Passive Vs Active Treatment Model
Which Type of Care is Right For You
As you can imagine, there are infinite reasons why pain can persist in the body. To complicate things, there are compensations the body will make to keep you in the dark about tissue damage until there are no more healthy tissues to compensate with, at which point, pain is felt. So, when pain is present, which type of care should you be seeking?
First, it's important to understand each model.
Traditional Chiropractic Philosophy (Passive Treatment Model) goes something like this – The ability of your nervous system to function is dependent on the “housing” (aka spine) of that nervous system functioning properly. When joints of the spine/pelvis are over stressed, or not articulating properly (alignment), that stress effects the nervous system by a process called somatovisceral reflex. This reflex states the following:
1) Inflammatory mediators accumulate around joints that don’t move properly.
2) There is a “spill over effect” around this area of irritation. This simply means nerves exiting and entering the spine around the area of irritation will also get aggravated by chemical irritation (inflammation is kind of like a sunburn for your nerves), or mechanical irritation (bone, muscle, or other tissue physically pressing against or compromising the nerve).
3) These irritated nerves don’t function properly, and the outcome of that poor function will manifest itself in different ways depending on the “jobs” of those nerves. Whether that’s too much activity (such as muscle spasms), or to little activity (weakness of hands in the case of Carpal tunnel) there will be a physical or physiological symptom as a result.
4) Restoring proper joint function will decrease stress/inflammation to the joint and, based on proximity, the nervous system. This equates to the body being able to regulate itself properly without the interference of unwanted chemical or mechanical compromise.
The maintenance of this system requires periodic treatment (usually including adjustments, massage, e-stim, laser, etc) so you can catch problems before they become injuries or illness.
I consider this a Passive Treatment Model because the patient is passive in the process of treatment.
ChiroStrength’s philosophy (Active Treatment Model) goes something like this – The brain controls everything about movement, and the presence or absence of pain is a reflection of these movement patterns. How we sit, stand, walk, exercise, etc., makes up the environment our body is in 24/7 which can promote health or injury, and your response to treatment depends on how healthy this environment is. If we can find where your movement is lacking, (coordination problem? Balance problem? Mobility problem? Stability problem?) we can coach you how to improve your movement environment outside the clinic so the treatment “lasts”. This often means your painful tissues are NOT the problem; they are just the over stressed areas in a poor movement environment. Treatment is necessary to improve health of tissues, and movement re-education is necessary to de-stress that tissue outside of the office.
I consider this an Active Treatment Model because treatment is infrequent, and outcomes depend on the active participation of the patient outside the clinic to utilize the coaching to improve the brain’s movement patterns to help support treatment.
So which care is right for you? Directly following an acute injury, such as right after an accident or during an acute disc herniation, the passive care model is likely your best bet. The active model is for you if you have chronic pain, you're often in and out of pain, or you are very active and need care that supports that activity/sport. Remember, the Active Care Model requires you to have enough pain free movement, such as getting in and out of a chair or on and off the floor, to engage the coaching drills. Also, if you are not intrinsically motivated to be pain free, the Active care model will probably not work for you ad success depends on your participation.
Most pain is like an onion; layered with compromised tissues that have failed to withstand the stress of your daily routine. Treat the pain, and you remove only one layer, but it will come back. But if we treat the pain, THEN remove each of these layers with a consistent, mindful, movement practice, you won’t be so dang easy to hurt!
The Trick is getting the RIGHT patient, to the RIGHT doctor, at the RIGHT time. And like I always say; Don’t just Mend. Transcend.