Frequently Asked Questions ( FAQs ) of Dr. Donovan

Why is pain worse in cold weather?

Millions of people live with pain, which can often worsen during the colder months. While experts are uncertain exactly why cold weather worsens chronic pain, we have several theories and mechanisms that could explain it.
Changes in barometric pressure, altered blood circulation patterns, tightened muscles, decreased physical activity, and changes in nerve sensitivity are all factors that can contribute to increased pain during colder months. Some of the chronic pain conditions that are most affected by cold weather include arthritis, neck pain, joint pain, knee pain, hip pain, back pain, headaches/migraines, carpal tunnel syndrome, and fibromyalgia.  Commonly old injury sites will ache when a patient gets chilled. However, there are things you can do to manage your pain, including using heat therapy, taking warm baths, staying active, traveling to somewhere with a warmer climate, staying hydrated, and maintaining your vitamin D levels. If your pain persists, consult with a pain management doctor to discuss your options.

Can I still be treated after I have had a hip replacement?

Yes absolutely! You are not alone in your concern and we have dozens of patients we treat at our office who have had hip or knee replacement surgery. Hip replacement surgery had helped so many people remain active when they otherwise might not have been able to. Those who have had hip replacement commonly also have lower back pain as well. Special care does need to be taken. When patients are a little worried I just slow down and make sure they understand that I can modify my technique I use to make them comfortable while maintaining effectiveness.

What Should I Bring To My First Visit?

Thanks for choosing Dr. Donovan as your Chiropractic and or Active Release provider. There are a few items that you can bring to make your first appointment go smoother. Please print and complete both the New Patient forms and Privacy Policy forms prior to your appointment time. These forms can accessed via this link Download & Print Form or call us at 650-348-4233 and we would be happy to either fax or email them to you. If you have insurance, please bring your proof of insurance or insurance card. Please also bring your calendar so we can schedule your next appointment if necessary. If you are visiting for a sports related injury, please bring your running shoes, sports gear, or anything (including Back, Neck, Shoulder etc MRI’s or X-rays)that you would like to discuss with your doctor during your appointment. If you are being seen for a upper back or shoulder problem bringing a tank top or t-shirt is helpful in allowing access to the area.

We trust these suggestions will make your first visit to Dr. Donovan’s office easy and enjoyable. We look forward to seeing you then. Should you have any questions prior to your appointment please feel free to call or email.

How long does a visit take?

The initial examination takes approximately 1 hour depending on the condition, complexity and history of the individual. A treatment visit lasts from 20 to 40 minutes depending on the condition or conditions being treated.

What can a  Chiropractor do for foot pain or problems?

Adjusting patient’s feet is a common occurrence at our office.  Foot function affects the backs function. Treating foot pain and dysfunction is about 20% of our practice. Chiropractor’s primary focus may be the treatment of the spine but Chiropractic and Active Release Technique treatment of the feet can benefit the whole person. Chiropractic adjustments and Active Release Technique (soft tissue therapy) work together and are  very helpful for foot and ankle conditions such as plantar fasciitis, neuromas, chronic ankle sprains (weak ankles), even improving neuropathic pain symptoms in Diabetic feet. Exercise and rehabilitation are a key element in resolving foot conditions and are almost always part of the treatment plan. Dr. Donovan has taken years of postgraduate training focusing on the treatment of non-spinal conditions such as foot, knee, hip, shoulder and elbow pain.

Can I see Dr. Donovan for Headache pain?

Certainly. Dr. Donovan treats patients with a variety of headaches, occasionally a patient may have more than one type of headache – at the same time. Chiropractic, Active Release Technique are very effective at treating a variety of headaches. Diet, Rest, Exercise, Alignment and Mindfulness also can play a part – particularly with more complicated cases. Occasionally, a multidisciplinary approach is needed. In those circumstances Dr. works as part of the team to help you get the results you want.

I don’t want to be adjusted. Is this the only way you treat patients?

Great question. Every patient is approached individually. I adjust my techniques to suit the patient not the other way around. After all, each patient has a unique history and unique preferences. Chiropractic adjustments are appropriate for certain conditions, but not always necessary to help a patient get the results they desire. Dr. Donovan offers a variety of techniques to help patients. Over the years he has had many patients who he has not used Chiropractic adjustments on.

What is Active Release Technique (ART)?

Active Release Technique treatment is a hands-on treatment and case-management system that allows a practitioner to diagnose and treat soft-tissue injuries and conditions. Soft tissue refers to muscle, ligament, tendon, fascia and nerves. These injuries are a growing cause of disability in this country.

This is accomplished by examination of the patient to find and reduce and or remove the poorly functioning soft tissue structures ensuring that:

· Optimal tissue texture and movement are restored.

· Strength, flexibility, relative movement and function is restored.

· Release any soft-tissue restrictions, entrapped nerves, restricted circulatory structures and or lymphatic structures.

ART is based on a well developed understanding or anatomy, physiology, and the biomechanics sports and everyday life. This can be used to help nearly everyone from Crossfit enthusiasts to office workers. Providers must be certified and engage in ongoing continuing education. As a dynamic technique, practitioners are involved in finding new and better ways of improving upon ART’s clinical efficacy.

What is the Selective Functional Movement Assessment (SFMA) ?

SFMA is a battery of 7 body movement tests designed to assess fundamental body movement patterns in patients with musculoskeletal pain (Lower back pain, Neck pain, Tension Headaches, Runners Knee etc). In performing an assessment from the perspective of movement patterns, the clinician has the opportunity to identify problems that may be seemingly unrelated to the main musculoskeletal complaint, but actually contribute significantly to the associated disability. Patterns like this, when left unaddressed, interfere with optimal recover. This concept is known as Regional Interdependence and is based on Mike Boyle’s Joint by Joint approach. It is a central part of the SFMA.

The assessment guides us to the most dysfunctional non-painful movement pattern. This is then broken-out or assessed in more detail. This approach is designed to overlay the existing physical exam. It serves as a model to merge the concepts of posture, muscle balance and the fundamental patterns of movement into a musculoskeletal practice. Addressing the most dysfunctional non-painful pattern first, the application of targeted interventions (manual therapy, Active Release Technique, Graston, Gua Sha, and therapeutic exercise) is not adversely affected by pain.

Is it OK to see a Chiropractor if I’m pregnant?

Pregnant mothers commonly find that Chiropractic adjustments make their pregnancy more comfortable. In fact, for each ten pounds of weight carried in front of the spine, you increase the internal disk pressure by fifty pounds. Moms to be frequently report that they feel better alignment and movement makes their delivery easier. Adjusting techniques are adapted to a patients size, age, and comfort. Pregnant women often find adjustments to their lower ribs, feet and hips particularly helpful during the third trimester. We use the patented Body Cushion to give pregnant women the option to comfortably lay face down while completely supported.

1. Chiropractic Management of Spinal-Related Disorders Meridel L. Gaterman Williams-Wilkins c. 1990

Chiropractic and Pregnancy

Once you go to the Chiropractor, do you have to go the rest of your life?

This is entirely up to you. We will discuss, you situation, your goals, my recommendations and any concerns you have.  Patients often elect to simply recover from a painful or dysfunctional situation and then discontinue care.  Patients can also choose to be seen periodically to manage problems or simply prevent them from becoming a unmanageable. I have not experienced a dental problem in years, yet I continue my checkups because preventing problems and or catching them early is important to me. Chiropractors either fix problems or help patients manage them and then do our best to keep new ones from developing. An important part of what I do is teaching patients how to care for themselves so you can maintain your health with the maximum amount of autonomy.

How many visits does it take?

This depends on your particular condition. A person with a long history or injuries, as you can imagine, would have a different treatment plan than one who had who did not. As a profession the average is nine visits – last time we checked.  We are regularly quicker than that!  Dr. Donovan will better be able to predict how many visits are necessary after your first examination. Dr. Donovan will give you recommendations and monitor your progress. Should you improve more quickly than expected he will adjust your treatment plan accordingly.

Are all patients adjusted the same way?

Dr. Donovan listens to each patients unique issues, preferences and history during the consultation. This coupled with a comprehensive chiropractic examination allows Dr. Donovan to develop an individual course of care. One plan does not fit all patients. No two patients are adjusted exactly the same way. We blend a variety of chiropractic techniques to find what works best. Our recommendations are based upon years of training and experience.

Is Chiropractic or Active Release appropriate for the Elderly?

Older folks are frequent patients at our office. They get their share of neck pain and back pain too. We use a variety of techniques that are all adaptable to individuals needs – no matter the age of the patient.  We adapt our approach to meet the needs and preferences of each patient.   It is a topic that has been studied for over 20 years:

“[Elderly] chiropractic users were less likely to have been hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs.” – Topics in Clinical Chiropractic, Coulter et al. (1996)

Is Chiropractic safe?

A recent study concluded that injury related to chiropractic adjustment was less than 1.25 incidents per million treatments. It is interesting to note serious complications from aspirin ingestion were 3,000 per one million patients. Chiropractic is one of the most conservative forms of intervention available today.

Can a person who has had back surgery see a Chiropractor?

Absolutely yes! We have many patients who have had lower back surgery of varying types. Patients who have had back surgery are treated differently based on  the surgery they have had. Unfortunately many of those who had spinal surgery discover a return of their original symptoms months or years later. This too common occurrence is know as “Failed Back Surgery Syndrome.” In fairness it does make for a more complicated case but does not prevent us from helping. The use of Active Release Technique with Chiropractic care often works best.

How much does it cost?

Our exam runs from $135 depending on the complexity of your case. There is no charge for Dr. Donovan to either consult with you or to present his findings once an examination has been performed. Individual visits run from $70 to $100 dollars depending on complexity of your case and how much treatment is done. If your insurance does not cover chiropractic, we have a payment plans that is within most people’s budget. Please feel free to call us prior to your visit if you have questions 650-348-4233.

What is a Frozen shoulder?

Also known as Adhesive Capsulitis, is a common clinical complaint. Commonly treated by Chiropractors and Physical Therapists, it varies significantly from mild to severe pain and restriction. Defining ‘frozen shoulder’ is not straightforward as it can vary significantly. It has been used incorrectly as a general diagnosis/description for vague shoulder pain and stiffness. The definition, cause, and treatment for it are subjects of debate among clinicians.  The onset and the quality of the pain are often surprising to patients.  Adhesive capsulitis often begins from no easily identifiable trigger and the pain and restriction of motion can be severe.

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Frozen Shoulder, not your typical shoulder pain…

We describe frozen shoulder syndrome as:
‘a soft tissue capsular restriction accompanied by painful and decreased active and
passive motion of the shoulder joint’ (Grubbs 1993).

Discovered and described as a peri-arthritis by Duplay in 1872, as Frozen Shoulder by Codman (1934) and finally Adhesive Capsulitis by Neviaser (1945).  He first recognized the “chronic inflammatory process” that resulted in capsular contraction of the shoulder joint.

Does Dr. Donovan use instruments to do soft tissue work?

Instruments offer additional ways to treat the muscles, ligaments and other structures of the body. This has provided a very useful addition to Active Release Technique. There are many techniques and makers of instruments from traditional Chinese Medicine (called “Gua Sha”), to Graston to the Sound Assisted Soft Tissue tools (SASTM). They all make it simpler to locate and treat fascial restrictions. Using an instrument or tool focuses the treatment force on to a smaller area, often reducing the force needed. The instrument does not compress like a finger pad does which allows you to treat differently – generally more gently. The goal is to trigger an inflammatory healing response. This will stimulate remodeling and the production of new soft tissue leading to more functional, less painful healing.

Key benefits with all soft tissue therapy, including with instruments

  • Reduces overall time of treatment
  • Allows faster rehabilitation and recovery
  • Reduces need for anti-inflammatory medications
  • Resolves chronic conditions thought to be permanent
  • Clients can continue to engage in everyday activities

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