What is Chiropractic?
What is Chiropractic?
Chiropractors treat problems with joints, bones and muscles, and the effects they have on the nervous system. Working on all the joints of the body, concentrating particularly on the spine, they use their hands to make often gentle, specific adjustments (the chiropractic word for manipulation) to improve the function of the joints, as well as the efficiency of the nervous system. This in turn enables the body to heal the injury which has occurred as a result of the underlying problem.
A Chiropractor is a specialist clinician. Four to five years of training mean highly developed diagnostic skills, and as a professional consultant he or she can diagnose your problem and will refer you to another health-care practitioner if necessary. Chiropractic does not involve the use of any drugs or surgery.
The effectiveness of chiropractic treatment is supported by research as well as by various UK government and medical organisations. Chiropractic is available to patients under the NHS, but this will depend on the situation within a specific NHS Primary Care Trust. Otherwise patients see chiropractors in a private capacity either through self referral or as a result of a referral from their GP, other doctor or health professional. Chiropractors also treat people who are seeking treatment through private health insurers.
The Regulation of Chiropractic
In common with medical practitioners and dentists, all chiropractors are registered by law under the Chiropractors Act 1994 and the title 'Chiropractor' is protected under this legislation. The profession is statutorily regulated through the General Chiropractic Council (GCC) and it is illegal to practise as a chiropractor without being registered with the GCC.
We are also members of the Royal College of Chiropractors.
How does it work?
Chiropractic works by unlocking stiff and dysfunctional joints, especially in the spine. Surely it can't be that simple! Well no it's not, but it is a good place to start. Whilst we do get the joints the moving, restoring flexibility decreases muscle spasm and inflammation. But the effects on the nervous system are even more profound.
Chiropractic and the brain
The nerve endings in the muscles, tendons and ligaments are stimulated by a chiropractic adjustment and this has an important effect on the brain. The pain threshold is raised and the brain improves control of those very muscles and this helps prevent re-injury. The combined effect is to solve the problem and take the pain away.
The effects of a single adjustment last for a few days. Each session builds on the one before so you may need several sessions to get a lasting improvement. It is a bit like getting fit. Going to the gym once may make you a bit sore but you won't get much benefit without going several times. We will give you a clear idea how many sessions will be needed.
At Alba our chiropractors will always endeavour to keep the number of sessions to a minimum. They will discuss the other options for treatment and refer you to someone else if they can't help.
Please only read this if you're really interested - it can be pretty boring! On the other hand the research does show that chiropractic works for back pain, neck pain, headaches and some other things.
Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis
Gert Bronfort PhD, DC, Mitchell Haas DC, MAb, Roni L. Evans DC, MSa and Lex M. Bouter PhDc The Spine Journal, Volume 4, Issue 3, May-June 2004, Pages 335-356
Despite the many published randomized clinical trials (RCTs), a substantial number of reviews and several national clinical guidelines, much controversy still remains regarding the evidence for or against efficacy of spinal manipulation for low back pain and neck pain.
Purpose: To reassess the efficacy of spinal manipulative therapy (SMT) and mobilization (MOB) for the management of low back pain (LBP) and neck pain (NP), with special attention to applying more stringent criteria for study admissibility into evidence and for isolating the effect of SMT and/or MOB.
Study design: RCTs including 10 or more subjects per group receiving SMT or MOB and using patient-oriented primary outcome measures (eg, patient-rated pain, disability, global improvement and recovery time).
Articles in English, Danish, Swedish, Norwegian and Dutch reporting on randomized trials were identified by a comprehensive search of computerized and bibliographic literature databases up to the end of 2002. Two reviewers independently abstracted data and assessed study quality according to eight explicit criteria. A best evidence synthesis incorporating explicit, detailed information about outcome measures and interventions was used to evaluate treatment efficacy. The strength of evidence was assessed by a classification system that incorporated study validity and statistical significance of study results. Sixty-nine RCTs met the study selection criteria and were reviewed and assigned validity scores varying from 6 to 81 on a scale of 0 to 100. Forty-three RCTs met the admissibility criteria for evidence.
Acute LBP: There is moderate evidence that SMT provides more short-term pain relief than MOB and detuned diathermy, and limited evidence of faster recovery than a commonly used physical therapy treatment strategy.
Chronic LBP: There is moderate evidence that SMT has an effect similar to an efficacious prescription nonsteroidal anti-inflammatory drug, SMT/MOB is effective in the short term when compared with placebo and general practitioner care, and in the long term compared to physical therapy. There is limited to moderate evidence that SMT is better than physical therapy and home back exercise in both the short and long term. There is limited evidence that SMT is superior to sham SMT in the short term and superior to chemonucleolysis for disc herniation in the short term. However, there is also limited evidence that MOB is inferior to back exercise after disc herniation surgery.
Mix of acute and chronic LBP: SMT/MOB provides either similar or better pain outcomes in the short and long term when compared with placebo and with other treatments, such as McKenzie therapy, medical care, management by physical therapists, soft tissue treatment and back school.
Acute NP: There are few studies, and the evidence is currently inconclusive.
Chronic NP: There is moderate evidence that SMT/MOB is superior to general practitioner management for short-term pain reduction but that SMT offers at most similar pain relief to high-technology rehabilitative exercise in the short and long term.
Mix of acute and chronic NP: The overall evidence is not clear. There is moderate evidence that MOB is superior to physical therapy and family physician care, and similar to SMT in both the short and long term. There is limited evidence that SMT, in both the short and long term, is inferior to physical therapy.
Our data synthesis suggests that recommendations can be made with some confidence regarding the use of SMT and/or MOB as a viable option for the treatment of both low back pain and NP. There have been few high-quality trials distinguishing between acute and chronic patients, and most are limited to shorter-term follow-up. Future trials should examine well-defined subgroups of patients, further address the value of SMT and MOB for acute patients, establish optimal number of treatment visits and consider the cost-effectiveness of care.