What Is a Chiropractor?

These doctors are best known for treating back pain

In This Article

A chiropractor is a health care professional who practices a type of complementary medicine that's concerned with the relationship between your body's structure and its functioning. 

Chiropractic diagnosis and treatment focuses mainly on the spine. This is because the nerves that branch from the centrally located spinal cord out to all areas of the body have to pass through the sides of the spinal column. Chiropractors believe that if the spinal bones are misaligned, this may negatively affect overall health because the misalignment impedes these nerves. By the same token, the chiropractic belief is that a well-aligned spine enhances general health. In this case, chiropractors say, the nerves that exit the spine do not experience blockages from nearby structures, and can, therefore, transmit their impulses freely.

The term “chiropractic” combines the Greek words cheir (hand) and praxis (practice) to describe a treatment done by hand. Hands-on therapy—especially spinal adjustments (or spinal manipulation)—is central to chiropractic care, which is completely drug-free. Chiropractic got its start in 1895 when a self-taught healer named David Palmer sought a drugless cure for disease. To develop his objective, Palmer turned to the ancient art of manual medicine.

Ten percent of adults saw a chiropractor in 2017, up from nine percent in 2012, according to a report from the Centers for Disease Control and Prevention. Chiropractic is the fourth most commonly used alternative medical approach used by Americans, according to a 2015 National Health Statistics Report.

Concentration

Chiropractic services are used most often to treat neuromusculoskeletal complaints, including back pain, neck pain, pain in the joints of the arms or legs, and headaches. Chiropractors also counsel patients on diet, nutrition, exercise, healthy habits, and occupational and lifestyle modification.

Here's a rundown on the conditions for which most people seek chiropractic care:

The core of chiropractic care usually involves treatment of common lower back pain conditions, both acute (sudden and severe) and chronic, through spinal manipulation. The pain could be related to an injury, caused by a disc problem or pinched nerve, or the result of arthritis.

Neck Pain

The biomechanics of the neck, aka the cervical spine, leave it vulnerable to pain and injury. Common causes of neck pain include whiplash, degenerative disorders like osteoarthritis, disc disease, and poor posture. Chiropractors often use a neck adjustment to improve the mobility of the spine, restore range of motion, and increase the movement of the adjoining muscles.

Headaches

Spinal manipulation and other chiropractic therapy options may be effective for treating tension headaches, migraines, and headaches, such as cervicogenic headaches, that originate in the neck. For instance, low-load craniocervical mobilization, which involves a gentler force than that used in spinal manipulation, may ease tension headaches.

Procedural Expertise

There are many different chiropractic techniques—100 to 200, depending on the source. But there's a significant amount of overlap between them, and many techniques are just slightly different versions of other techniques. Here's an explanation of the key procedure chiropractors perform, spinal manipulation, as well as some other specialty techniques.

Spinal Manipulation

The main mode of chiropractic care is spinal manipulation, which is sometimes referred to as a "chiropractic adjustment." Adjustments are done manually (using hands) or mechanically (using a small instrument), and involve applying a controlled force to the joints in and around your spine. The goal of spinal manipulation is to place the body into a proper position to improve spinal motion and physical function of the entire body.

While the mainstay of the chiropractic profession is the adjustment of the spine, most chiropractors also adjust the pelvis as a routine part of the treatment. Some also regularly adjust other joints, such as the knees, feet, wrists, and more.

Flexion Distraction Therapy

This technique, which involves using a special table that distracts and flexes the spine in an automated and gentle rhythmic motion, helps to increase spinal motion and remove pressure from disc bulges and spinal nerves.

Spinal Decompression

A type of motorized traction, spinal decompression is used most often in the treatment of disc injuries. The goal is to gently separate the vertebrae, creating a vacuum between the targeted vertebrae and relieving painful pressure. As a result, bulging discs may retract and alleviate pressure on nerves and other structures in your spine.

Manipulation Under Anesthesia

Spinal manipulation under anesthesia (MUA) is a non-invasive procedure that may be recommended to relieve chronic neck and back pain when other treatments haven't worked. The procedure involves sedating the patient and performing a series of mobilization, stretching, and traction maneuvers that would otherwise be too painful due to muscle spasms and/or excessive scar tissue.

Most chiropractic treatments are also accompanied by therapies, such as application of heat or ice, electrical stimulation, orthotic supports for your shoes, rehabilitative exercise, counseling about diet, weight loss, and other lifestyle factors, and nutritional supplements.

Training and Certification

Admission to a chiropractic college requires a minimum of 90-semester hour credits of undergraduate study, mostly in the sciences. Doctors of chiropractic (D.C.) are educated in nationally accredited, four-year doctoral graduate school programs through a curriculum that includes a minimum of 4,200 hours of classroom, laboratory, and clinical internship. The average D.C. program is equivalent in classroom hours to allopathic (M.D.) and osteopathic (D.O.) medical schools. Some chiropractors pursue a two- to three-year residency for training in specialized fields.

Chiropractic is regulated individually by each state and the District of Columbia. All states require completion of a Doctor of Chiropractic degree program from a CCE-accredited college. Examinations administered by the National Board of Chiropractic Examiners are required before obtaining a license to practice. To maintain their license, most states require chiropractors to earn annual continuing education (CE) credits through state-approved CE programs. Chiropractors’ scope of practice varies by state in areas such as the dispensing or selling of dietary supplements and the use of other complementary health approaches, such as acupuncture or homeopathy. 

Appointment Tips

While many medical doctors view chiropractic as a "controversial" treatment, this type of treatment has become more mainstream in recent decades. Many insurance plans cover it, and research collaborations exist between traditional medical disciplines and chiropractic. If you're suffering from back, neck, or other joint aches and pains, your doctor may refer you to a chiropractor. You can also consult with a chiropractor directly without a doctor referral.

If your doctor can't refer you to a chiropractor, ask family and friends for recommendations. You can also use the "find a doctor" feature on the website of the American Chiropractic Association. To look into a certain chiropractor's standing, check out the chiropractic board's website in your state. There, you can find out if they're currently licensed and if there have been any complaints filed against them.

Compared with other types of complementary or alternative care, coverage of chiropractic by insurance plans is extensive. According to the National Center for Complementary and Alternative Medicine, more than 50 percent of health maintenance organizations (HMOs), more than 75 percent of private health care plans, and all state workers' compensation systems covered chiropractic treatment as of 2002. In addition, Medicare covers chiropractic visits, and at least two dozen states cover chiropractic treatment under Medicaid.

Visiting a chiropractor is similar to visiting other healthcare providers, but it does have some unique elements. While the office setting and intake procedures are quite familiar, the chiropractic treatment table is distinctive. These tables are often quite elaborate to allow specific positioning and movement during spinal adjustments.

The chiropractor will start by taking a patient’s history, then perform a routine physical examination, followed by an exam of your whole spine. For example, if you have low back pain, the chiropractor would also likely examine your neck because the adaptations resulting from injury or misalignment of spinal bones (subluxations) in one area can result in secondary irritations somewhere else in the spine. Imaging or lab tests (such as MRI, CT scan, or X-ray) may be used to confirm a diagnosis. The physical exam typically includes a variety of assessments, such as range of motion tests, palpation, reflex testing, muscle strength comparisons, and neurological and orthopedic tests focused on the main complaint.

Based on the extent, timing, or severity of the patient’s condition, chiropractic interventions may require several visits. Patients may also receive advice on home care, lifestyle modifications, exercise instruction, and nutritional advice. 

Keep in mind that doctors of chiropractic are conservative care doctors; their scope of practice does not include the use of drugs or surgery. If your chiropractor diagnoses a condition outside of this conservative scope, such as a fracture or an indication of an organic disease, he or she will refer you to the appropriate medical physician or specialist.

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