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    Chiropractic care for back pain

    Chiropractic care is a way to diagnose and treat health problems that affect the nerves, muscles, bones, and joints of the body. A health care provider who provides chiropractic care is called a chiropractor.

    Hands-on adjustment of the spine, called spinal manipulation, is the basis of chiropractic care. Most chiropractors also use other types of treatments.

    What Happens During a Visit to a Chiropractor?

    The first visit usually lasts 30 - 60 minutes. Your chiropractor will want to know about your goals for treatment and your health history. You will be asked about your:

    • Past injuries and illnesses
    • Current health problems and medicines you are taking
    • Lifestyle
    • Diet
    • Sleep habits
    • Exercise
    • Mental stresses you might have
    • Use of alcohol, drugs, or tobacco

    Tell your chiropractor about any physical problems you may have that make it hard for you to do certain things. Also tell your chiropractor if you have any numbness, tingling, weakness, or any other nerve problems.

    After asking you about your health, your chiropractor will do a physical exam. This will include testing how well your spine moves. This is called spinal mobility. Your chiropractor may also do some tests, such as checking your blood pressure and taking x-rays. These tests look for problems that might be adding to your back pain.

    Treatment usually begins at the first or second visit.

    • You may be asked to lie on a special table, where the chiropractor does the spinal manipulations.
    • The most common treatment is manipulation your chiropractor does by hand. It involves moving a joint in your spine to the end of its range, followed by a light thrust. This is often called an “adjustment.” It realigns the bones of your spine to make them straighter.
    • The chiropractor may also do other treatments, like massage and other work on soft tissues.

    Some people are a little achy, stiff, and tired for a few days after their manipulation. This is because their body is adjusting to its new alignment. You should not feel any pain from the manipulation.

    How Many Treatments Will You Need?

    More than one session is usually needed to correct a problem. Usually treatments last several weeks. Your chiropractor may suggest two or three short sessions a week at first. These would last only about 10 - 20 minutes each. Once you start improving, your treatments may be just once a week. You and your chiropractor will talk about how effective the treatment is based on the goals you discussed in your first session.

    What Conditions Does Chiropractic Treat Best?

    Chiropractic is most effective for treating:

    • Subacute back pain (pain that has been present for 3 months or less)
    • Flare-ups of chronic (long-term) back pain
    • Neck pain

    Who Should Not Be Treated with Chiropractic?

    People should not have chiropractic treatment in the parts of their bodies that are affected by any of these conditions:

    • Bone fractures or bone tumors
    • Severe arthritis
    • Bone or joint infections
    • Severe osteoporosis (thinning bones)

    Very rarely, manipulation of the neck has damaged blood vessels or caused strokes. But the screening process your chiropractor does at your first visit is meant to see if you might be at high risk for these problems. If you are, your chiropractor will not do neck manipulation.

    References

    Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD008112.

    Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.

    Walker BF, French SD, Grant W, Green S. Combined chiropractic interventions for low-back pain. Cochrane Database Syst Rev. 2010;(4). Review.

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                Review Date: 10/18/2011

                Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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