What Happens at the Chiropractor?

While visiting a chiropractor is similar to visiting other healthcare providers, it does have some unique elements. You will likely find the office setting and intake procedures quite familiar, but many notice the distinctive appearance of the chiropractic [1] treatment table. These tables are often quite elaborate to allow specific positioning and movement during spinal adjustments and thus assist the chiropractic treatment.

A typical visit to a chiropractor includes an initial intake, physical exam, treatment, and follow-up plan.

What happens during the intake?

An initial chiropractic consultation is very similar to that of a standard medical intake. You will likely complete a health questionnaire and answer questions about your health history. Typically the chiropractor asks you to indicate where you are experiencing discomfort by marking the areas on a drawing of the human body.

What happens during the physical exam?

The chiropractor will start with a routine physical exam, then follow it with an exam that focuses on the spine, with particular attention given to the areas of complaint. The chiropractor will most likely examine your whole spine. For example, if you had a low back complaint [2], the chiropractor would also likely perform a neck exam because the adaptations resulting from injury or subluxation in one area can result in secondary irritations somewhere else in the spine.

Most often, a chiropractor will take X-rays of your spine prior to treatment. The purpose of the X-rays is to study the condition of the bony anatomy and soft tissues. It also helps the chiropractor understand the extent of wear, any anomalies in your spine, and other factors that will guide the development of the treatment plan.

The physical exam typically includes a variety of assessments, such as range of motion tests, palpation, reflex testing, muscle strength comparisons, and neurological and orthopedic tests focused on the main complaint.

What goes into a treatment plan?

Following the assessments, the chiropractor will develop a treatment plan that takes into account:

• The extent of your injury or irritation
• Your general health
• The condition of your spine as affected by age and previous injury
• What your goals are - this is most important item

Your goals of treatment should result from the discussion you have with your chiropractor. Many people seek simple relief of pain or discomfort, while others want to begin a regimen of ongoing care meant to improve their general health.

In initial consultations, your chiropractor will tell you the status of your condition and recommend an approach to care. Ask questions. As in any professional-patient relationship, trust and mutual understanding are vitally important.

What is a typical treatment?

"Adjustments" are usually the central part of chiropractic treatment. The chiropractic adjustment is a therapeutic manipulation that uses controlled force, leverage, direction, amplitude, and velocity directed at specific joints. In other words, an adjustment involves a lot more than simply opening up a joint. Click the videos listed in the column on the left to see examples.

Your chiropractor will most often make these adjustments to the spine, but he or she might adjust other joints, such as the ankle, knee, wrist, elbow, or shoulder in order to restore structural alignment or to improve joint function. Again, proper structure is necessary for proper function, and proper extremity function is an important part of healthy daily living.

When being treated for a complaint such as back or neck pain [2], you will most likely receive a series of adjustments, separated by either a day or a few days, to incrementally reduce the irritation and improve normal function. This might continue for several weeks, usually diminishing in frequency.

If you can't tolerate the manual adjustments, you may instead receive mild or non-force techniques.

Adjustments are often accompanied by non-manual therapies such as application of heat or ice, electrical stimulation, orthotic supports for your shoes, rehabilitative exercise, counseling about diet, weight loss, and other lifestyle factors, and nutritional supplements.

References

Haldeman, S., Chapman-Smith, D and Peterson, D.M. (Eds.). (1993). Guidelines for chiropractic quality assurance and practice parameters: Proceedings of a consensus conference commissioned by the Congress of Chiropractic State Associations. Gaithersburg, MD: Aspen Publishers.

Peterson, D. H. & Bergmann, T.F. (2002). Chiropractic technique: Principles and procedures (2nd ed.). St. Louis, MO: Mosby.

Souza, T. A. (2005). Differential diagnosis and management for the chiropractor: Protocols and algorithms. Sudbury, MA: Jones and Bartlett Publishers.