What Is It?
The best known and most widely used alternative therapy in the United States today, chiropractic focuses on the manipulation of the spine and other joints to help treat a variety of problems involving bones, joints, muscles, ligaments, and tendons.
In most states, chiropractic physicians are primary-care, first-contact physician who use a conservative, holistic, and integrative approach to patient care. Chiropractic physicians treat, correct, and prevent neurological, skeletal, or soft tissue dysfunction by employing spinal and other articular adjustments and manipulations. They also utilize other conservative means for promoting wellness, including: nutritional counseling, physiologic therapeutics, meridian therapy/acupuncture, trigger point therapy, exercise, lifestyle counseling, botanical medicine, homeopathic remedies, emotional support, and stress management
Chiropractic physicians primarily use their hands to apply pressure to a joint or group of joints. (In fact, the name “chiropractic” is derived from Greek words meaning “done by hand.”) This treatment is known as an “adjustment” or a “manipulation.” The aim of using manipulation is to provide relief for pain or stiffness, and to improve posture as well as the function of nerves, joints, and muscles.
Spinal manipulation has been practiced for thousands of years; there are records of it from ancient Egypt and China. The birth of modern chiropractic, however, is often cited as September 18, 1895, the date that Daniel David (“D. D.”) Palmer, a grocer and apprentice of magnetic healing in Davenport, Iowa, reportedly restored hearing to a man who had been deaf for 17 years, simply by adjusting misaligned vertebrae.
In the years that followed, Palmer founded the first chiropractic school and refined his discipline, becoming convinced that pinched nerves caused by misalignments of the vertebrae were responsible for nearly all disease. His work remains the foundation of many aspects of chiropractic today.
How Does It Work?
Chiropractic takes a structural, nutritional, and emotional approach to health care. The chiropractor aims to gently restore the natural and delicate balance that exists in all healthy individuals.
To do this, a chiropractor locates vertebrae that do not move properly, particularly along the spine. These fixations or restrictions can cause inflammation and eventually pain and dysfunction in nerves, joints, and muscles. Chiropractic physicians treat joint fixations or restrictions by adjusting the bones (and their associated muscles and joints) gently with their hands. When corrected by manipulation, the integrity of the nervous system is restored, ensuring optimal function.
What You Can Expect
After reviewing your medical history, the chiropractic physician will discuss your general health with you and conduct a thorough physical examination, which will include orthopedic and neurological evaluations. The session might include a review of past X rays or you may be asked to have new images taken. The course of treatment will probably include a series of manipulations to help regain mobility to the vertebrae in your spine or other problem areas.
The chiropractic physician may ask you to lie down on a padded massage-type table for spinal manipulation or you may be seated on a stool or in a special chair that provides access to your back. You may be treated fully clothed or asked to undress and wear a hospital gown.
Before doing any manipulation, the doctor should explain exactly what the process involves. Typically, chiropractic is performed using very little force, although techniques vary. As the chiropractor applies pressure to your spine, you may hear (and feel) a popping sound, like a knuckle cracking. You should not feel any serious discomfort from the adjustment, however. If you do, it is important to let the chiropractor know immediately. Many patients find the experience relaxing. Most describe feeling less pain, reduced tension, and more flexibility in the areas that were adjusted.
Some chiropractors (called “straight” chiropractors) adhere strictly to D.D. Palmer’s theories, using only spinal adjustments to treat problems. Others (known as “mixers”) combine spinal adjustments with adjunct therapies such as massage, heat or ice treatments, rehabilitative exercises, acupuncture, cranial manipulation, and nutritional counseling.
An initial visit usually lasts at least an hour. Subsequent visits may only take 10 to 30 minutes. Sometimes one session with a chiropractor is all that is required to relieve pain. An average course of treatment for an acute problem involves three to five visits a week for two weeks.
Chiropractors generally have working relationships with M.D.s and D.O.s (doctors of osteopathy) and will refer you to one–often an internist or a neurologist–if your condition persists and further testing or treatment appears necessary.
Health Benefits
Chiropractic has been shown to be a particularly useful treatment for the relief of acute (or temporary) low back pain. In 1994, the United States Agency for Health Care Policy and Research recommended chiropractic manipulation as a safe initial form of treatment for acute low back pain in adults. The agency urged most patients to try conservative treatment such as chiropractic before opting for more aggressive measures such as drugs and surgery.
Chiropractic care can also ease pain in the mid-back, neck, and joints of the arms, hands, and legs. Although scientific research has not provided conclusive proof of its effectiveness, many people report that chiropractic provides relief from the pain of migraine and other headaches, muscle spasms, and nerve inflammation that can cause numbness and tingling.
How To Choose a Practitioner
Chiropractic physicians are licensed in all 50 states and the District of Columbia, and must pass a certification exam with the National Board of Chiropractic Examiners. A Doctor of Chiropractic (D.C.) usually has a bachelor’s degree, four to five years of graduate study in chiropractic care, as well as clinical training. Many health insurance policies cover chiropractic.
Cautions
If you have been diagnosed with rheumatoid arthritis, sciatica, or osteoporosis, have your chiropractor consult with your primary care physician prior to treatment (certain kinds of spinal manipulations could make these conditions worse).
If your back pain is accompanied by a fever, it’s important to consult your primary care doctor, or have your chiropractor do so, to rule out conditions that need medical attention.
Be well,
David Edelberg, MD