Frequently Asked Questions (FAQ)
Q: What conditions do chiropractors treat?
A: Doctors of Chiropractic (DCs) care for patients of all ages, with a variety of health conditions. DCs are especially well known for their expertise in caring for patients with back pain, neck pain and headaches...particularly with their highly skilled manipulations or chiropractic adjustments. They also care for patients with a wide range of injuries and disorders of the musculoskeletal system, involving the muscles, ligaments and joints. These painful conditions often involve or impact the nervous system, which can cause referred pain and dysfunction distant to the region of injury. The benefits of chiropractic care extend to general health issues, as well, since our body structure affects our overall function. DCs also counsel patients on diet, nutrition, exercise, healthy habits, and occupational and lifestyle modification.
Q: How do I select a doctor of chiropractic?
A: One of the best ways to locate a doctor of chiropractic (DC) near you is by searching through your insurance provider directory, or by the "Find A Doctor" site. You can also select a DC is by getting a referral from a friend, family member, colleague, or another health care provider.
Q: Is chiropractic treatment safe?
A: Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of neuromusculoskeletal complaints. Although chiropractic has an excellent safety record, no health treatment is completely free of potential 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, stiffness or aching, just as they do after some forms of exercise. Current research shows that minor discomfort or soreness following spinal manipulation typically fades within 24 hours.
Neck pain and some types of headaches are treated through precise cervical manipulation. Cervical manipulation, often called a neck adjustment, works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasm, which helps relieve pressure and tension. Neck manipulation, when performed by a skilled and well-educated professional such as a doctor of chiropractic, is a remarkably safe procedure.
Some reports have associated high-velocity upper neck manipulation with a certain rare kind of stroke, or vertebral artery dissection. However, evidence suggests that this type of arterial injury often takes place spontaneously in patients who have pre-existing arterial disease. These dissections have been associated with everyday activities such as turning the head while driving, swimming, or having a shampoo in a hair salon. Patients with this condition may experience neck pain and headache that leads them to seek professional care—often at the office of a doctor of chiropractic or family physician—but that care 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 one to three cases in 100,000 patients who get treated with a course of care. This is similar to the incidence of this type of stroke among the general population.
If you are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms. This will help your doctor of chiropractic offer the safest and most effective treatment, even if it involves referral to another health care provider.
When discussing the risks of any health care procedure, it is important to look at that risk in comparison to other treatments available for the same condition. In this regard, the risks of serious complications from spinal manipulation for conditions such as neck pain and headache compare very favorably with even the most conservative care options. For example, the risks associated with some of the most common treatments for musculoskeletal pain—over-the-counter or prescription non-steroidal anti-inflammatory drugs (NSAIDS) and prescription painkillers—are significantly greater than those of chiropractic manipulation.
According to the American Journal of Gastroenterology, people taking NSAIDS are three times more likely than those who do not to develop serious adverse gastrointestinal problems such as hemorrhage (bleeding) and perforation. That risk rises to more than five times among people age 60 and older.
Moreover, the number of prescriptions for powerful drugs such as oxycodone and hydrocodone have tripled in the past 12 years. The Centers for Disease Control and Prevention (CDC) has reported that abuse of these commonly prescribed painkillers are among the leading causes of accidental death in the United States. Overdoses of opioid painkillers are responsible for some 15,000 deaths per year; that’s more than the number of deaths from cocaine and heroin combined.
Doctors of chiropractic are well trained professionals who provide patients with safe, effective care for a variety of common conditions. Their extensive education has prepared them to identify patients who have special risk factors and to get those patients the most appropriate care, even if that requires referral to a medical specialist.
Q: Does chiropractic treatment require a referral from an MD?
A: A referral is usually not needed to see a doctor of chiropractic (DC); however, your health plan may have specific referral requirements. You may want to contact your employer’s human resources department—or the insurance plan directly—to find out if there are any referral requirements. Most plans allow you to just call and schedule an appointment with a DC.
Q: Is chiropractic treatment appropriate for children?
A: Yes, children can benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.
Q: Are chiropractors allowed to practice in hospitals or use medical outpatient facilities?
A: Chiropractors are being recognized to admit and treat patients in hospitals and to use outpatient clinical facilities (such as labs, x-rays, etc.) for their non-hospitalized patients. Hospital privileges were first granted in 1983.
Q: Do insurance plans cover chiropractic?
A: Yes. Chiropractic care is included in most health insurance plans, including major medical plans, workers’ compensation, Medicare, some Medicaid plans, and Blue Cross Blue Shield plans for federal employees, among others. Chiropractic care is also available to active-duty members of the armed forces at more than 60 military bases and is available to veterans at more than 60 major veterans medical facilities.
Q: What type of education and training do chiropractors have?
A: Doctors of chiropractic are educated as primary-contact health care providers, with an emphasis on diagnosis and treatment of conditions related to the musculoskeletal system (the muscles, ligaments and joints of the spine and extremities) and the nerves that supply them. Educational requirements for doctors of chiropractic are among the most stringent of any of the health care professions. The typical applicant for chiropractic college has already acquired nearly four years of pre-medical undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology and related lab work. Once accepted into an accredited chiropractic college, the requirements become even more demanding — four to five academic years of professional study are the standard. Doctors of chiropractic are educated in orthopedics, neurology, physiology, human anatomy, clinical diagnosis including laboratory procedures, diagnostic imaging, exercise, nutrition rehabilitation and more.
Because chiropractic care includes highly skilled manipulation/adjusting techniques, a significant portion of time is spent in clinical technique training to master these important manipulative procedures. In total, the chiropractic college curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. The course of study is approved by the Council on Chiropractic Education, an accrediting agency that is fully recognized by the U.S. Department of Education.
Once complete, the doctor of chiropractic may go even further, obtaining a specialty degree known as a diplomate in any one of numerous fields of study, including neurology, orthopedics, radiology, sports chiropractic, rehabilitation, nutrition, and many more.
Q: What is a subluxation?
A: The word "subluxation" is a term doctors of chiropractic use almost exclusively, which is why you may not of heard of it until now. It simply means a "misalignment." Your spinal bones (vertebrae) protect your spinal cord primarily, but the spinal discs between them allow the spine to move in a forward (flexion), backward (extension), sideways (lateral flexion), or twisting (rotation) direction. Sometimes, a spinal bone will move too far and get "stuck" in that position. This is the misalignment, or subluxation, that doctors of chiropractic look for, and treat.
Q: Can I tell if I have a subluxation?
A: Not always. A subluxation is like a dental cavity—you may have it for a long time before symptoms appear. That's why periodic spinal checkups are so important. Although it may be possible to know you have a subluxation, it is rarely possible to be sure you don't. Regular spinal checkups are always a good idea, and they promote good health from the inside out.
Q: How can a subluxation pose so many problems?
A: A subluxation in and of itself is not the biggest problem. Yes, when a spinal bone goes out of place, it may cause irritation, inflammation, muscle spasms, and/or nerve pressure. The bigger problems a subluxation poses is long-term spinal health issues down the road.
The biggest problem a subluxation can cause is with the spinal discs between the bones. It has been shown through research and study that the spinal discs expand and contract with spinal movement, pulling in and pushing out a water-like fluid called synovial fluid. It is this synovial fluid that bathes the spinal disc in nutrients upon entering, and removes waste products while leaving, keeping the spinal disc healthy and hydrated.
The spinal discs are like sponges. When the spine moves, the synovial fluid moves in and out in a normal pattern. When a subluxation occurs, normal spinal movement is altered, which in-turn alters the synovial fluid movement. Initially, there many not even be signs of a problem, but down the road the problems will creep in slowly.
The cells in the spinal discs need the synovial fluid nutrients to grow, repair, and heal the disc tissue. Without these nutrients, the cells die, causing the disc tissue to break down, a process known as degeneration. This process may not be seen on an x-ray until 5, 10, even 15-20 years down the road. By then, sometimes, it is too late to treat the spine and get the tissues to heal properly.
This is why doctors of chiropractic will recommend an aggressive treatment plan in the beginning phases of care. Time is of the essence, and the doctor of chiropractic knows he/she needs to get the patient's spine moving properly again: 1.) to remove pain, spasms, and inflammation; 2.) to get the spinal joints and synovial fluid moving again; and 3.) to restore spinal joint and disc health.
This is also why doctors of chiropractic will recommend maintenance care. After the initial stages of care, a periodic adjustment can help a person maintain their spinal health. The doctor of chiropractic will recommend a frequency that is appropriate for you. Some people with more strenuous work and physical activity may need more frequent maintenance (i.e. once per week) where others may only require the occasional adjustment (i.e. once per month).
Q: What is a chiropractic adjustment and how is it performed?
A: A chiropractic adjustment or manipulation is a manual procedure that utilizes the highly refined skills developed during the doctor of chiropractic’s intensive years of chiropractic education. The chiropractic physician typically uses his or her hands to manipulate the joints of the body, particularly the spine, in order to restore or enhance joint function. The chiropractic physician may also employ the use of pieces of the treatment table that "drop," or an instrument, to perform the adjustment. This helps to remove the subluxations in your spine, and also often helps resolve joint inflammation and reduces the patient's pain. Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.
Q: Why is there a popping sound when a joint is adjusted?
A: Adjustment (or manipulation) of a joint may result in the release of a gas bubble between the joints, which makes a popping sound. The same thing occurs when you “crack” your knuckles. The noise is caused by the change of pressure within the joint, which results in gas bubbles being released. There is usually minimal, if any, discomfort involved. If the chiropractor opts to use the table pieces, or an instrument, to adjust you, this popping sound may not even occur.
Q: Can I adjust myself?
A: No. Since a chiropractic adjustment is a specific force, applied in a specific direction to a specific joint, it is virtually impossible to adjust oneself safely, correctly and accurately. It is possible to turn or bend or twist in certain ways to create a "popping" sound that sometimes mimics a chiropractic adjustment. Unfortunately, this type of joint manipulation is usually counterproductive, often making an already unstable spine even more unstable, and can sometimes be dangerous. Adjusting the spine is not for amateurs!
Q: Is chiropractic treatment ongoing?
A: The hands-on nature of the chiropractic treatment is essentially what requires patients to visit the chiropractor a number of times. To be treated by a chiropractor, a patient needs to be in his or her office. In contrast, a course of treatment from medical doctors often involves a pre-established plan that is conducted at home (i.e. taking a course of antibiotics once a day for a couple of weeks). A chiropractor may provide acute, chronic, and/or preventive care thus making a certain number of visits sometimes necessary. Your doctor of chiropractic should tell you the extent of treatment recommended and how long you can expect it to last.
Q: Do chiropractors take x-rays?
A: Yes, chiropractors take X-rays to reveal the internal structure and alignment of the spine. We are also concerned about underlying disease processes and disorders of the spine such as spinal deterioration, arthritis of the spine, abnormal development, bone spurs, disc disorders, tumors and spinal curvature. X-rays also provide a blueprint for correcting the spine back to optimal health and alignment. If an x-ray is required, your chiropractor will discuss this option with you.
Q: Can a person who had back surgery see a chiropractor?
A: Yes. It's an unfortunate fact that more than half of those who had spinal surgery discover a return of their original symptoms months or years later. They then face the prospect of additional surgery. This too common occurrence is known as "failed back surgery syndrome." Chiropractic may help prevent repeated back surgeries. In fact, if chiropractic care is used initially, back surgery can often be avoided in the first place.
Q; Is it OK to see a chiropractor if I'm pregnant?
A: Any time is a good time for a better functioning nerve system. Pregnant mothers find that chiropractic adjustments help with pregnancy discomforts, like sciatica, improve their pregnancy and make delivery easier for themselves and their baby. Also, certain chiropractic techniques can be used to help properly position the baby for delivery. Adjusting methods are always adapted to a patient’s size, weight, age and condition of health.
Q: How popular is chiropractic care?
“Chiropractic is the largest, most regulated, and best recognized of the complementary and alternative medicine (CAM) professions. CAM patient surveys show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high. There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades.” Meeker, Haldeman (2002), Annals of Internal Medicine
Inclusion of a CAM Therapy (chiropractic care) for the management of musculoskeletal pain in an integrative, inner city, hospital-based primary care setting (Abstract), January, 2010
Musculoskeletal (MSK) pain, in particular low-back and neck pain, is an ubiquitous societal problem with high economic costs. While the provision of care to people suffering from MSK conditions has traditionally been delivered by separate practitioners, there has been recent interest in new models of care delivery that promote team-based or integrative care. Objectives: Our project undertook the novel inclusion of a complementary and alternative therapy (CAM)-chiropractic-in a hospital environment. Study Group: All adult patients referred to the chiropractic program were eligible to participate as long as they had English language proficiency. Methods: The study utilized a mixed-methods approach which employed an ethnographic qualitative research design using interview-based data and semi-structured, in-depth interviews, as well as survey instruments and a specific clinical outcomes protocol. Results: Successful integration of the chiropractic services was accomplished. Both patients and providers reported very high levels of satisfaction with the inclusion of the services. Clinically important improvements in levels of pain and disability were obtained for all complaint categories. Conclusions: The success of this integration study has resulted in the chiropractic services being maintained as a permanent service in the hospital. Chiropractic treatment appears to be a useful adjunct in the management of MSK pain conditions, even in highly systematized settings of primary care hospital clinics and for clinically complex and marginalized populations.