Once your history is gathered, the chiropractor may complete a physical exam, or they may begin treatment. This may be a manual spinal manipulation, or the chiropractor may use various chiropractic instruments. After your adjustment is complete, the chiropractor will recommend a schedule of follow-up visits. The number of visits will depend on your current health condition, how much pain you’re in, and what other therapies you’re using to treat your pain. Chiropractic care is always best done in addition to other pain management treatments, such as physical therapy, medication, or pain-reducing injections.
Throughout its history chiropractic has been the subject of internal and external controversy and criticism. According to Daniel D. Palmer, the founder of chiropractic, subluxation is the sole cause of disease and manipulation is the cure for all diseases of the human race. A 2003 profession-wide survey found "most chiropractors (whether 'straights' or 'mixers') still hold views of innate Intelligence and of the cause and cure of disease (not just back pain) consistent with those of the Palmers." A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today." Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license. For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as subluxation. Collectively, systematic reviews have not demonstrated that spinal manipulation, the main treatment method employed by chiropractors, is effective for any medical condition, with the possible exception of treatment for back pain. Chiropractic remains controversial, though to a lesser extent than in past years.
The percentage of the population that utilizes chiropractic care at any given time generally falls into a range from 6% to 12% in the U.S. and Canada, with a global high of 20% in Alberta in 2006. In 2008, chiropractors were reported to be the most common CAM providers for children and adolescents, consuming up to 14% of all visits to chiropractors. In 2008, there were around 60,000 chiropractors practicing in North America. In 2002–03, the majority of those who sought chiropractic did so for relief from back and neck pain and other neuromusculoskeletal complaints; most do so specifically for low back pain. The majority of U.S. chiropractors participate in some form of managed care. Although the majority of U.S. chiropractors view themselves as specialists in neuroleptic malignant syndrome conditions, many also consider chiropractic as a type of primary care. In the majority of cases, the care that chiropractors and physicians provide divides the market, however for some, their care is complementary.
There are several surgical treatments available to treat cervical spine disorders. Factors that help determine the type of surgical treatment include the specifics of the disc disease and the presence or absence of pressure on the spinal cord or spinal nerve roots. Other factors include age, how long the patient has had the disorder, other medical conditions and if there has been previous cervical spine surgery.
All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted spinal cord injury. To be safe, always check with your medical doctor to make sure your condition will benefit from chiropractic or other pain relief alternatives.