Chiropractors specialise in diagnosing, treating and preventing mechanical disorders of the spine, joints and muscles. The term chiropractic is derived from the Greek words cheiro, meaning 'hand' and praktos, 'doing', because practitioners work manually to restore normal function.
Chiropractors focus on re-aligning the spine by 'adjusting' vertebrae, but also work on the rest of the musculo-skeletal system (bones, joints, tendons, ligaments and muscles).
Chiropractic was developed by a Canadian osteopath, David Daniel (DD) Palmer, who speculated about the potential of spinal adjustments in 1895 after he apparently cured a patient's long-term deafness by manipulating badly aligned neck vertebrae.
Offshoots of chiropractic include network spinal analysis, which concentrates on the interaction of the vertebrae and uses a sequence, or 'network', of 12 adjustment techniques. McTimoney chiropractic focuses on the patient's whole body at each session and uses gentle, relatively uncomplicated forms of adjustment.
Chiropractic is often confused with osteopathy and there are many similarities, but the essential difference is that osteopaths use fewer X-rays, more soft-tissue manipulation and make less use of hard thrusts directly on the spine.
what it's supposed to do
The spine is regarded as the key mechanical support of the body as well as the main 'telephone line' of the nervous system, carrying the nerves that link body systems and the brain. Spinal nerves run between the vertebrae and branch into a complex network of nerves all over the body. Any damage or strain on the spine is therefore thought likely to have far-reaching effects through the nervous system, not just on joints and muscles but on internal organs and the hormonal, circulatory and other body systems.
So by 'adjusting' and 're-aligning' the spine and mobilising joints, chiropractors claim to relieve pressure on the nervous system. This is not only said to relieve joint and muscle pain but to help problems in parts of the body, such as the digestive system, that appear to have no relation to the back.
People usually see a chiropractor for pain in the back, neck, shoulders, arms or legs caused by accident, injuries at work, poor posture, sports injuries, pregnancy, arthritis. Treatment may also benefit headaches (a pinched nerve in a neck vertebra, for example, may be the cause of persistent migraine), digestive disorders, menstrual pain and even asthma and glue ear.
what happens
The initial appointment usually takes about 30-60 minutes. A full case history is taken, including medical history and lifestyle factors, such as the kind of work and exercise you do. Then you'll be asked to undress to your underpants and given a gown for a physical examination and assessment of your posture and the way you sit and move. The practitioner examines by palpation (touch and feeling) and manoeuvres you into various positions to assess the functioning of your spine, joints and muscles. Your reflexes, pulse and blood pressure may be checked and very commonly, X-rays are taken.
Techniques consist of soft-tissue work to relax tensed muscles and make joint manipulation less painful, and repeated rhythmical manoeuvres to take joints through their normal range of movement. 'High velocity' direct thrusts are rapid, forceful but controlled movements to adjust problem joints. These may be accompanied by a painless cracking sound, said to be caused by the collapse of tiny gas bubbles created by the change of pressure in the joint fluid.
Treatment can cause mild discomfort and stiffness the following day. The number of treatments depends on the problem and your age, but you'll probably need two or three 15- to 20-minute sessions in the first week to ten days. You will almost always be given exercises to do at home.
what's the evidence?
A convincing number of scientific trials now support claims that chiropractic can help lower back pain. Studies carried out by the Medical Research Council in the British Medical Journal in 1990 and 1995 showed chiropractic was more effective than hospital out-patient care in treating patients with lower back pain. In a few parts of the UK chiropractic treatment is now available on the NHS.
precautions
Go to the safety first section of 'before you start' for some general precautions to take into account when considering a complementary therapy.
Vigorous manipulation should be avoided if you have badly prolapsed ('slipped') discs.
Manipulation may not be inappropriate or even harmful if you have osteoporosis, inflammation, infections, cancer, circulatory problems or a recent fracture.
how to find a practitioner
The Chiropractic Act of 1994 granted chiropractors statutory regulation, similar to doctors, dentists and physiotherapists. The chiropractorsÕ professional body, the General Chiropractic Council (see help and info), maintains a register of practitioners, sets educational standards and accredits training establishments, runs a professional development programme, provides codes of conduct, ethics and practice, organises complaints and disciplinary procedures and requires members to take out indemnity insurance. It is now illegal for any practitioner to call themselves a chiropractor unless they are registered with the General Chiropractic Council.
