MOD029 – Chiropractic
Definition:
Chiropractic is a healthcare profession that focuses on diagnosing and treating musculoskeletal disorders, particularly spine-related issues, through manual adjustments and manipulation of the spine and other joints. It is a form of alternative medicine that emphasizes the body’s ability to heal itself without the use of drugs or surgery.
Explanation:
Chiropractors believe that misalignments or subluxations in the spine can disrupt the nervous system’s function and lead to various health problems. Through hands-on adjustments, chiropractors aim to restore proper alignment and facilitate the body’s natural healing processes. This approach is based on the principle that the structure of the body, particularly the spine, affects the function of every part of the body via the nervous system.
Chiropractic care often includes:
- Spinal manipulation and adjustments
- Soft tissue therapy
- Exercise and lifestyle advice
- Nutritional counseling
- Use of other modalities such as ultrasound or electrical stimulation
While primarily focused on musculoskeletal issues, some chiropractors also claim to address other health concerns through spinal adjustments. However, the scientific evidence for effectiveness beyond musculoskeletal conditions is limited.
Chiropractic is recognized as a legitimate healthcare profession in many countries and is often integrated with conventional medical care for certain conditions, particularly lower back pain.
Evidence to Efficacy:
There is evidence supporting the efficacy of chiropractic care for certain conditions, particularly musculoskeletal disorders. Several studies, including some conducted in the UK, have demonstrated positive outcomes:
The UK BEAM trial, a large randomized controlled trial published in the BMJ in 2004, found that spinal manipulation, as practiced by chiropractors, provided additional improvement in back function and pain for patients with low back pain compared to “best care” in general practice.
A review commissioned by the Royal College of Chiropractors in 2011 (the Warwick Review) found moderate positive evidence for manipulation/mobilisation with exercise for rotator cuff disorders, spinal mobilisation for cervicogenic headache, and mobilisation for miscellaneous headaches.
The National Institute for Health and Care Excellence (NICE) guidelines recommend manual therapy, including spinal manipulation as practiced by chiropractors, as part of a treatment package for managing low back pain with or without sciatica.
A 2010 review published in the journal Chiropractic & Osteopathy (now called Chiropractic & Manual Therapies) demonstrated robust randomized controlled trial evidence that chiropractic care is effective for conditions including back pain, neck pain, and some types of headaches.
Research published in the European Journal of Pain in 2015 found that spinal manipulation was effective for chronic low back pain, showing significant improvement in pain and function compared to sham treatments.
Governing Body:
The regulatory landscape and professional organisations for chiropractic in the UK is:
The General Chiropractic Council (GCC) is the main statutory regulatory body for chiropractors in the UK. Established by the Chiropractors Act 1994, the GCC:
- Maintains a register of qualified chiropractors
- Sets standards for education, conduct and practice
- Investigates complaints and takes action against chiropractors who fall short of GCC standards
All practicing chiropractors in the UK must be registered with the GCC.
Other important organisations include:
British Chiropractic Association (BCA): The largest professional association for chiropractors in the UK.
Royal College of Chiropractors (RCC): Promotes excellence in chiropractic care and provides postgraduate training.
McTimoney Chiropractic Association: Represents chiropractors who practice the McTimoney technique.
Chiropractic education in the UK is provided by several institutions:
- AECC University College
- University of South Wales
- London South Bank University
- McTimoney College of Chiropractic
These institutions offer undergraduate and postgraduate programs accredited by the GCC.
What Good Looks Like:
In the context of chiropractic care, here’s what a good experience should look like for you:
Clear communication: Your chiropractor should explain the treatment plan clearly, including what techniques they’ll use and why. You should feel comfortable asking questions and receive understandable answers.
Thorough assessment: Before any adjustments, you should receive a comprehensive physical examination. This may include range of motion tests, posture analysis, and palpation of your spine and joints.
Personalised approach: Your treatment should be tailored to your specific needs, not a one-size-fits-all approach. The chiropractor should consider your medical history, current condition, and personal goals.
Gentle yet effective adjustments: During spinal manipulation, you should feel a controlled, precise force applied to your joints. While you might hear popping sounds, the process shouldn’t be painful.
Immediate feedback: Your chiropractor should check in with you during the adjustment, asking how you’re feeling and if you’re experiencing any discomfort.
Holistic care: Beyond spinal adjustments, you might receive complementary treatments like soft tissue therapy, exercises, or lifestyle advice to support your overall health.
Respect for your comfort: You should feel at ease throughout the session. If you’re ever uncomfortable, your chiropractor should immediately respond to your concerns.
Noticeable effects: After the adjustment, you might feel immediate relief or increased mobility. Some people experience a sense of relaxation or increased energy.
Education: Your chiropractor should provide you with information about your condition and offer advice on how to maintain the benefits of your treatment between sessions.
Remember, a truly effective chiropractic session should leave you feeling heard, respected, and actively involved in your own care, with a sense that your overall well-being is being addressed, not just your immediate symptoms.
What to Ask a Practitioner:
What techniques do you use for spinal adjustments?
Desired answer: You should expect the practitioner to explain that they use a variety of techniques tailored to each patient’s needs, including manual adjustments, mobilisation, and instrument-assisted methods. They should also mention that they will explain each technique before using it and ensure you are comfortable throughout the treatment.
How do you diagnose and assess musculoskeletal conditions?
Desired answer: The practitioner should describe a thorough physical examination process, including orthopaedic and neurological tests. They may also indicate that they use X-rays or other imaging if necessary and that they will explain their findings and proposed treatment plan in detail.
What are the potential risks or side effects of chiropractic treatment?
Desired answer: You should expect the practitioner to acknowledge that while chiropractic care is generally safe, some patients may experience temporary soreness or stiffness after treatment. They should reassure you that serious complications are rare and that they will discuss any specific risks relevant to your condition before treatment.
How do you ensure the safety of cervical (neck) manipulations?
Desired answer: The practitioner should discuss their approach to neck adjustments, including any precautions they take and how they assess for potential risks like vertebral artery issues.
How do you address concerns about the ‘cracking’ sound during adjustments?
Desired answer: They should explain the cause of the sound (cavitation) and assure you that it’s not bones cracking, addressing any anxieties you might have about the process.
Related Therapies:
Physiotherapy (MOD207): A healthcare profession that assesses, diagnoses, treats, and works to prevent disease and disability through physical means, using evidence-based techniques to promote movement, reduce pain, restore function, and prevent disability.
Osteopathy (MOD121): A system of medicine that emphasizes the physical manipulation of muscle tissue and bones to diagnose, treat, and prevent illness or injury, based on the principle that the body’s systems are interconnected and capable of self-regulation and self-healing.
Massage Therapy (MOD097): This hands-on therapy involves manipulating the body’s soft tissues to relieve tension, reduce pain, and promote relaxation. It can enhance the effects of Reiki by addressing physical discomfort and improving circulation.
Acupuncture (MOD007): A traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to balance energy flow (Qi) and promote healing. Acupuncture can complement Reiki by addressing energetic blockages.
Yoga (MOD182): A physical and spiritual practice that combines postures, breath control, and meditation. Yoga can complement Reiki by promoting physical flexibility and mental clarity, enhancing overall well-being.
Pilates (MOD130): A low-impact exercise system that focuses on strengthening the core, improving flexibility, and enhancing overall body awareness through controlled movements and breathing techniques, often using specialized equipment.
Craniosacral Therapy (MOD090): A gentle hands-on technique that releases tensions deep in the body to relieve pain and dysfunction.
Naturopathy (MOD113): A system of alternative medicine based on the healing power of nature.
Mindfulness-Based Stress Reduction (MBSR)(MOD106): A structured program that combines mindfulness meditation and yoga to cultivate awareness and reduce stress.