What is Chiropractic?

Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

Doctors of Chiropractic, often referred to as Chiropractors or Chiropractic Physicians, practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis, and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.

The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.” The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.  Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours.

In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. When other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.

Dr. Smith may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate. He will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other members of the health care team.

Are chiropractors educated as well as medical doctors (MDs) and osteopaths (DOs)?
To receive the doctor of chiropractic degree, candidates must complete extensive undergraduate prerequisites and four years of graduate-level instruction and internship at an accredited chiropractic institution. Comprehensive knowledge of all systems of the body and diagnostic procedures enable the DC to thoroughly evaluate a patient, address disorders relating to the spine, and determine the need for referral to another health care provider.

Do I have to see my medical doctor before I see a chiropractor?
No. Doctors of Chiropractic are primary health care providers. According to the Center for Studies in Health Policy, "The DC can provide all three levels of primary care interventions and therefore is a primary care provider, as are MDs and DOs. The doctor of chiropractic is a gatekeeper to the health care system and an independent practitioner who provides primary care services. The DC's office is a direct access portal of entry to the full scope of service."

Does a chiropractor have to have a license to practice?
Doctors of Chiropractic are licensed in all 50 states. DCs have been licensed and recognized for many decades in all states, the District of Columbia and Puerto Rico.

What is the scientific basis for chiropractic care?

The practice of chiropractic is based on sound scientific principles.  The existence of the nervous system as the primary control mechanism of the body is an undisputed scientific fact. Its relationship with the spine is the focus of the practice of chiropractic. The spine develops in utero to provide two primary functions: (1) allow for freedom of movement and (2) house and protect the spinal cord. When the vertebrae of the spine become misaligned through trauma or repetitive injury, two major consequences will result: (1) the range of motion becomes limited and (2) spinal nerves emerging from the spinal cord are compromised. DCs use the term "subluxation" to describe such disruptions. Interruption of nerve flow can eventually lead to pain, disability, and an overall decrease in the quality of life. Conversely, the removal of that interference has been shown to have significant, lasting health benefits. Through the adjustment of the subluxation, the doctor of chiropractic endeavors to restore normal nerve expression. The body is then able to respond appropriately to any imbalance in the system, thus relieving symptoms and restoring health.

Can a person who had back surgery see a chiropractor?
Yes. It's an unfortunate fact that up to half of those who had spinal surgery discover a return of their original symptoms months or years later. They then face the prospect of additional surgery. This too common occurrence is known as "Failed Back Surgery Syndrome." Chiropractic may help prevent repeated back surgeries. In fact, if chiropractic care is initially utilized back surgery can often be avoided in the first place.

Is it OK to see a chiropractor if I'm pregnant?
Yes!  Pregnant women find that chiropractic adjustments improve their pregnancy and make delivery easier for themselves and their baby. Adjusting methods are always adapted to a patient’s size, weight, age, and condition of health.  Low back pain and sciatica are two types of problems commonly seen in pregnant women.  Dr. Smith works closely with several OB’s in the area in coordinating care for patient’s pregnancy-induced low back pain.

Do chiropractors treat conditions other than back pain?
Chiropractors provide effective treatment for all types of soft tissue disorders and not just back and neck ailments. This includes conditions of the joints of the extremities like the ankle, knee and shoulder.  On our home page you can see the list of all the different conditions Dr. Smith can treat.

What is that cracking sound?

That "cracking" sound is air, gas and fluid escaping from the joint. It is the same thing that happens when you crack your knuckles. The patient’s bones do NOT crack.

Do I have to keep coming back forever?

No! In our office, Dr. Smith treats each patient and their condition individually.  Your treatment plan will be determined according to your specific condition. 

Do I have to have x-rays?

Dr. Smith will determine if films are necessary during the examination and then will discuss this with you.  If x-rays, MRIs, or other diagnostic testing/imaging is needed he will order those during your first appointment.

If I bring my own, fairly recent x-rays, do I have to take new ones?

If you have them, please DO bring them, as they will help Dr. Smith with his examination. If the doctor determines at the end of the examination that new films are necessary, he will advise you and discuss why he feels they are necessary.

Will my insurance cover chiropractic?

Most insurance plans cover chiropractic. We will verify your benefits when you come to our office for the first visit.  Dr. Smith is a preferred provider for all major insurance carriers.

Evidence for the Effectiveness of Chiropractic

Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective. Many other studies have shown that chiropractic care can contain costs and get workers back on the job in less time than other treatments. The following are excerpts from a few of the more recent studies:

For Acute Low-Back Problems

“Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.”

– Journal of Manipulative and Physiological Therapeutics, Nyiendo et al (2000)

In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.

-- British Medical Journal, Korthals-de Bos et al (2003)

For Long-Term Low-Back Problems
"There is strong evidence that manipulation is more effective than a placebo treatment for chronic low-back pain or than usual care by the general practitioner, bed rest, analgesics and massage."

-- Spine, Van Tulder and Bouter et al. (1997)

"...improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear."

-- British Medical Journal, Meade et al. (1995)

"Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after 12 months."

-- British Medical Journal, Koes et al. (1992)

For Pain

“The results of the literature review confirm the common clinical experience of doctors of chiropractic: neck manipulation is beneficial for patients with certain forms of chronic neck pain.”

--Journal of Manipulative and Physiological Therapeutics, Vernon et al. (2007)

"...patients suffering from back and/or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments, thus reinforcing previous results showing the benefits of chiropractic treatment for back and neck pain."

-- Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)

"...for the management of low-back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system."

-- The Manga Report (1993)

For Headaches
“Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.”

-- Duke Evidence Report, McCrory et al. (2001)

“The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” ‘

-- Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)

For the Elderly
"[Elderly] chiropractic users were less likely to have been hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs."

-- Topics in Clinical Chiropractic, Coulter et al. (1996)

For Containing Costs and Getting Workers Back on the Job
“Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.”

– Journal of Manipulative and Physiological Therapeutics , Haas et al. (2005)

First contact chiropractic care for common low back conditions costs substantially less than traditional medical treatment and "deserves careful consideration" by managed care executives concerned with controlling health care spending.

-- Medical Care, Stano and Smith (1996)

"The overwhelming body of evidence" shows that chiropractic management of low-back pain is more cost-effective than medical management, and that "many medical therapies are of questionable validity or are clearly inadequate."

“Chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care. Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks.”

-- American Journal of Public Health, Hertzman-Miller et al. (2002)