Take That Back

No Pain, No Gain: Douglas Seckendorf in his East Side office.Photo: Jessica Wynne

Brooke Astor told Oscar de la Renta about it, and if it was good enough for Mrs. Astor, and, come to think of it, for Henry and Nancy Kissinger, Ralph and Ricky Lauren, and – wait a minute, isn’t that Roger Ailes over there, and Über–investment banker Pete Peterson? – then it was plenty fine for the celebrated designer.

No, it isn’t Sirio’s place – Le Cirque 2000 – at lunchtime. It’s Douglas Seckendorf’s, Dr. Seckendorf to you, chiropractor to the accomplished, well-heeled, well-connected, and, well, sore.

“What he can do for you, Le Cirque cannot,” says De la Renta. “He is a magician.”

Indeed: Seckendorf, founder of Manhattan Sports Medicine, seems to be able to make back misery disappear. Along with several other New York practitioners, he has staked out his turf – the musculoskeletal region – and is showing A-list patients, who clearly haven’t got time for the pain, that V-I-O-X-X isn’t the only way to spell relief.

These chiropractors have become something of a secret weapon for those who refuse to take back pain lying down, who want to give a wide berth to bed rest, painkillers, and especially surgery.

“I had back surgery a year and a half ago, but after the surgery, I was in a car accident and had whiplash and horrible pain in my elbows and arms,” says De la Renta. “The doctor said I would need another surgery on my cervical vertebrae, and I have to tell you, I went to Dr. Seckendorf every day for six weeks and not only did I not have to have the surgery, I have never again had any pain.”

Same deal with Peterson, head of the Blackstone Group, who had an assortment of problems, chief among them Achilles’-tendon issues and stenosis (narrowing of the canal where the nerves exit the spine). He heard about Seckendorf from a fellow resident of the River House who’d taken his tennis elbow to countless doctors, finally scoring with the good chiropractor.

“In a matter of weeks, my Achilles’ tendon was cured,” says Peterson. “Later, when an orthopedic surgeon said I should have surgery for the stenosis, Doug said, ‘Pete, we don’t understand the intricacies of the back as much as we think.’ He suggested back-strengthening exercises and cortisone injections at the Hospital for Special Surgery. I had two and I was fine.

“Since I’ve been going to him, it’s a veritable Who’s Who of New York. I don’t think I’ve ever been there and not recognized somebody. You approach his business with a question, but when you see the results … He’s almost like a medical doctor.” Peterson means this as a compliment, and Seckendorf takes it as such. Unlike many of his fellow chiropractors, and unlike some patients, he has nothing against orthopedists and neurologists (who are among his best referral sources). He also has nothing against injections, surgery, and anti-inflammatories. He simply wants it understood that there’s more out there.

“If you’re not a candidate for surgery, it’s a conundrum,” says Seckendorf, 37, who – maybe it’s the lab coat, maybe the open, boyish look – recalls ER’s Noah Wyle. He eschews New Age sounds and New Age scents in favor of a radio set, quite loudly, to WCBS-FM. “You’ve gone to an orthopedist, you’ve been given an MRI, you’re given a diagnosis like ‘It looks like you’ve slipped a disc.’ If it’s a progressive guy, he’ll give you a list of physical therapists who may not specialize in the spine. Otherwise, it’ll be ‘Here’s an anti-inflammatory. Go rest.’

“But the people I take care of don’t want to be given an anti-inflammatory and not go to work. They’re doers. Nothing irritates someone who’s used to being active more than being told they can’t run,” adds Seckendorf, whose East 58th Street facilities include X-ray, a small Cybex-stuffed gym where patients are monitored by exercise physiologists, physical therapists, and chiropractors, and whose offerings include back school (course work includes the proper way to brush your teeth, get dressed, pick out a package, pick up a child, swing a golf club). The fee for the first visit is $325; follow-up sessions run from $125 to $140.

Investor and philanthropist Henry Kravis began seeing Seckendorf first for elbow problems, then back, then neck. “I’ve seen a lot of chiropractors and he’s a big notch above – he thinks like a doctor,” says Kravis, a founding partner of Kohlberg Kravis Roberts & Co. (and majority owner of Primedia, New York’s parent company). “When he finally determined that I did need neck surgery, he recommended four doctors and went with me to every one of them to make sure I wasn’t missing anything they were telling me. He doesn’t sugar-coat and he explains everything.”

“Patients want to be proactive,” says chiropractor Steven Margolin, founder of the lower Fifth Avenue “wellness center” that bears his name and treats the aches and pains of, among others, actresses Kristen Johnston and Cynthia Nixon with massage, acupuncture, and nutritional counseling along with chiropractic. “They want to know what they can do to decrease their symptoms and help reduce the chances of their returning. They’ve gone through the usual medical route, and they’re either tired of being on medication or haven’t got the results they wanted.”

Cilda Shaur, a former dancer, came to Margolin after the second of two car accidents put her on her back for eight weeks with severe whiplash and nerve damage down her right arm. “I had seen chiropractors before, some good, some bad, but I just didn’t want to go through all that sifting again. I finally went, and could have kicked myself: Why did I wait so long? The way he puts his hands on your back, he’s just one of those guys who’s a healer.”

The move toward chiropractic is consumer-driven. “A lot of patients are really ticked off with medicine right now,” says Woodson Merrell, executive director of the Continuum Center for Health and Healing, a lower Fifth Avenue outpost of Beth Israel Medical Center whose waiting area is a cross between the reading room of a well-endowed library and the foyer of a sleek Japanese restaurant. “They want nothing to do with conventional therapy.” Thus, the Continuum Center offers chiropractic, acupuncture, and aromatherapy along with the standard playlist: pediatrics, gynecology, internal medicine. In this, it has created a smart business model.

“We tend to see our patients more frequently,” says Karen Erickson, the center’s senior chiropractor and one of the first to be credentialed by a teaching hospital. “We also tend to spend more time with them, generally, than do doctors, so we really know them. It’s common that I’m the portal of entry for a patient into the health-care system – I’m in a position to refer that patient to an internist, a gynecologist.

“It’s good for the patient and for the doctor who gets the referral,” adds Erickson, whose office, fitted out with an area rug and an elegant green leather chiropractic table, smells pleasantly of peppermint. Her soothing room and equally soothing, assured manner help explain why she, along with the resident acupuncturist, has the center’s most prominent practice, one that includes designers, performers, and writers, among them playwright Warren Leight.

“Five years ago, I was rear-ended by a truck,” he says. “When you have something like that, it reverberates through your body in ways you don’t expect. You might feel better five months later and worse two years later. You end up chewing a lot of Advil and Vioxx.

“I was sent to Karen by a friend who had migraines. I was skeptical, but I’m a writer. I’m skeptical of everything,” says Leight, whose Side Man won the Tony in 1999. “I thought I’d give it a try because the painkillers were a drag. It had not occurred to me that you could go to someone who would run her hand down your spine and know where it’s hurting. She always knows where it hurts. I go to Karen like an 80-year-old and come out like a 45-year-old. I also haven’t gotten as sick as often since seeing Karen,” Leight adds, saying of a session with her, “It seems to re-center your body’s immune system.”

That’s the kind of statement sure to get an orthopedist’s back up. “Any suggestion that chiropractors have the ability to treat non-muscular skeletal conditions like digestive and visual problems and breathing difficulties, I think it would be appropriate to apply the word bunk,” says Eli Bryk, chairman of orthopedic surgery at St. Vincent’s Hospital. “Many people swear by chiropractors, and they’re not crazy,” he concedes. “There have been findings that patients with simple muscle aches do receive benefit from manipulation. But really, what a lot of chiropractors are doing is physical therapy.”

Seckendorf bristles at the chiropractor–physical therapist comparison. “We both use some of the same modalities, like hot and cold packs, and we both do hands-on therapy,” he allows. “But physical therapists are not spine specialists. We are.”

This whole identity and image thing is something chiropractic has been struggling with for years. Not too many years ago, chiropractors were, at best, regarded as part of the alternative-medicine movement, at worst as quacks and bone crackers. “We’ve gotten away from the word crack,” says chiropractor Lawrence DeMann Sr., whose patients include politicians and theater directors. “Now we call them adjustments.” Until the matter was successfully challenged in court in 1987, an amendment to the American Medical Association’s canon forbade doctors from referring a patient to a chiropractor or accepting a referral from a chiropractor. “The AMA referred to chiropractors as rabid-dog killers and latent homosexuals who liked to put their hands on people,” says Jerome F. McAndrews, spokesman for the Arlington, Virginia–based American Chiropractic Association.

When Demann began practicing 35 years ago and was at a party with some M.D. friends, he was asked about his specialty. “I said I was a chiropractor, and a pall fell over the room,” he recalls. “Now when I go to a party and say I’m a chiropractor, people will crowd around and say, ‘I’ve got a pain in my shoulder.’ ‘There’s a pain in my back … What do I do?’ ” Last year, according to McAndrews, 25 million people headed to chiropractors to find out, a 47 percent increase from the early nineties.

Still, the adjustment in thinking has only gone so far. Doctor taxonomy has it that if you can’t get into med school, you go to med school in Mexico. Failing that, you go to osteopathy school. If you can’t get in there, you go to dental school (except in New York, where the status order is reversed). If you can’t cut it there, you head for podiatry school. If you couldn’t get in anywhere, you became a chiropractor.

Seckendorf himself was premed at Boston University. “I wanted to go into health care,” he says, “but I knew I wanted to do something that would let me do both diagnosis and hands-on treatment and be involved in prevention.” Bingo.

In his eleven years of practice, he has tried to make a distinction between his M.O. and that of his colleagues. “The classic chiropractic approach might be to look at someone and say, ‘You have one leg that’s longer than the other, your left shoulder is higher than the right,’ ” Seckendorf says. “Your muscles should be lengthened. We should adjust your spine to take pressure off nerves and make your body work more efficiently. The philosophy is that you develop inherent mal-positions in your spine as you move through life.”

He takes only those patients who come to him with a specific spinal complaint, turning away people who are interested in chiropractic as prophylaxis or as a sort of glorified massage. He deals strictly with neck and back problems, mostly herniated discs, keeps his volume low and his patients’ tours of duty short. The average treatment runs for two months with visits two to three times a week, and is, says Seckendorf, consistent with orthopedic treatment.

“If you were lying on my table, my therapies would be traction, electrical stimulation, heat packs, ice packs, and manual lengthening of the soft tissues. We don’t do manipulations or cracking here. It’s not that I’m against it for certain conditions, but for my patient population, which is mostly disc herniations, it’s contra-indicated.”

“What sets Doug apart is that he evaluates patients as much as a medical doctor does, and he’s careful to rule out other, more serious causes, like malignancies, kidney or ovary disease, and aneurysms,” says orthopedic spine surgeon Baron Lonner. “He also doesn’t keep them coming back for unnecessary treatments and gives them a long-term plan of back maintenance.

“Before,” he adds, “my feelings about chiropractors were neutral to negative. But because of Doug, I have a more open attitude about them.”

Pain, as Cilda Shaur, the former dancer, learned, tends to make you more open-minded. “I was 23 when I was first injured and I thought I would never dance again because I was so messed up. The idea of someone cracking my back – that was not the thing to do. But I wanted my life back. And then I went and I was fine within a month. Now I’m moving to Boston and all I can think is, Oh, God, I’ve got to find another chiropractor.”

Take That Back