About Chiropractic

1. Chiropractic is Safe.

Records form insurance and court cases have constantly shown that chiropractic is the safest portal of entry health care available to the public today. Although no healthcare procedures are 100% safe, chiropractic stands on its record of safety and effectiveness unmatched in healthcare.

To learn more about the safety record of chiropractic please visit the website Chiropractic Is Safe at www.chiropracticissafe.org.

2. Chiropractic is the fastest-growing and second-largest primary health care profession.

2. Chiropractic is the fastest-growing and second-largest primary health care profession.

There are approximately 60,000 doctors of chiropractic (DCs) in active practice in the United States spread from rural areas to inner cities. More than 10,000 students are currently enrolled in chiropractic educational programs accredited by a federally-recognized body (CCE).

3. Chiropractic services are in high demand.

3. Chiropractic services are in high demand.

Tens of millions of Americans routinely opt for chiropractic services and this number is rapidly growing. In 1993, more than 30 million consumers made chiropractic a regular part of their health care program.

4. Doctors of Chiropractic receive extensive education.

4. Doctors of Chiropractic receive extensive, demanding professional education on par with medical doctors (MDs) and osteopaths (DOs).

To receive the doctor of chiropractic degree, candidates must complete extensive undergraduate prerequisites and four years of graduate-level instruction and internship at an accredited chiropractic institution. Comprehensive knowledge of all systems of the body and diagnostic procedures enable the DC to thoroughly evaluate a patient, address disorders relating to the spine and determine the need for referral to another health care provider.

5. Doctors of Chiropractic are primary health care providers.

5. Doctors of Chiropractic are primary health care providers.

According to the Center for Studies in Health Policy, "The DC can provide all three levels of primary care interventions and therefore is a primary care provider, as are MDs and DOs. The doctor of chiropractic is a gatekeeper to the health care system and an independent practitioner who provides primary care services. The DC's office is a direct access portal of entry to the full scope of service."

6. Doctors of Chiropractic are licensed in all 50 states.

6. Doctors of Chiropractic are licensed in all 50 states.

DCs have been licensed and recognized for many decades in all states, the District of Columbia and Puerto Rico.

DCs have also been recognized in nations around the world, see our international links!

7. Chiropractic is recognized by governmental health care programs.

7. Chiropractic is recognized by governmental health care programs.

Chiropractic is included in Medicare, Medicaid, Federal Employees Health Care Benefits Programs, Federal Workers' Compensation and all state workers' compensation programs. Chiropractic students are qualified to receive federal student loan assistance and DCs are authorized to be commissioned as health care officers in the U.S. Armed Forces.

8. The practice of chiropractic is based on sound scientific principles.

8. The practice of chiropractic is based on sound scientific principles.

The existence of the nervous system as the primary control mechanism of the body is an undisputed scientific fact. Its relationship with the spine is the focus of the practice of chiropractic.

The spine develops in utero to provide two primary functions:

1. allow for freedom of movement
2. house and protect the spinal cord

When the vertebrae of the spine become misaligned through trauma or repetitive injury, two major consequences will result:

1. the range of motion becomes limited
2. spinal nerves emerging from the spinal cord are compromised

DCs use the term "subluxation" to describe such disruptions. Interruption of nerve flow can eventually lead to pain, disability, and an overall decrease in the quality of life. Conversely, the removal of that interference has been shown to have significant, lasting health benefits. Through the adjustment of the subluxation, the doctor of chiropractic endeavors to restore normal nerve expression. The body is then able to respond appropriately to any imbalance in the system, thus relieving symptoms and restoring health.

9. Doctors of chiropractic provide effective, inexpensive treatments.

9. Doctors of chiropractic provide effective, low-cost health care for a wide range of conditions.

Studies conducted according to the highest scientific standards and published by organizations not affiliated in any way with chiropractic institutions or associations continue to show the clinical appropriateness and effectiveness of chiropractic care. One of the most recent, funded by the Ontario Ministry of Health, stated emphatically that:

"On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain...There would be highly significant cost savings if more management of low back pain was transferred from physician to chiropractors."

10. The doctor of chiropractic is an effective source of preventative and wellness care.

10. The doctor of chiropractic is an effective source of preventative and wellness care.

The anatomical focus of the DC on the human spine has created the perception of the DC as just a "back doctor." Although this perception is not entirely incorrect, it is very much incomplete. Doctors of chiropractic are a highly appropriate resource in matters of work-place safety, stress management, injury prevention, postural correction and nutritional counseling."

11. The chiropractic adjustment is a safe procedure.

11. The chiropractic adjustment is a safe procedure.

Chiropractic adjustments are performed nearly one million times every working day in the United States. There is a singular lack of actuarial data that would justify concluding that chiropractic care is in any way harmful or dangerous. Chiropractic care is non-invasive, therefore, the body's response to chiropractic care is far more predictable than its reactions to drug treatments or surgical procedures. Of the nearly one million adjustments given every day in this country, complications are exceedingly rare. Perhaps the best summary statement on the subject of safety was published in 1979 by the Government of New Zealand which established a special commission to study chiropractic. They found:

"The conspicuous lack of evidence that chiropractors cause harm or allow harm to occur through neglect of medical referral can be taken to mean only one thing: that chiropractors have on the whole an impressive safety record."

The following are excerpts about chiropractic and are reprinted from:

The National Institutes of Health's

1. What is chiropractic?

1. What is chiropractic?

The word "chiropractic" combines the Greek words cheir (hand) and praxis (action) and means "done by hand." Chiropractic is an alternative medical system and takes a different approach from conventional medicine in diagnosing, classifying, and treating medical problems.

The basic concepts of chiropractic can be described as follows:

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.
Chiropractic therapy is given with the goals of normalizing this relationship between structure and function and assisting the body as it heals.

2. What is the history of chiropractic?

2. What is the history of chiropractic?

Chiropractic is a form of spinal manipulation, which is one of the oldest healing practices. Spinal manipulation was described by Hippocrates in ancient Greece.^1-3

In 1895, Daniel David Palmer founded the modern profession of chiropractic in Davenport, Iowa. Palmer was a self-taught healer and a student of healing philosophies of the day. He observed that the body has a natural healing ability that he believed was controlled by the nervous system. He also believed that misalignments of the spine, interrupt or interfere with this "nerve flow." Palmer suggested that if an organ does not receive its normal supply of impulses from the nerves, it can become diseased. This line of thinking led him to develop a procedure to "adjust" the vertebrae, the bones of the spinal column, with the goal of correcting subluxations.

3. Who uses chiropractic and for what health problems?

4. What kind of training do chiropractors receive?

3. Who uses chiropractic and for what health problems?

Americans made 192 million visits to chiropractors in 1997.⁴
88 million of those visits were for back pain or neck pain.⁵
104 million were for other conditions besides back and neck pain.⁵
Conditions commonly treated by chiropractors:
- Back Pain
- Neck Pain
- Headache
- Sports Injuries
- Repetitive Strains
- Arthritis
National Institutes of Health (NIH)

4. What kind of training do chiropractors receive?

Chiropractic training is a 4-year academic program consisting of both classroom and clinical instruction.

At least 3 years of preparatory college work are required for admission to chiropractic schools.^12,13

Students who graduate receive the degree of Doctor of Chiropractic (D.C.) and are eligible to take state licensure board examinations in order to practice.

The Council on Chiropractic Education, an agency certified by the U.S. Department of Education, is the accrediting body for chiropractic colleges in the United States.¹⁴

5. What do chiropractors do in treating patients?

5. What do chiropractors do in treating patients?

During your initial visit the chiropractor will take your health history.

He will perform a physical examination, with special emphasis on the spine, and possibly other examinations or tests such as x-rays.¹⁵

If he determines that you are an appropriate candidate for chiropractic therapy, he will develop a treatment plan.

When the chiropractor treats you, he may perform one or more adjustments.

An adjustment is a manual therapy, or therapy delivered by the hands. Given mainly to the spine, chiropractic adjustments involve applying a controlled, sudden force to a joint. They are done to increase the range and quality of motion in the area being treated.

6. Have side effects or problems been reported
from using chiropractic to treat back pain?

6. Have side effects or problems been reported from using chiropractic to treat back pain?

Patients may or may not experience side effects from chiropractic treatment. Effects may include temporary discomfort in parts of the body that were treated, headache, or tiredness. These effects tend to be minor and to resolve within 1 to 2 days.^7,17

The rate of serious complications from chiropractic has been debated. There have been no organized prospective studies on the number of serious complications. From what is now known, the risk appears to be very low.^14,16,17 It appears to be higher for cervical-spine, or neck, manipulation (e.g., cases of stroke have been reported^18,19). The rare complication of concern from low-back adjustment is cauda equina syndrome, estimated to occur once per millions of treatments (the number of millions varies; one study placed it at 1 in 100 million¹⁶).^1,20,a

7. Does the government regulate chiropractic?

7. Does the government regulate chiropractic?

Yes, chiropractic practice is regulated individually by each state and the District of Columbia. Most states require chiropractors to earn continuing education credits to maintain their licenses.^1,13 Chiropractors' scope of practice varies by state--including with regard to laboratory tests or diagnostic procedures, the dispensing or selling of dietary supplements, and the use of other CAM therapies such as acupuncture or homeopathy.^13,14,23 Chiropractors are not licensed in any state to perform major surgery or prescribe drugs.

In Oregon, chiropractors can become certified to perform minor surgery and to deliver children by natural childbirth.^14,23,24

8. Do health insurance plans pay for chiropractic treatment?

8. Do health insurance plans pay for chiropractic treatment?

Yes, coverage of chiropractic care by insurance plans is extensive.

As of 2002, more than 50 percent of health maintenance organizations (HMOs), more than 75 percent of private health care plans, and all state workers' compensation systems covered chiropractic treatment.¹

Chiropractors can bill Medicare, and over two dozen states [including North Carolina] cover chiropractic treatment under Medicaid.²³

References

References

Meeker WC, Haldeman S. Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Annals of Internal Medicine. 2002;136(3):216-227.
Kaptchuk TJ, Eisenberg DM. Chiropractic: origins, controversies, and contributions. Archives of Internal Medicine. 1998;158(20):2215-2224.
Bronfort G. Spinal manipulation: current state of research and its indications. Neurologic Clinics. 1999;17(1):91-111.
Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. Journal of the American Medical Association. 1998;280(18):1569-1575.
Wolsko PM, Eisenberg DM, Davis RB, et al. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine. 2003;28(3):292-297.
Coulter ID, Hurwitz EL, Adams AH, et al. Patients using chiropractors in North America: who are they, and why are they in chiropractic care? Spine. 2002;27(3):291-296.
Vickers A, Zollman C. ABC of complementary medicine. The manipulative therapies: osteopathy and chiropractic. BMJ. 1999;319(7218):1176-1179.
Atlas SJ, Nardin RA. Evaluation and treatment of low back pain: an evidence-based approach to clinical care. Muscle and Nerve. 2003;27(3):265-284.
Pengel HM, Maher CG, Refshauge KM. Systematic review of conservative interventions for subacute low back pain. Clinical Rehabilitation. 2002;16(8):811-820.
Assendelft WJ, Morton SC, Yu EI, et al. Spinal manipulative therapy for low back pain. Annals of Internal Medicine. 2003;138(11):871-881.
Complementary medicine: fact and fiction about chiropractic. Harvard Health Letter. 1999;24(3):1-3.
The Council on Chiropractic Education. Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status January 2003. Council on Chiropractic Education Web site. Accessed at www.cce-usa.org on June 16, 2003.
Eisenberg DM, Cohen MH, Hrbek A, et al. Credentialing complementary and alternative medical providers. Annals of Internal Medicine. 2002;137(12):965-973.
Agency for Health Care Policy and Research. Chiropractic in the United States: Training, Practice, and Research. Rockville, MD: Agency for Health Care Policy and Research; 1998. AHCPR publication no. 98-N002.
Dagenais S, Haldeman S. Chiropractic. Primary Care. 2002;29(2):419-437.
Shekelle PG, Adams AH, Chassin MR, et al. Spinal manipulation for low-back pain. Annals of Internal Medicine. 1992;117(7):590-598.
Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22(4):435-440.
Hufnagel A, Hammers A, Schonle PW, et al. Stroke following chiropractic manipulation of the cervical spine. Journal of Neurology. 1999;246(8):683-688.
Jeret JS, Bluth M. Stroke following chiropractic manipulation: report of 3 cases and review of the literature. Cerebrovascular Diseases. 2002;13(3):210-213.
Haldeman S, Rubinstein SM. Cauda equina syndrome in patients undergoing manipulation of the lumbar spine. Spine. 1992;17(12):1469-1473.
Haldeman S, Rubinstein SM. Compression fractures in patients undergoing spinal manipulative therapy. Journal of Manipulative and Physiological Therapeutics. 1992;15(7):450-454.
Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Spine. 2002;27(20):2193-2204.
Cooper RA, Henderson T, Dietrich CL. Roles of nonphysician clinicians as autonomous providers of patient care. Journal of the American Medical Association. 1998;280(9):795-802.
Chiropractic regulatory boards. Federation of Chiropractic Licensing Boards Web site. Accessed at www.fclb.org/boards.htm on June 16, 2003.
Hsieh CY, Adams AH, Tobis J, et al. Effectiveness of four conservative treatments for subacute low back pain: a randomized clinical trial. Spine. 2002;27(11):1142-1148.
Cherkin DC, Deyo RA, Battie M, et al. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. New England Journal of Medicine. 1998;339(15):1021-1029.
Bronfort G, Goldsmith CH, Nelson CF, et al. Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial. Journal of Manipulative and Physiological Therapeutics. 1996;19(9):570-582.
Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. New England Journal of Medicine. 1995;333(14):913-917.
Pope MH, Phillips RB, Haugh LD, et al. A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine. 1994;19(22):2571-2577.
Triano JJ, McGregor M, Hondras MA, et al. Manipulative therapy versus education programs in chronic low back pain. Spine. 1995;20(8):948-955.
Meade TW, Dyer S, Browne W, et al. Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up. BMJ. 1995;311(7001):349-351.
Assendelft WJ, Koes BW, van der Heijden GJ, et al. The effectiveness of chiropractic for treatment of low back pain: an update and attempt at statistical pooling. Journal of Manipulative and Physiological Therapeutics. 1996;19(8):499-507.
Ernst E. Chiropractic spinal manipulation for back pain. British Journal of Sports Medicine. 2003;37(3):195-196.
Ernst E. Chiropractic care: attempting a risk-benefit analysis. American Journal of Public Health. 2002;92(10):1603-1604.
Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study. American Journal of Public Health. 2002;92(10):1634-1641.
Sran MM. Commentary on "Chiropractic spinal manipulation for back pain." British Journal of Sports Medicine. 2003;37:196.