The American Chiropractic Association (ACA) receives many questions about chiropractic. Below are answers to the most commonly asked questions.
What conditions do chiropractors treat?
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.
How do I select a doctor of chiropractic?
You can locate a doctor of chiropractic (DC) by browsing the ACA Find a Doctor page, searching the Yellow Pages, speaking with friends, or contacting your local chamber of commerce. Because stringent educational and professional requirements are required for state licensure, the public is assured of academic competence and clinical experience.
Does chiropractic treatment require a referral from an MD?
No, a patient does not need referral by an MD before visiting a doctor of chiropractic. Chiropractors are first contact physicians, and are so defined in federal and state regulations. Following a consultation and examination, the doctor of chiropractic will arrive at a diagnosis under chiropractic care, or refer the patient to the appropriate health care provider.
Is chiropractic treatment safe?
Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of neuromusculoskeletal complaints. Although chiropractic has an excellent safety record, no health treatment is completely free of potential adverse effects.
The risks associated with chiropractic, however, are very small. Many patients feel immediate relief following chiropractic treatment, but some may experience mild soreness or aching, just as they do after some forms of exercise. Current literature shows that minor discomfort or soreness following spinal manipulation typically fades within 24 hours.
Neck pain and some types of headaches are treated through precise cervical manipulation. Cervical manipulation, often called a neck adjustment, works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasm, which helps relieve pressure and tension.
Neck manipulation is a remarkably safe procedure. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, there is not yet a clear understanding of the connection. The occurrence appears to be very rare—1 in 5.85 million manipulations— based on the clinical reports and scientific studies to date. If you are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms. This will help your doctor of chiropractic offer the safest and most effective treatment, even if it involves referral to another health care provider.
It is important for patients to understand the risks associated with some of the most common treatments for musculoskeletal pain -- prescription and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) -- as these treatments may carry risks significantly greater than those of chiropractic manipulation. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers like ibuprofen.
Is chiropractic treatment appropriate for children?
Yes, children can benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.
Are chiropractors allowed to practice in hospitals or use medical outpatient facilities?
Chiropractors are being recognized to admit and treat patients in hospitals and to use outpatient clinical facilities (such as labs, x-rays, etc.) for their non-hospitalized patients. Hospital privileges were first granted in 1983.
Do insurance plans cover chiropractic?
The majority of all insured American workers have coverage for chiropractic services in their health care plans. For example, the federal government’s Office of Personnel Management offers chiropractic coverage for federal employees in both the Mail Handlers and BCBS benefit plans. In addition, there is a chiropractic benefit in Federal Workers’ Compensation, and chiropractic care is available to members of the armed forces at more than 40 military bases, and is available at nearly 30 veterans’ medical facilities.
What type of education and training do chiropractors have?
Chiropractors are educated as primary contact health care practitioners, with an emphasis on musculoskeletal diagnosis and treatment. Educational requirements for doctors of chiropractic are among the most stringent of any of the health care professions. The typical applicant at a chiropractic college has already acquired nearly four years of pre-medical undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology and related lab work. Once accepted into an accredited chiropractic college, the requirements become even more demanding — four to five academic years of professional study are the standard. Because of the hands-on nature of chiropractic, and the intricate adjusting techniques, a significant portion of time is spent in clinical training.
In total, the chiropractic curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. The course of study is approved by an accrediting agency that is fully recognized by the U.S. Department of Education.
How is a chiropractic adjustment performed?
Chiropractic adjustment or manipulation is a manual procedure that utilizes the highly refined skills developed during the intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function. Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.
Is chiropractic treatment ongoing?
The hands-on nature of the chiropractic treatment is essentially what requires patients to visit the chiropractor a number of times. To be treated by a chiropractor, a patient needs to be in his or her office. In contrast, a course of treatment from medical doctors often involves a pre-established plan that is conducted at home (i.e. taking a course of antibiotics once a day for a couple of weeks). A chiropractor may provide acute, chronic, and/or preventive care thus making a certain number of visits sometimes necessary. Your doctor of chiropractic should tell you the extent of treatment recommended and how long you can expect it to last.
Why is there a popping sound when a joint is adjusted?
Adjustment of a joint may result in release of a gas bubble between the joints that makes a popping sound – it’s exactly the same as when you “crack” your knuckles. The noise is caused by the change of pressure within the joint that results in gas bubbles being released. There is no pain involved.
What can I do about a chiropractor I feel is behaving in an unethical manner?
From time to time ACA receives correspondence asking if certain chiropractic procedures are normal and/or asking where or how to file a complaint against a doctor of chiropractic.
The ACA does not necessarily have specific policy statements on all types of chiropractic procedures. You may check our policies page to see if a specific item has been discussed; for example, you can learn more about the mostly commonly used chiropractic techniques by clicking here: Techniques. For billing/coding questions, you can check our coding and reimbursement area by clicking here: Coding/Billing.
ACA is the largest organization for doctors of chiropractic but does not have disciplinary means over doctors who are not members; doctors who are members can face discontinuation of membership if the matter is severe enough and another authority has seen fit to revoke a doctor’s license. The ACA itself has no regulatory authority to suspend a doctor’s license, and does not act as a repository for complaints about doctors. In most cases, for complaints about doctors of chiropractic, as with other healthcare providers, the ultimate authority is the individual state board of licensure. You can click here to see a list with contact information for all state boards.
If the nature of your concern with a doctor of chiropractic involves a billing dispute, we highly recommend that you first discuss the issue with your individual doctor of chiropractic. What may seem incorrect can often be clarified after having reviewed the case with your doctor. If your case involves an insurer, ensure that you are clear on exactly what your plan will pay for regarding chiropractic coverage. Oftentimes, insurance plans may have a blanket statement that they pay for chiropractic care but may not pay for all of your visits or all of your therapies. If, after discussing your concerns with both the doctor and your insurer, you feel your issue has gone unresolved, you may wish to contact your state department of insurance.
If the nature of your concern with a doctor of chiropractic involves an ethical complaint about the doctor’s relationships with his or her patients, including any inappropriate sexual behavior, we recommend you immediately contact your individual state board of licensure. In addition, if your doctor is listed in our Find a Doctor search engine, please relay your concern to Maura Barnes, ACA Legal Affairs Assistant, at mbarnes@acatoday.org.
