Chiropractic diagnosis may involve a range of methods including skeletal imaging, observational and tactile assessments, and orthopedic and neurological evaluation.[46] A chiropractor may also refer a patient to an appropriate specialist, or co-manage with another health care provider.[54] Common patient management involves spinal manipulation (SM) and other manual therapies to the joints and soft tissues, rehabilitative exercises, health promotion, electrical modalities, complementary procedures, and lifestyle advice.[3]
There are many possible signs of spinal cord trouble in the neck,8 with or without neck pain, mostly affecting the limbs in surprisingly vague ways that can have other causes: poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); an awkward gait. Sometimes people have both neck pain and more remote symptoms without realizing they are related.
Chiropractors faced heavy opposition from organized medicine.[37] DD Palmer was jailed in 1907 for practicing medicine without a licence.[217] Thousands of chiropractors were prosecuted for practicing medicine without a license, and D.D. and many other chiropractors were jailed.[37] To defend against medical statutes, B.J. argued that chiropractic was separate and distinct from medicine, asserting that chiropractors "analyzed" rather than "diagnosed", and "adjusted" subluxations rather than "treated" disease.[37] B.J. cofounded the Universal Chiropractors' Association (UCA) to provide legal services to arrested chiropractors.[37] Although the UCA won their first test case in Wisconsin in 1907, prosecutions instigated by state medical boards became increasingly common and in many cases were successful. In response, chiropractors conducted political campaigns to secure separate licensing statutes, eventually succeeding in all fifty states, from Kansas in 1913 through Louisiana in 1974.[37] The longstanding feud between chiropractors and medical doctors continued for decades. The AMA labeled chiropractic an "unscientific cult" in 1966,[29] and until 1980 advised its members that it was unethical for medical doctors to associate with "unscientific practitioners".[218] This culminated in a landmark 1987 decision, Wilk v. AMA, in which the court found that the AMA had engaged in unreasonable restraint of trade and conspiracy, and which ended the AMA's de facto boycott of chiropractic.[21]
Chiropractors use hands-on spinal manipulation and other alternative treatments, the theory being that proper alignment of the body's musculoskeletal structure, particularly the spine, will enable the body to heal itself without surgery or medication. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress, such as sitting without proper back support.