Frequently Asked Questions
- What is Chiropractic?
- What do Chiropractors treat and how?
- What is a Chiropractic adjustment and how does it work?
- Does the treatment hurt?
- Is Chiropractic care safe?
- Are there any risks involved?
- What's the difference between Chiropractic, Osteopathy and Physiotherapy?
- What will happen when I visit the clinic for the first time?
- How long will my treatment sessions last?
- How many times will I have to come back for treatment?
- Will I need an X-Ray?
- Do I have to be referred by my GP?
1. What is Chiropractic?
Chiropractic is a well established primary contact healthcare profession with a history of over one hundred years. Chiropractors use a variety of techniques and tests to diagnose and treat problems in the musculoskeletal systems of the body; the joints, muscles, tendons and ligaments with specific reference to the spine and the nervous system. Chiropractors train for a minimum of four years at college and must complete further studies to remain up to date with advances in the field each year.
Chiropractic was discovered in 1895 by a Canadian called Daniel David Palmer who went on to open the Palmer School of Chiropractic in 1897 in Davenport, Iowa. Throughout the 20th Century the profession saw world-wide growth and support gained by extensive research from both chiropractors and other healthcare professionals. The profession has continued to grow into the 21st century with many new advances in techniques.
2. What do Chiropractors treat and how?
Chiropractors aim to remove interference from the nervous system by restoring the normal function to the musculoskeletal system, which includes the joints, muscles, tendons and ligaments.
Common presenting complaints include:
- Low back pain
- Disc injuries
- Neck pain
- Whiplash injuries
- Knee problems
- Hip problems
- Shoulder/arm pain
- Tennis/golfer's elbow
- Arthritic pain/stiffness
- Sports injuries
- Sleep problems
- Recurrent infections
- Sports injuries
- Other adult complaints
Chiropractic treatment utilises a variety of techniques; most commonly what is termed a chiropractic adjustment, also known as spinal manipulative therapy (SMT). They may also use a variety of soft tissue techniques to aid with the release of muscular tensions.
3. What is a Chiropractic adjustment and how does it work?
A chiropractic adjustment is a specific thrust applied to a joint in order to improve its function. This thrust is termed a HVLA treatment which means high velocity and low amplitude, this means that the joint to be treated is placed in exactly the correct position to allow maximum effect from minimal force. Some techniques use force that is no more than you could comfortably put on your eyeball! Adjustments are designed to improve the function of the joints and the nervous system and therefore reduce muscular spasm and inflammation in the area local to the joint. The adjustment is typically provided by hand, but chiropractors may also use a variety of tools for this purpose.
4. Does the treatment hurt?
The majority of patients suffer little or no discomfort during the application of the treatment, however those patients in a significant amount of pain may suffer momentarily with the positioning of the joint to be treated, this pain is generally minimal and very short term. It is not uncommon that patients may experience some minor affects following treatment, for example mild soreness of muscles and joints lasting up to 48hrs, but this is usually only mild and can be attributed to the structures adjusting to the treatment. Your chiropractor will tell you the best way to manage this.
5. Is Chiropractic care safe?
There have been some indications in the media that Chiropractic is an unsafe medical profession, however these claims are misguided and unfounded. Almost every medical intervention available carries with it some risk, this is no different with chiropractic treatment. However, evidence shows that chiropractic techniques are significantly safer not only than several frequently used medical procedures but also when compared to everyday activities such as having your hair washed, overhead work (for example painting the ceiling) or even turning your head while reversing your car.
Recent papers demonstrating the safety of chiropractic treatment are summarised below (in chronological order) including links to the appropriate articles and journals for further reading:
Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a population based case-control and case crossover
Published in the journal 'Spine' in February 2008, this study investigated the incidence of patients suffering strokes after visiting a chiropractor and after visiting their primary healthcare provider (GP). This study 'found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care'.
The Benefits Outweigh the Risks for Patients Undergoing Chiropractic Care for Neck Pain: A Prospective, Multicenter,
Published in the Journal of Manipulative and Physiological Therapeutics in July 2007, this study investigated the risks vs. benefits for chiropractic care of neck pain. The authors concluded that 'Adverse events may be common, but are rarely severe in intensity. Most of the patients report recovery, particularly in the long term. Therefore, the benefits of chiropractic care for neck pain seem to outweigh the potential risks'.
A Risk Assessment of Cervical Manipulation vs. NSAIDs for the Treatment of Neck Pain.
Published in the Journal of Manipulative and Physiological Therapeutics in October 1995, this study compares the effectiveness and associated risks of chiropractic treatment and treatment using Non Steroidal Anti-Inflammatory Medication (NSAIDs; for example paracetemol) for neck pain. The conclusions were that 'the best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. There is no evidence that indicates NSAID use is any more effective than cervical manipulation for neck pain'.
You will also find on the site hosting the article abstracts (www.chiro.org) much more information about chiropractic.
6. Are there any risks involved?
As with every medical intervention there are some small risks associated with chiropractic treatment. As mentioned above you may see some mild side effects. Very rarely manual treatments, as those given by chiropractors, have been associated with some more serious risks:
- While rare, some patients have experienced muscle and ligament sprains or strains, or rib fractures following spinal manual therapy in the thoracic spine.
- There have been reported cases of injury to a vertebral artery following neck adjustment, manipulation and mobilization. Such vertebral artery injuries may on rare occasions cause stroke, which may result in serious neurological injury and/or physical impairment. This form of complication is an extremely rare event, occurring about once in every 5.85 million treatments.
- There have been reported cases of disc injuries following spinal manipulative therapy, although no scientific study has ever demonstrated that such injuries are caused, or may be caused, by adjustment or manipulative techniques. This form of complication is also an extremely rare event occurring about one time per ten million treatments.
7. What's the difference between Chiropractic, Osteopathy and Physiotherapy?
Osteopathy and Chiropractic generally have more similarities than differences, and there are also many similarities with Physiotherapists as well. All three professions utilise manual techniques to provide relief for musculoskeletal problems as listed above.
Osteopathy started in America in the late 19th century, as did chiropractic, and focuses on the role of the musculoskeletal system in the overall health of a patient. Differences to chiropractic are in the philosophies of the two professions; Chiropractors work on a primarily neurological basis (to do with the nerves of the body) where as Osteopaths look at the body fluids. The techniques used to remove any spinal misalignments also differ in their application and finally Chiropractors are qualified to take and read X-rays where osteopaths are not.
Physiotherapists differ slightly more from both Chiropractors and Osteopaths, primarily in their origins and the actual remit of their work. Physiotherapy started around the time of the Crimean War (mid 1800s) and worked with the rehabilitation of war injuries and of patients following surgical procedures. The actual remit of physiotherapy is described very aptly in the name; as physical therapists their primary objective is to treat a pre-diagnosed complaint, not to work as diagnosticians, and therefore the majority of their work is centred on the prescription of rehabilitative exercises. However in more recent years Physiotherapy has grown to encompass aspects of manual treatment such as manipulation and soft tissue release techniques.
8. What will happen when I visit the clinic for the first time?
Your initial consultation visit will last the longest of all your treatment sessions and usually takes up to one hour. You will be given the privacy to change into a gown before being asked into the treatment room. During this time your chiropractor will go through with you:
- Your past medical history and questions regarding your lifestyle.
- A detailed case history regarding the complaint(s) you are presenting with.
- A thorough examination to evaluate your range of motion and posture, and neurological and orthopaedic testing and chiropractic assessment.
- A comprehensive explanation of your condition, the causes of your symptoms and whether or not chiropractic can help along with how that will be achieved. If chiropractic cannot help or further testing is needed you will be referred to the appropriate specialist to continue your care.
- A full explanation of your proposed treatment plan.
- If you are happy with your explanation and treatment plan your first session will include your first chiropractic treatment.
9. How long will my treatment sessions last?
Subsequent treatment sessions last fifteen minutes and include a review of the complaint and the continued treatment in accordance with the pre-agreed treatment plan.
10. How many times will I have to come back for treatment?
The answer to this question will depend heavily on the complaint for which you are being treated, the length of time you have been suffering with it, its severity and the lifestyle factors playing a part in its progression. Your personal treatment plan will be discussed with your during your first visit in your Report of Findings (RoF); however the treatment plan must be viewed as a guide as the factors mentioned above can change as the treatment progresses. Again this will be discussed fully with you.
11. Will I need an X-Ray?
Your chiropractor is trained to utilise all the appropriate methods to determine the nature and cause of your complaint. Chiropractors are qualified to refer patients for x-rays, however this will depend on your individual case. All referrals for x-ray must meet stringent guidelines (called IR(ME)R) in order to decide whether an x-ray is clinically justified, this will be explained by your chiropractor should it be applicable.
12. Do I have to be referred by my GP?
At the Family Chiropractic Clinic we have a good relationship with many local healthcare professionals and do see patients who are referred to us by GPs. However as mentioned above chiropractors are primary contact healthcare professionals so you do not need to be referred by anyone to visit.