What is chiropractic?
The word ‘chiropractic’ comes from the Greek words cheir (meaning ‘hand’) and praktikos (meaning ‘done’) – namely, done by hand. Chiropractors are primary contact practitioners (which means they can see patients without a referral from a GP). They focus on treating the spine by using their hands to examine and treat health conditions related to the bones, muscles and joints (musculoskeletal problems).
Chiropractors are trained to recommend exercises to treat and rehabilitate health conditions related to the bones, muscles and joints, as well as to provide nutritional, dietary and lifestyle advice.
They use a broad range of methods to diagnose musculoskeletal problems, including hands-on clinical examination, and diagnostic imaging such as x-rays or MRIs. These and other diagnostic methods are used to determine when chiropractic treatment is appropriate.
If chiropractic care is not appropriate, or if your health condition needs to be co-managed with other health care professionals, your chiropractor will refer you to the appropriate health care provider.
In many cases, such as lower back pain, chiropractic care may be a person’s primary method of treatment. For some medical conditions, chiropractic services may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.
When to consider chiropractic care
Chiropractic care may help if you are experiencing aching joints or muscle pain that is affecting your ability to get through the day, or preventing you from doing your favourite activities. It can also help maintain healthy spine and joint function, even if you do not have painful symptoms.
People commonly visit a chiropractor for help with:
- back pain
- neck pain
- strains and sprains from daily activities
- overuse injuries
- work and sports-related injuries
- restricted movement in the back, shoulders, neck or limbs
When you attend a chiropractic examination your chiropractor will:
- conduct a thorough medical history
- look at your vital signs – namely your body temperature, pulse, respiration rate (breathing rate) and blood pressure
- visually inspect for spinal curves or other visible health indicators
- use their hands to palpate (feel) your spine and the muscles and other soft tissues that support it
- conduct orthopaedic examinations – these are examinations designed to detect health conditions relating to the spine, bones, joints, muscles and soft tissues, including ligaments and tendons. Among other things, an orthopaedic exam includes moving the joint and measuring its range of movement
- conduct neurological examinations – these are examinations designed to assess the function of your motor, sensory and cranial nerves (such as testing your reflexes and testing for numbness).
Where required, your chiropractor can also refer you directly for other diagnostic tests such as an MRI or x-ray.
Based on their examination, your chiropractor will give you a differential diagnosis (that considers all of the potential causes of your primary complaint) and a working diagnosis (the most likely cause of your primary complaint). They will explain this diagnosis, including its natural history (when you would expect it to resolve), the treatment options available to you and any benefits or risks associated with those treatments.
Common chiropractic treatments include a range of different techniques, such as:
- spinal manipulation, sometimes called chiropractic adjustment – using the hands to apply controlled force to a joint of the spine
- mobilisation – gentle movement of the joint to increase its range of motion
- application of heat or ice
- soft tissue techniques – such as massage
- activity modification – suggesting how to make changes to your day-to-day activities to alleviate discomfort and enable recovery
- lifestyle advice – such as healthy eating and physical activity advice
- physiologic therapeutics – such as use of ultrasound, laser or TENS
- orthotics – shoe inserts that help support the feet and improve posture and alignment
- drop piece table technique – the use of a specially designed table to help mobilise a joint in a controlled way
- treatment of other joints, including feet, ankles, shoulders, wrists, elbows.
Your chiropractor will discuss these with you as part of a shared decision-making process.
One of the most common and well known therapeutic procedures performed by chiropractors is spinal manipulation (sometimes referred to as a ‘chiropractic adjustment’, although this technique is also used by osteopaths and physiotherapists). The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement as a result of a tissue injury.
Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function.
Manipulation or adjustment of the affected joint and tissues restores mobility, thereby alleviating pain and muscle tightness, allowing tissues to heal.
Spinal manipulation is very safe when performed by a trained, registered practitioner, although some people may experience mild soreness or discomfort following treatment. This usually resolves within 12 to 48 hours. Your chiropractor will discuss this with you prior to any intervention in a process called informed consent.