A chiropractor can help treat back pain and more
By Natasha Persaud
Chiropractic care has risen in popularity among Americans, but many people still aren’t sure what chiropractors do or the range of conditions they treat. We caught up with Scott Bautch, D.C., spokesperson for the American Chiropractic Association, to answer essential questions about this form of alternative medicine.
What does a chiropractor do?
“A chiropractor typically treats musculoskeletal problems by correcting faulty body mechanics. Problems that can be helped include injury to muscles, tendons, ligaments, bones, joints or spinal discs,” says Bautch. “Our goal is to minimize your pain, strengthen your body and prevent further injury.
In addition to strain, chiropractors help treat chronic health conditions that you might not expect, he says: “We also treat arthritis, fibromyalgia, headaches, mild to moderate asthma and the jaw pain known as TMJ.”
A chiropractor may be the sole provider of care for your condition, or he or she may co-treat the condition along with your medical doctor. “We use more hands-on corrections than a medical doctor does,” Bautch says, “including adjustments, a wide range of special exercises and nutrition. Our aim is to prevent further injury by helping your bones and muscles return to normal positions and function naturally."
Is a chiropractor a medical doctor?
“No. Chiropractic care evolved from a different philosophy of health care than conventional medicine, so we don’t prescribe medications,” says Bautch. “While medical doctors typically use drugs to treat the symptoms of disease, we look for a root cause of the problem within the body’s structure, such as the misalignment of a vertebra of the spine. Ideally, we want to treat a patient before medication becomes necessary or minimize the need for medication.
“It’s important to note, though, that most chiropractors are knowledgeable about pharmacology, drug reactions and side effects. Most chiropractors recognize when a patient’s condition requires medical attention, and we have an excellent track record for referring patients to conventional medical doctors when necessary.”
As for the difference between chiropractic care, physical therapy and massage therapy: “Chiropractic care shares a few elements with physical therapy and massage therapy, but it’s a different profession; chiropractors are trained to diagnose health problems of the musculoskeletal system, for one thing, and we may treat differently.”
What can I expect from my first visit?
“Chiropractors perform some of the same kinds of exams and diagnostic tests that general practitioners do, but we look at the results in a totally different way. Chiropractors believe that pain is often the result of poor body mechanics,” Bautch says.
“First, we gather information, similar to what you’re asked at any doctor’s office: a history of your symptoms; a list of your medications and past surgeries; a history of medical conditions of your family members; and a general review of your heart and lung function. We may also ask you about activities you do on the job and your diet. We may also do a general physical exam to check your reflexes, height, weight and blood pressure. We also ask you to fill out a pain chart, which asks where you’re feeling pain, when, and how it’s hindering you from performing your usual activities, such as driving, sleeping, working or concentrating.
“In the exam room, chiropractors ask questions to gain further insight into your condition, such as what makes your pain better or worse. If appropriate, we’ll also perform diagnostic tests such as X-ray, nerve conduction tests (EMG), or something called physical capacity exams, which check your functional capacities, such as lifting or endurance.
"Diagnostic tests and images are important tools for chiropractors because we’re looking carefully at the body’s structure, particularly the spine, for mechanical dysfunction. Taking all the information together, we rule out certain conditions and rule in others to eventually reach a diagnosis.
“Then we tailor a treatment plan for you that may include chiropractic adjusting, muscle and structural balancing, physical rehabilitation, therapeutic activities to do at home and at work and lifestyle guidance. Chiropractors use the ‘rule of opposites’: If you’ve injured your back by slouching forward, then we’ll suggest techniques that help you bend backward. That helps to release tension and pressure in the affected spot. Our goal with treatment is to minimize your pain, strengthen your body and prevent further injury.”
How is a chiropractic adjustment performed?
“Chiropractors use a wide variety of techniques to manipulate or adjust a stiff or injured joint,” Bautch says. “Typically, a chiropractor uses his or her hands, and sometimes a tool called an activator, to apply gentle pressure and a controlled thrust to bones to help release them. Over several sessions, the adjustments introduce improved mobility to the joint, allowing the muscles and bones to eventually resume a more normal position. There are many, many techniques, and chiropractors have different styles.
“If a person has a mid-back problem, for example, I have him or her lie face down on a chiropractic table, and begin to manipulate the soft tissue in the back to loosen up the muscles and prepare the area. Then I palpate different areas of the back to determine which vertebrae of the spine are affected. Putting a hand on either side of a vertebra, I apply gentle force to start to bring motion back to the joint. The patient may hear a popping sound as air escapes the joint; it’s nothing to be concerned about. That is an adjustment. It may take a few sessions of therapy to regain motion in the affected joint, but some patients report feeling immediate relief.”
Does an adjustment hurt?
“Any time you extend the range of motion in a stiff jointwith an adjustment or from doing at-home exercisesthere’s a chance of soreness. But over time, you’ll experience relief, which outweighs the temporary discomfort.”
Can a spinal or neck adjustment cause stroke?
“According to a 2008 study in the journal Spine, patients are no more likely to suffer a stroke following chiropractic treatment than they would after visiting their family doctor,” says Bautch. “The overview of the study indicated that patients may have pre-stroke symptoms that sent them to a health-care practitioner.
“Strokes may have been associated with a chiropractic neck adjustment because of the very rare occurrence of a tear to a vertebral artery, which passes through the spine at the upper neck and into the skull. An injury to the artery could lead to a blood clot, which can break free and travel upward to the brain. If the clot blocks an artery in the brain, it can impede the supply of blood and oxygen, causing a stroke and leading to brain damage.
"Since patients with undiagnosed vertebral artery dissection experience head and neck pain prior to having a stroke, some might seek a chiropractor’s care, but it’s vital that they seek emergency care.”
Everyone should be aware of these signs of stroke:
- Sudden difficulty speaking (slurred speech)
- Sudden onset of confusion or loss of consciousness
- Sudden numbness or tingling on one side of the face or body, or both
- Sudden difficulty walking or standing upright
- Sudden severe headache
- Sudden severe unexplained upper-neck pain
- Sudden trouble with vision or sight
How does a chiropractor treat arthritis, asthma, carpal tunnel syndrome and headaches?
“For osteoarthritis, or wear and tear on the joints,” Bautch says, “a chiropractor works to reestablish motion by adjusting the joints and prescribing exercises to do at home. The goal is to decrease stress and pressure on the joint, and to help you resume your usual activities. If you normally walk or run for exercise, chiropractors might suggest pool exercises and bike riding instead.
“For rheumatoid arthritis, which is an inflammatory condition, we’ll look at diet, nutrition and activity—things that could be aggravating the condition and causing flare-ups.
"For mild to moderate asthma, a chiropractor may be part of the patient's medical team by relieving muscle soreness and adjusting the spine to try to improve breathing ability, for both the short and long term. We also investigate nutritional and lifestyle factors that might be contributing to the problem. For example, in rare cases, asthma may be caused by a milk allergy.
“Carpal tunnel syndrome is a mechanical problem that results from overuse of a joint, such as injury to the wrist from typing on the computer. Other causes may be thyroid problems, side effects from birth control pills or pregnancy. To speed recovery, chiropractors may ice the wrist and try to restore mobility by manipulating it in a gentle, controlled way. To prevent further injury, chiropractors teach patients how to keep their hands neutral during sleep and other daily activities.
“Chiropractors help bring relief to people suffering from fibromyalgia, or pain all over the body, by working on their muscles and joints.
“A lot of headaches come from misalignment in the upper back and neck that, in turn, irritate the nerves running through the skin surrounding the scalp. Sleeping on the couch or reading too long in one position could lead to these problems. Chiropractors adjust the vertebrae and bones in the upper back and neck to relieve the pressure on the nerves that are causing pain.
“In TMJ, the jaw becomes misaligned from things like chewing gum, clenching the teeth, resting the chin on hands or suffering whiplash during a car accident. A chiropractor works to relax the muscles and adjust the jaw bones.”
How can you tell when severe neck or back pain requires immediate medical attention versus chiropractic treatment?
“If back pain is accompanied by fever or flu-like symptoms,” says Bautch, “the likely cause is infection, and you should see a medical doctor. On the other hand, if you have a reason for the pain, such as that you strained yourself while doing some activity or during a car accident, or if you can reproduce the pain by movement or activity, then it’s likely that chiropractors can treat it."
If you experience any of these symptoms, seek emergency care:
- Sudden loss of bowel or bladder control
- Severe headache that you’ve never had before that’s accompanied by nausea and vision problems. While it may indicate a migraine, it could also indicate a more serious condition, such as stroke.
- Extreme pain that has no known cause.
Do I need ongoing visits with a chiropractor to experience the benefits?
“The average patient needs 8 to 12 visits per episode, pain or flare. About 80 percent of patients complete their care by 18 visits. Only one in five patients needs to go past 18 visits.”
Does insurance cover chiropractic care?
"In the majority of states in the U.S., chiropractic care is covered to some degree. Contact your insurance carrier to determine how much of your care is covered."