Adjustments/Manipulations

Adjustments and manipulations help correct abnormal movement patterns of vertebrae, which have caused the body to function abnormally. This is done using a manual manipulation where the doctor uses a high velocity, short lever arm thrust applied directly to the vertebra, or through the use of an activator adjustment where a specific tool is used to perform the adjustment.

Manual manipulation is often accompanied by an audible sound, which is the release of oxygen, nitrogen, and carbon dioxide. Joint pressure is released and a cavitation occurs. This sensation is commonly relieving, though minor discomfort can occur for the first 48 hours if the surrounding tissues were in spasm or inflamed before the adjustment.

At times like this, we will advise you to apply ice, rest, and increase your fluid intake. The objective of this service is to reduce the subluxation resulting in increased range of motion, reduced nerve irritation, and improved function.

Ancillary Supports/Braces

A lot of conditions that benefit from chiropractic care also benefit from the use of a brace or stabilization device. We may recommend any one of these to help your progress:

• Cervical pillows
• Swiss balls
• Low back braces
• Rib belts
• Carpal tunnel supports
• Elbow wraps
• Knee braces/sleeves
• Heel lifts
• Topical analgesics, such as Biofreeze

Cryotherapy

Cryotherapy is when you apply ice to injured tissues. Cryotherapy can cause a numbing or pain-relieving effect as it functions as an anti-inflammatory and a natural pain reliever. The ice constricts blood vessels, which in turn help relax muscle spasms. Cryotherapy will produce the most benefit if applied more frequently for shorter time spans throughout the day. We generally recommend applying ice in 20 minute intervals 4–6 times a day during acute phases of injury.

Custom Foot Orthodics

Orthodics are devices designed to restore normal foot function. Poor foot function can cause heel pain, knee pain, or lower back pain. Orthodics are custom made and can:

• Help re-align your foot
• Alleviate problems that may be occurring in other parts of your body
• Even out weight distribution
• Provide shock absorption
• Decrease pain in the ball of the foot, corns between toes, and bunion formation
• Benefit patients who have any walking imbalance issues

If you have any of these, you might be a good candidate for orthotics:

• Flat feet
• Dropped arches
• Heel pain
• Knee pain
• Shin pain
• Achilles tendonitis
• Metatarsalgia
• Ankle sprains
• Neuromas
• Tendonitis
• Arch pain
• Pronation
• Top of the foot pain

We take a detailed, computerized image of the bottom of the foot and send it off to our orthotics distributor, Foot Levelers. Your orthotics will arrive in our office in approximately 10 business days. Once you receive your orthotics, there is an adjustment period. During the first 48 hours of use, wear them 3–4 hours each day. Increase your wear to 6–8 hours for the remainder of the week. Second-week orthotics can be worn the entire day.

Orthotics generally will last 12–18 months, if you properly take care to preserve the lifespan.

Electrical Muscle Stimulation

Another therapeutic modality we use is electrical muscle stimulation (EMS). EMS allows the body to secrete endorphins and other natural pain killers through electrotherapy. A low frequency stimulation of electric impulses runs through the tissues in the area of injury.

Most patients describe the sensation of EMS as relaxing but with a slight “pins and needles” sensation. EMS:

• Aids in pain relief
• Reduces swelling in soft tissues
• Increases blood circulation, which promotes healing
• Decreases muscle atrophy

Graston Therapy

Graston therapy is a form of instrument assisted soft tissue mobilization that is used to effectively break down scar tissue and fascial restrictions. This technique uses specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation. Graston therapy is beneficial in a variety of conditions and can be applied all over the body.

For more information on this technique call our office or visit the Graston Technique website at http://www.grastontechnique.com/.

Nutritional Supplements

We carry a wide array of nutritional supplementary products. We will educate you on what you may need to improve and maintain your health and well-being. All of our products are pharmaceutical grade so you won’t be getting the additives that are so commonly found in readily available nutritional products. The brands we carry are:

• Juice Plus
• Monavie
• Nutrametrix
• Isotonix
• Thorne
• Metagenics
• Nutrition Dynamics
• Nordic Naturals

Rehabilitative Exercise

We have a complete rehabilitation center featuring Fitness Plus brand exercise equipment. If you've been involved in a motor vehicle accident or work injury, we will take you through our rehabilitation exercise program to help re-educate injured tissues. Some patients who have not sustained serious injuries to their necks or backs also benefit from our exercise program, as long as their condition is chronic or there’s been minimal progress in their condition. Also, patients who are more likely to stick with an on-site exercise program rather than exercising at home can benefit from this amenity.

Surface EMG/Range-of-Motion Muscle Testing

We use Myovision to assess the inflammatory state of our patients. Myovision assesses surface temperature skin changes, which can pinpoint areas of potential subluxation, muscle adhesions and spasms, and of course pain.

J-TECH or range of motion/muscle testing is a medically necessary computerized test that follows the functional progress and changes throughout the period of your physical medicine and rehabilitation treatment. What we find from these exams determines the extent of functional loss and assists in developing and modifying your treatment plan. We will retest you in 4–6 weeks to measure your progress.

Therapeutic Exercises

Once your condition has shown measurable improvement, we give you special exercises unique to your problem. You can perform these exercises in the comfort of your own home and can improve the effectiveness of your spinal correction as much as 30–40 percent. This enhances the treatment process and helps to maintain healing benefits. It also reduces the likelihood of future problems. All the exercises are simple and easy to perform and are very effective at achieving your treatment goals.

Ultrasound

Ultrasound at our clinic shouldn't be confused with diagnostic ultrasounds used in prenatal screenings. Instead, it's a therapeutic procedure using sound waves to treat injured muscles, joints, and soft tissues. These sound waves vibrate back and forth at high speeds to help decrease scar tissue, adhesion formation, and inflammation, which all can hinder the body’s innate healing powers.

Ultrasound works with heat and vibration created by sound waves penetrating deep into the tissues. Unhealthy calcium deposits and lactic acid accumulations are broken down and dispersed. The heat caused by a therapeutic ultrasound increases circulation and blood flow so muscle spasms relax and the healing process is accelerated.

The sound waves created by an ultrasound treatment are transmitted through gel. Patients who have had this form of treatment describe feeling nothing at all or a pleasant warming sensation below the skin’s surface.

X-rays

We take X-rays in our office on an as-needed basis. They are not mandatory before we perform any treatment. Factors that help determine the need for X-rays are:

• History of trauma
• History of systemic infection
• History of cancer
• History of congenital anomalies
• History of ligament laxity
• When exam findings don’t reveal enough information for us to confidently diagnose

If we determine X-rays are necessary, we will show and discuss them in detail with you. We will explain the nature of the condition, the steps that need to be put into place for treatment, and the need for referral if indicated.

Chiropractors treat the problem not just the symptoms.

Chiropractic philosophy is such that if you only treat the symptoms, the underlying problem is still there and will continue to recur if left untreated. In most patients, symptoms are the last thing to show up. Our bodies are designed to absorb daily stresses for long periods of time before we notice there is a problem. It’s our body’s “innate” intelligence at work.

After time and continued stress, or when an injury is put on the body, we as patients realize that something may be wrong and only then seek treatment. Commonly our doctors hear, “I didn’t do anything,” or “I just woke up with this,” when in reality the problem had been slowly progressing for some time. It’s like an iceberg—above the surface is the symptom, below the surface is the cause of the symptom.

The science of chiropractic care centers around the body’s spine. The spine houses and protects the spinal cord, which is the “switchboard” through which nerve impulses are transmitted by the brain to all parts of the body.

In the event of a stress to our spines, vertebrae misalign and can interfere with nerve transmissions, inhibit mobility, and cause pain or discomfort. This is called a subluxation. The word subluxation is derived from the Latin word for "somewhat" or "slightly" (sub) and "to dislocate" (luxate).

Subluxations can be caused by:

• A car accident
• A fall
• A sudden jar
• Trauma
• Improper sleeping positions
• Poor posture
• Improper lifting processes
• Emotional stress
• Biochemical stress

Emotional stresses sometimes can be worse than physical stresses. When we are upset or stressed out, we tend to carry all our stress in our neck and shoulders, don’t sleep well, and run our immune systems down in the dumps.

Biochemical stresses refer to anything we are exposed to in our environment or anything we put into our bodies. Intake of caffeine, nicotine, alcohol, aspartame, and lack of water are examples of biochemical ways we affect our bodies.

Chiropractic treatment works to repair subluxations through realignment of the affected vertebrae, so nerve impulses are no longer restricted. When the spine is properly aligned, the cause of pain and malfunction is removed and the body is restored and returned to normal.

Our chiropractic adjustments are not limited to the spine. We are trained extensively on extremity adjusting such as shoulders, knees, ankles, elbows, and wrists.

Chiropractors take the time to listen.

Dr. Shane and Dr. Tonya have been trained to evaluate your total health picture and will ask questions about your lifestyle, work habits, and overall stress level during the initial consultation. This allows them to focus on the core problems and causes.

While the primary goal in a lot of cases is to relieve pain, the larger goal is to restore good health. Good health cannot be attributed solely to medication, surgery, or chiropractic adjustments. Good health comes from a healthy lifestyle and proper spinal function.

Dr. Shane and Dr. Tonya carefully assess each patient using modern diagnostic procedures. Treatment generally focuses on manual spinal manipulation or activator spinal manipulation, both called the chiropractic adjustment. The decision to perform manual or activator spinal manipulation is based on a number of factors:

• The condition the patient presents
• Severity of the patient’s condition
• Prior experience with one form of treatment
• The doctors’ professional opinion

In some cases, therapy (i.e., electrical muscle stimulation, ultrasound therapy, cryotherapy, trigger point therapy) is also used to provide relief and speed healing.

Chiropractic care helps millions of people get relief from pain without the use of drugs or surgery. Studies show that chiropractic care is twice as effective as medical treatment in returning workers to the workplace following a back injury. The Agency for Health Care Policy Research Guidelines recommends the use of spinal manipulation for acute low back problems over any other treatment.

Our chiropractic care is safe for all ages—newborns to grandparents. We use gentle hands-on and Activator treatment to help you enjoy life without pain.

Dr. Tonya L. Dockter, D.C.

Dr. Tonya is a Bismarck, N.D. native. She completed her Doctor of Chiropractic degree at Northwestern College of Chiropractic in 1998. Shortly after becoming licensed, she practiced in the Fargo-Moorhead area where she owned and operated Miller Chiropractic Center until the fall of 2001. In August of 2001, she and her husband, Dr. Shane Miller, relocated to Bismarck and joined in partnership with a fellow chiropractor at Prairieview Chiropractic. October of 2003, Dr. Tonya and her husband left Prairieview Chiropractic and formed Capital Chiropractic. They have been practicing together ever since. She is in her 21st year of practice and thoroughly enjoys getting to work with patients and families of all ages. Dr. Tonya has advanced training in chiropractic techniques for expectant mothers as well as for infant and pediatric patients. She also attends multiple continuing education conferences annually to keep updated on the latest chiropractic techniques and trends to supply the best and well rounded treatment for her patients. In her spare time, she enjoys spending time with her husband of 21 years; her children, Madelyn age 17; Gavin age 15 who keep her very busy with all their school and sporting activities; being outdoors, exercise of all kinds, and scrapbooking.

Dr. Shane D. Miller, D.C.

Dr. Shane Miller is originally from Donnybrook, N.D. He graduated from Northwestern College of Chiropractic (NWCC) in 1998. Prior to studying at NWCC, he attended Minot State University and North Dakota State University. Dr. Miller has been practicing for 21 years, and he has been in this current location in Bismarck for 17 years. Dr. Miller has kept up with continuing education classes, ensuring that his patients receive the most comprehensive and advanced chiropractic care. He has also received additional training in rehabilitative exercises. In his spare time, he enjoys being a true outdoorsman by taking full advantage of nature’s many bounties through hunting and fishing, watching football, and spending quality time with his family.