by Nicole Berardoni M.D., Paul Lynch M.D., and Tory McJunkin M.D.
Chiropractic is a healthcare profession that focuses on disorders of the neuromusculoskeletal system; modern chiropractors use the best scientific, non-drug related treatments to treat muscles and joints. Chiropractic care is used most commonly to treat low back pain, neck pain, pain in the joints of the shoulders, knees and hips, and headaches.
Doctors of chiropractic earn a health degreeDoctors of chiropractic (D.C.) are referred to as chiropractors or as chiropractic physicians. In Arizona, chiropractors practice a drug-free, hands-on approach to healthcare that includes patient examination, diagnosis, and treatment but excludes prescription medication. Chiropractors have broad diagnostic skills and can have advanced board certifications in physiotherapy rehabilitative exercises and treatment modalities, as well as acupuncture and other Eastern modalities. Chiropractors are well-trained to provide nutritional, dietary, and lifestyle counseling in relation to symptoms as well.
The most common type of treatment performed by doctors of chiropractic is known as spinal manipulation, also called chiropractic adjustment. The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted with the hands or use of specific tools. When your vertebrae are adjusted, tiny pockets of gas are released from the joints, sometimes making a popping noise. This is the same sound heard when knuckles crack.When vertebrae become misaligned, they can place pressure on the spinal nerves and cause pain. This condition is known as spinal dysfunction, vertebral restriction, or subluxation. This can occur as a result of a tissue injury caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses such as sitting with poor spinal posture for an extended period of time. These type of injuries to the joints and surrounding muscles cause physical and chemical changes that can result in inflammation, pain, and diminished function for the patient. Manipulation of the affected joint and tissues restores mobility, thereby alleviating pain and muscle tightness and allowing tissues to heal.
Careful history-taking and orthopedic and neurological testing are standards of practice in chiropractic offices. This helps to determine if chiropractic care is appropriate and to rule out more serious diagnoses like cancer or fractures. Based upon the exam, possible additional imaging may be ordered such as X-rays or MRI. If there are unusual neurological findings with advanced loss of strength or reflexes, the chiropractor will refer the patient to a spine surgeon or pain management specialist prior to initiating chiropractic care.
Most patients don’t realize risks associated with chiropractic care are far safer than those associated with the most common over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS) like (ADVIL) ibuprofen and (ALEVE) naproxen. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers. Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of neuromusculoskeletal complaints. Chiropractic has an excellent safety record, but almost all treatments have the potential for adverse effects.
The risks associated with chiropractic, however, are very small. Many patients feel immediate relief following chiropractic treatment, but some may experience mild soreness or aching, just as they do after some forms of exercise. Current research shows if patients experience minor discomfort or soreness following spinal manipulation, it typically fades within 24 hours.
Neck manipulation is a remarkably safe procedure. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, recent evidence suggests that this type of arterial injury often takes place spontaneously, or following everyday activities such as turning the head while driving, swimming, or having a shampoo in a hair salon. Patients with this condition experience neck pain and headache that leads them to seek professional care at the office of a doctor of chiropractic or family physician. However, the care provided is not the cause of the injury. The best evidence indicates that the incidence of artery injuries associated with high-velocity upper neck manipulation is extremely rare, about 1 case in 5.85 million manipulations. When compared to the risks associated with over-the-counter NSAIDs, any risk associated with chiropractic care is far safer than common OTC NSAIDs.
Chiropractic care can provide immediate and long-term relief, with fewer known side effects than both pharmaceutical and invasive options for pain care.
- 2004;329;1377 BMJ United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care.
- 1995;311:349-351 BMJ Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up