Chiropractic
How can chiropractic nourish you?
Chiropractic is a complementary healthcare discipline that involves diagnosing and treating mechanical problems of the musculoskeletal system [1] without the use of drugs or surgery. The word ‘chiropractic’ is derived from the Greek words ‘cheir’ and ‘praktos’, meaning ‘hand’ and ‘done’ [2] or ‘practised’, so the combination roughly translates to ‘done by hand’.
The original version of chiropractic was developed by Daniel David Palmer, a 19th-century spiritualist [3]who experimented with magnetic healing prior to founding this modality. In its earliest form, chiropractic included beliefs about the role of the nervous system [4] in causing ill health which are inconsistent with established principles of mainstream medicine.
As chiropractic education evolved, the profession increasingly embraced a medical and scientific understanding [5] of the musculoskeletal system, and today, many chiropractors work cooperatively with doctors and other healthcare providers. In 2016, an influential article recommended [6] the best definition for chiropractors as “musculoskeletal practitioners with a special emphasis on spinal pain”.
Chiropractic has much in common with osteopathy, which emphasizes musculoskeletal alignment, performing manipulations[7] of the spine and various joints, and a non-invasive, whole-body approach to health. Chiropractors are trained to identify health conditions which are not suitable[8] for chiropractic treatment and will refer their patients to a GP or suitable specialist. In Australia, chiropractors are registered health professionals regulated by the Australian Health Practitioner Regulation Agency (AHPRA)[9].
Benefits of Chiropractic
The majority of evidence suggesting the effectiveness of chiropractic is focused around spinal conditions. Although one study reported temporary adverse effects [10] such as tiredness and dizziness after chiropractic intervention, the researchers concluded that the benefits of reduced neck pain and disability may outweigh the risks of treatment. There is evidence to suggest spinal manipulation followed by exercise offers greater benefits [11] for back pain than exercise alone.
Reviews of randomised controlled trials suggest that spinal manipulative therapy may be one of several effective treatments [12] for chronic lower back pain. There is evidence to indicate chiropractic may help relieve the symptoms of migraine headaches [13], and research also suggests spinal manipulation may be equally effective as surgery [14] in the treatment of sciatica.
Another possible benefit of chiropractic is a decreased reliance on pain medication. The results of a systematic review suggest people receiving chiropractic care for musculoskeletal pain are estimated to be 49% less likely to be prescribed opioids for pain management [15]than those treated by other health professionals.
Chiropractic may assist in relieving symptoms related to:
What to expect from a chiropractic session
In some respects, a visit to your local chiropractor has similarities to seeing a GP[16] or other healthcare provider. To begin, the chiropractor -- often shortened to ‘chiro’ -- will obtain a detailed medical history from you, examine you and complete an orthopaedic assessment[17], then suggest a diagnosis. Chiropractors are trained in using X-rays [18] as one of their diagnostic tools to help evaluate your condition. Your chiro will then customise a suitable treatment plan, which may involve massage and recommendations about exercise [19] and nutrition, as well as spinal adjustments.
A chiropractor performs an adjustment by delivering a swift and carefully directed push or thrust to a joint [20]whose movement is restricted. Chiropractors use their hands or an instrument designed to carry out this adjustment, to improve mobility and restore the joint’s natural function[21].
Due to the examinations and diagnostics involved, your first chiropractic session may last up to an hour or more. Follow-up sessions are usually shorter in duration, and on average, it will take 6-10 visits to obtain the best results[22]. The number and duration of your visits will depend on your specific treatment plan.
Chiropractic is unsuitable if you are suffering from advanced osteoporosis or other conditions affecting your bones, as well as illnesses such as arthritis[23], which compromise the stability of your joints. However, chiropractors are trained to modify their adjustments to the individual and may assist with these conditions. If chiropractic is not advisable, your chiropractor will direct you to a practitioner or specialist[24] better equipped to ensure your best health outcome.
Adverse effects from chiropractic are usually minor and temporary, although there are rare cases when more serious complications[25] including disc herniation or stroke have been reported. However, the hazards are small if you are being treated by a suitably trained practitioner[26], and this modality has a lower risk profile than conventional spinal treatments[27] involving medication or surgery.
As with any exercise or wellness program, please consult your medical professional before commencing chiropractic. If you have any concerns at all, also speak to your chiropractor, who will be happy to address these and evaluate whether chiropractic is a suitable treatment for you.
References
1. Chiropractic. Allied Health Professions Australia; [cited on 2024 Nov 27].
2. History of Chiropractic. American Chiropractic Association; [cited on 2024 Nov 27].
3. Lazarus D. Chiropractic treatment, a $15-billion industry, has its roots in a ghost story. Los Angeles Times; 2017.
4. Hirst K. What is the history of chiropractic? Thorne Road Chiropractor; 2022.
5. Evans R, Leininger B. History of chiropractic. University of Minnesota; [cited on 2024 Nov 27].
6. Walker BF. The new chiropractic. Chiropractic & Manual Therapies; 2016.
7. Chiropractor or osteopath: Who should you see? Invacare; 2021.
8. Chiropractic. Better Health Channel; [cited on 2024 Nov 27].
9. Regulating Australia’s chiropractors. The Chiropractic Board of Australia; [cited on 2024 Nov 27].
10. Rubinstein SM, Leboeuf-Yde C, Knol DL, De Koekkoek TE, Pfeifle CE, Van Tulder MW. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. Journal of Manipulative and Physiological Therapeutics; 2007.
12. Rubinstein SM, Van Middelkoop M, Assendelft WJ, De Boer MR, Van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Library; 2011.
13. Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, et al.. Evidence-Based Guidelines for the Chiropractic Treatment of Adults with Headache. Journal of Manipulative and Physiological Therapeutics; 2011.
14. McMorland G, Suter E, Casha S, Du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? a prospective randomized clinical study Journal of Manipulative and Physiological Therapeutics; 2010.
15. Lowry F. Chiropractic care tied to significant reduction in opioid scripts. Medscape; 2019.
16. Chiropractic: in depth. NCCIH; [cited on 2024 Nov 27].
17. What happens during your first chiropractor visit. Canberra Spine Centre; [cited on 2024 Nov 27].
18. Advice for chiropractors on the use of radiography (x-rays). The Chiropractic Board of Australia; [cited on 2024 Nov 27].
19. Chiropractic and You. Australian Chiropractors Association; [cited on 2024 Nov 27].
20. Chiropractic Adjustment – What is it? Chiropractor Melbourne; [cited on 2024 Nov 27].
21. What is a chiropractic adjustment? Australian Chiropractors Association; [cited on 2024 Nov 27].
22. Chiropractic adjustment. Mayo Clinic; [cited on 2024 Nov 27].
23. Perle SM, Ciccone T. Chiropractic Care: What Are the Real Risks? Health Central; 2019.
24. Chiropractic. Central Coast Spinal Care Centre;
25. Chiropractic Adjustment. Cleveland Clinic; 2022.
26. Is chiropractic safe? Integrated Wellbeing Centre; [cited on 2024 Nov 27].