A chiropractor is involved with the diagnosis and treatment of musculoskeletal and nervous system disorders, mainly by manual adjustment and manipulation of the spine. They differ from osteopaths by focusing primarily on the spine and joints, whereby an osteopath treats other areas of the body. A chiropractor treats “subluxation”, when vertebrae are out of position, and there is a loss of functional ability and often pain. It is the belief that this misalignment interferes with the body’s ability to heal itself.
The ultimate aim of a chiropractor, is to treat, but also to educate in order to prevent reoccurrence of the problem. In addition to formulating an individual treatment plan dependent upon your particular problem, a chiropractor will advise you about your diet and lifestyle, consider your walking style and posture. They may recommend orthotics, supplements, an exercise regime, stretches or diet modification. As well as treatment, chiropractors are able to use tools to aid recovery. Back support belts, bands or pillows may be advised.
Chiropractic treatment is not available on the NHS, so it is important to consider various factors when looking for one. All chiropractors are required to register with the General Chiropractic Council. Rapport is an important consideration- do you feel comfortable and able to talk to your chiropractic doctor? They should be friendly, courteous, and happy to answer any questions or address any concerns you may have. Do they listen to you when you talk about your symptoms and how you feel about treatment techniques? You need to feel comfortable, and it is your decision as to whether to accept their recommended treatment plan.
A chiropractic treatment programme can help with many conditions, some of which are:
- Back sprain, when ligaments have been torn or overstretched.
- Back strain, when muscles and/or tendons have been over, or inappropriately used.
- Spinal osteoarthritis (Mainly a result of aging).
- Headaches. Some types of headaches are as a result of strained neck muscles.
- Whiplash injury. In an accident when a vehicle stops suddenly, the head and neck can be wrenched forwards and backwards quite violently. This can result in neck and/or lower back pain.
- Degenerative Disc Disease. The cushioning between vertebrae in the spine breaks down and wears as we age.
- Sciatica. If the sciatic nerve becomes irritated or compressed, pain may be experienced which travels down the buttock and below the knee in one leg.
- Referred pain experienced in the hips, knees, feet shoulders or elbows.
The first visit will involve talking about your health and the problem. Your spine will be examined, with special consideration given to the problem area. Assessments may be carried out to determine the range of movement you have, your reflexes, muscle strength and nerve involvement. The appointment will last 30-60 minutes. The chiropractor will diagnose the problem, and talk to you about the proposed treatment plan.
As part of the diagnosis, depending on the presenting problem, x-rays or MRI scans may be required. X-rays are often used to rule out certain conditions, and in certain circumstances:
- If a fracture is suspected.
- If infection is suspected.
- If a significant disease is a possibility.
- If joint disease may be present.
- Patients over the age of 65.
- If osteoporosis is suspected.
Treatment will usually start at the same time as your assessment. You will be required to sit or lie on a specially designed table which will allow the chiropractor to position and manipulate you. You may need to remove some clothing in order for the spine to be accessed, but a gown will be provided. You may wish to have a chaperone to accompany you to treatment sessions. Treatment will probably involve having ‘adjustments’, which are therapeutic manipulations. Controlled force is used to give areas of the spine short, sharp thrusts. Other joints may also be manipulated. Often you will hear a cracking sound, which is made when gas bubbles escape from the fluid around the joints. Sometimes gentler movements are used upon the joints, involving stretching and pulling the muscles. Non- force techniques use heat, ice or electrical stimulation, for example. Treatment should not be painful, but you may experience a little discomfort.
Your chiropractic doctor will talk to you about the number of treatments you will need, how often you will need to come and the price of treatment. He will recommend other treatments or therapies if he feels that your condition would benefit from them. Acupuncture or massage therapy may be incorporated into your treatment plan. The aim is to remove any pain you are suffering, advise you how to prevent any future problems and how to improve your lifestyle.
Chiropractic is considered a safe therapy in skilled hands. There are some conditions which would not be suitable, such as rheumatoid arthritis. There is an increased risk with osteoporosis sufferers. As a general rule, it is acceptable for most individuals to have. It has been shown that for sufferers of osteoarthritis of the knee, better pain relief was perceived when chiropractic was used with exercise, than with exercise alone1. It has been demonstrated to be a cost effective treatment for sub-acute or chronic lower back pain2, and “significantly better pain relief and functional improvement” was gained in the short and long term for patients suffering from tennis elbow3.
- 1. Jansen, MJ et al ‘Strength Training Alone, Exercise Training Alone, and Exercise Therapy with Passive Manual Mobilisation Each Reduce Pain and Disability in People with Knee Osteoarthritis: A Systematic Review.’ J. Physiother. 2011 Vol 57(1) 11-20.
- 2. Lin, CW ‘Cost-Effectiveness of Guideline- Endorsed Treatment for Lower Back Pain: A Systematic Review’. European Sine Journal 2011. Vol 20 (7) 1024-1038.
- 3. Meserve, BB et al ‘A Systematic Review of the Effectiveness of Manual Therapy in Treating Lateral Epicondylitis’. J. Manip. Theo. 2008 Vol 16 (4) 225-37.