to altered gait and compensatory movements due to pain.


The minimum we would do is as follows.

Testing your reflexes: To test the efficacy of your spinal nerves, these come out of your spine and travel down into your arms and legs and in the case of the thoracic spine, travel around to the chest and abdomen, following the ribcage. These nerves supply strength to our muscles, our deep tendon reflexes and sensation to the skin. Each nerve will supply a different part of the trunk or extremity.  Decreased and increased reflexes mean different things and can have different causes. For example, you can have a decreased or absent reflex if you have a disc herniation that is pressing on the nerve.


Testing your muscle strength (Myotomes) Muscle strength can be reduced from compression of the spinal nerve, a tear in the tendon or muscle, pain in general or other nerve problems. Testing the strength allows us to work out the most likely cause. Pain can make muscles work less well and, in this instance, you may find that strength in those muscles comes back quite quickly after a treatment.


BP and pulse: Whether you are aware you have raised blood pressure and are already on medication, or whether you have undiagnosed high blood pressure we can check it, monitor it and refer you, if needed, to your GP.  


Range of motion We will go through your general spinal range of motion, and that of your individual joints, including the arms and legs.


Muscle and joint palpation. We will check which of your muscles are tight and/or sore, and which joints are restricted and/or tender.


Orthopaedic testing: This is more specific testing of the joints to narrow down the structures that are generating the pain and helps us work out if the problem is more likely to be a muscle, tendon or joint.


Functional Testing How well does your body move in every day activities? Can you get up and down off a chair without using your hands? Can you stand on tip toes, can you squat down, can you reach behind your back? Can you get up and down off the floor easily? These are movements we should be able to do day to day without too much trouble. If we can’t do them, we need to address that.

 

Additional tests if indicated by your case history and examination

These are usually done if any of the basic tests have flagged up something else that needs to be checked. Or if you have said something in the case history that made us suspicious of an underlying cause.

·         More in depth neurological exam

·         Urinalysis (most pregnant patients will have a urine test as standard)

·         Basic heart/chest/lung/abdominal exam

 

Report of Findings

This is where we explain what we have found, if we can help you, how we can help you, the time frame we are looking at and how you can manage and help the process along at home.

We encourage lots of questions so please feel comfortable to ask us as many as you need to.  The more you understand about your pain and your body the better. We do this every day but to you, it can feel like a different language. Pain can also be worrying and we promise, here at Pembroke Chiropractic Clinic, there is absolutely no such thing as a stupid question! Ask away!


Steve, during a report of findings. Helping people understand their pain.
Steve, during a report of findings. Helping people understand their pain.

We will go through any perceived risks at this point too. No clinical intervention is without risk, and we try and minimise risk through a thorough case history and examination. This can be as small as being sore after treatment, to bruising and more severely fractures (Think osteoporosis and why it is important to know about this).



 

First Treatment


At Pembroke Chiropractic Clinic, we like to do the first treatment on the same visit as your consultation. There are a few reasons we would delay treatment or not go ahead with treatment at all. This may include

·         Needing referral to GP for imaging (X-RAY/MRI/Ultrasound) or Blood tests

·         Someone else might be a better fit for your condition. Such as massage therapist or personal trainer. This may even be another Chiropractor, such as one who has had more training in an area such as working with children or pregnant women.

·         This might be better self-managed at home such as an acute sprain/strain.

·         You personally would like to self-manage with exercises and just wanted peace of mind from the consultation


You will be given some gentle movements or stretches to do between your appointments and advice on how to manage you pain at home. Including using things such as ice/heat/topical creams, moving little and often or resting etc.

Everything will then be provided on a hand-out for you including the areas we found issues in your body, the treatment plan, advice given and exercises given. There is so much to take in during your first appointment, it’s so handy to have it in written form that you can refer to and study in your own time.

When you leave, our work doesn’t stop there. We make clinical notes about you, and for some patients prepare rehabilitation plans, GP letters, referrals and any other information we feel needed to create a comprehensive file on you.

 

In summary, booking in is best done by ringing 01646 686856 or through our online booking www.pembrokechiro.co.uk

We take a 50% deposit for all new patient appointments*

The initial consultation is a big chunk of time and work for our chiropractors and reception staff. Due to the length of the appointment, they are not in large quantity each week and sometimes people have to wait to be seen. Cancelling your appointment with 24 hours notice allows us to offer this appointment to someone who may be on the waiting list.

We look forward to welcoming you at our clinic,

 

*Refundable if you need to cancel when you let us know 24 hours prior to the appointment time

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