WHAT IS CHIROPRACTIC?
Chiropractic is a primary healthcare profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is a focus on reducing pain and disability by improving joint function and promoting rehabilitation. Management places an emphasis on manual techniques, including but not limited to, spinal adjustment, and other joint and soft-tissue manipulation.
Some of the methods used to this day by modern chiropractors had their origins from the time of Hippocrates, the father of medicine, and are found in many ancient cultures.
Chiropractic originated in North America at the end of the nineteenth century. Like every other health profession, modern chiropractic is vastly different from its early pioneer days. As science has evolved and research has informed better approaches to care, so chiropractic has embraced evidence-based education and practice.
Chiropractors do not prescribe drugs or undertake surgery. The word ‘chiropractic’ originates from the Greek chiro and praktikos, literally meaning ‘practiced by hand’. It is one of the manual therapy professions and uses manipulation of the spine (referred to by chiropractors as spinal adjustments) to restore function and movement to stiff and restricted joints.
Chiropractic is practiced in over 100 countries around the world. How chiropractic is practiced depends on its legal status, including any defined scope of practice, and cultural factors.
National chiropractic association members of the EMMECF are also members of the World Federation of Chiropractic (WFC). The WFC serves as the global voice of the chiropractic profession and is a non-state actor in official relations with the World Health Organization.
WHAT IS A CHIROPRACTOR?
Chiropractors are primary health care professionals who have a particular interest in the neuromusculoskeletal system. This means that they are concerned with the way that the joints, muscles and ligaments of the body function and how function is connected to the nervous system and to general health.
Chiropractors undergo many years of training to ensure that they are qualified to assess, manage, diagnose and treat a range of health conditions. They are best known for their care of the spine – low back pain is the biggest single cause of disability globally – but also treat a wide range of other conditions, including joint pain and disability related to sports injuries, headaches arising from the neck and pregnancy-related musculoskeletal pain.
Chiropractors treat patients across the life course, from the very young to older people. Assessment and treatment is tailored to take account of age-related factors, such as the delicate joints and tissues of newborns to bone fragility in the elderly. Many people mistakenly think that chiropractic is all about spinal manipulation and ‘cracking’ joints, but the work of chiropractors goes far beyond that.
Chiropractors are trained to use a package of care that is tailored to the particular characteristics of the patient. They may use a range of manual techniques, including spinal manipulation and mobilization, but many chiropractors also use forms of acupuncture, electrotherapy and other adjunct therapies. They may prescribe home exercise and give advice on lifestyle management. Where appropriate, they may refer for advanced investigations such as blood tests or diagnostic imaging, or refer to other health professionals.
WHAT CONDITIONS DO CHIROPRACTORS TREAT?
Chiropractors are best known for treating mechanical disorders of the spine and joints. These are also sometimes referred to as musculoskeletal disorders or, when they also involve the nervous system, neuromusculoskeletal disorders.
The most common conditions treated by chiropractors are low back pain and neck pain. Low back pain is the single biggest cause of years lived with disability. It is also one of the most widespread and costly causes of sickness absence. Although most episodes of low back pain resolve within 12 weeks, some people experience pain beyond this point, which is when it gets referred to as chronic back pain.
Back pain is very common. Four out of every five people will experience back pain in their lives. It is estimated that over a billion people worldwide have back pain at any time. It can be difficult to manage and many people seeing chiropractors with back pain may have previously visited other health professionals.
After low back pain, the most common conditions seen by chiropractors are neck pain and headaches. Many headaches have their origins in dysfunction of the joints of the neck and can be helped by chiropractors.
Because of their expertise in treating mechanical disorders of the spine and joints, many elite athletes use chiropractors to keep them in optimal shape. In 2012, for the first time, chiropractors were part of the medical services team at the Olympic Games. Every NFL American Football team has a chiropractor on staff and players on the professional golf tour are accompanied by a team of chiropractors. Their expertise in diagnosing and treating the spine and joints makes chiropractors an indispensable part of the modern sports medical team.
As well as the spine, chiropractors treat upper extremity disorders (such as shoulder, elbow, wrist and hand conditions) and lower extremity disorders (hip, knee, ankle and foot conditions).
Chiropractors treat people across the full life course and work with neonates and infants as well as the elderly. Treatment is modified depending on the age and condition of the patient.
Some chiropractors describe success treating non-mechanical disorders and report benefits of care for general health. The current scientific evidence of effectiveness is limited, and research is ongoing to investigate what chiropractors observe in their practices.
YOUR FIRST VISIT TO A CHIROPRACTOR…
When you first visit a chiropractor they will undertake a full assessment to determine your problem and the best way to manage it, and whether chiropractic is in fact the right approach for you.
Chiropractors are trained to take a full case history. This may involve you filling in a series of forms and questionnaires and a verbal consultation where the chiropractor will seek information about the nature of the reason you attended, your medical and drug history, your lifestyle and your family history.
Sometimes it is necessary to obtain further information through advanced investigations such as X-rays or blood tests. If these are necessary, your chiropractor will fully explain to you why they are needed and how they will benefit your management.
Prior to starting treatment, your chiropractor will provide you with a full explanation of their findings and what care they recommend for you along with the estimated number of sessions required. They will advise you on your suitability for chiropractic care, risks and benefits associated with the proposed treatment, any other alternatives to chiropractic care, and any other health professionals who may be better placed to manage your condition. They may seek permission to write to your GP. This is all part of a process known as informed consent and is designed to ensure that you are equipped with as much information as possible to be able to consent to chiropractic treatment.
Treatment may or may not be provided on the first visit. This often depends on the complexity of your condition and any tests that may need to be performed outside the clinic.
TRAINING AND EDUCATION
Chiropractors are primary health care professionals. This means that while many patients are referred by their general medical practitioner or other health care provider, there is no requirement to be referred and potential patients may contact the chiropractic clinic or office directly to request an appointment.
Chiropractors undergo a minimum of four years of training prior to graduation. There are almost 50 educational institutions providing chiropractic education throughout the world. Twenty of these programmes are located in North America, ten programs are offered in Europe, seven in Latin America, six in Australasia, two in Africa and one in the Eastern Mediterranean.
In countries where chiropractic has primary legislation, standards of education and training for chiropractors are prescribed. There are a number of accreditation agencies that set out the framework for the content and standard of chiropractic training. An overarching body, the Councils on Chiropractic Training International (CCEI), bring many of these accreditation agencies together.
In some countries, notably the United States of America and Canada, applicants for chiropractic programmes are required to have completed a relevant undergraduate degree. In others, entry into chiropractic degree programmes is direct. The award granted at the conclusion of the programme varies throughout the world. In the USA and Canada, graduates are awarded a Doctor of Chiropractic degree. Other institutions, depending on the nature of the jurisdiction, may award a Masters or Bachelors degree.
In the early years of chiropractic training, students study subjects that are common to many health professions, including anatomy, physiology and biochemistry. Courses in neuroanatomy, neurophysiology, pathology and neurology also form part of all chiropractic programmes. As experts in manual therapy, there is an emphasis on biomechanics, biophysics and the acquisition of manual therapy skills such as spinal adjustment and other forms of joint and soft tissue manipulation.
Regardless of the award, upon graduation from accredited institutions, chiropractors have completed a rigorous course of training that enable them to be safe and competent to assess, diagnose, manage and treat patients.
In many countries, chiropractors are required to undertake continuing professional development. This helps to ensure that chiropractors stay up to date and inform themselves of the latest evidence. This lifelong learning is common to many health professions and helps to ensure that patients receive safe and effective care.