Questions to Ask About Chiropractic Techniques
are many different chiropractic techniques. Some doctors of chiropractic perform joint manipulation with their hands only, while others use various instruments. Additionally, some chiropractors treat using quick but firm manipulation while others have a lighter touch.
Common hands-on techniques include the following:
Spinal manipulation
This treatment is most typically associated with chiropractic care. A chiropractor uses their hands to perform a quick high-velocity, low-amplitude adjustment of a spinal joint. This adjustment involves enough force to release the joint out of its restricted motion (but within the joint’s anatomical limits) in an effort to improve mobility and reduce pain. This quick manipulation is technically referred to as a “high velocity, low amplitude” thrust (HVLA) and typically causes a popping or cracking sound, called cavitation. Some people enjoy the HVLA form of manipulation and find it therapeutic, whereas other people may find this sound disturbing. Although the procedure itself is not painful, in the presence of inflammation where simply touching the area causes tenderness, some brief discomfort is common.
Spinal mobilization
This technique involves slow and steady movement of the spinal joints through their range of motion—either by using the hands or a device, or stimulation of the spinal joints using an instrument. While this treatment shares the same goals as spinal manipulation, some people may prefer spinal mobilization because it is gentler and does not involve audible popping or cracking sounds. Though gentler in approach, in some cases mobilization may result in a slower recovery and hence, a longer course of care than manipulation.
What three things should you be looking for when you are trying to choose a chiropractor?
- Choose a chiropractor who you feel comfortable with. Meet with several chiropractors and talk with them at length. You might have to provide a lot of medical history about yourself and ensure that your chiropractor knows about any past injuries. If you do not feel comfortable providing personal information to a certain chiropractor, then meet with a different one. Don’t be afraid to confirm a chiropractor’s qualifications and contact several references.
- Location and hours. If you are going to receive regular chiropractic treatments, you may have to attend several times weekly. The times that you attend should be convenient to you, whether you will be going to your appointments before or after work (on the way home or to work) or during a lunch break. Be sure that the office you go with is located such that you can attend at that office conveniently. If you cannot get away from work maybe you can find an office that has some weekend hours that are convenient to you.
- Your chiropractor should have some type of treatment plan for your particular issue. Ask them to review the plan with you and discuss your progress as you receive treatments. A good chiropractor will work with your medical doctor if you have a specific issue to ensure that the treatment plan is going to address your specific problems. Your doctor will probably want you to sign some type of legal release before they can speak to your chiropractor, but it is definitely in your best interest to provide that release. Your doctor will be able to provide your chiropractor with any information they need regarding your injury(ies) including x-rays, scan results and any testing that has been done.
Chiropractors often give advice on how to avoid future problems by evaluating:
- Home exercise program. Patient-specific exercises and stretches are often started early in care, usually within the first 3 visits as multiple studies support spinal manipulation with exercise produces the best outcomes or results.3-5
- Altering detrimental or asymmetric lifestyle habits or implementing various back supports, belts, or pillows to better support the spine may be recommended. Instruction may also be given for ergonomically correct ways to bend, lift, pull, and push.
- May include analysis of gait, sitting posture, or standing posture. Performing stretches and massages with a foam roller, and exercises with elastic bands may be recommended for home use to help improve posture.
- The use of specialized shoe insoles and/or a heel lift may help reduce postural imbalance.
- Tips for eating a healthier diet may reduce pain from chronic inflammation, improve overall wellbeing and boost energy levels.
Indications for X-rays in Chiropractic Care
As a general guideline, x-rays are recommended in the chiropractic healthcare setting to3:
- Diagnose a recent trauma which may have resulted in a fracture at any age; minor trauma in people between ages 50 and 70 years old; and those over age 70 due to the risk of osteoporosis-related fracture.
- Diagnose spondyloarthritis that may be causing spinal degeneration.
- Monitor a spinal deformity that might be progressing, such as kyphosis or scoliosis.
An x-ray is indicated if it is likely to help guide the type of treatment recommended for the patient. In any of the above cases, an x-ray would likely provide critical information that will direct treatment protocols and/or referral options for the patient.
Contraindications for an X-ray
X-rays are not medically necessary for most chiropractic patients. Specifically, an x-ray should not be performed for any of the following reasons:
- To identify problems with soft tissues (muscles, tendons, or ligaments) or within the spinal disc itself. X-rays are only effective in identifying pathology with bones and joints, not with soft tissues. An MRI is usually needed to identify soft-tissue problems (for example, a disc or nerve pathology).
- Purely for exploratory purposes. A qualified health practitioner will typically have a good idea of the cause of the patient’s pain before ordering the x-ray and will use the result to confirm their findings. Similarly, most chiropractors will have a good idea of the specific pathology they are trying to rule out with an x-ray.
- If there is a possibility that the patient could be pregnant.
- To monitor how a patient’s spine is responding to treatment.4
- To evaluate recent onset of back pain (less than 6 weeks duration) without a clear clinical reason.4