The KISS principle in solving chronic pain. When you want to help someone feel and function better, I find that the KISS principle often helps me help others more effectively and efficiently. KISS stands for keep it simple stupid. The healthcare system has done a great job at making healthcare complicated, risky, and costly. Health professions, hospital systems, group practices, insurance companies, drug companies, and other healthcare manufacturers and facilities have taken their places in society. Welcome to the disease model of care. Patients are educated from early on with pediatricians that their medical providers and the systems they work in have the answers to your health and longevity. We are taught that blood tests are an indication of health and pain needs to be controlled usually medicinally or more invasively through pain management. We are led to believe that we are not the sum of our parts and a painful part needs a specialist to evaluate that part. We learn that diseases are scary and must be treated using specialists, tests, and drugs. There is little mention that the system has little understanding of why most people are in pain or that medical providers have so little training in how to properly evaluate and treat it, forcing them to refer to specialists and segmenting the care of problems that are often solved simply and with little cost or risk. The model has moved away from primary care being your advocate in this complicated system to the segmentation of care with their expensive and often ineffective and overly complex multi-specialist model. Hospital systems understood this and purchased many primary care practices to assure the flow of patients comes to them first. We are all paying for this with increased insurance premiums while being deprived of more appropriate solutions by hospitals that want to keep patients in their networks of specialists. Covid-19 has shown us that there is a huge problem when hospitals lost money when elective procedures were not able to be done. The irony of this is that the system is set up for intervention rather than health. More medical specialists mean more procedures and more damaged joints years later requiring the need for knee and hip replacements. These procedures are avoidable with better musculoskeletal healthcare when you are younger. In the world of musculoskeletal medicine, allopathy, the largest and most dominant part of our health care system is poorly educated in the musculoskeletal system and professions such as chiropractic are far more capable and much better trained in the management of pain and mechanical dysfunction that causes pain. Many chiropractors, such as our offices have assumed the role of primary care for the musculoskeletal system, sometimes referred to as primary spine. Many of our patients visit for the first time believing pains are just an inconvenience needing an adjustment or two which is what they have been taught by allopathy and that things just happen to nice people when they are doing an activity. Visiting a chiropractor for the first time can be scary because you don’t know what to expect, but having blood tests can also be scary as well. Once patients feel better from their first couple of chiropractic visits, they understand the role of the chiropractor better but if their distress is too high, they will often opt for the medical options of pain meds, tests, and other things that may potentially be harmful to them. Many of these patients are never sent back to the chiropractor once their symptoms lessen. Often, pain management the right way by using a chiropractor is slower when the problem is more chronic. It takes time for the chiropractor to figure out all the things involved in a chronic problem in many instances, yet many patients are impatient. Insurance carriers have made access to simpler effective care more costly through high deductibles, high copays, and tiered networks. Other countries make this far more affordable and have shown their effectiveness through lower costs and a healthier public. Most people have chronic problems that became acute and many of them had problems that were ignored or medicated instead of understood and mitigated early on. The irony here is that a patients’ perception of normal is often just an understanding of how they usually feel and that pain is what motivates them to take action when the pain does not resolve on its own. In other words, normal is what we usually feel like and this can be different for everyone but is it normal or just normal to us? Insurance companies, by making things more costly forces patients make financial decisions rather than healthcare decisions and years later, they pay the prices with damaged joints, arthritis, and chronic preventable problems. In the allopathic world, blood tests, cursory exams, medication, and referrals to specialists with orders for tests such as an MRI are common. The waiting for the appointment and testing approach to care will often make an acute problem more chronic. It is the disease model of care for a mechanical problem. Sometimes these professionals will offer chiropractic care as an option or send everyone for physical therapy to the part in question. The irony here is that often the mechanism behind your pain is not where you feel it or the part being subjected to the test, procedure, or rehabilitation. This results in poorer satisfaction, addictions to drugs such as opioids, and high costs personally and to society at large. Knee problems for example can be a foot problem, a problem with the core, or even an old ankle injury. In the chiropractic world, the model is simpler; a thorough musculoskeletal evaluation, possibly an x-ray, and then a treatment that is designed to reduce pain and improve how the patient feels and moves. This is the KISS principle in action. Most patients give their chiropractors high marks as compared to medical professionals for their care and cost and like the approach according to Consumer Reports. Most patients who visit chiropractors first can avoid many unnecessary and invasive tests, drugs, procedures, and costs. Chiropractors will refer you to medical care if it is required and will order tests such as an MRI if you are not progressing in an appropriate amount of time. Chiropractors are the body mechanics of the healthcare system having knowledge in improving the way you move and function, which addresses why we hurt. Chiropractors will see their utilization rise dramatically when insurers get out of the way and medicare fully covers their care. On the other hand, you as the patient can do what is best for you and see a chiropractor first. You may be pleasantly surprised at how well you feel and function with their primary care approach to the musculoskeletal system. Your first chiropractic visit will include the following: 1: Holistic history and evaluation. 2. Recommendations and treatment, usually on the first visit. Treatment from a chiropractor includes exercises, manipulation of the spine and extremity joints where indicated, myofascial release to the tight tissues preventing you from moving appropriately, and possibly other soft tissue methods such as the Graston technique. 3. Foot orthotics may be recommended if necessary to level the pelvic and correct structural asymmetries in your body. 4. X-rays if needed. 5. Referral to another specialty if the problem is outside the scope of chiropractic care. In pain, use the KISS principle. See a chiropractor first. Chiropractors are your one-stop shop for most musculoskeletal problems Book online here.