Learning how to cope with chronic pain helped Domenic to keep moving forward

After experiencing pain like no other from a regular walk, Domenic was diagnosed with spinal stenosis, which led to years of struggle with finding care and treatment. Eventually, a visit to a chiropractic ‘bootcamp’ helped Domenic strengthen his body and learn the value of taking things slow. 

There is new hope in the circle of care of some patients with arthritis. Domenic Manieri, a patient with spinal stenosis found it at Toronto’s Mount Sinai Hospital after years of experiencing leg and back pain.

“One day, I was going for a walk when I felt my leg cramp,” says Domenic. “I couldn’t move it. Some time after, my back began to hurt and that’s when I decided it was time to see my family doctor. He diagnosed me with arthritis.”

The Beginning of a Long Treatment Journey

Arthritis is the most prevalent long-term health condition in Canada, affecting approximately 20 per cent of the population¹. It encompasses over 100 diseases and is characterized by inflammation in the joints or other areas of the body such as the hip, knee, or spine². The number of people living with arthritis in Canada is expected to increase by 3 million by 2040³.

Despite its prevalence, finding the right care for arthritis is a challenge for many patients for many reasons. Oftentimes, its early signs and symptoms can mimic those of other diseases. Because there are many forms of arthritis and the condition has the potential to affect multiple joints in the body, treatment must be tailored and individualized to the patient’s specific needs⁴. Typically, patients begin by seeing their family doctor or a rheumatologist⁵.

“At the time of my diagnosis, I didn’t even know what arthritis was,” says Domenic. “I was referred to an orthopedic surgeon and was given anti-inflammatory pills. However, my pain progressed, and I soon began to experience very painful nerve pain in my back.”

Domenic at the 2017 Knights of Columbus golf tournament

In fact, Domenic experienced such a bad flare up that he couldn’t even sit down. He went to the emergency department at his nearest hospital and was sent home with a prescription for opioids. This marked the beginning of Domenic’s long and frustrating journey of finding the right care to address his arthritic pain.

“Medication is great for short-term pain relief, but as a patient, you want to get to the root of the problem and learn how you can help yourself on an ongoing basis,” says Domenic. “There’s a lot of options we’re not presented with in terms of what the cause of our pain could be and what can be done to alleviate it.”

For the next several years, Domenic saw many specialists, including osteopaths and physiotherapists. Each time, he received a different kind of treatment plan, none of which seemed to hit the mark.

“Every specialist I was referred to provided consultation and advice based on their expertise, but all differed in their opinion, making things a lot more confusing for me,” says Domenic. “It got to a point where I felt like pulling my hair out. I didn’t know where else to go. I was seeing a lot of specialists, but my pain persisted.”

Over half of those living with arthritis are under the age of 65 and the onset of arthritis varies depending on the type⁶. Due to its propensity to affect multiple joints of the body, a significant proportion of people living with arthritis report difficulties with mobility and activities of daily living such as doing housework and running errands.

Learning How to Cope with Pain Through Chiropractic Care

The light at the end of the tunnel came when Domenic made an appointment with his long-time podiatrist. He immediately recommended Domenic to the Chiropractic Spine Clinic and Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis & Autoimmune Diseases at Mount Sinai Hospital. It was here that Domenic was diagnosed with spinal stenosis and found hope for managing his symptoms.

For the next six weeks, Domenic participated in the clinic’s 12-week bootcamp, working closely with Dr. Aksa Ahmed, a chiropractor at the Chiropractic Spine Clinic.

“All of the doctors were extremely knowledgeable about arthritis and my pain,” says Domenic. “They worked with me to strengthen my body with targeted exercises, tips on walking, and home stretches and modifications based on my pain level. I really learned to understand my body. For example, I learned that it’s okay to slow down if I’m in pain.”

At the Chiropractic Spine Clinic at Mount Sinai Hospital, Dr. Ahmed takes an individualized approach to supporting patients with various conditions, including degenerative disc/joint disease, rheumatoid arthritis, ankylosing spondylitis, spinal stenosis, and spondyloarthropathies and radiculopathies. Chiropractic treatment for chronic conditions typically involves a combination of manual therapy and exercises, education and self-management, and coping strategies, such as mindfulness meditation and guided imagery to help patients manage the stress and anxiety that can come with their diagnosis.

“Once a patient is diagnosed with arthritis, they will often get seen by a variety of specialists, including rheumatologists, family doctors, and neurologists,” says Dr. Ahmed. “Unfortunately, chiropractors are often left out of this circle of care. This presents a huge gap in our health care system because chiropractors are trained to be able to work alongside other health care professionals to treat patients with arthritis. It is one more tool in a patient’s toolbox to consider when searching for the best possible care to help manage their pain and improve the functional limitations that can come about from a condition like arthritis.”

Chiropractic care is a patient-centred, non-invasive, hands-on, regulated health care profession focused on the spine, muscles, joints, and nervous system. Chiropractors use the best available evidence and clinical expertise to diagnose issues that affect the body’s movement, including back and neck pain, strains, work and sports injuries, and pain associated with arthritis. Chiropractic care is the primary method of treatment for many medical conditions, such as low back pain. Chiropractors are trained to help patients manage the pain and functional limitations associated with arthritis by using a combination of manual therapy, exercise prescription and self-management strategies.

“The biggest takeaway from my chiropractic appointments is that I learned how to cope with my pain,” says Domenic. “The tricky thing with arthritis is that you will always have it. It’s important to accept this, learn to take care of your body, and keep moving. Motion is lotion.”

Domenic, left, presenting a cheque to the Habitat for Humanity with proceeds from the Knights of Columbus 2019 golf tournament

Getting Back to a (Modified) ‘Normal’

Today, it’s been eight years since Domenic first saw Dr. Ahmed. He now goes to the clinic mainly when he has a flare up or as required.

“Even on days when my pain is particularly bad, I know that my treatment will be modified for the best possible outcome,” says Domenic. “These specialists know all the doors to knock at.”

“Most people don’t take the time to find out what arthritis is really about and the various available treatment options,” says Domenic. “Looking back, I was one of those people. I wish there were better ways for patients to know their treatment options so that they can make more informed decisions about the care that their body needs.”

“Arthritis is a complex medical condition for two reasons: It’s chronic and there’s no cure,” says Dr. Ahmed. “As our population ages, there’s no better time for chiropractors to play an active role in a patient’s circle of care and work alongside rheumatologists and other specialists to ensure the best outcomes for patients. It’s important to empower patients with viable, evidence-based options, such as chiropractic care to discuss with their specialists.”

“As patients, it’s up to us to make a positive change in our lives,” says Domenic. “Chiropractic care may not be for everyone, but it helped me minimize my pain and learn to take a step back and listen to my body. It was nice to know that I had additional options to choose from based on what my body was telling me. This, combined with a positive mindset has helped me accept my lifelong condition and realize that there is hope after all.”

For more information on how chiropractors can help, visit Help to Manage Your Arthritis.

References:

¹ Arthritis Community Research and Evaluation Unit (ACREU) for the Arthritis Society.  (2019).  Status of Arthritis in Canada – based on an analysis of Statistics Canada’s Canadian Community Health Survey (CCHS) 2015-17.

² Arthritis Society. About Arthritis – What is Arthritis? 

³ Arthritis Community Research and Evaluation Unit (ACREU) for the Arthritis Society.  (2019).  Status of Arthritis in Canada – based on an analysis of Statistics Canada’s Canadian Community Health Survey (CCHS) 2015-17.

^{4, 5} Arthritis Society. Treatment & Prevention.

⁶ Arthritis Community Research and Evaluation Unit (ACREU) for the Arthritis Society.  (2019).  Status of Arthritis in Canada – based on an analysis of Statistics Canada’s Canadian Community Health Survey (CCHS) 2015-17.

Originally posted by the Ontario Chiropractic Association