Chiropractic

What is chiropractic?#

The word “chiropractic” comes from the Greek words cheir (meaning “hand”) and praktikos (meaning “done”) - that is, done by hand. In many places, chiropractors are primary contact practitioners, which means they can see patients without a referral from a doctor. They focus on the spine and use their hands to examine and treat conditions related to the bones, muscles and joints (musculoskeletal problems).

Chiropractors are trained to recommend exercises to treat and rehabilitate musculoskeletal conditions, and to give nutritional, dietary and lifestyle advice. They use a range of methods to diagnose problems, including hands-on clinical examination and diagnostic imaging such as x-rays or MRIs. These methods help determine when chiropractic treatment is appropriate.

If chiropractic care is not appropriate, or if your condition needs to be co-managed with other health professionals, your chiropractor will refer you to a suitable provider. In many cases, such as lower back pain, chiropractic care may be a person’s main method of treatment. For some conditions it may complement medical treatment by relieving the musculoskeletal aspects associated with the condition.

When to consider chiropractic care#

Painful joint and back problems can be caused by work, accidents, sports injuries, household chores and even the stress of daily living. Chiropractic care may help if you have aching joints or muscle pain that affects your ability to get through the day or to do your favourite activities. It can also help maintain healthy spine and joint function even if you do not have painful symptoms.

People commonly visit a chiropractor for help with:

• back pain and neck pain
• headache and whiplash
• strains and sprains from daily activities
• overuse injuries and work or sports-related injuries
• arthritis
• restricted movement in the back, shoulders, neck or limbs

The chiropractic examination#

When you attend a chiropractic examination, your chiropractor will usually:

• take a thorough medical history
• check your vital signs, such as body temperature, pulse, breathing rate and blood pressure
• visually inspect for spinal curves or other visible health indicators
• use their hands to palpate (feel) your spine and the muscles and soft tissues that support it
• conduct orthopaedic examinations, which assess the spine, bones, joints, muscles and soft tissues, including moving a joint and measuring its range of movement
• conduct neurological examinations, which assess the function of your motor, sensory and cranial nerves, such as testing reflexes and checking for numbness

Where required, your chiropractor can also refer you for other diagnostic tests such as an MRI or x-ray. Based on the examination, they will give you a differential diagnosis (which considers all the potential causes of your complaint) and a working diagnosis (the most likely cause). They will explain the diagnosis, including when you might expect it to resolve, the treatment options available, and any benefits or risks of those treatments.

Chiropractic treatments#

Chiropractors use a range of techniques, which they will discuss with you as part of a shared decision-making process. These can include:

• spinal manipulation
• mobilisation - gentle movement of a joint to increase its range of motion
• drop-piece table technique, using a specially designed table to help mobilise a joint in a controlled way
• treatment of other joints, including feet, ankles, shoulders and wrists
• exercises, stretching and soft tissue techniques such as massage
• reassurance and lifestyle advice, such as healthy eating and physical activity
• application of heat or ice
• physiologic therapeutics, such as ultrasound, laser or TENS
• orthotics - shoe inserts that help support the feet and improve posture and alignment

Spinal manipulation#

One of the most common and well-known procedures performed by chiropractors is spinal manipulation, sometimes called a “chiropractic adjustment” (the technique is also used by osteopaths and physiotherapists). Its purpose is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement after a tissue injury.

Tissue injury can be caused by a single traumatic event, such as improperly lifting a heavy object, or by repetitive stress, such as sitting in an awkward position with poor posture for a long period. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain and reduced function. Manipulation of the affected joint and tissues restores mobility, which relieves pain and muscle tightness and allows tissues to heal.

Spinal manipulation is very safe when performed by a trained, registered practitioner, although some people may have mild soreness or discomfort afterwards. This usually settles within 12 to 48 hours. Your chiropractor will discuss this with you before any treatment, in a process called informed consent.

Regulation and finding a chiropractor#

In many countries, chiropractic is a regulated health profession, and chiropractors must be registered and meet professional standards, codes and guidelines. Becoming a registered chiropractor generally requires completing an accredited chiropractic program at university, or an equivalent program that meets the standards of the relevant regulator. To find a chiropractor, you can ask your usual healthcare provider or contact a recognised professional association in your area.

Key points#

• Chiropractors are often primary contact practitioners, which means they can see patients without a referral from a doctor.
• A range of diagnostic methods is used to determine when chiropractic treatment is appropriate.
• In many cases, such as lower back pain, chiropractic care may be a person’s main method of treatment.
• It can also help maintain healthy spine and joint function, even if you do not have painful symptoms.

Where to get help#