Are all chiropractors the same?

 Simply stated, No! There of two factions in the profession. The first is thought of as philosophically-based and the second is scientific or evidence-based.

The first group has a dogmatic perspective on the profession. The clinical thought process is devoid of any scientific reasoning or critical thinking. They believe that “nerve interference” is caused by “subluxations” and that all are at risk. The whole spine is treated regardless of region of complaint. The only manner in which patients are treated is with manipulation. This practitioner is usually engaged in a doctor-centered practice and does not collaborate with medical doctors. There is typically no definite end to this type of treatment and poor outcome measures are used.

The second group uses the best available evidence in clinical decision making. This practitioner frequently collaborates and communicates with medical doctors. This doctor uses a myriad of manual procedures and exercise. Manual treatment is including but not limited to manipulation depending on the condition. The type of practice model employed by this practitioner is patient-centered. This type of care is finite and outcomes oriented.


How does chiropractor care differ from physical therapy?

– Chiropractors specialize in the evaluation and treatment of neck pain, low back pain, and headaches. Physical therapists are trained at rehabilitating peripheral joint conditions, traumatic brain injury, and post-stroke patients.  Chiropractors are trained as point of entry doctors, meaning that do not require a referral from a medical provider.  They also have the ability to order and interpret all diagnostic testing and imaging and can refer patients to other providers for interventional procedures or further treatment.  Physical therapists are not clinical doctors.  They typically require a referral from your family doctor, are not allowed to order any diagnostic imaging or testing and are not trained to interpret those tests (such as x-ray, MRI, and blood work).  Both Chiropractors and physical therapists employ many of the same treatment techniques such as exercise/rehabilitation, ultrasound and electrical muscle stimulation, soft tissue techniques, and cervical and lumbar traction. In addition to those techniques, Chiropractors also selectively utilize spinal manipulative therapy on ideal candidates.


Should I tell my medical doctor that I am receiving chiropractor care?

– We encourage our patients to inform their medical care providers that they are receiving treatment at our facility.  In fact, our practice has been built through collaborating with medical practitioners.

As a courtesy to our patients and their caregivers, we will gladly forward a copy of our patient’s initial evaluation report to their primary care physician.  Many of our patients request that we contact their primary care providers in order to introduce ourselves, or to provide them with information about our practice. The key to comprehensive care is communication.


Does insurance cover chiropractor treatments?

– Yes, many health insurance companies reimburse for a portion of chiropractic treatment.  We will call to confirm your benefits and highly recommend that you do the same.


Are chiropractor adjustments safe?

– In general, chiropractic treatments carry a very low risk of complication. Approximately 25% of patients will experience short-term [24 hours] local soreness following the initial treatment. This may represent shore term muscle tension or low-grade inflammation from the treatment.

The risk of serious, irreversible complication is rare.  Estimates for neck adjustments are between 1 in 400,000 and 1 in 5.85 million.  With regards to the low back, estimates for serious complication are “1 in many million”.  It is important that you discuss any specific concerns with your treating chiropractor prior to receiving treatment.


Are all patients manipulated?

– No, not all patients are ideal candidates for spinal manipulative therapy (SMT).  Like any treatment, the risk to benefit ratio must be analyzed. Also, the chosen treatment approach should be directed at the pain producing tissue. For example, if the joint is believed to be the cause of the patient’s symptoms, SMT may be performed. If the injury is to the disc, traction and position release techniques (McKenzie) will be utilized. If soft tissues are the problem, therapy will be directed at those tissues either with an instrument, PT modalities or by hand.

Additionally, there are contraindications to SMT that include: fracture, ligamentous instability, acute arthriditie (RA), clotting disorders, aneurysm, severe osteoporosis, psychological disease, and vertebrobasilar insufficiency. Because these conditions vary in seriousness, treatments are always chosen very carefully.


I don’t want to be adjusted, can I still receive treatment? 

– Spinal manipulative therapy is not for everyone or every condition.  Like any treatment approach patient selection is important.  Should you not consent to receive this form of treatment; other less “invasive” approaches can be utilized.


Is it true that once you have chiropractic treatment, you must keep going back?

– No.  Care given at our office is finite and patient centered.  We generally suggest a treatment plan that has an end-point.  At that point the patient is discharged from our care with instructions to continue with their prescribed strengthening exercises.


How long does it take to receive a treatment?

– Most treatment sessions require between 15-30 minutes; depending upon the depth and scope of care necessary.  The initial examination typically lasts 45-60 minutes, depending on the complexity of a patient’s condition, and whether a treatment is received immediately after the initial evaluation.


What is the popping noise that occurs during a treatment? 

– Your spinal joints contain a fluid known as synovium.  The synovial fluid contains dissolved gasses; mostly carbon dioxide.  When your spine is adjusted, a vacuum is created within the joint and the dissolved gasses come out of solution, forming a gas bubble.  This vacuum creates a “pop”.


How long does it usually take to get better from an episode of back pain?

– Approximately 80% of patients with low back pain are significantly improved within 2-4 weeks of care.


Can you help with a pinched nerve? 

– Yes.  Pinched nerves in the neck or low back can cause arm or leg symptoms such as numbness, tingling, or weakness.  These conditions are typically treated initially with ergonomic or lifting advice, manual therapy or modalities.  About 20% pinched nerves worsen in the first month or fail to resolve over a 1-3 month period.  Such cases may require additional testing such as an MRI.  We will make the appropriate referrals in these instances.