Neurological Exams

A neurological examination is sometimes performed to determine if any part of your body has incurred damage to its central nervous system. Many health problems have been associated with nerve damage, and such, this exam can significantly improve the chances of making a thorough diagnosis.

A neurological exam involves a thorough exploration of the body's arms, legs, and trunk.

If you have a neurological exam, your chiropractor may look for signs of:

• Bowel or bladder problems
• Gait problems (walking, running, climbing stairs, etc.)
• Muscle spasms or twitching
• Numbness, tingling, or pain and whether changing positions relieves those symptoms
• Problems with balance
• Weakened muscle strength and tone
• Weakened reflexes (a sign of possible damage to the spinal cord, nerves, or muscles)
• Weakness (consistent or intermittent) in your arms or legs

Ice Therapy

In many cases, temporary pain, and even additional injury, can be minimized and even avoided by a simple application of ice. Ice, applied in a timely manner and in an appropriate way, can reduce inflammation. Inflammation left unchecked can allow the source of the pain to continue doing damage to muscles, ligaments, tendons, and other structures.

Ice causes the veins in the affected tissue area to constrict. This reduces the flow of blood while acting as kind of anesthetic to numb the pain. But when the ice is removed (and this is key), the veins compensate by opening large, allowing a large volume of blood to rush to the affected area. The blood brings with it important chemicals that aid in the healing process.

Ice therapy is not recommended as a form of treatment for any kinds of rheumatoid arthritis, Raynaud's Syndrome (a circulatory disorder of blood vessels of the extremities), colds or allergic conditions, paralysis, or areas of impaired sensation.

Exercise

Exercise and other kinds of physical activity can go far in keeping your body strong and healthy, able to fight disease and ward off injuries from pulling, pushing and lifting. A healthy and fit body also generally recovers faster from Injury and Pain.

In general, there are three basic types of exercise: strengthening. stretching and aerobic. Here's a brief description:

• Strengthening exercises focus on the abdominal and back muscles because these play a key role in supporting your spine and maintaining good posture.
• Stretching exercises target the soft tissues in your legs and surrounding your spine. These muscles provide the flexibility you need to move and get around.
• Aerobic exercises foster a strong and healthy heart and lung function. These kinds of exercises generally involve large muscle groups.

Other kinds of mild exercises include those that help you correct or maintain good posture (with a focus on the neck and back); ease tension from prolongued periods of sitting.

Lifestyle and Nutrition Counseling

Chiropractors believe that when your body is in a state of homeostasis, or balance, all of its varied systems function properly to repair or reverse injury or disease.

It is a holistic approach to patient care, one that focuses on a patient's total wellness, or well-being, instead of specific diseases, or ailments. This intricate physiological and biochemical interrelationship among various parts of your body-including its spinal, musculoskeletal, neurological, and vascular systems-is what chiropractors dedicate themselves to exploring and treating, with special attention to nutrition, exercise, and healthy emotional and environmental relationships. When one or more of these systems is impaired, your body ceases to function normally and your resistance to disease is compromised. 

Lifestyle counseling is a critical part of what Chiropractic Care involves-from providing advice on lifting techniques, sleep, posture, exercise, and nutrition and diet, to ergonomic work environments and sports and recreational injury prevention.

Exercise and other kinds of physical activity can go far in keeping your body strong and healthy, able to fight disease and ward off injuries from pulling, pushing and lifting. A healthy and fit body also generally recovers faster from injury and pain. Like exercise, proper nutrition provides a wealth of benefits-both physical and emotional-that contribute to your body's strength and its ability to ward off disease and disability. A healthy diet translates into a healthy body; the proper mix of vitamins, minerals and other nutrients are the best recipe for ensuring your skeletal, muscular, nervous and circulatory systems function smoothly.

Type of Treatments: Corsets, Braces, and Splints

Corsets, braces and splints are used in Chiropractic Treatment. A common application of braces is used to treat children with idiopathic scoliosis, or curvature of the spine.

Back braces are only recommended for younger children (girls between 11 and 13, and boys between 12 and 14). The primary goal of orthotic treatment involving a back brace is to stop the progression of the curvature; braces do not normally reverse curvature that has already taken place.

Type of Treatments: Adjustments

Chiropractic Adjustments have been shown to be a safe and effective alternative treatment for pain and injury.

Chiropractors perform 95 percent of all adjustments in the world to correct the subluxations, or misalignments, of the vertebrae in the spine. Chiropractic adjustments are performed by applying gentle, yet firm pressure to a bone. The goal of any adjustment is to restore the bone to its natural, or original, position. The important thing to remember is the act the adjustment frees-not forces-a vertebrae to allow it to find its natural position. This is accomplished by the body's innate intelligence.

Chiropractic adjustments are performed to treat a wide variety of conditions, including (but not limited to):

• Arthritis
• Bursitis
• Carpal tunnel syndrome and other repetitive strain disorders
• Chronic muscle pain and stiffness
• Headaches
• Most musculoskeletal and sports-related injuries
• Nerve disorders
• Pain and stiffness in the back, chest, abdomen, neck, hips and shoulders, as well as extremities such as arms, legs, and feet
• Sciatica pain
• Scoliosis
• Tendonitis
• Whiplash and other traumatic injuries

Adjustments can be performed while sitting, standing, or lying down. Some adjustments involve special instruments or tables.

Some common adjustment techniques include:

• Instrument adjustments, which involve a spring-loaded device.
• Lumbar roll, in which the chiropractor applies a firm, yet quick thrust to a misaligned vertebra while the patient lies on his or her side.
• Motion palpation, a hand technique the chiropractor uses to determine if your vertebrae are properly aligned.
• Release work, in which the chiropractor uses gentle pressure with the fingers to separate the vertebrae.
• Table adjustments, which entail lying on a specially designed table that drops when pressure is applied to a specific area. The dropping motion allows more gentle adjustments than some manual adjustments do.
• Toggle drop, which entails firm pressure applied on a specific area of the spine by using crossed hands.

Chiropractors take many factors-including size, weight, and muscle structure-into consideration when deciding on which adjustment to make. Sometimes, ice, electrical stimulation, or massage therapy (including traction massage) are used prior to a spinal manipulation in order to relax the muscles.

In some cases, it may necessary to perform an adjustment while you are sedated. Spinal manipulation under anesthesia, which is considered a very safe procedure, is usually reserved for patients with conditions such as chronic neck, back, and joint pain, muscle spasm, shortened muscles, and fibrous adhesions.

Another form of adjustment called craniosacral therapy, or "CST," involves exerting very mild pressure to the body's craniosacral system, which is comprised of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord. This includes the cranium-which is composed of the skull, face and mouth, and the "sacrum," or tailbone. CST has been shown to provide relief from chronic neck and back pain, scoliosis, brain and spinal cord injuries, migraines, chronic fatigue, nervous system disorders, jaw joint problems, and stress disorders. (Such conditions as aneurysm and intracranial hemorrhage prohibit this kind of therapy.)

Adjustments almost always do not involve any pain or discomfort. The important thing for a patient to keep in mind is to remain relaxed, because stiffening up may impede the adjustment process. Popping sounds are sometimes heard during adjustments; these are usually pockets of air being released behind a joint or other bony structure.

Adjustments can leave you with a greater sense of well-being, calm, and most importantly, on the road to a life without pain. Following an adjustment, some patients experience mild aching or soreness in their spinal joints or muscles, which can usually be relieved by an ice or heat pack.

Adjustments have been shown to:

• Increase blood flow
• Increase pain tolerance levels
• Increase range of motion
• Increase the body's secretion of "good" chemicals such as melatonin and endorphins
• Reduce blood pressure
• Reduce tension and muscle pressure

Type of Treatments: Acupuncture

Many have heard of it. Few know very much about it. Yet, Acupuncture is one of the oldest healing arts in the world, practiced centuries ago by ancient Chinese as a method of curing a host of ailments.

Today, Americans make as many as 12 million visits per year to acupuncture practitioners, according to the most recent statistics from the Food and Drug Administration. Many people who have experienced acupuncture report relief from pain and a sense of euphoria, or well-being.

There are currently more than 10,000 Certified Acupuncturists-one-third of them physicians-practicing in this country.

Acupuncture involves the application of extremely fine needles into one or more of the 2,000 acupuncture points on the human body. These points are said to link 12 main and eight secondary pathways. These channels, or pathways, are called "meridians." The meridians are believed to conduct energy between the body's skin and internal organs. Part of the controversy surrounding acupuncture stems from the fact that scientists cannot correlate the 20 pathways, or meridians, with the human body's blood circulation and nerve paths.

Nevertheless, acupuncture theory holds that energy conducted by meridians, also called qi (pronounced "chee"), is known to coordinate the balance between one's spiritual, emotional, mental, and physical state. Acupuncture is believed to help in balancing the opposing forces called yin and yang. A healthy person's yin and yang are said to be in a state of harmony.

Acupuncture has about as many critics as it does advocates. Medical researchers have shown in dozens of high profile studies, however, that acupuncture can be an effective alternate treatment for a myriad of health problems-from central nervous system-related conditions and immune system response.

Acupuncture is known to have a profound impact on pain. The theory is that the application of fine needles in acupuncture points stimulates the release of chemicals, such as endorphins or opiates, which dull or alleviate pain while releasing hormones, neurotransmitters, and other chemicals that aid in healing or regulating things, such as blood pressure.

Evidence has shown that the body's 2,000-plus acupuncture points do conduct electricity, and this flow of current may play a role in triggering the release of helpful chemicals in the body to where they are needed most.

Does acupuncture hurt?

Acupuncture needles are so incredibly small and thin (up to 50 times thinner than a standard hypodermic needle), they are barely noticeable when inserted. Some people who experience acupuncture report feeling nothing at all; other report feeling a mild discomfort, followed by a mild sensation of cramping, tingling, numbness, warmth, or heaviness. Acupuncture needles are normally left in place for 20-40 minutes.

Acupressure, another alternative therapy rooted in ancient Eastern medicine, involves exerting pressure on specific body points by use of the fingers of the hand, palm, or elbows.

Type of Therapy: Ultrasound Therapy

Many of us have heard about how Ultrasound is used as a diagnostic test to explore disease process and injury in the human body. Diagnostic ultrasound, for example, can be used to look at joints, nerve roots, tendons, ligaments and muscles and pinpoint signs of inflammation and scar tissue. In some cases, ultrasound helps the chiropractor identify the proper course of treatment.

But ultrasound has another exciting application in the form of deep heat therapy. Therapeutic ultrasound uses heated sound waves and applies the energy to soft tissues and joints. The fast-moving waves essentially massage soft tissues effortlessly, and in most cases, painlessly.

Therapeutic ultrasound:

• Alleviates muscle spasms
• Reduces inflammation and swelling
• Improves range of motion
• Helps increase blood flow
• Lowers pain and stiffness

Therapeutic ultrasound is typically applied using a small, hand-held wand. Therapeutic ultrasound is often used as one method to treat Lower Back Pain. It is not used to treat acute inflammatory conditions or in patients who have had a laminectomy.

Type of Therapy: Massage Therapy

Therapeutic Massage involves manipulating the soft tissues of the body to prevent and alleviate pain, discomfort, muscle spasm, and stress.

As in many kinds of therapy, therapeutic massage is one part of your overall chiropractic treatment plan.

Massage therapy:

• Alleviates headache-associated pain
• Helps improve your ability to walk with a normal and balanced gait
• Helps lower your blood pressure
• Improves your breathing as a result of a more relaxed diaphragm
• Improves your range of motion, muscle tone, and flexibility
• Increases your blood flow, which aids in the healing process and allows muscles to work more efficiently;
• Reduces stiffness, pain and muscle tension

Stimulates the body to release helpful chemicals such as endorphins. Massage has been shown to be an effective treatment for a wide variety of health problems, including:

• Stress
• Sleep apnea and insomnia
• Sinusitis
• Range of motion
• Pain (chronic and temporary)
• Myofascial pain
• Jaw disorders
• Injuries such as pulled or strained muscles and ligaments
• Headache
• Digestive disorders, including spastic colon and constipation
• Circulatory problems
• Carpal tunnel syndrome
• Asthma and bronchitis
• Arthritis
• Allergies

In some cases, devices may be used to perform massage. Traction massage entails lying on your back on a special table with a pillow under your knees. The table has small rollers that glide up and down your spine. Traction massage helps stretch and massage the muscles in your back, and is not a form of spinal adjustment. In fact, traction massage may sometimes be used to make an adjustment go more smoothly.

Type of Therapy: Lumbar Stabilization

When the muscles supporting the lower spine need to be strengthened, lumbar stabilization may be used in your chiropractic treatment as a form of Physical Therapy. Lumbar stabilization helps you develop strength, flexibility, and endurance and also has been shown effective in alleviating Lower Back Pain.

The key to lumbar stabilization is achieving a "neutral spine" position. The neutral spine position is that which is the least painful but most sound posture for your lower back.

When your spine is in a neutral position:

• The discs and vertebrae are able to absorb shocks and other forces acting on the spine in an optimal way.
• There is less tension on the ligaments and joints of your spine.
• Your posture is centered.

Once your learn how to go to your neutral spine position, lumbar stabilization teaches you how to maintain that position through a technique called "proprioception." Proprioception teaches you how to know where your joints are at any given time.

Lumbar stabilization helps you:

• Better control the movements affecting your spine
• Heal muscle strains, sprains, and damaged ligaments
• Know how to avoid future injuries
• Reduce pain in your lower back

Type of Therapy: Ice Therapy

Ice massage, or Cryotherapy, is effectively used to treat many kinds of injuries, including those associated with back or Neck Pain.

Ice causes the veins in the affected tissue area to constrict. This reduces the flow of blood while acting as kind of anesthetic to numb the pain. But when the ice is removed (and this is key), the veins compensate by opening large, allowing a greater volume of blood to rush to the affected area. The blood brings with it important chemicals that aid in the healing process.

Back and neck injuries frequently involve muscle sprains and strained ligaments, which can spasm and become inflamed.

Ice massage can provide a number of benefits, including:

• Assisting the body in minimizing tissue damage
• Mitigating muscle spasms
• Reducing or eliminating pain by numbing sore soft tissues
• Slowing and reducing inflammation and swelling

Ice Therapy is not recommended as a form of treatment for any kinds of rheumatoid arthritis, Raynaud's Syndrome (a circulatory disorder of blood vessels of the extremities), colds or allergic conditions, paralysis, or areas of impaired sensation.

Type of Therapy: Heat Therapy

While Ice Therapy is used to reduce swelling, heat therapy is used to relax the muscles and increase circulation. Both kinds of therapy help reduce pain.

Heat therapy is often used in patients who have chronic, or long-lasting pain. Heat therapy can involve many kinds of methods, from simple heating pads, wraps, and warm gel packs, to sophisticated techniques, such as therapeutic ultrasound.

Back injuries can create tension and stiffness in the muscles and soft tissues of the lumbar region, or lower back. In many cases, your circulation may be impeded. The tension in the muscles can sometimes escalate to spasms.

Heat therapy:

• Dilates the blood vessels of the affected muscles, allowing them to relax and begin healing
• Helps lower discomfort by reducing the amount of pain signals going to the brain
• Increases the ability of your muscles to easily flex and stretch, thereby decreasing stiffness

Heat Therapy, as well as ice therapy, are normally a part of an overall chiropractic treatment plan and rarely accomplish maximum results without it.

Heat therapy is not used on swollen or bruised tissues, or in patients who have dermatitis, deep vein thrombosis, diabetes, peripheral vascular disease, open wounds, cardiovascular conditions such as hypertension.

Type of Therapy: Exercise Therapy

Exercise Therapy is a form of Chiropractic Treatment used to help manage pain, rehabilitate damaged soft tissues such as muscles, ligament and tendons, and restore normal range of motion and function.

Such therapy has been shown to alleviate pain, improve overall muscle strength and range of motion, improve balance, as well avoid further deterioration of muscle tissues. The overall goal of an exercise therapy program is to promote healing and prevent further damage and injury to your body's musculoskeletal system. Exercises programs also help in minimizing scar tissue formation following an injury or surgery.

Most exercise programs are designed to improve cardiovascular conditioning and bolster your strength. Many exercises involve flexing and extending specific parts of the body.

As a patient, you play a pivotal role in the outcome of any therapeutic exercise program. Your dedication to following the steps outlined in the program will go a long way in ensuring its success.

Type of Therapy: Electrotherapy

Because the body's nerves are electrical conductors, medical professionals have long held that stimulating nerve endings with small electrical current can produce beneficial results.

The theory behind electrotherapy as part of Chiropractic Care is that such stimulation to affected nerves and muscles encourages the body to release pain-killing chemicals, such as opiates and endorphins, and blocks pain signals from being transmitted to the brain.

Electrotherapy is a Pain Management technique, and as such, is part of an overall chiropractic treatment regimen. Electrotherapy is usually involved in the early treatment stages, especially right after an injury. Ice and heat therapy may be combined with electrotherapy to boost its pain-killing powers.

Electrotherapy normally involves placing small adhesive pads on the skin at various points on the body. Electrotherapy is generally not painful. The adhesive pads may cause a minor skin irritation after being removed, and in some instances, patients may feel a mild stinging after therapy.

Common types of electrotherapy include:

• Galvanic stimulation (GS) - High voltage pulsed galvanic stimulation has been used in acute low back pain to reduce muscle spasm and soft tissue edema (swelling). It is commonly used despite the lack of hard scientific evidence for its efficacy. Its effect on muscle spasm and pain is felt to occur by its counter-irritant effect, effect on nerve conduction, and a reduction in muscle contractility.
• Radiofrequency rhizotomy - Normally used for chronic cases of facet joint syndrome, a degenerative condition in which joint cartilage wears thin, causing stiffness, inflammation, muscle spasms, and later osteoarthritis. This procedure applies heated radio-frequency waves to the joint's nerves that carry painful impulses.
• Transcutaneous Electrical Nerve Stimulation (TENS) - This is the most common type of electrical stimulation used today. TENS therapy is normally used to treat chronic, or long-term pain in the lower back. Small electrodes are placed inside an elastic-type belt worn around the lumbar region. Percutaneous electrical nerve stimulation (PENS), an enhanced and newer type of pain management therapy, makes use of very thin needles (much like those in acupuncture), which are inserted in the lower back by the chiropractor. Small, battery-powered TENS units also are available for use at home, work, or other activities. The patient is able to control the level and frequency of stimulation, and self-administer impulses during episodes of pain.
• Interferential current (IFC) - This is a kind of TENS therapy in which high-frequency electrical impulses are introduced deep into the tissues near the center of the pain.

Your First Visit

Be ready to provide your medical history, which will be essential for preparing a course of treatment for you.

Medical records, such as diagnostic test results, or imaging results, such as X-rays and MRIs, also will provide important information about your condition.

Certain things in your health history are particularly vital to a Chiropractor. This information could provide important clues that will allow your chiropractor to properly diagnose your problem. Such clues include whether you have or have had:

• Bone disorders such as osteoporosis
• Circulatory problems (poor circulation could be a sign that you have a subluxation, for example)
• Dizziness or blurred vision
• Heart conditions such as hypertension or high blood pressure
• Infections, especially those affecting your spine
• Injuries, such as bone fractures, muscle sprains, or disc injuries
• Joint disorders such as arthritis
• Sleep apnea

Be prepared to answer such questions as:

• Did the onset of your pain immediately follow an injury?
• Is there anything you do that improves or worsens the pain?
• When and how did your pain start?
• Where is the pain centered?

The physical exam 

Here's what to expect:

The first order of business is checking your vital signs, reflexes, and blood pressure. Sometimes, measurements will be taken to determine arm and leg length. Next, you will be asked to do a series of simple and easy activities or exercises. These exercises will provide information about your motor skills, balance, and gait, among others. These tests also help determine your range of motion, muscle tone and strength, and integrity of your nervous system. Any abnormalities could provide clues about a condition. You may be asked to:

• Bend forward, sideways, or backwards - Misaligned spinal vertebrae can sometimes be detected during this exercise.
• Flex and extend your leg - This is a test for signs of sprain and helps determine the integrity of your joints (also called the "Yeoman's Test").
• Grip something such as a rubber ball - Your grip strength is vital for showing signs of muscular or nerve damage.
• Lie down and raise one leg - This is often referred to as the "Thomas Test," in which the Chiropractor gently pushes on your raised leg to check for hip joint mobility.
• Stand and raise one leg - This test can sometimes show whether you have sciatica, a nerve disorder in your lower back. Another test may involve pushing on your raised leg to determine whether you have pain, inflammation, or imbalance in the joints between your spinal vertebrae. (This is also called the "Psoas Muscle Test.")
• Stand or sit - Posture can sometimes show whether you have misalignments in your spine.
• Walk a straight line - This test measures your gait, and helps to determine if you have a normal walking pattern.
• Walk in place - Abnormalities in the way your pelvis and spine coordinate can be seen during this test.

Next, a short physical exam by the chiropractor will involve palpation, or use of the hands, to explore the alignment of your spine and other structures, as well as provide information on any stimuli that may cause pain.

Depending on your condition, a series of diagnostic tests may follow. These tests may include MRIs, CT scans, X-rays, blood work, and other laboratory tests.

The chiropractor may also consult with you about making important lifestyle changes, such as exercise, nutrition, and smoking cessation, to improve you chances of healing faster, or preventing further injury.

Treatments - Doctor in San Antonio TX

Chiropractors diagnose and treat a broad range of physical conditions in patients with muscular, nervous, and skeletal problems, especially the spine.

Chiropractors make use of conventional diagnostic tests, such as X-rays, MRIs, and lab work, as well as specific procedures that involve manipulation by hand of various parts of the body. Chiropractors are best known for their ability to correct misalignments of the spine, which are called Subluxations. But spinal manipulation is only a small part of what chiropractors do as part of an overall plan to manage and relieve pain and many kinds of ailments. Other kinds of treatments chiropractors are capable of providing include:

• Electrotherapy
• Therapeutic exercise
• Ice/heat therapy, including therapeutic ultrasound
• Lifestyle and nutrition counseling
• Massage Therapy
• Physical rehabilitation
• Stress management

Common Myths

In spite of its long recognition by the medical community and the government as a safe, proven and effective treatment, many people today still have misconceptions about chiropractic care.

Daniel David Palmer, who is known as the father of Chiropractic, bore the brunt of criticism for creating this branch of medicine's healing arts. Despite Palmer's early successes in treating patients with a myriad of ailments through spinal manipulation, chiropractic adjustments were not readily accepted by the medical community. In fact, the established medical community back in the late 19th century worked hard to discredit him, and had a hand in convincing authorities to indict Palmer for practicing medicine without a license. He was sentenced to 105 days in jail and ordered to pay a $350 fine.

The established medical community's assault on the chiropractic profession continued even as late as the 1970s, when a group of chiropractors sued the American Medical Association and several other medical organizations for disseminating untrue and damaging information about their profession. The plaintiffs alleged that the AMA and others deliberately lied in order to destroy the chiropractic field because they viewed it as a threat, or competition, for their health care dollars. The court agreed with the chiropractors and called the AMA's actions "lawless" and unfounded. The case was eventually heard in the United States Supreme Court, which upheld the original verdict against the AMA.

Much has changed since that landmark decision, and today, the medical community has come to recognize the value of chiropractic care. Today, more than a century later, hundreds of thousands of patients routinely receive competent care-and relief from their suffering-from the nation's more than 60,000 doctors of chiropractic.

Here's a look at some of the more common misconceptions about chiropractic care.

Chiropractors treat back pain and little else.

Nothing could be further from the truth. While chiropractic adjustments can be especially helpful in relieving pain for facet joint injuries, osteoarthritis, and sacroiliac joint dysfunction, scores of patients with chronic headaches, sinus problems, high blood pressure, ear infections, leg pain, arthritis, and many other illnesses have reported significant relief after chiropractic therapy. Chiropractors do more than manipulate the musculoskeletal parts of the body, and are capable of providing a myriad of services that include acupuncture, electric muscle stimulation, exercise programs and instruction, heat/cold therapy, herbal therapy, lifestyle and nutrition counseling, manipulation under anesthesia, massage, physical rehabilitation, physiotherapy, stress management, traction, and ultrasound.

Chiropractors prescribe medications to Relieve Pain and perform surgery, when needed.

Chiropractors believe that many ailments can be corrected if the body's interrelated bone, nerve and vascular systems are in balance, allowing the body to heal itself. A branch of the healing arts concerned with disease processes, chiropractic care is a recognized form of therapy that focuses on improving your overall health and well-being-without the use of drugs or surgery.

Those who undergo spinal manipulation are at high risk of injury.
In general, proper chiropractic treatment of your body's lumbar, or lower back, region, involves very little risk, and the rewards can be significant. In fact, a recent study by the Rand Corporation found that a serious adverse reaction from cervical (neck) manipulation may occur less than once in 1 million treatments. The American Chiropractic Association believes those odds are even greater-about one in every 2 million treatments-the same odds of dying in a commercial airline crash. A more recent article in the Canadian Medical Association Journal found only a 1-in-5.85-million risk that a chiropractic adjustment of the neck may result in vertebral artery dissection.

Chiropractors are not viewed as being in the medical mainstream.

The medical community today formally recognizes the value of Chiropractic Care, and medical doctors routinely acknowledge chiropractic care as a conservative treatment option for patients with lower back pain. Moreover, many medical doctors recognize a chiropractic diagnosis and accept it as the first line of treatment for functional disorders of the entire musculoskeletal system. The prestigious Texas Back Institute (TBI), the largest freestanding spine specialty clinic in the country, once included only surgeons and other medical doctors among its staff. In the late 1980s, the Institute hired its first doctor of chiropractic. Today, close to half of the Institute's patients see a chiropractor first when beginning their treatment. The National Naval Medical Center in Bethesda, Maryland, and the successful Complementary and Alternative Medicine Center at the National Institutes of Health have established chiropractic internship programs.

Chiropractic care is generally unsafe and ineffective. 

Numerous studies throughout the world have shown that Chiropractic Treatment, including manipulative therapy and spinal adjustment, is both safe and effective for back pain. In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy (nerve roots exit the spine and enter the body; if one of these roots is sick or injured in the area where it leaves the spine, it is called a radiculopathy). A 1996 study in the journal Spine echoed that study, and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical doctors.

Cervical manipulation can cause a stroke. 

A 2003 study published in the journal Neurology asserted that chiropractic treatments were the culprit in a patient's stroke, claiming that a cervical adjustment led to a vertebral artery dissection (VAD). According to the American Chiropractic Association, the study is fraught with design flaws and needlessly alarms the public about a safe and effective form of treatment for Neck Pain and headaches. The ACA claims that VAD is a rare type of stroke associated with many other commonplace activities such as talking on the telephone, swimming, stargazing, overhead work, hair shampooing, and even sleeping. In fact, according to the ACA, a recent biomechanical study found that the forces transmitted to the artery during cervical manipulation are less than one-ninth the force necessary to stretch or otherwise damage a normal vertebral artery. "Based upon this study and other recent evidence, many experts now believe that it is physically impossible for a competently performed neck manipulation or adjustment, as provided by a trained doctor of chiropractic, to cause a vertebral artery dissection unless the artery already has a significant pre-existing weakness," according to the ACA.

Benefits of Chiropractic Care

One of the main causes of pain and disease in the human body can be traced to improper alignment of the vertebrae in your spinal column. This is called a subluxation. Through carefully applied pressure, massage, and manual manipulation of the vertebrae and joints, pressure and irritation on the nerves is relieved and joint mobility is restored, allowing your body to return to its natural state of balance, called homeostasis. Put another way, when the bones in your spine are allowed to go back to their proper positions, the nerve energy can resume its normal flow and your body's natural healing processes can function properly.

In general, proper Chiropractic Treatment of your body's lumbar, or lower back, region, involves very little risk, and the rewards can be significant.

Chiropractic or osteopathic manipulations can be especially helpful in relieving pain for facet joint injuries, osteoarthritis, and sacroiliac joint dysfunction, because such conditions respond well to mobilization. Moreover, scores of patients with chronic headaches, sinus problems, high blood pressure, ear infections, leg pain, arthritis, and many other illnesses have reported significant relief after chiropractic therapy.

Increasingly over the past few decades, the medical community has come to accept and recognize chiropractic care as a valid form of treatment for a variety of neuro-musculoskeletal conditions, and as a conservative treatment option for patients with lower back pain. Moreover, many medical doctors recognize a chiropractic diagnosis and accept it as the first line of treatment for functional disorders of the entire musculoskeletal system.

Studies by leading medical journals in recent years have confirmed the benefits of chiropractic care:
A 1993 report by the Ontario Ministry of Health concluded that Chiropractic Care was the most effective treatment for lower back pain. The agency also recommended that chiropractic care be fully integrated in the Canadian government's health care system.

In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy.

A 1996 New England Journal of Medicine study of outcomes and costs for acute low back pain found that patients treated by Chiropractors were significantly more satisfied than those who saw primary care, orthopedic or managed care practitioners.

A 1996 study in the journal Spine echoed that study, and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical doctors.

In 2001, the Center for Clinical Health Policy Research at Duke University concluded in a study that spinal manipulation resulted in almost immediate improvement for cervicogenic headaches, or those that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

What is a Chiropractor?

The word chiropractic comes from the Greek words, "chiro," meaning hand, and "practic," meaning practice, or treatment. Thus, "treatment by hand" is an appropriate definition since chiropractors typically use their hands to manipulate different parts of the body in an effort to promote healing and wellness.

A Chiropractor, also known as a doctor of chiropractic ("D.C."), diagnoses and treats a broad range of physical conditions in patients with muscular, nervous, and skeletal problems, especially the spine.

A branch of the healing arts concerned with disease processes, Chiropractic Care is a recognized form of therapy that focuses on improving your overall health and well-being�without the use of drugs or surgery.

Chiropractors make use of conventional diagnostic tests, such as X-rays, MRIs, and lab work, as well as specific procedures that involve manipulation by hand of various parts of the body. Chiropractors are best known for their ability to correct misalignments of the spine, which are called subluxations. But spinal manipulation is only a small part of what chiropractors do as part of an overall plan to relieve pain and mitigate many kinds of ailments. Other kinds of treatments chiropractors are capable of providing include:

• Acupuncture
• Electric muscle stimulation
• Exercise programs and instruction
• Heat/cold therapy
• Herbal therapy
• Lifestyle and nutrition counseling
• Manipulation under anesthesia
• Massage
• Physical rehabilitation
• Physiotherapy
• Stress management
• Traction
• Ultrasound

Best known for their treatment of back and neck pain, chiropractors sometimes specialize in areas such as sports medicine, orthopedics, neurology, nutrition, internal disorders, and diagnostic imaging. Many back specialists consider chiropractic an integral part of an overall care plan toward treating injury and disease.

History of Chiropractic

For centuries, scientists, physicians-even philosophers-have long believed that the body's spinal cord is at the root of many ailments that have nothing to do with back or Neck Pain.

But the birth of the Chiropractic profession was not to occur until the late 19th century -September 18, 1895, to be exact-in the small offices of the Palmer Cure & Infirmary in Davenport, Iowa. Late that day, Canadian-born Daniel David Palmer was in his office, trying to have a conversation with the building's janitor, Harvey Lillard.

Palmer noticed that Lillard was nearly deaf, and asked the man what caused him to lose his hearing. Lillard didn't know, but told Palmer his hearing began diminishing after a back injury he sustained while stooping in a cramped position. Lillard remembered hearing a "pop" in his back, and suffered hearing loss for years after that.

It was a revelation that capped what Palmer had long suspected-an indubitable connection between the spine and disease--that misalignment of the spinal column interferes with normal nerve function, and thus, leads to a host of maladies. Palmer suspected that if he were able to return the popped vertebrae in Lillard's back to its original position, it would also restore his hearing. Using a technique called the "spinous process," Palmer gently repositioned the vertebra with a firm thrust.

Lillard's hearing began to return. Over the next week, Palmer continued his spinal manipulation treatment on Lillard; each day, his hearing gradually improved. Palmer coined a term for his new technique-chiropractic (from the Greek words, "chiro," meaning hand, and "practic," meaning practice-and dedicated his practice from that point forward to use of the new therapy.

In the ensuing months, Palmer treated flu, sciatica, migraine headaches, stomach complaints, epilepsy and heart trouble with adjustments he called "hand treatments"-all without the use of drugs, medications, or surgery.

Despite Palmer's early successes, chiropractic adjustments were not readily accepted by the medical community. Palmer was later indicted for practicing medicine without a license and was sentenced to 105 days in jail and ordered to pay a $350 fine.

Palmer is the author of two well-known books-The Science of Chiropractic and The Chiropractors Adjuster. He died at the age of 68 in Los Angeles.

His son, Bartlett Joshua, carried on his father's work and was instrumental in getting chiropractic recognized as a licensed profession.

In the 20th century, the chiropractic profession has grown into a respected branch of the healing arts-largely through research and recognition by the government and medical community. Here are some milestones:

• In 1944, the Chiropractic Research Foundation (CRF) was created by the National Chiropractic Association to promote and obtain research funding.
• In the 1960s, the National Chiropractic Association became the American Chiropractic Association (ACA) and the CRF became the Foundation for Accredited Chiropractic Education, whose main purpose was to assist chiropractic colleges in gaining accreditation.
• In 1974, the U.S. Department of Health, Education and Welfare recognized the Council on Chiropractic Education (CCE), and the Foundation for Accredited Chiropractic Education was reorganized as the Foundation of Chiropractic Education and Research (FCER).
• In 1975, the U.S. Department of Health Education and Welfare sponsored a research conference on spinal manipulation, an event that raised awareness of the need for research. Out of that, the Chiropractic Research Council (CRC) was born to assimilate research directors from the nation's chiropractic colleges.
• In 1979, the Foundation of Chiropractic Education and Research expanded its research program and established a competitive scientific review process for submitted proposals.
• Today, 14 English peer-reviewed chiropractic journals routinely publish the results of chiropractic research.

Educational Requirements

Education

The educational requirements for chiropractors are similar to that of medical doctors. In general, chiropractors must complete four years of undergraduate study from one of the nation's 17 accredited Chiropractic colleges. During the first two years of study, students receive classroom and laboratory work in anatomy, physiology, public health, microbiology, pathology, and biochemistry; the final two years involve courses in manipulation and spinal adjustments, as well as clinical experience in areas that may include physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition, biomechanics, radiology, and natural medicine.

Undergraduate study is followed by a one-year internship at a college clinic. Many chiropractic colleges rotate interns through hospital rounds with medical students. Many chiropractors also undertake four to five additional years of advanced or post-graduate study in a clinical area.

After obtaining their Doctor of Chiropractic degree, chiropractors must complete at least two board exams-the National Board of Chiropractic Examiners (NBCE) exam and the board exam from the state in which they practice.

Credentials

All 50 states license Doctors of Chiropractic to practice. All chiropractors must meet certain requirements, including:

• Completion of a four- or five-year chiropractic college course of study at an accredited program leading to the Doctor of Chiropractic degree.
• Satisfactory completion of board exams.
• Ongoing continuing education courses or programs offered by accredited chiropractic programs and institutions, as well as chiropractic associations.

Chiropractors also are able to obtain certification in such areas as orthopedics, neurology, sports injuries, occupational and industrial health, nutrition, diagnostic imaging, thermography, spinal rehabilitation and internal disorders.

Chiropractic Principles

When all of your body's inter-related systems-including your musculoskeletal, nervous and vascular systems-are in balance and functioning properly, your body possesses a remarkable knack for healing itself. This state is called homeostasis.

Stress, accidents, sports injuries, even over-exertion, can cause your spine to fall out of its natural alignment. When this happens, your nervous system ceases to function properly, and this could lead to back and Neck Pain, headaches, and other kinds of problems. Moreover, many types of pain and disease can be linked to problems with your spinal cord and nervous system. It is this "mind-body" connection that forms the tenet of the principles under which Chiropractors practice their healing art.

The two major, underlying principles are:

• The structure and condition of the body influences how it functions and heals.
• The mind-body relationship is essential in maintaining health and healing.

Put another way:

• Your body's functions are all interrelated, and its ability to heal is contingent on these interrelationships.
• A healthy body comes from a healthy nervous system, especially a healthy spine.

Chiropractors believe in a holistic approach to patient care by focusing on a patient's total wellness, or well-being, instead of specific diseases, or ailments. It is this intricate physiological and biochemical interrelationship among various parts of your body-including its spinal, musculoskeletal, neurological, and vascular systems-that chiropractors dedicate themselves to exploring and treating, with special attention to nutrition, exercise, and healthy emotional and environmental relationships. When one or more of these systems is impaired, your body ceases to function normally and your resistance to disease is compromised.