Chiropractic

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Chiropractic

Topic Overview

Chiropractors treat problems that affect the alignment of the muscles and bones of the body. They base their treatment on the theory that if the bones in your spine are out of alignment, that can cause many medical problems, especially problems of the nervous system.

Most chiropractors take a natural approach to promoting health through lifestyle changes, nutrition, and exercise. And most believe that medicines and surgery should be saved as treatments of last resort for many conditions.

Many chiropractors have extra training in physical rehabilitation and specific exercise therapy. Some also use nutritional analysis, herbal therapy, and acupuncture.

After graduating from chiropractic school, chiropractors must pass an examination to get a licence to practice.

What does chiropractic treatment involve?

Chiropractic treatments usually involve adjusting the joints and bones in your spine using twisting, pulling, or pushing movements. Some chiropractors use heat, electrical stimulation, or ultrasound to help relax your muscles before doing a spinal adjustment.

Spinal adjustment is done through a variety of methods. For example, the chiropractor may use his or her fingers or hands to apply pressure to and move the vertebrae slightly beyond their normal range of motion. Treatment may also involve careful twisting of the head, shoulders, and hips.

Other types of treatment may include:

  • Heat or ice.
  • Corsets or braces.
  • Ultrasound.
  • Strength and conditioning exercises.
  • Biofeedback.
  • Relaxation therapy.

Some chiropractors use X-rays to diagnose conditions.

Research has shown that chiropractic treatment works well for low back pain.1

Is chiropractic treatment safe?

Ask your chiropractor about risks. Side effects of treatment may include minor pain or discomfort after an adjustment, headaches, and fatigue. Most of these effects go away within a day.

Most chiropractors, physiotherapists, and others who do this type of treatment will work with your medical doctor to make sure you are getting the right treatment.

Rarely, a herniated disc or other problems can occur when chiropractic adjustment is used to treat neck or back pain. This can cause pain, weakness, and numbness in the buttocks and down the legs. And it may affect bladder and bowel control.

It's important to let your medical doctor know if you are also seeing a chiropractor. It may not be safe for you to rely only on chiropractic treatment.

What to expect from your visit

If you've never been to a chiropractor before, you may be a little worried about what will happen. But the fact is, visiting a chiropractor for low back pain is simple, safe, and usually painless.

And a visit to the chiropractor results in immediate relief for many people.

Your first visit will be a lot like a first-time visit to any new doctor. It's likely to include:

  • A health history. You will probably fill out a long form of questions about your health. The chiropractor may also ask additional questions, such as whether you have headaches or migraines or sleeping problems. He or she may also ask you about your diet and your activity level.
  • A physical examination. You probably won't have to take off all of your clothes. The chiropractor may check your posture, looking for things that aren't normal, such as one shoulder or hip that is higher than the other. The examination may also include a muscle test. This involves pressing an arm or leg against the chiropractor's hand to test strength. You may also walk a short distance so that the chiropractor can check your gait or other arm or leg movements.

You may also have an X-ray of your spine. Many chiropractors use X-rays to diagnose back problems. But not all chiropractors agree that the information gathered from an X-ray is valuable enough to make up for the radiation that the patient is exposed to.

When the chiropractor has all the information, it's time to sit down with you and talk about treatment. If the treatment plan includes an adjustment, you could have it the same day or at a later appointment.

What do spinal adjustments feel like?

The most familiar type of spinal adjustment is the hands-on approach: You lie on a table while the chiropractor uses his or her hands to feel for certain parts of your spine and then make quick, gentle pressing motions. Some people call this "cracking" your back because of the popping sound that is sometimes made. But nothing is actually "cracking"; the sound happens when the tissues of the spinal joint in question are stretched.

Spinal adjustments normally don't hurt. If you're already in pain because of your back, it may hurt to move. But the adjustments are aimed at making you feel better.

Some chiropractors use a drop table for adjustments. Parts of the table drop slightly when the chiropractor presses down on a patient's back. The table is noisy, but the adjustments are gentler than the hands-on method.

Some chiropractors use a hand-held tool called an activator to do spinal adjustments. This is even more gentle.

How to choose a chiropractor

Ask your medical doctor to help you find someone. Some medical doctors aren't willing to consider chiropractic treatment. If you and your doctor can't agree on how to treat your low back pain, you may want to consider getting a second opinion or finding another doctor who is more aware of the benefits of chiropractic treatment.

Try to interview one or two chiropractors before you start treatment.

Look for someone who:

  • Is willing to co-ordinate treatment with your doctor or other health care workers.
  • Will tell you about home treatment and exercises.
  • Diagnoses problems with a physical examination and an interview, using X-ray in unusual cases.
  • Is willing to refer you to a specialist when needed. This may include an orthopedist, a neurosurgeon, or an oncologist for further testing, or a registered dietitian for nutritional counselling.
  • Uses slow, gentle manual techniques.

Avoid someone who:

  • Uses X-rays as a standard diagnostic test, especially full-body X-rays or X-rays of children. These give unnecessarily high levels of radiation.
  • Bases his or her practice on the unproven theory that subluxation (partial dislocation of two joint surfaces) causes many diseases.
  • Uses manipulation to treat such problems as lung and ear infections, skin conditions, eye problems, and learning disabilities.
  • Promotes regular manipulation as a way to prevent illness or joint problems.

Chiropractors are not your only choice for providing spinal manual treatment. Other practitioners who can do this include:

References

Citations

  1. Chou R, Huffman LH (2007). Nonpharmacologic therapies for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 147(7): 492–504.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Marc S. Micozzi, MD, PhD - Complementary and Alternative Medicine
Last Revised May 24, 2011

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.