FAQ's About Chiropractors

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Common, Frequently Asked Questions or FAQ's About Chiropractors

What exactly does a chiropractor do?

Chiropractors practice a a wide variety of ways. And there are sub-specialists among them, including orthopedics, internal medicine, radiology, neurology, and more. Generally, most of their work is done in treatment of spinal problems, without drugs or surgery. And their treatment techniques can vary widely. When the profession originated, in 1895, it focused on manipulative treatment of the spinal joints; what they call โ€œadjustmentsโ€. And, for most chiropractors, thatโ€™s still their primary treatment, but their methods of practice vary considerably.

FAQ About Chiropractor

Are chiropractors โ€œrealโ€ doctors?

Of course they are.  They are well-educated, state licensed, medico-legally insured, must do continuing education, and are closely scrutinized by their authoritative professional body.  The chiropractic education is similar in its basic science courses to medicine.  Where they differ is in the clinical components of their education.  To see, and compare, the respective professions’ currucula, you can go the some of the chiropractic colleges’ websites.  Most people are surprised to see that chiropractors’ educations exceed the rigor of medical physicians in several components, including total number of hours of didactic schooling, and specialization of components such as radiology.  And like other types of doctors, including podiatrists, dentists, orthodontists, and veterinarians, they are held to a high standard of competency and conduct.

What is the difference between chiropractors and physical therapists?

This varies among individual practitioners.  Generally, chiropractors use more manipulative โ€œadjustmentsโ€ to the spine for their patientsโ€™ painful spines. And, generally, physical therapists do more exercise instruction for their patients with spinal pain. Both professions usually use a variety of other โ€œphysical medicineโ€ procedures as part of their treatments. Both professions specialize in a variety of other treatments, so specific practitioners differ considerably. For several reasons, physical therapists receive many more referrals from medical doctors for treatment. Most people will probably see a physical therapist sometime in their lifetime. Chiropractors remain less popular among the general public and as referees from medical doctors.”

Do you need a referral to see a chiropractor?

No. Chiropractors are doctors who are considered competent to see patients independently. They are able to evaluate patients, diagnose their problems, treat them competently, and refer patients for diagnostic testing or to other specialists when appropriate.  And, of course, with this privilige comes responsibility.  Chiropractors are very competent practitioners and, in fact, have very high approval ratings among patients.  Patients appreciate that for many physical, musculoskeletal problems, a hands-on approach to treatment makes sense, and is usually preferable to simply taking medication.  Furthermore, chiropractors pay very low malpractice insurance premiums that surprise other doctors, evincing a high level of competence, and low rates of malpractice claims.

What to wear when you see a chiropractor?

Generally, you can wear your regular clothing and most treatments donโ€™t require disrobing. There may be some occasions when gowns are provided, such as during examination, but this varies with the problem and doctor.
If youโ€™re going to do exercises as part of your treatment, you should dress for that purpose.  Probably, the only clothing issue of note, is to try to be relatively clean, because you will generally be lying on a table for a varying amount of time, and some measure of cleanliness is appreciated.  Having said that, many people come for treatment diretly from work, including physical labor, and that is not usually a problem.

Can a chiropractor write prescriptions?

Chiropractors can write prescriptions for diagnostic testing and to other healthcare providers. They can also write prescriptions for supports and braces. And they can recommend dietary supplements. But they cannot write prescriptions for medications. Chiropractorsโ€™ training does not include prescription medications, nor do they want to write prescriptions for medications. Of course, medications are sometimes appropriate but it is not within the legal scope of chiropractic, and chiropractors want to distinguish themselves as โ€œdruglessโ€ providers.

Can a chiropractor help with a herniated disc?

Herniated discs are very common problems that chiropractors treat and help. Depending upon the severity of the herniated disc problem, the treatment will vary among several types. Most disc herniations will not require surgical treatment, and will improve from chiropractic treatment, or other non-surgical treatments, including physical therapy or injections.  Among patients who seek medical treatment for their disc herniations, only about 2% will require surgery.  The remaining 98% will improve enough that they will not need surgery, although they may continue to have some, intermittent pain.  The conventional wisdom of natural history of disc herniations says that most are self-limited if you can manage your pain until it gets better.  But I think this is too simplistic a description of disc lesions.  Some disc pain can persist unchanged for many years, and medical treatments are practically essential.

Can a chiropractor help spinal stenosis?

There are two ways we use the term, โ€œstenosisโ€, which means narrowing of the spine. This narrowing, i.e. stenosis can occur in several places in your spine. It is most common in the low back, but can occur in the neck, where it is more dangerous because it can damage your spinal cord.

Some narrowing is expected by the age of about 50 years. But sometimes when we say stenosis, it is only a description of mild, trivial narrowing, that is not causing any pain or disability. And other times we mean a very severe narrowing that is painful and disabling, and can only be helped with surgery, to remove some boney and ligamentous tissues in order to reduce the narrowing.

Generally, when stenosis is mild, chiropractors can help. When the stenosis is moderate, chiropractors may be able to help. But when the stenosis is severe, only a surgeon can help.

The severe kind of stenosis is seen in people who cannot stand up straight, they walk around bent over, they lean on grocery carts, they can only walk for a few minutes and then must sit down to rest, and then they can get up and walk again for a short while. In this case, they need surgery to decompress their spines, reducing the stenosis, and restoring their walking capacity. Their usual symptoms are pain and numbness and tingling in both buttocks and legs. We call these symptoms neurogenic claudication. This is a brief, simple explanation of spinal stenosis and its treatment.

Can a chiropractor help with shoulder pain?

Often the answer is yes. There are two common sources of shoulder pain; the shoulder joint, and the neck. Neck problems include the joints, discs and nerves.  Shoulder joint pain is usually made worse with reaching overhead.  Shoulder pain from the neck is not usually made worse with raising the arm, but can be made worse with movements of the neck, especially looking up, and toward the painful side.

Chiropractors may be able to help either problem. Both problems are very common, and sometimes they are both a problem. Chiropractors can usually help one or both problems.

Here are a few tips about both. If the pain is felt in the shoulder blade or between the shoulder blades, that is a neck problem about 95% of the time.  Itโ€™s called referred pain and it does mislead a lot of people, including doctors and physical therapists about the origin/cause of the pain. Another less commonly helpful tip is that if raising the arm alleviates the pain, then you almost certainly have a neck problem, not a shoulder problem.  

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