What to Expect
A checklist of what to bring to your first appointment:
Please bring your insurance card and one form of Photo ID to your first appointment. If your treatment is covered by Workers’ Compensation, bring a letter of authorization from your Workers’ Compensation carrier which should include the case number / claim number, date of injury and your Adjuster’s name and phone number.
A List of Personal Health Questions or Concerns
Sometimes we forget all the things we wanted to tell or ask the doctor, so make a list of your symptoms, questions or concerns before you come to your appointment. And don’t forget to bring it with you!
You will be asked to fill out a New Patient Packet for your first appointment. These forms include Patient Information, Health History, HIPAA Notice of Privacy Practices, HIPAA Disclosure and a Financial Policy. For your convenience, you may wish to complete these forms prior to your first appointment and either bring it in with you to your appointment or you can FAX the completed forms to 907-222-6550.
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here.
If you have seen other physicians, please have your medical records transferred to our office before your scheduled appointment. During your first consultation with Dr. Maxwell, a medical history will be taken and reviewed. Dr. Maxwell will collect more specific information pertaining to your current condition during your visit. Be sure to answer all questions honestly and accurately as certain movements are intended to produce, or not produce, discomfort.
Recent MRI that is less than a year old
A recent MRI is needed for your first visit so that Dr. Maxwell can correctly diagnose your condition as a physical exam alone cannot achieve this. If you do not have an existing MRI less than 1 year old, you will need to get a new one ordered. You may obtain a new MRI before seeing Dr. Maxwell by asking your chiropractor / Family Doctor / Pain Management Physician to order you the relevant MRI for your condition. These tests are painless and act as a medical photograph of your body. For simple muscle-related back pain, X-rays are of limited value because they do not show muscles and discs, only bones. Dr. Maxwell may use X-rays to determine if there are any fractured vertebrae after a fall, or if there is a narrowing of the disc space which may imply a disc problem. In some cases, we may use a CT scan to determine what may be causing you pain however this scan is limited in showing soft tissue. Ultimately, it is your responsibility that you bring the correct and recent MRI to your appointment.
Relieving your symptoms
As a result of your first consultation with Dr. Maxwell, the following recommendations may be made:
• Therapeutic & diagnostic procedures such as Epidural Steroid Injections (injections of a steroid and numbing medicine into the spinal canal near the spinal cord) with a Pain Management Physician in order to identify the pain generator.
• Tests such as a Discogram / CT scan in order to fine tune the diagnosis, which are performed by a Pain Management Physician
• Ongoing treatment and evaluation by a Pain Management Physician for medication to reduce pain and inflammation
• Radiology scans (e.g. MRIs, x-rays) which are performed by a Radiologist
• Surgery if appropriate and necessary
• Dr. Maxwell is a huge believer in the benefits of conservative therapies such as those listed below, to relieve pressure on the irritated nerves and provide pain relief. Patients who ultimately require surgery often recover more quickly and easily, thanks to the non-invasive pre-operative care from the following therapies:
Recommended conservative therapies:
Acupuncture is an alternative treatment method and one of the oldest forms of therapy practiced in the world, effective in treating a wide range of symptoms and conditions. This traditional Chinese treatment involves the insertion of thin needles into the skin into the underlying tissue at precise locations known to help relieve pain and other symptoms. Acupuncture can be used to treat many different medical conditions, including:
• Postoperative pain
• Headaches, neck and back pain and other orthopedic conditions
• Menstrual cramps
• Fibromyalgia and carpal tunnel syndrome
• Sinusitis and asthma
• Gastritis, nausea, vomiting and other gastrointestinal conditions
• This treatment is often combined with more conventional ones, such as prescription drugs, to maximise results and allow patients to return to their regular activities more quickly.
During the acupuncture treatment, the needles are inserted into the skin at targeted areas and depths depending on each patient’s individual symptoms. Only sterile, single use needles are used during acupuncture in order to ensure patient safety. Patients may experience an aching sensation when the needles reach their desired location. The needles are usually kept in place for five to 20 minutes, and may receive electrical or heat impulses during this time. Patients often undergo a series of weekly or biweekly treatments, usually with 12 total treatment sessions.
It is important for patients to have this treatment performed by a licensed professional, as improper administrations can result in pain and other side effects. Some patients may experience soreness, bleeding and bruising at the site of the injection, but these side effects are usually mild and go away on their own. Patients with bleeding disorders or those taking blood thinning medication should not undergo acupuncture treatment.
In general, acupuncture is a safe procedure with little to no side effects and is effective for most patients, including those who do not respond well to more traditional treatment options. For more information about this treatment, do not hesitate to ask your doctor if your medical condition can benefit from acupuncture.
Back pain and low back pain can often be alleviated and even prevented with a few simple exercises to strengthen the muscles of the back, stomach, hips and thighs. Activities such as running, walking, swimming and bicycling are excellent ways to keep these muscles strong and flexible. There are also numerous stretching and strengthening exercises that condition these muscle groups, including wall slides, leg raises and sit-ups. Talk with your doctor about which activities are best for you. Whatever fitness regimen you choose, it is important to start out slowly if you have not been active in a long time, and to stretch thoroughly before and after exercising to prevent injury.
Ultimately, you’ll take an active role in your own therapy. To protect your neck or back from further injury:
• Practice good posture whether you’re sitting, standing, or moving.
• Have your workspace evaluated. Rearrange it as suggested.
• When lying down, support your neck with a special cervical pillow or rolled-up towel.
Chiropractic therapy is an alternative healthcare approach that focuses on disorders of the musculoskeletal system. Practitioners typically forgo medical treatment for hands-on manipulation of the problem area, most notably the spine. By mechanically adjusting the spinal column through various techniques, chiropractic therapists can effectively reduce or eliminate pain from many parts of the body, although this treatment is most effective for lower back pain.
Chiropractic therapy is generally referred to as a “holistic” approach to medicine; it will treat not only the symptoms presented but also the body as a whole. Although spinal adjustment is the most common treatment used, chiropractors may use a variety of techniques to treat the joints and muscle tissues of the body, such as:
• Electrical muscle stimulation
• Heat or ice therapy
• Ultrasound therapy
• Dietary suggestions
• Clinical kinesiology
• Rehabilitative exercise
Many patients seek chiropractic care for other reasons besides back pain. Neck pain and chronic headaches are other ailments that can often be effectively treated through chiropractic treatment. The chiropractor uses the aforementioned methods to restore the relationship between structure and function of the human body parts. These allow the patient to take advantage of the powerful self-healing ability of the body, without relying on outside substances to treat their condition.
There is a limited potential for risks involved with chiropractic healthcare. Serious side effects are extremely rare and are normally caused by a pre-existing condition, such as a hypertensive individual undergoing a stroke during adjustment. Negligence is more likely to cause a significant problem than anything, so ensuring that your chiropractic is certified and licensed can go a long way.
Minor side effects such as soreness, stiffening and recurrent pains may occur depending on the technique used and severity of its application. Most of these occur approximately one hour after treatment and subside within a day or two. Overall, chiropractic treatment is a safe alternative medicine when employed skilfully and properly.
Massage therapy is a healing art that promotes relaxation and well-being with the manipulation of muscle layers and connective tissue. Conducted by a professional massage therapist, your massage will take place in a quiet, serene environment on a padded massage table. Before the massage begins, your therapist will discuss your concerns and what your expectations are for your massage. The therapist will either use a special oil or lotion during your massage in order to avoid additional friction to your skin.
• Benefits of Massage Therapy
• There are many benefits that can be received from massage therapy. Some of them include the following:
• Relieve muscle tension and stiffness
• Provide comfort during pregnancy
• Promote healing
• Increase recovery time after exercise
• Reduce pain
• Reduce post surgical adhesions and swelling
• Lower blood pressure
• Strengthen the immune system
• Relieve headache symptoms
• Types of Massage Therapy
Your massage therapist will discuss with you the goals of your massage before the massage begins in order to determine which type of massage therapy you may need. There are many forms of massage therapy available, they include:
• Deep tissue
• Hot Stone
• Myofacial release
Conditions Treated with Massage Therapy
As part of a physical rehabilitation program, massage therapy has been used in the treatment of some of the following conditions: