The World Health Organization found chiropractic care in general is safe when employed skillfully and appropriately. There is not sufficient data to establish the safety of chiropractic manipulations. Manipulation is regarded as relatively safe but complications can arise, and it has known adverse effects, risks and contraindications. Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints. Relative contraindications are conditions where increased risk is acceptable in some situations and where low-force and soft-tissue techniques are treatments of choice; these contraindications include osteoporosis. Although most contraindications apply only to manipulation of the affected region, some neurological signs indicate referral to emergency medical services; these include sudden and severe headache or neck pain unlike that previously experienced. Indirect risks of chiropractic involve delayed or missed diagnoses through consulting a chiropractor.
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.
Chiropractic overlaps with several other forms of manual therapy, including massage therapy, osteopathy, physical therapy, and sports medicine. Chiropractic is autonomous from and competitive with mainstream medicine, and osteopathy outside the US remains primarily a manual medical system; physical therapists work alongside and cooperate with mainstream medicine, and osteopathic medicine in the U.S. has merged with the medical profession. 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.
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
How do you stretch the latissimus dorsi? The latissimus dorsi is a large muscle that stretches from the middle to lower back. While overuse can lead to pain, some movement may provide relief. We describe exercises that stretch and alleviate pain in this muscle, also known as the lats. Here, learn to identify, relieve, and prevent pain in the latissimus dorsi. Read now
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.
Employment of chiropractors is projected to grow 12 percent from 2016 to 2026, faster than the average for all occupations. People across all age groups are increasingly becoming interested in integrative or complementary healthcare as a way to treat pain and to improve overall wellness. Chiropractic care is appealing to patients because chiropractors use nonsurgical methods of treatment and do not prescribe drugs.
"Physiologists divide nerve-fibers, which form the nerves, into two classes, afferent and efferent. Impressions are made on the peripheral afferent fiber-endings; these create sensations that are transmitted to the center of the nervous system. Efferent nerve-fibers carry impulses out from the center to their endings. Most of these go to muscles and are therefore called motor impulses; some are secretory and enter glands; a portion are inhibitory, their function being to restrain secretion. Thus, nerves carry impulses outward and sensations inward. The activity of these nerves, or rather their fibers, may become excited or allayed by impingement, the result being a modification of functionality – too much or not enough action – which is disease."
Your neck is a complex interlocking structure consisting of bones, joints, nerves, muscles, tendons and ligaments. Its main job is to hold up the weight of your head which, at around 5 kilograms, is no mean task. Add to this the requirement that the head must be able to move from side to side and up and down (and do these simultaneously), plus the fact that the neck has to form a conduit for the spinal cord, carry blood vessels to and from the head, and contain passageways for air and food, and you have quite a complex feat of engineering. No wonder then that our necks cause us pain and discomfort, not only on occasion, but for some people in an ongoing fashion.The main physical structures in the neck are the seven interlocking vertebrae. They are called the cervical vertebrae, numbered C1 through to C7. C1, also known as the atlas, is the closest one to your head, followed by C2, which is also known as the axis. Each vertebra is connected to the next by facet joints, and between the vertebrae are intervertebral discs — rubbery cushions made mostly of cartilage that act as shock-absorbers.When should I seek immediate medical treatment for neck pain?Severe neck pain that occurs after a neck injury can be a serious problem, and you should see your doctor immediately. Also, if you have problems with neck pain and experience symptoms such as loss of bladder or bowel control, shooting pains, numbness, tingling, or weakness in the arms or legs, especially if these symptoms come on suddenly or get worse quickly, you should see your doctor straight away.Neck pain and stiffness that’s associated with headache and fever can be a sign of meningitis (an infection of the membranes surrounding your brain and spinal cord). Meningitis is a serious disease, and you should seek immediate medical treatment if you or your child are experiencing these symptoms.Symptoms of neck painSymptoms of neck pain and the sensations you feel can help your doctor to diagnose the cause. Here are some symptoms.Muscle spasmA spasm is a sudden, powerful, involuntary contraction of muscles. The muscles feel painful, stiff and knotted. If you have neck muscle spasms, you may not be able to move your neck — sometimes people call it a crick in the neck. Your doctor or physiotherapist may call it acute torticollis or wry neck.Muscle acheThe neck muscles are sore and may have hard knots (trigger points) that are tender to touch. Pain is often felt up the middle of the back of the neck, or it may ache on one side only.StiffnessThe neck muscles are tight and if you spend too long in one position they feel even tighter. Neck stiffness can make it difficult or painful to move your neck.Nerve painPain from the neck can radiate down the arms, and sometimes, the legs. You may feel a sensation of pins and needles or tingling in your arms, which can be accompanied by numbness, burning or weakness. This pain is typically worse at night.HeadachesHeadaches are common in conjunction with neck problems. They are usually a dull aching type of headache, rather than sharp pain. While the headaches are often felt at the back of the head, the pain may also radiate to the sides, and even the front of the head.Reduced range of motionIf you can’t turn your head to the side to the same degree towards each shoulder, or you feel limited in how far forward you can lower your head to your chest, or how far you can tilt your head back, you may have reduced range of motion. Your doctor will be able to test this.Common causes of neck painWhiplashThis commonly follows a car accident in which the person’s car is hit from behind while it is stationary or slowing down. The person’s head is first thrown backwards and then when their body stops moving, the head is thrust forward. This type of injury can strain your neck muscles and cause ligaments in the neck to stretch or tear.The pain from whiplash, which is usually worse with movement, does not always start immediately — it may take several days to come on. Neck pain and stiffness may be accompanied by muscle spasm, dizziness, headaches, nerve pain and shoulder pain.Muscle strainOngoing overuse of your neck muscles (which can be caused by a poor neck position during everyday activities, particularly computer work) can trigger neck muscle strain, causing chronic neck pain and stiffness. The pain is often worse with movement and may be associated with headaches, muscle spasms and restriction of neck movements.Degenerative disc diseaseAs we grow older, the soft gelatinous centre of the shock-absorbing discs in our spines dries out. This causes the discs to become narrowed, and the distance between the vertebrae to decrease.Herniated discIf the tough outside layer of one of the cervical discs tears, the soft gelatinous centre may bulge outwards — this is known as a herniated disc. Herniated discs can put pressure on nerve roots as they leave the spinal cord, causing pain in the neck as well as pain, numbness and weakness in the arms.Cervical spondylosisThis degenerative condition of the cervical spine is due to normal ageing and wear and tear on the cervical discs and the vertebrae. It is also known as cervical osteoarthritis, and is more common among older people.The development of bone spurs often accompanies this degeneration of the spine. Bone spurs, also known as osteophytes, are small outgrowths of bone tissue that are formed when the cartilage covering bone is worn away and bone starts to rub on adjacent bone. The bone spur is the body’s attempt to protect the bone surface. Unfortunately, the bone spur can sometimes pinch or press upon the nerve roots as they leave the spinal canal.Symptoms associated with cervical spondylosis include neck pain and stiffness that often improves with rest. The pain may radiate to the shoulders or between the shoulder blades. If there is nerve root compression, there may be numbness, pain or weakness in the arms.Cervical spinal canal stenosisDegenerative changes in the vertebrae can lead to narrowing of the canal in which your spinal cord lies — this is known as cervical spinal canal stenosis. As the canal becomes narrower, it can put pressure on the spinal cord. The associated neck pain is usually worse with activity, and may radiate to the arms or legs. Arm or leg weakness can also occur. Sometimes people with cervical spinal canal stenosis have no symptoms. Occasionally, it may give rise to Lhermitte's sign — an electric shock-like feeling down the body when the neck is bent forward.Tests and diagnosisYour doctor may be able to determine the cause of your neck pain from your history and physical examination, but sometimes tests such as X-rays, MRI scans and CT scans are required to find the exact cause of your symptoms. These scans can assess the spine and be used to show disc problems, spinal cord problems or compression of your nerve roots.Sometimes doctors will order electromyography (EMG) or nerve conduction studies — tests that evaluate the electrical activity in nerves and muscles to help determine if there is any nerve damage related to your neck problems.It can be difficult to identify the precise source of neck pain even after investigations. Generally, X-ray abnormalities do not correlate well with pain. Some people have severe spondylosis on X-rays, but have no pain. The key thing that your doctor should be able to tell is if the pain is involving pressure on the nerve roots or spinal cord. Last Reviewed: 18 December 2012
Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM); and a 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine. Many chiropractors believe they are primary care providers, including US and UK chiropractors, but the length, breadth, and depth of chiropractic clinical training do not support the requirements to be considered primary care providers, so their role on primary care is limited and disputed.
Numerous controlled clinical studies of treatments used by chiropractors have been conducted, with conflicting results. Systematic reviews of this research have not found evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain. A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition. Spinal manipulation may be cost-effective for sub-acute or chronic low back pain but the results for acute low back pain were insufficient. The efficacy and cost-effectiveness of maintenance chiropractic care are unknown. There is not sufficient data to establish the safety of chiropractic manipulations. It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases. There is controversy regarding the degree of risk of vertebral artery dissection, which can lead to stroke and death, from cervical manipulation. Several deaths have been associated with this technique and it has been suggested that the relationship is causative, a claim which is disputed by many chiropractors.
Chiropractic treatment of the back, neck, limbs, and involved joints has become more accepted as a result of research and changing attitudes about additional approaches to healthcare. As a result, chiropractors are increasingly working with other healthcare workers, such as physicians and physical therapists, through referrals and complementary care.
In addition to practicing chiropractic, Dr. Robins has taught on the college/university level since 1999 instructing and developing courses in health sciences as well as health care management. Being in Indianapolis has provided the opportunity for Dr. Robins to actively participate in legislative bodies addressing issues that impact governmental health policies and regulations toward healthcare. She has also worked with health care lobbies to affect change in legislation and has had the opportunity to participate in a professional exchange to Korea with a U.S. Delegation.
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
Patients seeking treatment at Town Center Chiropractic with Dr. V.J. Maddio, Dr. Michael Morris, Dr. Jeffrey Fife and Dr. Sheridan Jones are assured of receiving only the finest quality care through the use of modern chiropractic equipment and technology. Dr. V.J. Maddio, Dr. Michael Morris, Dr. Jeffrey Fife, Dr. Sheridan Jones and the staff have a genuine concern for your well-being!
I finally met the chiropractor! We started out by talking a little about the reason for my visit, and what my goals were. Next, he performed a Selective Functional Movement Assessment, which basically helps the chiropractor find the root and cause of any symptoms—they do this by breaking down dysfunctional patterns logically rather than simply finding the obvious source of the pain.