Chiropractic: An Introduction
Chiropractic is a health care
approach that focuses on the relationship between the body's structure—mainly the spine—and its functioning.
Although practitioners may use a variety of treatment approaches, they primarily perform adjustments to the
spine or other parts of the body with the goal of correcting alignment problems and supporting the body's
natural ability to heal itself.
© Matthew Lester
- People seek chiropractic care primarily for pain conditions such as back pain, neck pain, and
- Side effects and risks depend on the type of chiropractic treatment used.
- Chiropractic practitioners in the United States are required to earn a Doctor of Chiropractic degree from
properly accredited colleges.
- Ongoing research is looking at effects of chiropractic treatment approaches, how they might work, and
diseases and conditions for which they may be most helpful.
- Tell your health care providers about any complementary and alternative practices you use. Give them a full
picture of what you do to manage your health. This will help ensure coordinated and safe care.
Overview and History
The term "chiropractic" combines the Greek words cheir (hand) and praxis (action) to describe a treatment done by
hand. Hands-on therapy — especially adjustment of the spine — is central to chiropractic care. Chiropractic, which
in the United States is considered part of complementary and alternative medicine. A group of diverse medical and
health care systems, practices, and products that are not presently considered to be part of conventional medicine.
Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of
conventional medicine. (CAM), is based on these key concepts:
- The body has a powerful self-healing ability.
- The body's structure (primarily that of the spine) and its function are closely related, and this
relationship affects health.
- Therapy aims to normalize this relationship between structure and function and assist the body as it
While some procedures associated with chiropractic care can be traced back to ancient times, the modern
profession of chiropractic was founded by Daniel David Palmer in 1895 in Davenport, Iowa. Palmer, a self-taught
healer, believed that the body has a natural healing ability. Misalignments of the spine can interfere with the
flow of energy needed to support health, Palmer theorized, and the key to health is to normalize the function of
the nervous system, especially the spinal cord.
Patterns of Use
According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAMA group of
diverse medical and health care systems, practices, and products that are not presently considered to be part of
conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine
is used in place of conventional medicine. use by Americans, about 8 percent of American adults and nearly 3
percent of children had received chiropractic or osteopathic manipulation in the past 12 months. Adjusted to
nationally representative numbers, these percentages mean that more than 18 million adults and 2 million children
received chiropractic or osteopathic manipulation in the previous year.
Many people who seek chiropractic care have chronic, pain-related health conditions. Low-back pain, neck pain, and
headache are common conditions for which people seek chiropractic treatment.
What To Expect From Chiropractic Visits
During the initial visit, chiropractors typically take a health history and perform a physical examination, with a
special emphasis on the spine. Other examinations or tests such as x-rays may also be performed. If chiropractic
treatment is considered appropriate, a treatment plan will be developed.
During followup visits, practitioners may perform one or more of the many different types of adjustments used in
chiropractic care. Given mainly to the spine, a chiropractic adjustment (sometimes referred to as a manipulation)
involves using the hands or a device to apply a controlled, sudden force to a joint, moving it beyond its passive
range of motion. The goal is to increase the range and quality of motion in the area being treated and to aid in
restoring health. Other hands-on therapies such as mobilization (movement of a joint within its usual range of
motion) also may be used.
Chiropractors may combine the use of spinal adjustments with several other treatments and approaches such as:
- Heat and ice
- Electrical stimulation
- Rehabilitative exercise
- Counseling about diet, weight loss, and other lifestyle factors
- Dietary supplements.
Side Effects and Risks
Side effects and risks depend on the specific type of chiropractic treatment used. For example, side effects from
chiropractic adjustments can include temporary headaches, tiredness, or discomfort in parts of the body that were
treated. The likelihood of serious complications, such as stroke, appears to be extremely low and related to the
type of adjustment performed and the part of the body treated.
If dietary supplements are a part of the chiropractic treatment plan, they may interact with medicines and cause
side effects. It is important that people inform their chiropractors of all medicines (whether prescription or
over-the-counter) and supplements they are taking.
Qualifications To Practice
To practice chiropractic care in the United States, a practitioner must earn a Doctor of Chiropractic (D.C.) degree
from a college accredited by the Council on Chiropractic Education (CCE). CCE is the agency certified by the U.S.
Department of Education to accredit chiropractic colleges in the United States. Admission to a chiropractic college
requires a minimum of 90 semester hour credits (approximately 3 years) of undergraduate study, mostly in the
Chiropractic training is a 4-year academic program that includes both classroom work and direct experience caring
for patients. Coursework typically includes instruction in the biomedical sciences, as well as in public health and
research methods. Some chiropractors pursue a 2- to 3-year residency for training in specialized fields.
Chiropractic is regulated individually by each state and the District of Columbia. Board examinations are required
for licensing and include a mock patient encounter. Most states require chiropractors to earn annual continuing
education credits to maintain their licenses. Chiropractors' scope of practice varies by state in areas such as
laboratory tests or diagnostic procedures, the dispensing or selling of dietary supplements, and the use of other
CAM therapies such as acupunctureA family of procedures that
originated in traditional Chinese medicine. Acupuncture is
the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal
needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health.
Or homeopathy: A whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to
heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness
or symptoms (an approach called "like cures like")..
Compared with other CAM therapies, insurance coverage for chiropractic services is extensive. Many HMOs (health
maintenance organizations) and private health care plans cover chiropractic treatment, as do all state workers'
compensation systems. Chiropractors can bill Medicare, and many states cover chiropractic treatment under Medicaid.
If you have health insurance, check whether chiropractic services are covered before you seek treatment.
Other Points To Consider
- Research to expand the scientific understanding of chiropractic treatment is ongoing.
- If you decide to seek chiropractic care, talk to your chiropractor about:
- His education, training, and licensing
- Whether he has experience treating the health conditions for which you are seeking care
- Any special medical concerns you have and any medicines or dietary supplements you are taking.
- Tell all of your health care providers about any complementary and alternative practices you use. Give them
a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
Recent research projects on chiropractic care supported by the National Center for Complementary and Alternative
Medicine (NCCAM) have focused on the:
- Effectiveness of chiropractic treatments for back pain, neck pain, and headache, as well as for other
health conditions such as temporomandibular disorders
- Development of a curriculum to increase the number of chiropractors involved in research
- Influence of people's satisfaction with chiropractic care on their response to treatment.
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