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Chiropractic

Published by Bupa's health information team, July 2009.

This factsheet is for people who are planning to have chiropractic treatment, or who would like information about it.

Chiropractic is a manual therapy mainly used for treating problems associated with bones, joints and the back.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your chiropractor's advice.

• About chiropractic
• Where can I find a chiropractor?
• About the procedure
• Is chiropractic effective?
• What are the risks?
• Questions and answers
• Related topics
• Further information
• Sources

About chiropractic

Chiropractic diagnoses, treats and prevents joint, muscle and ligament conditions. Chiropractors use their hands to make specific adjustments to joints, concentrating particularly on the spine. This is called manipulation.

Chiropractors believe misalignment of the spine causes health problems and that spinal manipulation corrects these misalignments, thus curing the problem. Manipulation is thought to improve the efficiency of your body's nervous system and enable natural healing.

Chiropractors claim that chiropractic is holistic and doesn't just treat the symptoms of a condition. It takes into account your medical history, lifestyle and personal circumstances.

Chiropractic is used as a complementary treatment (one given alongside conventional treatments). It's suggested for several health conditions including:

• back and neck pain
• back pain related to a woman's monthly period
• headaches and migraines
• asthma
• leg pain and sciatica
• sports injuries
• colic in babies

There are a range of conventional treatments for the health conditions listed. Ask your GP for advice.

Where can I find a chiropractor?

All chiropractors are registered and regulated by the General Chiropractic Council (GCC). You can search the website or phone the organisation for a chiropractor in your area.

All GCC-registered chiropractors must carry out at least 30 hours of learning activities each year as part of a continuing professional development programme to ensure they maintain high standards of practice.

About the procedure

Your chiropractor will ask detailed questions about your medical history, diet, lifestyle and emotional state. He or she will also examine you. You may be asked to sit, stand, walk and possibly carry out other movements. Your reflexes may be tested with a reflex hammer. Your chiropractor may also request that you have an X-ray image taken to help make a diagnosis.

Treatment is usually carried out while you lie down in various positions. Chiropractors often use a manipulative technique on the spinal column and pelvic area consisting of short, rapid forceful movements called high-velocity thrusts. These are designed to realign and mobilise the spine, and may result in an audible sound - a clicking similar to knuckles being stretched.

Your initial consultation with a chiropractor will last about 30 minutes to an hour. If you have any further appointments, they will be shorter than the first, as your chiropractor will already have your background information. The number of treatments you will need and how often you will need them depends on your condition. At your first treatment session, your chiropractor should give you an idea of the length of treatment required.

Some chiropractors offer active rehabilitation exercise programmes, which focus on fitness and endurance to help symptoms. Chiropractors believe this can reduce disability as well as significantly reduce the chances of recurrent episodes of back and neck pain.

Your chiropractor will discuss carrying out further investigations or may refer you to your GP if your condition doesn't improve.

Is chiropractic effective?

The scientific evidence for some of the claims of chiropractic is of variable quality.

Some studies show that chiropractic can limit acute low back pain and the National Institute for Health and Clinical Excellence (NICE) recommends chiropractic for this condition. Back pain is pain that comes from the muscles, nerves, bones, joints and other parts of the back. If the pain lasts for less than three months, it's called acute back pain. If the problem goes on for longer, it's known as sub-acute or chronic back pain. The medical terms acute and chronic refer to how long the symptom lasts for, rather than how severe it is.

The Department of Health's report, 'The Musculoskeletal Services Framework for England' refers to chiropractic as a treatment option for musculoskeletal conditions (conditions that affect the muscles, bones and joints).

Whether chiropractic is useful for other conditions, such as migraine or tension headache, is uncertain - the evidence is limited. The research is often conflicting and while symptoms of some illnesses improve, the best evidence generally fails to prove that chiropractic cures illnesses. While there is anecdotal evidence and chiropractic treatment is accepted by many conventional medical practitioners, there is little scientific evidence to prove that it's effective. More research is needed.

What are the risks?

Chiropractors insist that spinal manipulation is extremely safe. However, there is much debate about this question and many non-chiropractic experts have a different view.

Side-effects

These are the unwanted, but mostly mild and temporary effects of a successful treatment.

These can include discomfort or mild pain at the point manipulation, stiffness or tiredness for a day or so. About half of all patients who have a chiropractic treatment get mild side-effects, although these don't usually last long.

Complications

This is when problems occur during or after the treatment.

Spinal manipulation, particularly when used on the upper spine (neck) has been associated with severe complications, such as damage to an artery and stroke. There have been about 700 recorded incidents of upper spinal manipulation being followed by severe complications including deaths.

For certain people, especially those affected by osteoporosis, forceful manipulation can be dangerous and should never be done. Chiropractors are trained to check if chiropractic is a suitable treatment and for other risk factors.

Related topics

• Osteopathy

Further information

• General Chiropractic Council
  020 7713 5155
  www.gcc-uk.org
• British Chiropractic Association
  0118 950 5950
  www.chiropractic-uk.co.uk

Sources

• About chiropractic. British Chiropractic Association. www.chiropractic-uk.co.uk, accessed 30 January 2009
• What is chiropractic? General Chiropractic Council. www.gcc-uk.org, accessed 30 January 2009
• What can I expect when I see a chiropractor? General Chiropractic Council. www.gcc-uk.org, accessed September 2007
• Haas M, Sharma R, Stano M. Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain. J Manipulative Physiol Ther 2005; 28(8):555-63
• Williams NH, Hendry M, Lewis R, et al. Psychological response in spinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled trials. Complement Ther Med 2007; 15(4):271-83
• Vernon H, Humphreys K, Hagino C. Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized clinical trials. J Manipulative Physiol Ther 2007; 30(3):215-27
• Complementary Medicine: information pack for primary care groups. Department of Health. www.dh.gov.uk, 2000
• Non-rigid stabilisation procedures for the treatment of low back pain. Interventional procedure guidance 183. National Institute for Health and Clinical Excellence (NICE), www.nice.org.uk, 2006
• Chiropractic for migraine. Bandolier. www.jr2.ox.ac.uk/bandolier, accessed January 2007
• Home page. British Chiropractic Sports Council. www.chirosport.org, accessed 31 January 2009
• Check the register. General Chiropractic Council. www.gcc-uk.org, accessed 30 January 2009
• CPD. General Chiropractic Council. www.gcc-uk.org, accessed 31 January 2009
• What is chiropractic? British Chiropractic Association. www.chiropractic-uk.co.uk, accessed 31 January 2009
• Musculoskeletal Services Framework. Department of Health. www.dh.gov.uk, 2006
• Ernst E. Chiropractic manipulation for non-spinal pain - a systematic review. N Z Med J 2003; 116(1179):U539
• Frequently asked questions. General Chiropractic Council. www.gcc-uk.org, accessed 31 January 2009
• Ernst E. Adverse effects of spinal manipulation: a systematic review. J R Soc Med 2007; 100:330-38
• Vohra S, Johnston BC, Cramer K et al. Adverse events associated with pediatric spinal manipulation: a systematic review. Pediatrics 2007; 119(1):e275-83
• Ernst E. Chiropractic: a critical evaluation. J Pain Symptom Manage 2008; 35(5):544-62
• Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. J R Soc Med 2006; 99:192-6

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: July 2009