What conditions do chiropractors treat?

Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints including, but not limited to, back pain, neck pain, pain in the joints of the arms or legs, headaches, and posture.

Does chiropractic treatment require a referral from an MD?

No, a patient does not need referral by an MD before visiting a doctor of chiropractic. Chiropractors are first contact physicians and are so defined in federal and state regulations. Following a consultation and examination, the doctor of chiropractic will arrive at a diagnosis under chiropractic care or refer the patient to the appropriate health care provider.

Is chiropractic treatment safe?

Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of neuromusculoskeletal complaints. Although chiropractic has an excellent safety record, no health treatment is completely free of potential adverse effects.

The risks associated with chiropractic, however, are very small. Many patients feel immediate relief following chiropractic treatment, but some may experience mild soreness or aching just as they do after some forms of exercise. Current literature shows that minor discomfort or soreness following spinal manipulation typically fades within 24 hours.

Neck pain and some types of headaches are treated through precise cervical manipulation. Cervical manipulation, often called a neck adjustment, works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasm, which helps relieve pressure and tension.

Neck manipulation is a remarkably safe procedure. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, there is not yet a clear understanding of the connection. The occurrence appears to be very rare —1 in 5.85 million manipulations — based on the clinical reports and scientific studies to date. If you are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms. This will help your doctor of chiropractic offer the safest and most effective treatment, even if it involves referral to another health care provider.

It is important for patients to understand the risks associated with some of the most common treatments for musculoskeletal pain — prescription and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) — as these treatments may carry risks significantly greater than those of chiropractic manipulation. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers like ibuprofen.

Here are more links regarding the safety of chiropractic:

Scott Haldeman, MD, DC reviewed malpractice claims records for a 10-year period between 1988 and 1997. In reviewing the outcomes following the application of 134.5 million cervical manipulations (commonly referred to as the chiropractic adjustment), the records indicated that there were 23 reported cases of stroke or vertebral artery dissection (VAD). [ 10 ] Of this group, 10 of the patients had the complicating factors of high blood pressure, use of oral contraceptives, or a history of smoking, all of which are associated with vascular disease. The actual incidence of stroke or VAD following cervical manipulation was found to be one per 5.85 million cervical adjustments. That means that the average chiropractor could work for 1430 years (or practice 48 full chiropractic careers!) before they might be involved with this type of litigation.

Arterial Dissections Following Cervical Manipulation: The Chiropractic Experience
Canadian Medical Association Journal 2001 ( Oct 2); 165 (7): 905–906

Guidelines for Chiropractic Quality Assurance and Practice Parameters Preceedings of the Mercy Center Consensus Conference; Page 171, Aspen Publications 1993

A Risk Assessment of Cervical Manipulation vs. NSAIDs for the Treatment of Neck Pain
J Manipulative Physiol Ther 1995 (Oct); 18 (8): 530–536

The Manga Report

The Ontario Ministry of Health commissioned Manga Report represents the largest analysis of scientific literature on the most effective and cost effective treatments for low back pain. After reviewing all of the international evidence on the management of low back pain, lead investigator Pran Manga, Ph.D., found the treatments provided by Doctors of Chiropractic were exceptionally safe – much safer than for standard medical treatments of similar conditions.

The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) – University of Ottawa, Canada.

Is chiropractic treatment appropriate for children?

Yes, children can benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.

Do insurance plans cover chiropractic?

The majority of all insured American workers have coverage for chiropractic services in their health care plans. For example, the federal government’s Office of Personnel Management offers chiropractic coverage for federal employees in both the Mail Handlers and BCBS benefit plans. In addition, there is a chiropractic benefit in Federal Workers’ Compensation, and chiropractic care is available to members of the armed forces at more than 40 military bases and is available at nearly 30 veterans’ medical facilities.

What type of education and training do chiropractors have?

Chiropractors are educated as primary contact health care practitioners, with an emphasis on musculoskeletal diagnosis and treatment. Educational requirements for doctors of chiropractic are among the most stringent of any of the health care professions. The typical applicant at a chiropractic college has already acquired nearly four years of pre-medical undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology and related lab work. Once accepted into an accredited chiropractic college, the requirements become even more demanding — four to five academic years of professional study are the standard. Because of the hands-on nature of chiropractic and the intricate adjusting techniques, a significant portion of time is spent in clinical training.

In total, the chiropractic curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. The course of study is approved by an accrediting agency that is fully recognized by the U.S. Department of Education.

How is a chiropractic adjustment performed?

Chiropractic adjustment or manipulation is a manual procedure that utilizes the highly refined skills developed during the intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function. Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.

Is chiropractic treatment ongoing?

The hands-on nature of the chiropractic treatment is essentially what requires patients to visit the chiropractor a number of times. To be treated by a chiropractor, a patient needs to be in his or her office. In contrast, a course of treatment from medical doctors often involves a pre-established plan that is conducted at home (i.e. taking a course of antibiotics once a day for a couple of weeks). A chiropractor may provide acute, chronic, and/or preventive care thus making a certain number of visits sometimes necessary. Your doctor of chiropractic should tell you the extent of treatment recommended and how long you can expect it to last.

Why is there a popping sound when a joint is adjusted?

Adjustment of a joint may result in release of a gas bubble between the joints that makes a popping sound – it’s exactly the same as when you “crack” your knuckles. The noise is caused by the change of pressure within the joint that results in gas bubbles being released. There is usually little or no pain as a result of the treatment.

How do I know if I herniated or slipped a disc?

Herniated discs are very painful and will often have the following symptoms: low back pain, sudden onset of leg pain without the presense of low back pain, pain in the heel, foot, posterior leg, gluteal region or groin area. Many patients suffering from herniated discs will not receive much relief with NSAID’s (Over-the-counter meds) and will often find one or two positions of relief such as bending over or leaning to one side. Often it is difficult to sleep, climb stairs, peform normal daily activities, as well as cough, sneeze, or have a bowel movement. Conservative care, such as chiropractic, can be performed to help alleviate syptoms in lower back and leg. Dr. Hecht suffered from this condition in high school after a sports injury and it was chiropractic that helped him get back to his activities without surgery.

Do you treat neck pain?

Pain located in the neck is a commonly treated condition for chiropractors. Neck pain can come from numerous disorders of the soft tissues or the skeletal structures in the neck, such as degenerative disc disease, sprain or strain injuries, whiplash, disc herniations, or an irritated (sometimes called a pinched) nerve. Neck pain is more commonly referred to as cervical pain. If you suffer from symptoms such as any type of neck pain, headaches, difficulty turning your head, numbness or tingling in the upper extremities, tenderness of the area skin, sharp or shooting pain, swelling in the upper extremity, and/or dizziness.

There are about 12 percent of female adults and 9 percent of male adults, feeling neck pain at any given time. A little less than half of the population has suffered at work with some sort of neck symptoms. However, they are much less likely to take time off work in order to heal. For those who “pop” their own neck, there are a few facts you should realize. As the neck becomes more and more flexible and eventually hypermobile, there is a loss in stability and protection. This will result in the perceived need for your to continue the bad habits of self-adjusting. Remember, there are many delicate structures that can become irritated and if strained or injured will result in neck pain or worse.

How Do I Know If I Have a Slipped Disc?

First, it should be noted that a disc doesn’t “slip.” Discs can herniate or partially herniate but they do not “slip in and out.” A partial herniation is the most common and in many cases does not cause the patient pain. Many studies have shown that more than 50% of people walk around daily with a partial herniation, sometimes called a disc buldge, and have no symptoms. However, once a person has a full buldge or herniation, they will often experience severe back pain and leg pain. In severe cases, they may even have full sensation loss or loss of bowel and bladder function. The last type of case is a sequestration which is not a chiropractic case. If you happen to have a sequestered disc fragment, surgery is the most common option. To review, because of the way each disc is attached to the vertebra above and below it, a disc cannot “slip” as once commonly thought. However, trauma or injury to the spine can cause discs to bulge, herniate, or become sequestered (break away from the disc). This can be quite painful, putting pressure on the spinal cord and nerve roots, often interfering with your daily life.

You should also understand that spinal discs have a poor blood supply. They depend upon the circulation of joint fluid to bring in nutrients and expel waste. This joint fluid is brought in when a spinal joint moves naturally. If a spinal joint loses its normal motion and this pumping action is impaired, the health of the disc will deteriorate. Much like a sponge, a healthy disc is flexible and absorbs moisture. However, when sponge dries out it becomes hard and stiff. Therefore, dysfunctional or non-functional joints provide great peril for disc health the longer they do not move properly.

The chiropractic approach to disc problems is to help restore proper motion and position to the spinal joints. Besides reducing disc bulging, better spinal function helps decrease inflammation so the slow process of healing the surrounding soft tissues can begin. Further, it will help reduce the disc pressure around the nerve allowing you to have less pain and more movement.

While results cannot be guaranteed, many patients have avoided needless surgery or a dependency on pain pills by choosing conservative chiropractic care. Even if you have tried chiropractic in the past, we encourage you to try a short series of treatments to help restore normal function, reduce back pain, and reduce the risk of further disc and joint degeneration. If no progress is made within the first series of treatments, you will be referred to an orthopedic surgeon for evaluation and care.

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