Chiropractic is a method for diagnosing and treating illnesses that affect the nerves, muscles, bones, and joints of the body. Daniel David Palmer founded chiropractic in 1895. Palmer was a self-taught healer who was studying spinal structure and manipulative techniques when he cured a man of deafness and acute back pain by realigning a displaced vertebra in his back. This and other successes led Palmer to believe that most diseases were a result of abnormal nerve transmission caused by "vertebral subluxation" (that is, misalignment of the spine).
Although most contemporary chiropractic practices have introduced additional therapies, spinal manipulation remains the essence of chiropractic. Today, chiropractic is the third largest independent health profession in the Western world, and the United States alone is home to 52,000 licensed chiropractors who together see 20 million patients a year.
What happens during a visit to a chiropractor?
The first visit typically lasts about an hour. The chiropractor takes a complete health history, including:
- Information on past injuries and illnesses
- Current conditions and medications
- Sleep habits
- Mental stresses
- Use of alcohol, drugs, or tobacco
During a physical exam, the chiropractor also tests the extent of spinal mobility and may perform various diagnostic tests, such as blood pressure and x-rays, to rule out other conditions. Treatment generally begins at either the first or second visit. Patients are typically asked to lie on a specially designed table, where the chiropractor performs the spinal manipulations.
The most common maneuver is manual manipulation, which involves movement of the selected joint to the end of its range, followed by a low-force thrust. The chiropractor may, however, use other treatments including massage and soft-tissue therapies. Some people experience minor aches, stiffness, and tiredness for a few days after the manipulation while their body adjusts to the new alignment.
How many treatments will be required?
More than one session is usually needed to correct a problem; a typical course of treatment lasts several weeks. The chiropractor may suggest two or three sessions a week (lasting only about 10 - 20 minutes), then reduce the frequency to weekly sessions once the condition being treated improves. Patient and chiropractor together evaluate the effectiveness of treatment based on the goals discussed in the first session.
What conditions are treated effectively with chiropractic?
Chiropractic has been shown to be effective for subacute back pain and flare-ups of chronic low back pain. It is also effective for neck pain. Manipulation of joints and the body’s soft tissues may also be helpful for pain from other conditions, such as frozen shoulder, tennis elbow and other sports injuries, and carpal tunnel syndrome.
Who should not be treated with chiropractic?
Individuals with bone fractures or tumors, acute arthritis, bone or joint infections, or advanced osteoporosis should avoid chiropractic therapy in areas affected by any of these conditions.
Patients should also tell their chiropractor about any physical disabilities they have, or if they are experiencing symptoms of numbness, tingling, weakness, or other neurological problems.
In extremely rare cases, manipulation of the neck has damaged blood vessels or caused strokes. The screening process, however, is designed to detect people at high risk for such problems and avoid neck manipulation.
How can a qualified practitioner be located?
Chiropractors are licensed in all 50 states. A chiropractic degree requires approximately the same number of educational hours as a medical degree, not including a medical doctor's residency training that can more than double this amount of time. The chiropractic program includes clinical experience, basic sciences, and the ability to diagnose structural (spinal) and functional (nervous system) problems.
At least one chiropractic organization serves each state in the U.S. The largest association in the profession of chiropractic is the American Chiropractic Association (ACA). For a list of licensed chiropractors in your area, visit the ACA's web site at www.acatoday.org.
Your doctor may also be able to help.
Andrew W. Piasecki, MD, Camden Bone and Joint, LLC, Orthopaedic Surgery/Sports Medicine, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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