Frequently Asked Questions:
What is the difference between Chiropractors and Osteopaths? Well historically they both started in America in the late 1800’s emphasising the idea that spinal manipulation could be used as a treatment for many medical conditions instead of pharmaceutical drugs. Chiropractors believed this was due to unblocking the nervous system so the body could function optimally whilst Osteopaths believed it was the blood supply that was being unblocked by spinal manipulation.
Does spinal manipulation optimise the nervous/vascular systems? Well first of all modern Chiropractic is the most successful form of conservative treatment for most muscular and joint problems as we now incorporate soft tissue therapies and exercises with manipulation. However some chiropractors and osteopaths still cling on to the old fashioned ways and claim to be able to treat non-musculoskeletal conditions too such as high blood pressure, asthma and infertility. Modern science has definitely raised some questions about the validity of these claims. Evidence is currently unclear, the hard core old fashioned practitioners (nicknamed “straights” or “TICS”) would say absolutely yes spinal manipulations free your nervous system of interference allowing your body to optimise its functions. Hard core sceptics would say it’s utter nonsense and we should only be treating muscoloskeletal conditions. As with most things the truth lies somewhere in between the extremes, some research supports chiropractic for non musculoskeletal conditions and some does not. At Exsicc the focus is entirely on musculoskeletal conditions only.
How long does it take to become a qualified Chiropractor? It takes 5 years to complete a masters degree in Chiropractic in the UK with a further year of supervised on the job training to achieve a doctorate in Chiropractic (DC). Osteopaths do one year less in basic training mainly because they spend less time on imaging techniques such as x-rays and MRI’s.
Why would I see a Chiropractor when I can get NHS physio? Most NHS physio’s have only done a 3 year bachelors degree in physiotherapy with very little focus on diagnosis or treatment of common musculoskeletal injuries. They are more geared towards specialist rehab cases like post stroke or cystic fibrosis. The kind of physio seen running on the pitch in professional sports has done at least an extra 2 years at university to catch up to the training of standard Chiropractors and has to be paid to see privately just like chiropractors.
My GP says it’s just my age and I only need painkillers? This is not true of all GP’s, some have specialist training in diagnosing and managing musculoskeletal conditions. However most GP’s get very little training on musculoskeletal conditions at university so they don’t have many more options for you than temporary pain relief with medications.
Do I need to get my GP to refer me to a Chiropractor? No Chiropractors are the best trained primary care physicians for diagnosing and treating musculoskeletal conditions. Having said that it is still sensible to keep the GP informed as they will be required to refer for imaging or surgery if needed, your Chiropractor will be able to tell you when this is necessary and write a letter to your GP.
Should I take painkillers aren’t they just masking my pain? Yes they are just masking your pain and this does mean you may not realise when you are causing further damage to your injury. Having said that painkillers will reduce your pain temporarily and some musculoskeletal conditions are very painful. Remember though painkillers have serious side effects if taken too often or in too large a dose. It is better to manage pain with exercises and ice (10 mins at a time).
If I go to the Chiropractor will they make me keep going forever? No nobody has to keep having treatment forever. After an initial course of treatment to resolve your condition your Chiropractor should give you some exercises to help you maintain your new state of good health. They should also however offer you regular treatment often termed “maintenance” (similar to servicing your car or regular trips to the dentist) because most people do not do their exercises well enough to keep their condition at bay so one treatment every few months can help to keep you feeling good instead of letting the symptoms all build back up again over time. It is of course your choice as to whether you take up this offer.
What is a manipulation and why does it make a “popping” sound? Manipulation is generally used to describe small, fast stretches of the joints that make an audible “pop” or “crack” if there are gas bubbles in the joint fluid that get suddenly released. Exactly like cracking your knuckles. It is not dangerous and does not cause arthritis, in fact regular manipulation of joints can help to reduce the symptoms of arthritis.
I read on the internet that cervical (neck) manipulation cause stroke? A researcher called Edzard Ernst has been one of the most vocal proponents of this idea. There have been a small number of cases (outside the UK) where strokes have been linked to neck manipulation. However the majority of the cases Ernst found were actually performed by untrained manipulators like GP’s and physio’s. Several large medical studies have tried to prove the link between neck manipulation and stroke without success. In fact in one recent study on thousands of patients who had a stroke found they were slightly more likely to have been to a GP than a chiropractor and studies on the biomechanics of manipulation show it does not cause any stretching to the vertebral artery so cannot injure it. The most likely reason for the association is people undergoing a stroke may feel neck pain, headaches and dizziness and present to a Chiropractor thinking they need neck treatment for a musculoskeletal problem. Chiropractors, like GP’s, are trained to recognise the signs of stroke and refer appropriately.
How many treatments will I need? Impossible to say without assessment as each case is different, however a good estimate is that it will take at least 4 sessions to get you pain free. There is no maximum number but if there were no signs of improvement after 8-10 sessions I would be questioning the effectiveness of the treatment or the accuracy of the diagnosis.
Do I need to take my clothes off for treatment? No it is possible to do many treatments and assessment through clothes. However assessment of posture is easier with the patient in underwear as some clothes will distort your shape. Also some treatments such as massage and acupuncture can only be done with exposed skin so if you are not comfortable with undressing to your underwear (you will still be offered a gown) then just tell your Chiropractor and they will do the best they can with you fully clothed.
Why are there different types of Chiropractor? For the same reason there are different types of Osteopath and Physiotherapist. We all share the same basic training to a certain extent but when therapists begin to work in the private sector and do post graduate training they begin to differ from one another even in the same profession as certain systems of assessment and treatment appeal to some therapists more than others. This is also true of patients who may find for the exact same conditions some patients do better with one type of therapy and some do better with a very different type of therapy. The important thing is to find something that works for you, don’t expect to be miracle cured in one session but equally don’t “flog a dead horse” for 20 sessions+ in the hope that it’s going to work soon.