Penny Domm, BS, MS, AT, C, DC Chiropractic physician
Dr. Mary Ann "Penny" Domm is co-owner of Aspen Chiropractic Clinic in Portland, OR. For more than twenty years, she has dedicated her life to caring for others through the practice of massage therapy, athletic training and chiropractic medicine. She currently maintains a busy and highly respected practice that is devoted to complementary and alternative medicine (CAM). Penny Domm is a 2005 member of The Heritage Registry of Who’s Who.
Penny Domm grew up in the Finger Lakes region of New York, where her mother's tireless commitment to community service influenced her dedication to the healing arts. Penny Domm learned the value of complementary and alternative medicine through the experience of her rural upbringing. Her family raised their own food and cared for their animals, and the family doctor was a chiropractor.
Penny Domm is an accomplished athlete and scholar. She learned to snow ski as soon as she learned to walk. Penny Domm earned USTA National Junior Ranking (tennis) as a teenager and went on to attend Ithaca College (NY) on a soccer scholarship. She also played tennis in her freshman year and distinguished herself for four years on the Ithaca varsity crew team. She is an avid golfer.
In 1994, Penny Domm received her Doctor of Chiropractic degree from Cleveland Chiropractic College- Los Angeles (CA). She began her healing arts career with a Massage Therapy Certificate from the Morris Institute (NJ). In 1984, she received her Bachelor of Science in Physical Education and Health from Ithaca College (NY) and the following year, she completed dual graduate degrees: Master of Science, Exercise Physiology (Athletic Training) and Master of Science, Sports Psychology (1985). Her dissertation is the seminal work in the field of sports-injury rehabilitation. [See Fisher AC, Domm MA, Wuest DA. Adherence to sports-injury rehabilitation programs. Physician Sportsmed.1988;16(7):47-52.]
In the capacity of Athletic Trainer, Certified and Chiropractic Physician, Penny Domm has worked with the following sports teams: New York Giants Football, U.S. Women's Soccer, U.S. Women's Pro Volleyball, Portland Forest Dragons (Arena Football) and Portland Power (Women's Pro Basketball). In her chiropractic practice, she works with Olympic athletes and other athletes involved in range of professional and recreational sports: baseball, crew, cycling, distance running, football, ski racing, softball, tennis, track and field.
For more than 15 years, Penny Domm has been a dedicated volunteer of her professional services to sports and philanthropic events in California and Oregon: AA Sports Limited events, California AIDS Ride, City of Ventura Corporate Games, GSGRA Regional Rodeo, TAC Ultra Marathon and The City of Los Angeles Marathon. In 2004, Penny Domm served as Medical Coordinator for the Bridge to Bridge Run, Hood to Coast Relay, Race for the Roses, ADA Summit to Surf and TYR Women's Triathlon.
Since 1986, Penny Domm has been awarded three academic appointments at WASC accredited colleges: Associate Professor of Exercise Science and Physical Education, Montclair State University (NJ), Assistant Professor of Health Sciences, West Coast University (CA) and Staff Clinician and Adjunct Faculty Member, Western States Chiropractic College (OR).
Penny Domm is a member of the Oregon Association of Minority Entrepreneurs.
2006 VOL 1, NO 2
Many people with low back pain wonder, "Do I need back surgery?" They talk about this among friends and family and even "Monday-morning Quarterbacks" talk about it at the office water cooler. The truth is, no one fits a particular profile for low back surgery. Patients with identical presentations of their illness will have completely different outcomes. This is the challenge of low back pain management and it requires dedication to the treatment plan from both the doctor and the patient.
For more than a decade, I have worked with medical doctors to help patients who suffer from low back pain associated with disc herniation. We agree that patients should receive a trial of conservative care prior to having surgery. Most patients recover adequately under conservative care and never need surgery, and surgical techniques have significant problems related to effectiveness, serious complications and cost.
When a patient presents with localized back pain or back pain with radiating leg pain, the usual chiropractic care includes spinal manipulation, physical therapy modalities, exercise plan and self-care education. Research shows, this protocol is superior to "usual medical care" in terms of reduced pain and disability. When patients do not recover adequately or their condition worsens in spite of therapy, I refer them for surgical consultation.
Recently, I treated two patients for low back pain who had comparable case histories: same gender, very close in age, similar work environment, similar exercise regimen, similar lifestyle factors. Both patients asked me, "Do I need back surgery?" and for each one, the answer was different.
Both patients reported that their low back pain "just came on" without a reason. Both patients experienced pain in their low back that radiated into their hip. Both patients tried ibuprofen, ice or heat, stretching and bed-rest without resolution of their symptoms. When I examined these patients, both experienced difficulty standing on the leg that corresponded to the side of their low back pain. However, neither patient showed signs of nerve root or spinal cord compression: both had good reflexes, preserved muscle strength and intact sensation in both legs and feet.
I suspected disc herniation in both patients and suggested ordering Magnetic Resonance Imaging (MRI) of the lumbar spine. I prefer to have MRI early in the course of care because I will know if the disc has herniated, ruptured or fragmented--each of these has potentially serious clinical complications. However, I explained, disc herniation by itself would not predict the severity of their problem or the outcome. Many patients recover from disabling back pain with no change in the size or location of the disc herniation. Both of my patients opted out of imaging until they had undergone a trial of conservative treatment, and I proceeded to treat them as though they had an inflamed low back (lumbar) disc.
Discs will rupture suddenly under a heavy load or gradually, as I suspected from the case histories of my two patients. The disc itself was probably the source of their pain, primarily from edema (swelling) around the nerve root and other inflammatory responses around the disc material. If the pressure of the disc material on the nerve root is causing pain, I expect to see changes in reflexes, muscle strength and sensation. I routinely evaluated both patients for these changes because they are clear indicators for surgery.
The treatment plan for Patient 1 and Patient 2 was similar. Both received a thorough examination that included aspects of chiropractic, neurological and orthopedic evaluations. I treated both patients on a similar schedule of visits with electric muscle stimulation, mechanical traction, soft tissue massage, non-force spinal manipulation, passive stretching and ice. I prescribed, for both, a home exercise regimen that included mild stretching and mild pelvic stabilization exercise. I advised both patients that I expected to see positive changes within three weeks of treatment.
Patient 1 experienced immediate pain relief following the first treatment but Patient 2 experienced no change either way. With each treatment, both reported they felt "a bit stronger". However, when Patient 2 began to experience sensation changes, increased radiating leg pain and decreased muscle strength, I immediately ordered MRI that showed a disc fragment that warranted surgery. I referred Patient 2 to a neurosurgeon who performed microlumbar discectomy, without complications.
Meanwhile, Patient 1 (who is the older of the two!) progressed as planned through 3 weeks of care, and at 8 weeks, the low back and radiating leg pain symptoms resolved completely. Patient 2 continues with a daily home exercise regimen of lumbar and pelvic stabilization exercises and remains symptom free.
-P. Domm, DC, ATC