The goal of all physicians regardless of specialty should be to bring relief to their patients and to educate so the patient can participate in the healing process while learning to improve lifestyle strategies that will prevent injury in the future and enhance their overall health and well being. 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 INJURIES and complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.
Doctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling. Many chiropractors take a different approach to the care they offer by looking at you holistically and functionally. These doctors are looking at diet, ergonomics and movement patterns, posture, and nutrition choices you have been making to help determine and treat the cause of your pain as opposed to focusing solely on your pain and symptoms. (ACA, www.aca.org)
The experience you have when going to a chiropractic office can differ depending on the practice style of the physician. Some offices specialize in specific types of patients populations like sports injuries, pediatrics or scoliosis and their clinical flow, type of techniques and modalities offered may be designed to best suit that type of patient. However, most practitioners will perform the following basic clinical steps.
Anytime you visit a doctor’s office, expect to fill out paperwork that gives your demographic information, health history, physical history, current activity levels, complaint details, current medications, and insurance information.
A key component of the diagnostic process begins with the doctor understanding your history. Your chiropractor will review any problems indicated in your paperwork, ask questions and discuss in detail your presenting complaints to get to the cause of your pain and injury. This is the time where the goals of the patient must be outlined, so the practitioner can have an idea how to gage progress, and understand any time constraints the patient may be working with. This is the most important part of the first visit with any patient.
After a thorough history has been obtained, an exam will be performed on the areas involved and including other general physical tests. Vitals will be taken, as well as range of motion markers, neurologic tests, orthopedic tests, and any other tests the physician deems necessary. If not enough information can be obtained through the physical evaluation, or if certain tests are positive, further imaging/testing may be indicated.
Extra Diagnostic Testing
This may include x-rays, blood work, MRI’s, CT’s or other tests. They vary from case to case and depending on the chiropractic physician.
Report of Findings
After the examination, and potentially after any extra testing is ordered/received, the findings should be discussed with the patient. Any question the patient may have about his/her condition should be brought up at this time. The doctor will go over his/her plans for treatment and what would be expected of the patient. This is the second most important part of the first interaction with the doctor. This is where education happens, and it is extremely important for the doctor and the patient to both fully understand the expectations of the other.
The goal of all physicians regardless of specialty should be to bring relief to their patients and to educate so the patient can participate in the process and learn lifestyle strategies that will prevent injury in the future.
Once the findings are presented to the patient and any questions are answered, care can begin. With conservative care, there are many avenues that the chiropractor may choose from when it comes to the healing process of his/her patients. These avenues include: passive modalities, active rehabilitation, chiropractic adjustments, manual therapy techniques, nutritional recommendations, diet modifications, and more. Each practitioner differs in their clinical process, but regardless of style, the patient should have a full understanding of what treatment they are receiving, why it is indicated, and how long they will need it. Conservative care is not an exact science, so some injuries/conditions may require longer treatment schedules than others, and needs may change as treatment proceeds.
Once treatment is underway the chiropractor may use different assessment techniques to track the progress of the individual patient. There are three phases of care in my office:
- Acute – When a patient is in pain, the main focus is to find the actual cause as well as get the patient out of pain as soon as possible.
- Supportive – While pain is often the last symptom to present itself, it is often the first symptom to be relieved. Depending on the condition, even though the pain has subsided may not mean that the tissue has healed fully or the condition is strong enough to keep from reoccurring. This is the most important stage, and one that is highly overlooked.
- Maintenance – This phase is once the condition is resolved and the patient has the strength and functionality to maintain their results. It’s important to keep progressing and continue to make sure that all structures are working well and function is maintained long term.