Reviews of research studies within the chiropractic community have been used to generate practice guidelines outlining standards that specify which chiropractic treatments are "legitimate" (i.e. supported by evidence) and conceivably reimbursable under managed care health payment systems. Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims. Chiropractic remains at a crossroads, and that in order to progress it would need to embrace science; the promotion by some for it to be a cure-all was both "misguided and irrational". A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice, which may have resulted from a lack of research education and skills.
Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care. Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal range of movement, but not so far as to dislocate or damage the joint. Its defining factor is a dynamic thrust, which is a sudden force that causes an audible release and attempts to increase a joint's range of motion. High-velocity, low-amplitude spinal manipulation (HVLA-SM) thrusts have physiological effects that signal neural discharge from paraspinal muscle tissues, depending on duration and amplitude of the thrust are factors of the degree in paraspinal muscle spindles activation. Clinical skill in employing HVLA-SM thrusts depends on the ability of the practitioner to handle the duration and magnitude of the load. More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues.
Many states also require applicants to pass a background check and state-specific law exams, called jurisprudence exams. All states require a practicing chiropractor to take continuing education classes to maintain his or her chiropractic license. Check with your state’s board of chiropractic examiners or health department for more specific information on licensure.
If the pain is due to muscle spasm or a pinched nerve, your provider may prescribe a muscle relaxant or a more powerful pain reliever. Over-the-counter medicines often work as well as prescription drugs. At times, your provider may give you steroids to reduce swelling. If there is nerve damage, your provider may refer you to a neurologist, neurosurgeon, or orthopedic surgeon for consultation.
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.
Seriously, learn from me on this one. No one wants to wear those medical shorts when starting a new treatment plan with a new healthcare professional—they do not build your confidence! I found athletic/workout clothes and sneakers to be the most comfortable option for me, especially when performing the exercises and getting an adjustment. I was able to move comfortably without feeling too restricted. Try not to wear clothes that are really thick like a sweatshirt. Instead, opt for thinly lined clothing or wear layers so that the chiropractor can easily perform the adjustment and assess how you’re moving.
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. The same review found that SMT appears to be no better than other recommended therapies. A 2016 review found moderate evidence indicating that chiropractic care seems to be effective as physical therapy for low back pain. A 2012 overview of systematic reviews found that collectively, SM failed to show it is an effective intervention for pain. 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. 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. 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. Specific guidelines concerning the treatment of nonspecific (i.e., unknown cause) low back pain are inconsistent between countries.
Analysis of a clinical and cost utilization data from the years 2003 to 2005 by an integrative medicine independent physician association (IPA) which looked the chiropractic services utilization found that the clinical and cost utilization of chiropractic services based on 70,274 member-months over a 7-year period decreased patient costs associate with the following use of services by 60% for in-hospital admissions, 59% for hospital days, 62% for outpatient surgeries and procedures, and 85% for pharmaceutical costs when compared with conventional medicine (visit to a medical doctor primary care provider) IPA performance for the same health maintenance organization product in the same geography and time frame.
Radiculopathy. A 2013 systematic review and meta-analysis found a statistically significant improvement in overall recovery from sciatica following SM, when compared to usual care, and suggested that SM may be considered. There is moderate quality evidence to support the use of SM for the treatment of acute lumbar radiculopathy and acute lumbar disc herniation with associated radiculopathy. There is low or very low evidence supporting SM for chronic lumbar spine-related extremity symptoms and cervical spine-related extremity symptoms of any duration and no evidence exists for the treatment of thoracic radiculopathy.
Hi Elizabeth — We’re so sorry to hear that you’re unable to find a chiropractor who worked so well for you. You may be able to contact your local chiropractic association directly and provide some more information to find him: http://www.scchiropractic.org/ or http://www.ncchiro.org/. If you’re unable to find him through either of those channels, you can look for a new one here: https://paindoctor.com/find-your-pain-doctor/. Hope that helps!
Doctors who treat neck pain can include general medicine physicians, including family medicine doctors and internists, as well as orthopedists, rheumatologists, neurosurgeons, neurologists, ENT specialists, emergency physicians, physiatrists, and chiropractors. Other ancillary health professionals who treat neck pain include physical therapists, massage therapists, and acupuncturists.
At each vertebral level, a pair of spinal nerves exit through small openings called foramina (one to the left and one to the right). These nerves serve the muscles, skin and tissues of the body and thus provide sensation and movement to all parts of the body. The delicate spinal cord and nerves are further supported by strong muscles and ligaments that are attached to the vertebrae.
Welcome to The Chiropractor Whitefish, located in beautiful downtown Whitefish, Montana. At The Chiropractor, we do our best to provide top notch service using specific gentle adjusting techniques and cutting edge technology. Our main priority is providing our patients with outstanding care, compassion, and physical relief, in an inviting atmosphere.
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.
The neck supports the full weight of the head and is very susceptible to muscle strain and the misalignment of, or damage to, the vertebra in the spinal column. Almost everyone experiences neck pain at some time. These pains can be simple, which disappear after a few days, or they can be chronic. Chronic neck pain is defined as pain that persists for 3 months or more.
In diagnosing the cause of neck pain, it is important to review the history of the symptoms. In reviewing the history, the doctor will note the location, intensity, duration, and radiation of the pain. Is the pain worsened or improved with turning or repositioning of the head? Any past injury to the neck and past treatments are noted. Aggravating and/or relieving positions or motions are also recorded. The neck is examined at rest and in motion. Tenderness is detected during palpation of the neck. An examination of the nervous system is performed to determine whether or not nerve involvement is present.
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.