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FAQ
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.
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. Most often is no pain involved.
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.
How large is the chiropractic profession?
Chiropractic is the fastest-growing and second-largest primary health care profession. According to Federation of Chiropractic Licensing Boards there are approximately 81,000 doctors of chiropractic (DCs) in active practice in the United States spread from rural areas to inner cities. More than 10,000 students are currently enrolled in chiropractic educational programs accredited by a federally-recognized body (CCE). The ratio of DCs to the general population, based on the Bureau of the Census figures is estimated to be one doctor of chiropractic for every 5,100 citizens. This compared dramatically to the ratio of medical providers to the general population as there are well over ten times more MDs than DCs. Thus the MD to general population ratio is approximately one to every 430 citizens.
How many people see chiropractors?
Chiropractic services are in high demand. Tens of millions of Americans routinely opt for chiropractic services and this number is rapidly growing. In 1993, more than 30 million consumers made chiropractic a regular part of their health care program.
Are chiropractors educated as well medical doctors (MDs) and osteopaths (DOs)?
To receive the doctor of chiropractic degree, candidates must complete extensive undergraduate prerequisites and four years of graduate-level instruction and internship at an accredited chiropractic institution. Comprehensive knowledge of all systems of the body and diagnostic procedures enable the DC to thoroughly evaluate a patient, address disorders relating to the spine and determine the need for referral to another health care provider.
Do I have to see my medical doctor before I see a chiropractor?
No. Doctors of Chiropractic are primary health care providers. According to the Center for Studies in Health Policy, "The DC can provide all three levels of primary care interventions and therefore is a primary care provider, as are MDs and DOs. The doctor of chiropractic is a gatekeeper to the health care system and an independent practitioner who provides primary care services. The DC's office is a direct access portal of entry to the full scope of service."
Does a chiropractor have to have a license to practice?
Doctors of Chiropractic are licensed in all 50 states. DCs have been licensed and recognized for many decades in all states, the District of Columbia and Puerto Rico.
Is chiropractic recognized by government agencies?
Chiropractic is recognized by governmental health care programs. Chiropractic is included in Medicare, Medicaid, Federal Employees Health Care Benefits Programs, Federal Workers' Compensation and all state workers' compensation programs. Chiropractic students are qualified to receive federal student loan assistance and DCs are authorized to be commissioned as health care officers in the U.S. Armed Forces.
I've heard that chiropractic really doesn't have a scientific basis. What are the facts?
The practice of chiropractic is based on sound scientific principles.
The existence of the nervous system as the primary control mechanism of the body is an undisputed scientific fact. Its relationship with the spine is the focus of the practice of chiropractic. The spine develops in utero to provide two primary functions: (1) allow for freedom of movement and (2) house and protect the spinal cord. When the vertebrae of the spine become misaligned through trauma or repetitive injury, two major consequences will result: (1) the range of motion becomes limited and (2) spinal nerves emerging from the spinal cord are compromised. DCs use the term "subluxation" to describe such disruptions. (For a thorough discussion of the subluxation go here). Interruption of nerve flow can eventually lead to pain, disability, and an overall decrease in the quality of life. Conversely, the removal of that interference has been shown to have significant, lasting health benefits. Through the adjustment of the subluxation, the doctor of chiropractic endeavors to restore normal nerve expression. The body is then able to respond appropriately to any imbalance in the system, thus relieving symptoms and restoring health.
Is chiropractic care effective?
Doctors of chiropractic provide effective, low-cost health care for a wide range of conditions.
Studies conducted according to the highest scientific standards and published by organizations not affiliated in any way with chiropractic institutions or associations continue to show the clinical appropriateness and effectiveness of chiropractic care. One of the most recent, funded by the Ontario Ministry of Health, stated emphatically that:
"On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain...There would be highly significant cost savings if more management of low back pain was transferred from physician to chiropractors."
Could I be hurt by chiropractic care? Is it really safe?
The process of chiropractic adjustment is a safe, efficient procedure which is performed nearly one million times every working day in the United States.
There is a singular lack of actuarial data that would justify concluding that chiropractic care is in any way harmful or dangerous. Chiropractic care is non-invasive, therefore, the body's response to chiropractic care is far more predictable than its reactions to drug treatments or surgical procedures. Of the nearly one million adjustments given every day in this country, complications are exceedingly rare. Perhaps the best summary statement on the subject of safety was published in 1979 by the Government of New Zealand which established a special commission to study chiropractic. They found:
"The conspicuous lack of evidence that chiropractors cause harm or allow harm to occur through neglect of medical referral can be taken to mean only one thing: that chiropractors have on the whole an impressive safety record."
In 1990, a detailed study on low back pain was published in the British Medical Journal (vol 300, p 1431). It compared chiropractic with hospital outpatient treatment for managing low back pain. It demonstrated that chiropractic was the more effective of the two. A follow-up study in 1995 confirmed this conclusion, reporting a 29 per cent improvement level for chiropractic over hospital treatment (BMJ, vol 311, p 349).
In 1997, at the World Chiropractic Congress in Tokyo, Danish researchers presented results showing that chiropractic reduced the duration of headaches by 69 per cent (compared with 37 per cent for massage) and their intensity by 36 per cent (compared with 17 per cent for massage). It also reduced the number of painkillers needed by 36 per cent. And a Dutch study shows that for shoulder pain arising from disorders of the spine or upper ribs, chiropractic manipulation has very positive effects (BMJ, vol 314, p 1320). But despite such evidence, the case for the profession is confounded by inaccurate use of the term chiropractic. In 1995, Alan Terrett, an Australian professor of health science, reviewed the published research on the complications of chiropractic neck manipulation. On contacting the original authors and patients, he found that many reported incidents were not severe at all and that many of the "chiropractic manipulations" were not performed by chiropractors.
The risks of chiropractic should be put in perspective. The Independent's article said that "chiropractic treatment can result in vascular damage in an unknown number of cases" - so it's not surprising it caused some alarm. Based on published cases and insurance reports, complications from genuine chiropractic manipulation to the neck are, at worst, a problem for 1 in 500,000 patients so treated. That's just 0.0002 per cent. In contrast, a 1995 risk assessment study (Journal of Manipulative and Physiological Therapeutics, vol 18, p 530) reported that nonsteroidal anti inflammatory drugs can carry a 0.4 per cent risk per year of severe stomach ulceration, possibly leading to perforation and death. Would the reluctant patient have chosen painkillers rather than chiropractic had he known?
Can a person who had back surgery see a chiropractor?
Yes. It's an unfortunate fact that up to half of those who had spinal surgery discover a return of their original symptoms months or years later. They then face the prospect of additional surgery. This too common occurrence is known as "Failed Back Surgery Syndrome." Chiropractic may help prevent repeated back surgeries. In fact, if chiropractic care is initially utilized back surgery can often be avoided in the first place.
Is it OK to see a chiropractor if I'm pregnant?
Anytime is a good time for a better functioning nerve system. Pregnant mothers find that chiropractic adjustments improve their pregnancy and make delivery easier for themselves and their baby. Adjusting methods are always adapted to a patient?s size, weight, age, and condition of health.
What can the public expect from a doctor of chiropractic?
# While the core concept of practice is based on healing without drugs or surgery, the specific scope may vary according to the laws of a specific jurisdiction. However, patients may commonly expect: A thorough physical examination to determine conditions which may be appropriate for chiropractic care;
# To be referred to another health care provider for conditions which are not appropriate for chiropractic care;
# To understand the type of care to be administered, and what results may be expected;
# Discussion with the doctor as the care continues, to evaluate both treatment effectiveness and projected duration;
# A clear understanding of financial arrangements;
# Appropriate, ethical care delivered in confidence, with respect for privacy and dignity.
Why won't my medical doctor refer me to a chiropractor? I think it would help.
Find another doctor who will. Your doctor is still "in the dark" as to the benefits of chiropractic care. The relationship between the medical & chirpractic professions has improved vastly over the past 10 years, but there remains a few staunch medical doctors out there who refuse to look at the benefits of chiropractic care.
Do chiropractors treat conditions other than back pain?
Chiropractors provide effective treatment for all types of soft tissue disorders and not just back and neck ailments. This includes conditions of the joints of the extremities like the ankle, knee and shoulder. What you may not be aware of is chiropractic's success in treating a number of non-soft tissue conditions like dysmenorrhea (painful menses), ulcers, migraine headaches, and ear infections in children. While we cannot claim to cure these conditions, we believe that many of these problems can be mimicked, aggravated and some times caused by disruptions in the nervous system as a result of spinal abnormalities. By correcting these spinal abnormalities like the vertebral subluxation, chiropractic has helped thousands of individuals overcome these conditions and regain control of their lives. A number of studies have also supported these findings. In one such study, spinal manipulative therapy was compared with standard medical treatments in the treatment of duodenal ulcers. The researchers Pikalov, MD, and Kharin, MD, found those subjects receiving spinal manipulations took an average of 16 days to heal vs. 26 days to heal in the standard medical treatment group. JMPT 1994;17(5):310-313
I have heard that once I start chiropractic care, I'll have to continue with it for the rest of my life. Is this true?
You may have heard the notion that once you go to a chiropractor you have to keep going back. Before we answer that question, ask yourself how many times you have visited a dentist? Like most people, you've probably gone dozens of times. Why? Quite simply, to prevent your teeth from literally rotting out of your head. Once chiropractic care eliminates your pain and rehabilitates the injured tissues we do recommend that you maintain a schedule of periodic spinal checkups. Like your dentist and like many of the medical experts are now recognizing, prevention is the key to reducing recurrences of existing health conditions and minimizing new injuries in the future. So the answer is yes, we want you to keep coming back, but just periodically (once every few months or so). Periodic chiropractic care minimizes spinal and nerve stresses, reduces recurrences of old injuries, prevents new injuries from developing, minimizes degenerative processes, which enhances overall health and wellness.
What can I do about a chiropractor I feel is behaving in an unethical manner?
If the nature of your concern with a doctor of chiropractic involves a billing dispute, we highly recommend that you first discuss the issue with your individual doctor of chiropractic. What may seem incorrect can often be clarified after having reviewed the case with your doctor. If your case involves an insurer, ensure that you are clear on exactly what your plan will pay for regarding chiropractic coverage. Oftentimes, insurance plans may have a blanket statement that they pay for chiropractic care but may not pay for all of your visits or all of your therapies. If, after discussing your concerns with both the doctor and your insurer, you feel your issue has gone unresolved, you may wish to contact your state department of insurance.
If the nature of your concern with a doctor of chiropractic involves an ethical complaint about the doctor’s relationships with his or her patients, including any inappropriate sexual behavior, we recommend you immediately contact the state board of licensure at http://www.doh.wa.gov/hsqa/Professions/disciplinary/complaint.htm
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