Epoch Chiropractic: Voted the Best Chiropractor in New Castle County in Delaware, 2012 Reader's Choice 2014 Award Winners for #1 Chiropractor Awarded a Trademark Women of Distinction - Honors Edition 2017 We're more than just Chiropractic. At Epoch, we provide quality Chiropractic care, including Auto and Work Injury cases, Spinal Decompression, Nutrition, Weightloss, Metabolic Analysis and more. Dr. Himani Patel specializes in Women and children, prenatal and pediatric care. In addition, we provide one-on-one ergonomic and postural corrective exercises for a healthier spine outside the clinic. OUR Patients get better! X-rays are performed on ... View Profile
Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age,[147] but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions.[146][148] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS.[149] There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke.[15] While the biomechanical evidence is not sufficient to support the statement that CMT causes cervical artery dissection (CD), clinical reports suggest that mechanical forces have a part in a substantial number of CDs and the majority of population controlled studies found an association between CMT and VAS in young people.[150] It is strongly recommended that practitioners consider the plausibility of CD as a symptom, and people can be informed of the association between CD and CMT before administrating manipulation of the cervical spine.[150] There is controversy regarding the degree of risk of stroke from cervical manipulation.[15] Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven.[17] However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable[17] or definite.[16] There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation.[151] The incidence of internal carotid artery dissection following cervical spine manipulation is unknown.[152] The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke.[153] The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension.[154] Cervical intradural disc herniation is very rare following spinal manipulation therapy.[155]

A large number of chiropractors fear that if they do not separate themselves from the traditional vitalistic concept of innate intelligence, chiropractic will continue to be seen as a fringe profession.[22] A variant of chiropractic called naprapathy originated in Chicago in the early twentieth century.[35][36] It holds that manual manipulation of soft tissue can reduce "interference" in the body and thus improve health.[36]
Chiropractic overlaps with several other forms of manual therapy, including massage therapy, osteopathy, physical therapy, and sports medicine.[19][59] Chiropractic is autonomous from and competitive with mainstream medicine,[60] and osteopathy outside the US remains primarily a manual medical system;[61] physical therapists work alongside and cooperate with mainstream medicine, and osteopathic medicine in the U.S. has merged with the medical profession.[60] Practitioners may distinguish these competing approaches through claims that, compared to other therapists, chiropractors heavily emphasize spinal manipulation, tend to use firmer manipulative techniques, and promote maintenance care; that osteopaths use a wider variety of treatment procedures; and that physical therapists emphasize machinery and exercise.[19]
DCs 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. Chiropractors 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 health care providers. 
A 2012 systematic review concluded that no accurate assessment of risk-benefit exists for cervical manipulation.[15] A 2010 systematic review stated that there is no good evidence to assume that neck manipulation is an effective treatment for any medical condition and suggested a precautionary principle in healthcare for chiropractic intervention even if a causality with vertebral artery dissection after neck manipulation were merely a remote possibility.[17] The same review concluded that the risk of death from manipulations to the neck outweighs the benefits.[17] Chiropractors have criticized this conclusion, claiming that the author did not evaluate the potential benefits of spinal manipulation.[158] Edzard Ernst stated "This detail was not the subject of my review. I do, however, refer to such evaluations and should add that a report recently commissioned by the General Chiropractic Council did not support many of the outlandish claims made by many chiropractors across the world."[158]
Neck pain can also be associated with headache, facial pain, shoulder pain, and arm numbness or tingling (upper extremity paresthesias). These associated symptoms are often a result of nerves becoming pinched in the neck. Depending on the condition, sometimes neck pain is accompanied by upper back and/or lower back pain, as is common in inflammation of the spine from ankylosing spondylitis.
Epoch Chiropractic: Voted the Best Chiropractor in New Castle County in Delaware, 2012 Reader's Choice 2014 Award Winners for #1 Chiropractor Awarded a Trademark Women of Distinction - Honors Edition 2017 We're more than just Chiropractic. At Epoch, we provide quality Chiropractic care, including Auto and Work Injury cases, Spinal Decompression, Nutrition, Weightloss, Metabolic Analysis and more. Dr. Himani Patel specializes in Women and children, prenatal and pediatric care. In addition, we provide one-on-one ergonomic and postural corrective exercises for a healthier spine outside the clinic. OUR Patients get better! X-rays are performed on ... View Profile
As noted, ratings sites or websites with a certified list of doctors, like PainDoctor.com, can help verify a chiropractor’s license and give you an idea of their philosophy and practice areas. Each site has slightly different information to give you a better picture of your chiropractor before your first visit. Find the best chiropractor for you by looking for ones who share lots of information and knowledge, whether on their website or on social media.
Involved in a car accident? You’re not alone. Many people become injured in accidents and don’t seek the treatment needed to properly restore mobility and function. At The Good Doctor, you’ll receive comprehensive chiropractic care that will alleviate pain and symptoms resulting from your injuries. Our Los Angeles chiropractor offers a variety of treatments and methods that will get you back to a normal, healthy state. If you’re suffering from headaches, back, neck or shoulder pain, we’re ready to help.

Finally, it’s important to know that it’s okay to change chiropractors if the doctor you find just isn’t a good fit. They may be perfectly qualified and capable, but if you aren’t comfortable with them, treatment may be less effective. Some patients love doctors who are straight and to the point, while others prefer someone who provides lots of explanation both before and during a procedure. Likewise, they may not be the best doctor to treat your specific pain condition. As with other doctors, chiropractors understand this and are happy to transfer your records to a different doctor.

Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.
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