Chiropractic Treatment

Contents

• What is chiropractic?
• What can chiropractic treat?
• Benefits of chiropractic treatment
• McTimoney technique
• How many treatments will I need?
• References

What is chiropractic?

Chiropractic is a conservative approach to health care which is non-surgical and drug free. Chiropractors may use a range of techniques, either passive or active, to reduce pain and disability with the aim of restoring normal function to the body.

The chiropractic profession is regulated in the UK by the Chiropractors Act 1994. The General Chiropractic Council (GCC) is the regulatory body which ensures that anyone calling themselves a chiropractor abides by a strict Code of Practice (CoP) and Standard of Proficiency (SoP).

A chiropractor will initially take a detailed case history and perform a thorough examination, which considers all aspects of the presenting complaint and may include orthopaedic and neurological  testing or imaging. At this point a chiropractor will refer to hospital or a GP if there are underlying conditions which require medical care.

Chiropractors take an integrated and holistic approach to the health needs of their patients, considering physical, psychological and social factors, so a full presenting picture is obtained before offering a treatment plan.

Treatments may include a very wide range of chiropractic techniques that vary in their approach (including manipulation, mobilisation, joint distraction, traction, passive/active range of motion); they may include soft tissues techniques (such as massage); heat/cold therapy; and active procedures such as exercises and rehabilitation. They will also offer self-help advice on lifestyle, exercise and diet and will provide support for pain management, sports injuries and active rehabilitation.

Chiropractic is concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal manipulation or adjustment. (World Federation of Chiropractic, 1999).

What can chiropractic treat?

In 2010 Gert Bronfort and colleagues (1) published a review that only examined randomised controlled trials (RCT) evidence, but found evidence that the care offered by chiropractors is effective for a wide range of conditions including neck pain, pain associated with hip and knee osteoarthritis, and some types of headache.

The most compelling evidence for chiropractic care relates to low back pain (2, 3) but chiropractors help people manage a range of other conditions. This does not necessarily mean that joint manipulation is used for all conditions, but that the package of care given by the chiropractor provides relief for the patient, for instance through manipulation or mobilisation followed by exercise which can improve the symptoms experienced by the patient (4, 5). Chiropractic intervention and posture training can limit episodes of acute pain and spinal rehabilitation, including components such as education, lifestyle change, weight loss, general fitness and specific low-back training exercises which may also be required (6). Chiropractic can increase the patient’s choice of treatments by offering a wider range of non-surgical, minimally invasive alternatives (7).

Patients will often self-refer to a chiropractor with symptoms that may be acute or very long standing. Usually people will find a chiropractor through word of mouth reports from friends or family that have experienced successful results, or from the register of chiropractors on the GCC website.

Benefits of chiropractic treatment

Chiropractors do not necessarily treat the presenting condition but they manage the presenting symptoms in order to help the patient. These symptoms may be musculoskeletal problems caused by accidents, stress, lack of exercise, poor posture, illness and everyday wear and tear. Patients with ongoing degenerative problems which cannot be ‘cured’ may come for treatment so that they are able to maintain their normal everyday activities such as playing with grandchildren, gardening or sports.

Pain is not the only reason that patients seek help from a chiropractor. Whilst no specific claims can be made about effectiveness, in clinical practice patients have reported improvement in a wide range of presenting complaints such as Irritable Bowel Syndrome (IBS), headaches, blood pressure problems, vertigo or dizziness, eczema, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome etc.

Chiropractors can be a valued part of an integrative multidisciplinary health care team which includes consultants, GP’s, pain management teams, podiatrists and physiotherapists all working to keep the patient as healthy and active as possible.

McTimoney technique

The McTimoney technique is just one of many different chiropractic techniques worldwide. It was developed by John McTimoney in Banbury, Oxfordshire in the 1950s and is now used by about a quarter of the chiropractors in the UK. It is characterised by its holistic approach, utilising the body’s own self-healing abilities. At each treatment the whole body is assessed and adjusted as necessary using precise, fast adjustments that do not appear to have much force. As such, it can be well tolerated by more fragile individuals as well as the elderly and young. The McTimoney technique is at the forefront of the chiropractic treatment of animals due to its systematic light force approach. The McTimoney Chiropractic Association (MCA) hold a register of chiropractors that use the McTimoney technique, together with those additionally trained to treat animals.

How many treatments will I need?

How many chiropractic treatments you will need depends on how long you have had the problem, how bad the problem is, what you do for yourself between treatments and how you respond to treatment. Typically, an average initial course may be between three and six treatments. According to the approach of the chiropractor these may be weekly, or twice or three times a week, but the chiropractor will explain what they think is wrong, what they intend to do about it and how many treatments they think you need before you start a course of treatments.

References

1. Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropractic & osteopathy 2010;18:3.

2. UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal 2004;329:1377.

3. UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectiveness of physical treatments for back pain in primary care. British Medical Journal 2004;329:1381.

4. COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. European Guidelines for the management of acute non-specific low back pain in primary care. European Commission Research Directorate General: Backpain Europe 2004.

5. COST B13 Working Group on Guidelines for Chronic Low Back. European Guidelines for the management of chronic non-specific low back pain in primary care. European Commission Research Directorate General: Backpain Europe 2004.

6. National Institute for Health and Clinical Excellence. IPG 183 - Non-rigid stabilisation techniques for the treatment of low back pain – guidance. NICE 2006.

7. Department of Health. Musculoskeletal Services Framework. Department of Health 2006.