The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon online tool.
A 2010 study describing Belgium chiropractors and their patients found chiropractors in Belgium mostly focus on neuromusculoskeletal complaints in adult patients, with emphasis on the spine.[83] The diversified technique is the most often applied technique at 93%, followed by the Activator mechanical-assisted technique at 41%.[83] A 2009 study assessing chiropractic students giving or receiving spinal manipulations while attending a U.S. chiropractic college found Diversified, Gonstead, and upper cervical manipulations are frequently used methods.[84]
The next step in the process was an X-ray. Having an X-ray done of your spine can help the chiropractor determine your treatment plan and can aid in the adjustment. That said, not all chiropractors will recommend an X-ray at your appointment. It turns out some chiropractors say that X-rays should be part of routine chiropractic care, while others argue X-rays aren't necessary for every patient. When researching potential chiropractors, feel free to ask if they recommend X-rays for all patients and how the X-rays can benefit your treatment plan.
Chiropractic is well established in the United States, Canada, and Australia.[18] It overlaps with other manual-therapy professions such as osteopathy and physical therapy.[19] Most who seek chiropractic care do so for low back pain.[20] Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues.[4] Many chiropractors describe themselves as primary care providers,[4][21] but the chiropractic clinical training does not support the requirements to be considered primary care providers,[2] so their role on primary care is limited and disputed.[2][21] Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "innate intelligence", and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[22]
Our North Wales / Lansdale / Blue Bell PA  Office is here to enhance your quality of life through chiropractic care, and we believe that chiropractic and a proper exercise program can improve your overall health. Chiropractors don't just making the pain disappear. Our team will place you on a plan to help your pain, but also help find the source of the problem, and also goals on how to get better. Dr. Allen Conrad has been a chiropractor for over since 2001, serving the North Wales and Lansdale PA area. His office specializes in spinal decompression therapy, massage therapy, and chiropractic care for many types of injuries. Dr. Conrad se ... View Profile
The Henderson Center was founded in 1985 as The Henderson Center Chiropractic Clinic in King of Prussia, Montgomery County, Pennsylvania, but was strictly a chiropractic clinic until 1993, when Dr. M Jonathan Garzillo, a chiropractor, joined the Center. Since then, the Center has expanded beyond just chiropractic to become a multi-specialty pain management practice, incorporating massage therapies, shiatsu therapy and chiropractic care. Dr. Garzillo also brought a simple philosophy to the Henderson Center. Instead of trying to prolong care, the Center works to relieve patients of their pain in the shortest time possible. I ... View Profile
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

“When your neck muscles become weak and you try to turn your head, the joint no longer moves smoothly because it’s now out of place,” Dr. Bang says. “Often the joint catches on something, either pulling a muscle or hitting the nerve irregularly, or maybe both. Then you’ll have instant pain and your body has a protective spasm. Your body doesn’t want you to get hurt more, so it will clench, causing you to feel like you can’t even move — and leaving you wondering what you did to injure yourself.”
In 2009, a backlash to the libel suit filed by the British Chiropractic Association (BCA) against Simon Singh, has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24-hour period,[199][200] prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice, to be wary of new patients and telephone inquiries, and telling their members: "If you have a website, take it down NOW." and "Finally, we strongly suggest you do NOT discuss this with others, especially patients."[199] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[201] The libel case ended with the BCA withdrawing its suit in 2010.[202][203]
We integrate Chiropractic, Physical Therapy and Functional Medicine to find the cause of your problem and help remove it. Dr. Knight's unique method combines a system of traditional Chiropractic adjustments along with a customized exercise or daily activities program designed to enhance the adjustments for greater overall effectiveness. Creating for you specialized techniques to provide relief from your worst symptoms and discover the root cause of your concerns. His initial program is intensified to derive the greatest potential for improvement within the shortest amount of time. By targeting specific areas of your spine, chiropractic care h ... View Profile

There are many benefits of seeing a chiropractor – both well-known and surprising. When most people think of chiropractic care, the spine comes to mind. While it is true that chiropractic care focuses on the spine to promote health, alleviate pain, and achieve balance, when performed by a certified practitioner chiropractic care can also help your skeletal, muscular, digestive, and nervous systems function in harmony. It can also treat many neurological disorders including ADHD, as well as relieve mental stress, pressure headaches, and symptoms associated with PMS and asthma.
The treatment of soft tissue neck and shoulder pain often includes the use of anti-inflammatory medication such as ibuprofen (Advil or Motrin) or naproxen (Aleve or Naprosyn). Pain relievers such as acetaminophen (Tylenol) may also be recommended. Depending on the source of pain, drugs like muscle relaxers and even antidepressants might be helpful. Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injections are often helpful for arthritis of the shoulder. For both neck and shoulder pain movement, exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. Your doctor can tell you which is the best course of treatment for you.
Dr. Grotzinger completed his pre-med at Drake university in Des Moines with a 4.0 GPA in 1976. He graduated from Palmer Chiropractic, Magna Cum Laude in 1981 having worked nights and fathering three children in the process. Since then he has worked both in solo practice and a number of multi-doctor clinics, gaining a wide variety of experience and proficiency. He prides himself on being an effective chiropractor who has balanced the ways of the old time chiropractors with today's emphasis on patient comfort.
Low back pain. A 2013 Cochrane review found very low to moderate evidence that SMT was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.[94] The same review found that SMT appears to be no better than other recommended therapies.[94] A 2016 review found moderate evidence indicating that chiropractic care seems to be effective as physical therapy for low back pain.[95] A 2012 overview of systematic reviews found that collectively, SM failed to show it is an effective intervention for pain.[96] A 2011 Cochrane review found strong evidence that suggests there is no clinically meaningful difference between SMT and other treatments for reducing pain and improving function for chronic low back pain.[97] A 2010 Cochrane review found no current evidence to support or refute a clinically significant difference between the effects of combined chiropractic interventions and other interventions for chronic or mixed duration low back pain.[98] A 2010 systematic review found that most studies suggest SMT achieves equivalent or superior improvement in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up.[99] Specific guidelines concerning the treatment of nonspecific (i.e., unknown cause) low back pain are inconsistent between countries.[100]
Stabilization surgery is sometimes—but not always—done at the same time as a decompression surgery. In some forms of decompression surgery, the surgeon may need to remove a large portion of the vertebra or vertebrae. That results in an unstable spine, meaning that it moves in abnormal ways, and that puts you more at risk for serious neurological injury. In that case, the surgeon will restabilize the spine. Commonly, this is done with a fusion and spinal instrumentation, or implantation of an artificial disc.
Finding a good, or even great, chiropractor doesn’t happen just by chance. It’s like anything else today–there are online options for finding user-generated reviews and recommendations to help you find the best chiropractor close to you. Add that to your network of family and friends, and peer-reviewed sites like PainDoctor.com, and you have the tools you need to make the best decision for you.
The nerve roots stem from the spinal cord like tree branches through foramen in the vertebrae. Each nerve root transmits signals (nerve impulses) to and from the brain, shoulders, arms, and chest. A vascular system of 4 arteries and veins run through the neck to circulate blood between the brain and the heart. Joints, muscles, and ligaments facilitate movement and serve to stabilize the structure.
Research suggests that not just sleep position, but sleep itself, can play a role in musculoskeletal pain, including neck and shoulder pain. In one study, researchers compared musculoskeletal pain in 4,140 healthy men and women with and without sleeping problems. Sleeping problems included difficulty falling asleep, trouble staying asleep, waking early in the mornings, and non-restorative sleep. They found that people who reported moderate to severe problems in at least three of these four categories were significantly more likely to develop chronic musculoskeletal pain after one year than those who reported little or no problem with sleep. One possible explanation is that sleep disturbances disrupt the muscle relaxation and healing that normally occur during sleep. Additionally, it is well established that pain can disrupt sleep, contributing to a vicious cycle of pain disrupting sleep, and sleep problems contributing to pain.
Jump up ^ Jansen MJ, Viechtbauer W, Lenssen AF, Hendriks EJ, de Bie RA (2011). "Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review". J Physiother. 57 (1): 11–20. doi:10.1016/S1836-9553(11)70002-9. PMID 21402325.
Serious research to test chiropractic theories did not begin until the 1970s, and is continuing to be hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine.[37] By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain.[37] In recent decades chiropractic gained legitimacy and greater acceptance by medical physicians and health plans, and enjoyed a strong political base and sustained demand for services.[21] However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions.[21] The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care.[21]
Many patients seek orthopaedic care for neck pain because orthopaedists are specifically trained to diagnose, treat, and help prevent problems involving the muscles, bones, joints, ligaments, and tendons. Although some orthopaedists confine their practices to specific areas of the musculoskeletal system, most treat a wide variety of diseases, injuries, and other conditions, including neck pain.
Determining a treatment strategy depends mainly on identifying the location and cause of the irritated nerve root. Although neck pain can be quite debilitating and painful, nonsurgical management can alleviate many symptoms. The doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur. Reducing physical activities or wearing a cervical collar may help provide support for the spine, reduce mobility and decrease pain and irritation. Trigger point injection, including corticosteroids, can temporarily relieve pain. Occasionally, epidural steroids may be recommended. Conservative treatment options may continue for up to six or eight weeks.
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Neck pain can have a number of causes, for example: simple muscle strain; injuries as a result of accidents or sports; repetitive or unusual movements; and degenerative conditions such as osteoporosis and arthritis. If you experience neck pain that persists for more than a few days, it would be advisable to consult you medical doctor or health professional.

Neck pain may result from abnormalities in the soft tissues—the muscles, ligaments, and nerves—as well as in bones and disks of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury (a sprain) or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms.
There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck. Within the neck, structures include the skin, neck muscles, arteries, veins, lymph nodes, thyroid gland, parathyroid glands, esophagus, larynx, and trachea. Diseases or conditions that affect any of these tissues of the neck can lead to neck pain.
Dr. Alexandra (Alex) Robins holds both BS and DC degrees, graduating from National College of Chiropractic in 1991. She practiced in Chicago for a couple of years before buying a practice in Indianapolis in1993, which focused on neuromusculoskeletal conditions as well as acupuncture. After 21 years of practice in Indianapolis, Dr. Robins closed her office and became involved with The Joint in 2016. As Dr. Robins states, “Being with The Joint has provided me with a wonderful opportunity to once again treat patients.”
Extremity conditions. A 2011 systematic review and meta-analysis concluded that the addition of manual mobilizations to an exercise program for the treatment of knee osteoarthritis resulted in better pain relief than a supervised exercise program alone and suggested that manual therapists consider adding manual mobilisation to optimise supervised active exercise programs.[115] There is silver level evidence that manual therapy is more effective than exercise for the treatment of hip osteoarthritis, however this evidence could be considered to be inconclusive.[116] There is a small amount of research into the efficacy of chiropractic treatment for upper limbs,[117] limited to low level evidence supporting chiropractic management of shoulder pain[118] and limited or fair evidence supporting chiropractic management of leg conditions.[119]

Determining a treatment strategy depends mainly on identifying the location and cause of the irritated nerve root. Although neck pain can be quite debilitating and painful, nonsurgical management can alleviate many symptoms. The doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur. Reducing physical activities or wearing a cervical collar may help provide support for the spine, reduce mobility and decrease pain and irritation. Trigger point injection, including corticosteroids, can temporarily relieve pain. Occasionally, epidural steroids may be recommended. Conservative treatment options may continue for up to six or eight weeks.

Chiropractic was founded in 1895 by Daniel David (D.D.) Palmer in Davenport, Iowa. Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease.[215] The first chiropractic patient of D.D. Palmer was Harvey Lillard, a worker in the building where Palmer's office was located.[37] He claimed that he had severely reduced hearing for 17 years, which started soon following a "pop" in his spine.[37] A few days following his adjustment, Lillard claimed his hearing was almost completely restored.[37] Chiropractic competed with its predecessor osteopathy, another medical system based on magnetic healing and bonesetting; both systems were founded by charismatic midwesterners in opposition to the conventional medicine of the day, and both postulated that manipulation improved health.[215] Although initially keeping chiropractic a family secret, in 1898 Palmer began teaching it to a few students at his new Palmer School of Chiropractic.[23] One student, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.[23]
Requirements vary between countries. In the U.S. chiropractors obtain a first professional degree in the field of chiropractic.[164] Chiropractic education in the U.S. have been criticized for failing to meet generally accepted standards of evidence-based medicine.[165] The curriculum content of North American chiropractic and medical colleges with regard to basic and clinical sciences has been more similar than not, both in the kinds of subjects offered and in the time assigned to each subject.[166] Accredited chiropractic programs in the U.S. require that applicants have 90 semester hours of undergraduate education with a grade point average of at least 3.0 on a 4.0 scale. Many programs require at least three years of undergraduate education, and more are requiring a bachelor's degree.[167] Canada requires a minimum three years of undergraduate education for applicants, and at least 4200 instructional hours (or the equivalent) of full‐time chiropractic education for matriculation through an accredited chiropractic program.[168] Graduates of the Canadian Memorial Chiropractic College (CMCC) are formally recognized to have at least 7–8 years of university level education.[169][170] The World Health Organization (WHO) guidelines suggest three major full-time educational paths culminating in either a DC, DCM, BSc, or MSc degree. Besides the full-time paths, they also suggest a conversion program for people with other health care education and limited training programs for regions where no legislation governs chiropractic.[46]
Neck pain results when the spine is stressed by injury, disease, wear and tear, or poor body mechanics. Acute neck pain is abrupt, intense pain that can radiate to the head, shoulders, arms, or hands. It typically subsides within days or weeks with rest, physical therapy and other self-care measures. You play an important role in the prevention, treatment and recovery process of neck pain. However, if chronic, pain will persist despite treatment and need further evaluation.
Mixer chiropractors "mix" diagnostic and treatment approaches from chiropractic, medical and/or osteopathic viewpoints and make up the majority of chiropractors.[22] Unlike straight chiropractors, mixers believe subluxation is one of many causes of disease, and hence they tend to be open to mainstream medicine.[22] Many of them incorporate mainstream medical diagnostics and employ conventional treatments including techniques of physical therapy such as exercise, stretching, massage, ice packs, electrical muscle stimulation, therapeutic ultrasound, and moist heat.[22] Some mixers also use techniques from alternative medicine, including nutritional supplements, acupuncture, homeopathy, herbal remedies, and biofeedback.[22]
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