Chiropractic – The Facts
“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
HOW IS CHIROPRACTIC REGULATED?
Chiropractic is a regulated health profession recognized by statute in all American states & Canadian provinces. Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor.
Each state has a regulatory board established by legislation in the same manner, and with the same structure and similar regulations as the regulatory bodies for other health care professions. The regulatory boards are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.
HOW ARE DOCTORS OF CHIROPRACTIC EDUCATED?
Like all primary health care providers, doctors of chiropractic undergo extensive education and training before becoming licensed professionals. Students begin by fulfilling undergraduate degree requirements, with a strong emphasis on the core sciences such as chemistry, anatomy, physiology, and physics.
The post-grad professional program leading to the Doctor of Chiropractic degree is very demanding. Chiropractic students continue their study of the sciences, including pathology and biochemistry, at a highly detailed level. Their education continues into the advanced clinical sciences including orthopedics, neurology, examination procedures, differential diagnosis, and X-ray interpretation. During this entire process, aspiring doctors of chiropractic gain knowledge of the philosophy and practice of health care and chiropractic. Doctors of chiropractic refine their technical adjusting skills in technique classes. During clinical internships student doctors perfect these skills.
Finally, all doctors of chiropractic must pass the rigorous national board exams and state exams before entering the field.
Our doctors have passed 5 national boards exams, more than most other medical professions.
WHAT DO CHIROPRACTORS TREAT?
Chiropractors do not “treat” anything, instead they enhance your ability to heal naturally. This is why the pain goes away; you are actually correcting it. This is in sharp contrast to hiding it with poisonous drugs and dangerous surgery. Chiropractors practice a manual approach to health care that includes patient assessment, diagnosis and treatment. As a result of taking a physical assessment and patient history, chiropractors are able to provide a differential diagnosis for the patient’s presenting condition(s) and develop a comprehensive treatment/management plan. Chiropractors are also trained to recommend therapeutic exercise, to utilize other non-invasive therapies, as well as to provide nutritional, dietary and lifestyle counseling.
The vast majority of patients who seek chiropractic health care do so for complaints of the musculoskeletal system, most often for conditions affecting the spine such as low back pain, neck pain and headaches. Research studies have demonstrated that chiropractic treatment is extremely effective for these conditions. In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. Where other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition and enhancing nervous system function.
Chiropractic care may also be palliative, providing symptomatic relief to patients with chronic conditions. By treating the musculoskeletal elements of such disorders, chiropractic treatment may improve the general well-being of the patient. In this regard, chiropractors are able to provide complementary care as one element of a patient’s overall treatment program.
WHAT IS AN ADJUSTMENT AND WHAT DOES IT DO?
The chiropractic adjustment, is a non-invasive, manual procedure that utilizes highly refined skills developed through years of intensive chiropractic education. An adjustment is a carefully controlled procedure delivered by a skilled practitioner to dysfunctional spinal or extremity joints. The primary goal is to improve areas of reduced movement in the joints that may be oppressing neural function from the spinal nerves. This allow relaxation and healing of supporting tissues, particularly of the spine, and decrease muscle tightness or spasm through the restoration of normal mechanics and improved functioning of the spine, extremities, organs and supporting soft tissue structures.
DO ADJUSTMENTS HURT?
Adjustments rarely cause discomfort. However, as it is a manually applied therapy, patients may sometimes experience mild soreness or aching following treatment which usually resolves within 12 to 48 hours. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients typically note positive changes in their symptoms immediately following treatment.
IS CHIROPRACTIC TREATMENT SAFE?
Yes. Complications from chiropractic treatments are rare. Your chiropractor will discuss all potential side effects and any risks along with the benefits of the care you receive. If your chiropractor diagnoses a problem that would be better treated by another health care professional, he or she will make an appropriate referral.
DO NECK ADJUSTMENTS CAUSE STROKE?
Neck Adjustments: The Most Recent Research. Neck adjustment is a precise procedure, generally applied by hand, to the joints of the neck. Neck adjustment works to improve joint mobility in the neck restoring range of motion and reducing muscle spasm, thereby relieving pressure and tension. Patients typically notice a reduction of pain, soreness, stiffness and improved mobility.
One certain neck adjustment, particularly of the top two vertebrae of the spine, has on very rare occasions been associated with stroke and stroke-like symptoms. While estimates vary, a range of one event per 5.85 million neck adjustments (.00000017%) is generally considered to be a conservative risk ratio by the research community. Only 4% of medical doctors perform “manipulations” and that accounts for nearly 25% of all incidences in a 58 year period. It has been said that one has a 300% greater chance of being struck by lightening than suffering a stroke actually caused by the one type of adjustment in question. This is considerably lower than the risk of serious adverse events associated with many common health treatments such as long-term use of non-prescription pain relievers or birth control pills.
An extensive commentary on chiropractic care, published in the February 2002 issue of the Annals of Internal Medicine, which is the journal of the American College of Physicians, reviewed more than 160 reports and studies on chiropractic. It states the following with regard to the safety of neck adjustment: “The apparent rarity of these accidental events has made it difficult to assess the magnitude of the complication risk. No serious complication has been noted in more than 73 controlled clinical trials or in any prospectively evaluated case series to date.”
A Canadian study, published in 2001 in the medical journal Stroke, also concluded that stroke associated with neck adjustment is so rare that it is difficult to calculate an accurate risk ratio. The study was conducted by the Institute for Clinical Evaluative Sciences and the authors have stated: “The evidence to date indicates that the risk associated with chiropractic manipulation of the neck is both small and inaccurately estimated. The estimated level of risk is smaller than that associated with many commonly used diagnostic tests or prescription drugs.”
The most recent research into the association between neck adjustment and stroke are biomechanical studies to assess what strain, if any, neck adjustment may place on the vertebral arteries. The preliminary findings of this ongoing work indicate that neck adjustment is done well within the normal range of motion and that neck adjustment is “very unlikely to mechanically disrupt the vertebral artery.”
There are many risk factors for stroke that stem from lifestyle choices; including blood clotting problems, hypertension, smoking, high cholesterol, birth control pills, heart problems and trauma such as blows to the head from car accidents or sports injuries. A patient’s health history and activities have to be examined very carefully in order to determine the most probable cause of a stroke.
This information was adapted from a document created by the profession as an educational tool for media and other health care professionals.