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Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health.  Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

Doctors of Chiropractic often referred to as chiropractors or chiropractic physicians - practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.

The most common therapeutic procedure 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 hypomobile - or restricted in their movement - as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.

Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours.

In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. When other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.

Doctors of chiropractic may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate.  Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient's condition, or the condition warrants co-management in conjunction with other members of the health care team.

What truly differentiates doctors of chiropractic from any other healthcare professionals is the fact that chiropractors are the only professionals who are trained to diagnose and treat what are called spinal subluxations.  The word "subluxation" comes from the Latin words meaning "somewhat or slight" (sub) and "to dislocate" (luxate).  So the term 'vertebral subluxation' literally means a slight dislocation or misalignment of the bones in the spine.

 When a subluxation occurs, a chiropractor can correct the misaligned bone and allow it to return to its proper position. This procedure is appropriately called an adjustment, and the adjustment enables the body to heal. The chiropractic adjustment is a quick thrust applied to a vertebra for the purpose of correcting its position, movement or both.  Adjustments are often accompanied by an audible release of gas that sounds like a "crack."  The sound sometimes shocks people a little bit the first couple times they get adjusted, but the sensation is usually relieving.  Occasionally, minor discomfort is experienced, especially if the surrounding muscles  are in spasm or the patient tenses up during the chiropractic  procedure.  There are times when the audible "cracking" does not occur.   This is often due to either significant muscle tightness or that the patient may be having a hard time relaxing during their adjustments.  However, the chiropractic adjustment is still important.  The leak is fixed. The wiring is fixed. Information is flowing again. To keep the wiring fixed, several adjustments over a course of time may be necessary, in addition to massage, physical therapy, stretching exercises, or strengthening exercises. In the chiropractic world, keeping the problem fixed and preventing its reoccurrence is just as important as the initial remedy.

There are actually five components that contribute to the vertebral subluxation complex (VSC).

 1. Bone Component - where the vertebra is either out of position, not moving properly, or are undergoing degeneration.  This frequently leads to a narrowing of the spaces between the bones through which the nerves pass; often resulting in irritation or impingement of the nerve itself.

 2. Nervous Component - is the disruption of the normal flow of energy along the nerve fibers, causing the messages traveling along the nerves to become distorted.  The result is that all of the tissues that are fed by those nerves receive distorted signals from the brain and, consequently, are not able to function normally.  Over time, this can lead to a whole host of conditions, such as peptic ulcers, constipation and other organ system dysfunction.

 3. Muscular Component - since nerves control the muscles that help hold the vertebrae in place, muscles have to be considered to be an integral part of the vertebral subluxation complex.  In fact, muscles both affect, and are affected by the VSC.  A subluxation can irritate a nerve, the irritated nerve can cause a muscle to spasm, the spasmed muscle pulls the attached vertebrae further out of place, which then further irritates the nerve and you have a vicious cycle.  It is no wonder that very few subluxations just go away by themselves.

 4. Soft Tissue Component - the VSC will also affect the surrounding tendons, ligaments, blood supply, and other tissues as the misaligned vertebrae tug and squeeze the connective tissue with tremendous force.  Over time, the soft tissues can become stretched out or scarred, leaving the spine with either a permanent instability or restriction.

 5. Chemical Component - is the change in the chemistry of the body due to the VSC.  Most often, the chemical changes, such as the release of a class of chemicals called "kinins," are pro-inflammatory; meaning that they increase inflammation in the affected area.

These changes get progressively worse over time if they are not treated correctly, leading to chronic pain, inflammation, arthritis, muscle trigger points, the formation of bone spurs, loss of movement,  as well as muscle weakness and spasm.  Chiropractors have known the dangers of the vertebral subluxation complex ever since the birth of the profession. More and more scientific research is demonstrating the tremendous detrimental impact that subluxation have on the tissue of the body.  In order to be truly healthy, it is vital that your nervous system be functioning free of interference from subluxations.  Chiropractors are the only health professionals trained in the detection, location, and correction of the vertebral subluxation complex through chiropractic care.

Wellness requires you to be a proactive agent for your body. You need to treat it well and not wait until you hurt before you decide to take care of it. As we've said before health is not merely the absence of disease any more than wealth is an absence of poverty. Let's remember health is not simply "feeling fine," for we know that problems may progress for years without causing any symptoms whatsoever. As you know by now, heart disease for example, often develops unnoticed for many years before it strikes: in fact, the first symptom of heart disease that many people experience is a heart attack or death.

Now let us be clear that we are not under the illusion that everyone who creates a wellness lifestyle will be immune from pain, sickness, and disease. There are many people who do everything right and still get sick and die. Some will argue that there are many people who do everything wrong and live long, seemingly healthy lives. However, since we have no way to predict who is who, we have to do our very best to reduce our risk and promote our health.

With regards to your wellness, the three main ideas that we really want to drive home...

 1. Health is not merely the absence of disease.

2. The body has an innate intelligence that runs a series of complex systems that rely on proper balance and coordination in order to function correctly.

3. By living a wellness lifestyle you can enrich your life with vibrant health.

Chiropractic Education

Educational requirements for doctors of chiropractic are among the most stringent of any of the health care professions.

The typical applicant at a 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 - who are licensed to practice in all 50 states, the District of Columbia, and in many nations around the world - undergo a rigorous education in the healing sciences, similar to that of medical doctors. In some areas, such as anatomy, physiology, and rehabilitation, they receive more intensive education than most medical doctors or physical therapists. 

Like other primary health care doctors, chiropractic students spend a significant portion of their curriculum studying clinical subjects related to evaluating and caring for patients. Typically, as part of their professional training, they must complete a minimum of a one-year clinical-based program dealing with actual patient care. In total, the curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. The course of study is approved by an accrediting agency which is fully recognized by the U.S. Department of Education. This has been the case for more than 25 years.

Before they are allowed to practice, doctors of chiropractic must pass national board examinations and become state-licensed. Chiropractic colleges also offer post-graduate continuing education programs in specialty fields ranging from sports injuries and occupational health to orthopedics and neurology. These programs allow chiropractors to specialize in a healthcare discipline or meet state re-licensure requirements.

This extensive education prepares doctors of chiropractic to diagnose health care problems, treat the problems when they are within their scope of practice and refer patients to other health care practitioners when appropriate.

What conditions do chiropractors treat?

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.


How do I select a doctor of chiropractic?

One of the best ways to select a doctor of chiropractic (DC) is by getting a referral from a friend, family member, colleague, or another health care provider. You can also locate a DC near you by using the American Chiropractic Association's Find a Doctor search tool.


Does chiropractic treatment require a referral from an MD?

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.


Is chiropractic treatment safe?

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 or aching, just as they do after some forms of exercise. Current literature 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 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 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 1 case in 5.85 million manipulations.

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.  

It is important for patients to understand the risks associated with some of the most common treatments for musculoskeletal pain -- prescription and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) -- as these treatments may carry risks significantly greater than those of chiropractic manipulation. 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 like ibuprofen.


Is chiropractic treatment appropriate for children?

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.


Are chiropractors allowed to practice in hospitals or use medical outpatient facilities?

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.


Do insurance plans cover chiropractic?

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 36 major veterans medical facilities. 


What type of education and training do chiropractors have?

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 an accrediting agency that is fully recognized by the U.S. Department of Education.

FAQ's


How is a chiropractic adjustment performed?

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--or an instrument--to manipulate the joints of the body, particularly the spine, in order to restore or enhance joint function. This 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. 


Is chiropractic treatment ongoing?

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.


Why is there a popping sound when a joint is adjusted?

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.

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