Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Paige, N. M., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., Mardian, A. S., Dougherty, P., ... Shekelle, P. G. (2017, April 11). Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. Jama, 317(14), 1451–1460. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2616395
Welcome to Rafey Chiropractic & Health Center located at 3377 Compton Road Suite 130 in Cincinnati, OH. We understand that choosing a chiropractor is a big decision. This article will help you learn the basics of chiropractic care. Please don't hesitate to contact our Cincinnati chiropractors with any further questions you have. We are here to help you achieve your goals.
To be completely honest, I was still a little nervous before my chiropractor performed the spinal manipulation. But I really had nothing to worry about. We discussed the potential side effects, which can include mild soreness (like you might feel after a workout). If you do feel sore, you can use a cold pack to help reduce any temporary soreness you might experience.
One of the most common concerns about the neck that is not especially worrisome: signs of “wear and tear” on the cervical spine, arthritis, and degenerative disc disease, as revealed by x-ray, CT scans, and MRI. Many people who have clear signs of arthritic degeneration in their spines will never have any symptoms, or only minor, and/or not for a long time.10 For instance, about 50% of fortysomethings have clinically silent disk bulges, and even at age 20 there’s a surprising amount of spinal arthritis. The seriousness of these signs is routinely overestimated by patients and healthcare professionals alike.11
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Temporal arteritis [healthline] is an inflammation of arteries in the temple, with a lot of symptoms: severe headache, fever, scalp tenderness, jaw pain, vision trouble, and ringing in the ears are all possible symptoms, along with neck pain. It’s almost unheard of in people younger than 50, and it usually occurs in people with other diseases or infections.

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]
From the students in the local schools to businesses and religious organizations, many people in the area call us the Chiropractor of choice. We continually support and participate in numerous civic and community groups including the Woodstock Business Association. Our office supports local charities to keep our philosophy of “Taking care of the family,” foremost in our minds.
^ Jump up to: a b c d e f g h i Nelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13 (1): 9. doi:10.1186/1746-1340-13-9. PMC 1185558. PMID 16000175. The length, breadth, and depth of chiropractic clinical training do not support the claim of broad diagnostic competency required of a PCP. Studies of chiropractic intern clinical experience provides no evidence that chiropractors are trained to a level of a diagnostic generalist for non-musculoskeletal conditions. For chiropractors to describe themselves as PCP diagnosticians is to invite comparisons to other PC diagnosticians, i.e., family practitioners, pediatricians and internists. Such comparisons will not reflect favorably on chiropractic. PCP: primary 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]
D. D. Palmer founded chiropractic in the 1890s,[23] after saying he received it from "the other world",[24] and his son B. J. Palmer helped to expand it in the early 20th century.[23] Throughout its history, chiropractic has been controversial.[25][26] Despite the overwhelming evidence that vaccination is an effective public health intervention, among chiropractors there are significant disagreements over the subject,[27] which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.[28] The American Medical Association called chiropractic an "unscientific cult" in 1966[29] and boycotted it until losing an antitrust case in 1987.[21] Chiropractic has had a strong political base and sustained demand for services; in recent decades, it has gained more legitimacy and greater acceptance among conventional physicians and health plans in the United States.[21]
In the U.S., chiropractors perform over 90% of all manipulative treatments.[210] Satisfaction rates are typically higher for chiropractic care compared to medical care, with a 1998 U.S. survey reporting 83% of respondents satisfied or very satisfied with their care; quality of communication seems to be a consistent predictor of patient satisfaction with chiropractors.[211]
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]
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]

Sharp, shooting pains are mostly neurological false alarms about relatively trivial musculoskeletal troubles: your brain reacting over-protectively to real-but-trivial irritations in and around the spine. The brain takes these much more seriously than it really needs to, but evolution has honed us to be oversensitive in this way. That’s not to say that the brain is always over-reacting, but it usually is. Most of the time, a sharp pain is a warning you can ignore.


Licensure takes place at the state level under specific state laws. Licensing and the scope of practice may differ from state to state. Most states require that chiropractors complete the National Chiropractic Board examination before they get their license. Some states also require chiropractors to pass a state examination. All states recognize training from chiropractic schools accredited by the Council of Chiropractic Education (CCE).
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.
There is no good evidence that chiropractic is effective for the treatment of any medical condition, except perhaps for certain kinds of back pain.[4][10] Generally, the research carried out into the effectiveness of chiropractic has been of poor quality.[89][90] Numerous controlled clinical studies of treatments used by chiropractors have been conducted, with conflicting results.[4] Research published by chiropractors is distinctly biased.[4] For reviews of SM for back pain chiropractic authors tend to have positive conclusions, while others did not show any effectiveness.[4]

Before I left, the office gave me a cold pack to use in case of any soreness. I didn’t have a need to use it, but everyone is different. “A cold pack can be a great tool to add to your wellness toolkit, since it can help control soreness, bruising and inflammation,” says Dr. Greg Doer, DC. Plus, it doesn’t just come in handy after a chiropractic adjustment. You can reuse it again and again.
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