Chiropractic is a health-care science that is mainly concerned with the health of the vertebral (spinal) column and the nervous system.
Currently the third largest health profession, after medicine and nursing,
Now taught at tertiary (unversity) level as a degree, post-grad degree, masters and most recently doctorate. "Doctor of Chiropractic" is the highest qualification.
Chiropractic is outside the broadly defined "medical profession" and is often referred to as complimentary or alternative.
There are sub-specialties within chiropractic that concentrate on various aspects of health and wellness, but spine and nerves are considered to be the base line.
Chiropractors do not all provide the same type of diagnosis and treatment, this is a distinction that must be made at the outset, as the differences between chiropractors are more than "variations on the theme", the differences are like chalk and cheese. (More on this later)
Spinal adjustments (manipulation) can help with back and neck pain and many other conditions related to restriction, tightness and loss of mobility, such as tension headache or aching in muscles and joints.
Some chiropractors use non-force techniques which are preferred by many people who don't like the feeling of adjustments (manipulation) or who are concerned about the safety of manual techniques. A popular alternative to manual techniques is "Instrument Adjusting", which utilises a variety of mechanical devices that deliver a very specific (and gentle) impact.
Chiropractors should generally provide patients with a choice. Some may also offer basic advice about nutrition, weight loss, exercise, ergonomics, relaxation techniques, body mechanics, home care (such as use of hot or cold packs), massage, and other self-help measures that might help relieve or prevent aches and pains.
Some chiropractors hold additional qualifications in acupuncture, naturopathy, physiotherapy and myofascial therapy trigger point dry needling.
As mentioned in the first paragraph, the services offered vary between practitioners so it is always a matter of enquiry to determine the "type" of practice.
Chiropractors are qualified to make appropriate judgments about the nature of their patients' problems, determine whether these problems lie within their scope and make appropriate referrals for problems that do not. If you can find one who uses manipulation and physical therapy appropriately and who is willing to coordinate with your personal physician, you can benefit from the best that both have to offer.
While some types of back pain can benefit from spinal manipulation, not every patient who sees a chiropractor needs it. Proper diagnosis should precede treatment of any type. This is why, if you consult a chiropractor, it is crucial to choose one who can make an appropriate diagnosis, uses spinal manipulation only when indicated, does not order unnecessary x-rays, and refers to an appropriate physician when needed. Chiropractors whose practice is not based on subluxation theory are in the best position to judge whether your problem requires medical treatment. Never rely upon the diagnosis of a proclaimed "straight" chiropractor...this practitioner will advocate chiropractic care in every case,
Many chiropractors offer physical therapy modalities as well as manipulation. However, many patients have told me that manipulation was more effective in providing immediate relief. it is best to seek treatment
Manipulation vs. Mobilization
Manipulation and mobilization are used primarily in the treatment of conditions related to mechanical-type problems in joints and muscles. Manipulation is a hands-on procedure used to restore normal movement by loosening joints and stretching tight muscles. In some cases, manipulation will restore normal movement by unlocking a joint or by breaking down adhesions. A popping sound often occurs when a spinal joint is stretched a little beyond its normal range of motion. Mobilization simply stretches soft tissues by moving joints through a full range of movement. Mobilization can increase the range of motion of the arms, legs, and shoulders, but manipulation may be more effective in relieving pain and restoring normal movement in the spinal joints.
Any portion of the spine that is tight, stiff, or painful on movement might benefit from appropriate manipulation. Different methods are used in different portions of the spine, since joint structure and the direction of movement in the neck and upper back differ from those of the lower back. For example: neck manipulation might be done while the patient sits on a stool; upper-back manipulation might be done while the patient lies facedown; and lower-back manipulation might be done while the patient lies on one side. Dozens of manipulative techniques can be used to meet the special needs of patients who must be positioned one way or another. Tables with specially designed cushions are used to support patients in certain postures.
Manipulation may improve the mobility of a cervical spine that has been stiffened by osteoarthritis or by scar tissue from an old injury. Disc degeneration caused by wear and tear or by injury is a common cause of loss of range of motion in the cervical spine and can often benefit from manipulation. Neck manipulation or mobilization may improve range of motion and provide relief for neck pain and muscle-tension headache. But remember that benefit must be weighed against risk. Neck manipulation should not be used unless symptoms indicate a specific need for it. It should be done gently with care to avoid excessive rotation that could damage the patient's vertebral artery. Neck manipulation should not be done immediately after an injury that causes acute neck pain. When the acute pain subsides, usually after a few days, manipulation may be useful to relieve fixations and restore normal joint mobility. Once the patient is symptom-free, it should be discontinued. A small percentage of chiropractors advocate neck manipulation to "balance" or "realign" the spine no matter where the patient's problem is located. I recommend avoiding such chiropractors.
Neck manipulation is safest when neck rotation does not exceed 15 degrees. When rotation is not indicated or appropriate, special techniques can be used with the patient in a face-down position so that manipulative traction can be applied or there can be thumb contact with specific spinal segments.
Patients who have pain caused by acute inflammation, as in rheumatoid arthritis or spondylitis, will rarely benefit from neck manipulation. Damage to upper cervical connective tissues in rheumatoid arthritis can also be a contraindication. .
Tension headaches, often called muscle-contraction headaches, may benefit from manipulation that loosens joints and stretches tight neck muscles. Some chiropractic case reports suggest that migraine headache can be relieved with cervical manipulation. However, true migraine is unlikely to be relieved by neck manipulation.
Before submitting to the risk of cervical manipulation for the treatment of headache, it is essential to determine whether the problem might be caused by a sinus infection, food sensitivity, a brain tumor, or another cause unrelated to the cervical spine. Fortunately, most headaches are of the simple tension or muscle-contraction variety. So there is a good chance that simple massage or stretching of neck muscles will relieve them.
Up and Down the Back
Pain in the upper and lower portions of the spine can often be treated successfully with manipulation and physical therapy. Low-back pain is more common, is usually more serious, and deserves more attention. Herniated discs are rarely a problem in the upper back or thoracic spine, for example, while a herniated disc in the lower back or lumbar spine can pinch spinal nerves and cause weakness and loss of sensation in the legs or encroach upon the spinal canal to impair bladder or bowel function (cauda equina syndrome). This is why the Agency for Health Care Policy and Research (AHCPR) guidelines for treating low-back pain caution against manipulating the lumbar spine when there is leg pain caused by nerve-root involvement .
Except when the thoracic vertebrae have been softened by disease or by aging, appropriate thoracic spine manipulation is rarely harmful and often can relieve backache related to fatigue, postural strain, arthritis, myofacitis, or other problems involving muscles and joints. Many people undergo thoracic spine manipulation simply for the relaxing effect that results from "popping the back."
Other Joints and Muscles
Uncomplicated mechanical-type problems of the muscles or joints of the shoulder, elbow, wrist, knee, ankle, and foot can often be helped by a competent chiropractor who uses physical therapy. Most chiropractors learn manipulative techniques for treatment of extremity joints, but these joints often benefit as much from mobilization as from manipulation. And they are often best treated by a physical therapist or an orthopedist. Chiropractors who have additional postgraduate training in orthopedics or sports medicine can be expected to have more extensive knowledge of injuries involving the extremities.
As with back pain, diagnosis is essential. When a condition under chiropractic care has not improved after two to four weeks, a second opinion might be in order. It is rarely necessary to continue any form of chiropractic office treatment month after month. Especially the five minute visits where the same procedure is repeated with no pre and post examination.
Pain in other joints is not often as ominous as shoulder pain that might occur as a result of a problem with the heart or the lungs or because of a disc herniation in the neck. But it is always necessary to rule out bone tumors, advanced forms of arthritis, and other problems before beginning long-course treatment of any kind.
Tips on Choosing a Chiropractor
You should avoid chiropractors who make extravagant claims or who advertise extensively!
Remember that diagnosis is critical to the establishment of proper treatment. Some chiropractors are competent in diagnosis, and some are not. For example, "straight" chiropractors who examine only the spine and who believe that "subluxated" vertebrae are the primary cause of illness may "analyze" the spine rather than offer a diagnosis. Such chiropractors may be unable to determine when chiropractic treatment should not be used.
Chiropractic can provide effective relief for back and neck pain as well as for various other musculoskeletal problems. You may also benefit from the comforting effect of a hands-on treatment that provides a pleasurable way of relieving the aches and pains of everyday stress and strain. As the benefits of spinal manipulation become better known as a result of scientific research, such treatment will become more accepted by the general medical professi