Chiropractic is a 100-year-old practice that uses non-invasive means to restore and improve health. Its tools include manipulation of the joints and surrounding tissue -- including muscles, tendons, and nerves -- to treat neck and back pain , joint pain, headache, muscle aches, and other health problems.

"Chiropractic as a health care discipline emphasizes the inherent power of the body to heal itself without the use of drugs or surgery," says Stephen Bolles, D.C. (doctor of chiropractic) of Minnesota. It's based on healing traditions used for thousands of years around the world, he says, and focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system). The interplay of those two, he says, has a profound effect on how individuals preserve or restore their health.

According to the National Center for Complementary and Alternative Medicine, a 2003 analysis of 39 clinical trials found that chiropractic treatments were about as effective as conventional medical care (including pain-relieving drugs, exercise, and physical therapy) in relieving low back pain.

Chiropractors receive four academic years of training, which follows a minimum of three years of pre-professional education. They pass national board examinations similar to those doctors of medicine must take. Doctors of chiropractic are licensed in all 50 states and make up the third largest licensed health care provider group in the United States.

During your first visit, your chiropractor will take a comprehensive health history, perform a physical exam, and, if indicated, do laboratory tests or imaging involving radiographs, CT scans, or an MRI. He or she will normally issue a report that explains the diagnostic findings and outlines a strategy for treating and managing your condition or health problems.

As a branch of integrative medicine, chiropractic pays special attention to emotional relationships affecting health, as well as its physiological and biochemical aspects. After a thorough evaluation, he or she may counsel you on how to prevent disease and enjoy better health through proper nutrition, exercise, and lifestyle changes, among other things. If a chiropractor decides that you have an illness that requires medical care, you'll be referred to a physician or other health care provider for treatment or co-management.

During the treatment itself, you'll probably lie or sit on an exam table while your chiropractor adjusts your muscles and joints -- especially your spine -- depending on your individual needs. He or she may also use a reflex tool to do adjustments. Spinal adjustments are normally pain-free, although some slight soreness may be present afterwards that should improve quickly on its own. Your chiropractor may also counsel you on appropriate exercises that you can do on your own.

Chiropractic adjustments benefit the body's physiology, according to some studies. One of these effects is to relax muscles and improve joint mobility, even long after the original injuries have taken place.

In the context of health care procedures, chiropractic treatments have a good safety record. About 30 million people see a chiropractor each year, and only a handful report serious injuries. The most common side effect of chiropractic adjustments is slight soreness, which you can usually relieve by icing the sore area. It's a good idea, though, to tell both your chiropractor and your regular doctor about each other, so they can coordinate your care.

Any health care procedure carries some risks; compared to even the risk of taking aspirin, the procedures used by doctors of chiropractic are very safe. Recent medical research has linked a particular chiropractic treatment, in extremely rare cases, with stroke. A number of peer-reviewed neurology journals and the Stanford University Medical Center's stroke center have reviewed reports of strokes following head and neck manipulation that had been performed by chiropractors and untrained providers as well. A study published in a peer-reviewed chiropractic journal, The Journal of Manipulative Physiological Therapy, found that the incidence of stroke following manipulation was low, but concluded that "there seems to be sufficient evidence to justify a firm policy statement cautioning against upper cervical rotation as a technique of first choice." (Neurology journals warn that any patients with neck pain or cerebrovascular problems should see a physician.)

The risk of stroke from chiropractic is extremely low, according to Anthony Rosner, Ph.D., the director of research at the Foundation for Chiropractic Education and Research. He points to a study using RAND data and published in Integrative Medicine, which estimates the risk of serious complications from cervical manipulation to be 6.39 per 10 million manipulations. Other studies put the risk much lower.

However more recently a Canadian consortium of 60 neurologists issued a warning on chiropractic care and made a call for a ban on manipulations on children. The Canadian neurologists estimated that 1 in 5,000 to 10,000 strokes is caused by neck manipulation. There also appears to be some risk to visual acuity. In a 2005 review of chiropractic upper spinal manipulations, 14 cases of injury occurred including loss of vision, diplopia and Horner's Syndrome.

It may be as easy as asking your doctor or calling your health plan; most plans have chiropractors in their network. State chiropractic associations or local colleges of chiropractic may refer you to local doctors of chiropractic (DCs). Or ask your friends and family for recommendations.

If you're seeing a chiropractor, you should expect to be referred to a medical doctor for evaluation, treatment, or co-management of conditions that require medical expertise.

Most health plans and HMOs cover chiropractic; check with your insurance company or health plan administrator.

Further Resources

American Chiropractic Association
Offers advice to consumers and can link you to a doctor of chiropractic in your area.
http://www.amerchiro.org

International Chiropractors Association
The goal of ICA is to advance chiropractic throughout the world as a health care profession.
http://www.chiropractic.org

Foundation for Chiropractic Education and Research
Resource for research and evaluation of efficacy data.
http://www.fcer.org

References

First published September 3, 1998
Last updated January 23, 2008
Copyright © 1998 Consumer Health Interactive and OneBody, Inc.

Or Find More On:

Back to top of page