F.A.Q. » General Chiropractic
The Answer:
Doctors of Chiropractic – also known as chiropractors – provide their patients with a drug-free, hands-on approach to health and wellness. Chiropractors have broad capabilities which range from performing therapeutic physical adjustments of the spine and recommending rehabilitative exercises to providing nutritional and lifestyle counseling.
One of the central treatments performed by chiropractors is a "spinal manipulation" or "chiropractic adjustment". The purpose of the adjustment is to restore joint mobility by manually applying a controlled force. By restoring the mobility of the affected joints a chiropractic adjustment can alleviate pain, reduce muscle tightness, and promote tissue healing.
With conditions such as low-back pain, chiropractic care may be the primary mode of treatment.
Before performing a treatment, Doctors of Chiropractic often conduct a thorough evaluation of the patient to determine if chiropractic treatment is appropriate or not. If it is determined that the patient’s specific condition is not suitable for chiropractic treatment or warrants co-management with other health care providers, then the patient is often referred to the appropriate health care provider.
The Answer:
Chiropractors primarily treat disorders of the musculoskeletal system and the nervous system (including the effects of these disorders on general health). Chiropractic care focuses on addressing neuromusculoskeletal complaints, including, but not limited to: back pain, neck pain, pain in the joints of the arms or legs, and headaches.
The Answer:
No, you do NOT need a referral by an M.D. to visit a Doctor of Chiropractic. Chiropractors are first contact doctors who are capable of arriving at a diagnosis under chiropractic care or referring the patient to the appropriate health care provider.
The Answer:
Although chiropractic care is widely recognized as a relatively safe, non-invasive therapeutic modality, no treatment is completely free of potential adverse effects.
Common Side Effects
According to the National Institutes of Health: "Reviews have concluded that spinal manipulation is relatively safe when performed by a trained and licensed practitioner. The most common side effects are generally minor and include temporary discomfort in the treated area, headache, or tiredness. These effects usually go away in 1 to 2 days."¹
Serious Complications
The rate of serious complications from spinal manipulation, although not definitely known, appears to be very low overall and related to the type of adjustment performed and the part of the body treated.
Low-back manipulation - A potential complication from low-back manipulation is cauda equina syndrome, a condition in which nerves in the lower part of the spinal cord become compressed, resulting in pain, weakness, and loss of feeling in one or both legs. Other functions - such as bowel or bladder control - may also be affected. Reports indicate that cauda equina syndrome is an extremely rare complication. In people whose pain is caused by a herniated disc, manipulation of the low back also appears to have a very low chance of either causing or worsening cauda equina syndrome.
Neck manipulation - Some reports have linked upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, but a clear understanding of the relationship has proven to be hard to establish. While we may not know the actual incidence of stroke associated with high-velocity upper neck manipulation, the occurrence appears to be rare - 1 in 5.85 million manipulations.² To put this risk into perspective, if you drive more than a mile to go shopping, you are at greater risk of serious injury from a car accident than from your chiropractic treatment.
It is also worth noting that other common treatments for musculoskeletal pain such as taking non-steroidal anti-inflammatory drugs (NSAIDS) may be associated with significantly greater risks than chiropractic manipulation. In fact, the American Journal of Gastroenterology estimated that 33% of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of painkillers such as aspirin or NSAIDs (e.g. ibuprofen)³
Furthermore, some patients elect to have invasive surgery for conditions that may also be helped by chiropractic manipulation. These surgical procedures may be associated with risk many times great than chiropractic treatment.
- National Center for Complementary and Alternative Medicine (NCCAM) Publication No. D409. Created April 2008.
- Haldeman S, et al. Arterial dissection following cervical manipulation: a chiropractic experience. Can Med Assoc J 2001;165(7):905-06.
- Lanas A, et al. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal anti-inflammatory drug use. Am J Gastroenterol 2005;100:1685–1693.
