Consulting a chiropractor

Consulting a chiropractor explains what to expect at your first appointment.

By Dr Barrie Lewis

This page was updated on 3rd December, 2019.

Consulting a chiropractor is really little different to a visit to any other doctor. You can expect him or her to

• take a history of your complaint,
  
• examine you and perhaps order xrays or a scan,
  
• make a diagnosis
  
• and treat you; only that will be quite different.

In almost all countries a DC is what is called a primary portal of entry practitioner. That means that you can consult him or her without first having to get a referral from your medical doctor.

Leg pain sciatica

Why would you want to consult a chiropractor anyway? There are many reasons. Perhaps you have had unremitting leg pain sciatica that hasn’t responded well to conventional treatment. Someone told you that even medicine's own research shows that lower back pain responds better to manipulation and exercises than to drugs and bed rest.

This slipped disc diary will give a tongue in cheek account of my own torment.

Ignored and neglected these lower back and leg pain symptoms progress inexorably until eventually a spinal stenosis explanation is required. Read more about it at this lumbar stenosis casefile.

Another condition requiring a spinal stenosis explanation is a lumbar facet arthropathy. Daily exercises to polish the rough spots on the facet cartilage will go a long way to improving the nutrition within the joint and facilitating healing after an injury. The alternative is less than satisfactory chiropractic and most unlikely ultimately failed back surgery too. 

Of course, though less commonly, lower back and leg pain may find their root in the femoral nerve, emerging from the mid to upper lumbar spine; usually though certainly not exclusively in the older person. This femoral nerve casefile describes the condition and the chiropractic care.

Lower back and leg pain exercises remain vital to prevent the slow deterioration of the condition with resulting pain and disability, and the everpresent threat of decompression surgery with all the risk entailed.

Consulting a chiropractor

Consulting a chiropractor is little different to any other doctor; only the treatment is different.

Or, perhaps you have had regular migraines for the last two years and you are tired of taking analgesics. You have heard that the pills actually cause headaches, and in any case you know that your doctor is treating the symptoms and not the cause.

Or maybe you sprained your ankle nine months ago, and you still cannot go for walks without pain in the lower leg and it is making you limp.

Chiropractors are trained to treat all the joints in the body so it could be your shoulder, your tennis elbow or even your jaw joint, a major cause of neck pain and headache.

Father Time is a much loved story of a young woman suffering from headaches. Use the site search function to find it. 

Jaw joint dysfunction, often called TMJ ear pain, is often felt in the neck since the sensory nucleus of the trigeminal nerve lies in the spinal cord in the upper cervical spine.
 

Neglected treatment for whiplash after an MVA, or fall off a horse, for example, frequently progress years later to far more complex symptoms of cervical stenosis. Spinal fixations from trauma reduce the nutrients reaching the cartilage, and a build up of waste products of metabolism; ultimately 'immobilisation arthritis' sets in resulting in narrowing of the canal.

Arm pain

Then arm pain begins as the nerve root is affected; that could be a frozen shoulder, tennis elbow or carpal tunnel syndrome, for example.

Here are a few arm pain case histories of interest.

And a more difficult cervical rib casefile.

Rib pain

Probably the most common adjustment given in the chiropractic clinic is in the midback, though this is not the most frequent complaint; that is lower back pain.

However rib pain is common; acute injuries involving deep breathing stabs respond very quickly to the chiropractic adjustment, but chronically unresolved conditions remain nuggety.

This rib pain treatment casefile after a fall from a bicycle is not atypical.

Tingling in arms and legs

Neurological symptoms such as tingling in arms and legs should never be taken lightly; they can be the precursor to more ominous developments and should be considered without delay.

This tingling in arms and hands is one of the most important pages at this site. It leads very often to subject material for alternative medicine research.

Shoulder, knee and ankle pain

Most chiropractors will also treat the peripheral joints such as shoulder, knee and ankle pain. Usually the patient presents initially with something like lower back pain and, when that is resolved, asks something like "Doc, can you also help my arm?"

This is typical. A young man who has been a patient for years arrives with patello femoral pain syndrome; that is under the kneecap.

Infantile colic

There are other reasons too, perhaps more obscure and controversial. Your baby has been crying day and night and you have heard that chiropractors can treat a huil baby very successfully to use the Dutch term. That is where the first conclusive research was done confirming that one of the main causes of infantile colic in small babies is a subluxation in the spine.

Most chiropractors will treat your child but there are advanced post graduate courses now for this specialization, generally called colic chiropractic.

Or, perhaps you have heard that chiropractic can sometimes help women fall pregnant when there is no medical cause for their infertility. Before considering the very expensive, and not terribly effective implantation techniques, perhaps consider your local DC. There is no research that I know of, alas, but every one of my colleagues, I'm certain, can entertain you with stories of how they made a patient pregnant; or your kidney condition and so on.

Consulting a chiropractor is a routine, ordinary thing to do. There is nothing outlandish about it. Now DCs themselves, that's another matter; they are a different breed.

Perhaps you are an athlete and you have heard from a fellow competitor how much he was helped with a recurring hamstring injury, or a rotator cuff syndrome, or shin splints after consulting a chiropractor. Since the advancement of post graduate courses that training chiropractors in sport injuries, there are now many chiropractors being invited to every level of sport, including the Olympics.

For example, nearly three quarters of the athletes attending the world games in Duisberg, Germany requested access to chiropractic during the games, with the result that 23 chiropractors were invited by the organizers to attend the games to treat the athletes. Because chiropractors endeavor to treat the cause of conditions which are often caused by subluxations of the spinal joints, or other joints such as in the ankle, rather than the symptoms such as pain in a muscle they have become the doctors of choice for many athletes.

• COLIC CHIROPRACTIC
  
• INFERTILITY CHIROPRACTIC

Outdoor lovers, what I recommend in fact with a large, broad-brimmed hat, never to be careful of the sun; it is both friend and foe. This acne body wash and melanoma page is a little sobering; use the site search function to find it.

The older patient

The older patient certainly has a place in the chiropractic clinic too. Bernard Preston, being elderly himself finds himself treating many folk in their eighties and nineties.

Or perhaps you are elderly, and all your joints ache, and your good friend has told you how her pain has been relieved by regular chiropractic treatment.

On the other hand, many medical sites grudgingly admit that the research about chiropractic is sound, but that it has no place for the elderly because of osteoporosis. Just how safe is chiropractic for the older person?

This cervical stenosis case file is pertinent to the older person.

Don't be anxious about Osteoporosis, or brittle bones. We use different techniques for the elderly, and a broken rib is a very rare occurrence - I confess to eight in thirty-seven years in practice! Chiropractic iatrogenic illness.

Just stand outside any chiropractor's office and you will see plenty of elderly people making their way to see their favourite practitioner. Consulting a chiropractor is no different. Only, because you have probably had the condition longer and things don't heal so quickly, it is probably going to take some hard work on the part of your chiropractor to fix your two year pain. Or twenty ...?

• CAUSES OF OSTEOPOROSIS
  
• Leg length inequality
  
• Sacroiliac joint treatment
  

Diet is extremely important for the older patient too. Researchers recently found that those over sixty-five, enjoying food rich in certain vitamins, were 280% less likely to become frail in the next 3.5 years⁽¹⁾; that is massive.

Upper leg, thigh and groin pain

Upper leg pain can be a diagnostic nightmare; consulting a chiropractor is no exception and a thorough examination is called for.

MIRACLES WE DO AT ONCE, the impossible takes a little longer ...

Mrs S, a 75 year old woman consulted me a month ago with right low back pain radiating to the side of her leg. She's had it for over a year. Two things were very clear:

1. A very short right leg
2. A severe sacroiliac joint fixation.

Today, after only three treatments, she reports that her upper leg, thigh and groin pain is 75 percent better. No, I'm not Dr Golden Hands; it's just basic chiropractic. You can experience the healing power of manipulation too from your local DC.

Consulting a chiropractor is no big deal. Do it if you have pain, and you are not getting better with your usual treatment; and perhaps if you have any so called medical condition that's not improving. We have not done a great job of advertising other complaints we can help.

Just this last month a new patient who has had unremitting facial pain and severe migraine headaches had been told it was related to certain foods in her diet by her doctor; she was taken bucketfuls of very strong medication. But no, the problem was from her jaw joint after it was forcibly opened to remove problem wisdom teeth under a general anaesthetic.

So how do you go about finding a chiropractor? You could try the yellow pages, or looking on the internet for a local list of practitioners. Better still would be to do some homework and start talking to your friends and acquaintances, and even your medical doctor. Many GPs are now referring patients to us on a regular basis.

The next step is simply to pick up the phone and make an appointment. It would be a good idea to get hold of any old xrays that you think might be relevant before consulting a chiropractor. New ones may be required, especially if yours are ancient, or you have recently had an injury, but often the old radiographs suffice. In the main they are digitally saved now and come on a CD.

Then try and prepare the way by thinking through when your condition started, and what injuries you have had that may have contributed to the pain; you may have to go back to your childhood. And lastly what really helps your chiropractor is if you already know what aggravates and relieves the ache, or tingling, for example.

The examination

Your chiropractor is usually a friendly person, genuinely interested in your condition. He or she will listen carefully to your story, and ask certain pertinent questions. Then he will give you a thorough examination, not only of your spine, but most likely he will check other joints in your body such as your hips and shoulders, your feet, and will take your blood pressure. You will be surprised by the depth of the orthopedic and neurological examination. New x-rays may be required.

You will be surprised by the attention to detail when first consulting a chiropractor. Just read any one of the Bernard Preston books, and you will know what I mean.

Report of findings

You may be treated at the first visit (especially if you are in acute pain) but more likely you will be asked to return with your spouse, at which time you will be given a full report of findings and the treatment protocol. Be ready to ask questions.

Why your spouse? Several reasons come to mind, but he or she may be concerned that you are consulting a chiropractor. He needs to be reassured. Or your better half is worried about the condition that is troubling you, same as you are, and it's better that he hears everything from the horse's own mouth.

Lastly, let us be honest. Consulting any doctor costs hard-earned cash, and your partner needs to be convinced that you are not simply throwing away more good money after bad by consulting a chiropractor.

Three phases of care

The treatment protocol may vary considerably, but most usually after consulting a chiropractor the treatment will fall into the three phases of care:

1. The pain phase. In this phase which usually last about 4-6 weeks, your chiropractor will be treating the cause of your condition in an attempt to reduce your pain. This phase varies enormously depending on the nature of your condition, how long you have had it and how severe it is. If could be several months, or it could be a few days.
2. The rehabilitation phase. During this phase you will have less treatment from your chiropractor, and the responsibility will gradually shift to your shoulders. You will be given certain exercises to do regularly at home, and you will most likely be asked to start walking, cycling or swimming. The intention is to strengthen your body, keep it supple, so the next episode doesn’t start again the next time you go and do some gardening.
3. The maintenance phase. If you have had your condition for a long time your chiropractor may well suggest you come in for an occasional but regular treatment. How often depends on many factors, but as a rough guide you can work on every two months. By then most people have started to creak and groan a bit, and it is time for a tune up. Usually before serious injuries, most people admit to a period when their bodies start to warn them that something is up. Chiropractors put a lot of emphasis on reducing these silent subluxations before they are the cause of something more serious. Maintenance care has its controversial side.

Be truthful

One last thought: don’t try hiding anything from your chiropractor. If you have had a setback gardening when you were not yet allowed to garden, or haven’t been doing your exercises, it only hurts you and confuses him if you try to conceal things. Tell him or her the whole truth, even if your face is a bit red. Otherwise he may change the treatment, or think of referring you out for surgery or drugs when it is not necessary at all.

Good luck. Remember Rome wasn’t built in a day and, while chiropractors do try to do miracles, the impossible may take a little longer.

Consulting a chiropractor you will find is no big deal.

Chiropractic First

The times, they are a-changing. Many people are now considering chiropractic first for their pains instead of swallowing bucket loads of pills.

One of the consequences is that your chiropractor will sometimes be RUNNING LATE.

Groin pain

Groin pain demands a thorough examination when consulting a chiropractor; expect it and, if you don't get it, vote with your feet.

• Developmental Hip Dysplasia
• Femoro Acetabular Impingement Syndrome

It may surprise you but, when consulting a chiropractor, you will probably find that s/he will examine your whole body. For example, it is now known that certain pre Hip Arthritis conditions, if diagnosed early, can profoundly change the course of the arthritis. A hip operation is no longer a foregone conclusion in cases of Developmental Hip Dysplasia (a greatly increased range of the hip) and Femoro Acetabular Impingement Syndrome (a very stiff hip, even in the young person).

But there's a proviso. If it's diagnosed early, and managed correctly, with chiropractic, of course.

Maigne's syndrome

Likewise, two upper lumbar spine conditions, Maigne's syndrome and Meralgia paresthetica also cause severe groin and upper leg pain and numbness. The good news is that, correctly managed, they too respond extremely well to chiropractic care.

• MAIGNES SYNDROME
  
• MERALGIA PARESTHETICA
  
• HIP ARTHRITIS
  
• UPPER LEG PAIN

For the chiropractor

Could a too-high first consultation fee be what's limiting the number of new patients coming to your practice? Read more... INITIAL CLINICAL CONSULTATION FEE.

Promising results for conditions not validated by alternative medicine research is unethical; nevertheless there are many conditions that we know respond to our treatment even though it is not validated; it is a fine line that every chiropractor walks.

Arthritis in lower back

Arthritis in lower back can make your life utterly miserable, but there's hope. Often it's been there for years, but the pain only started three months ago. Is the arthritis really the cause of your pain? Or is it an incidental finding.

Daily at the Chiropractic Coalface we are treating patients with arthritis. The pain goes away, or is much less. Was the arthritis really the cause?

• ARTHRITIS IN LOWER BACK

These lower back and leg pain exercises are in my book mandatory for every single person; like brushing your teeth. There's such an epidemic of disabling pain and high cost treatment that prevention is the key; make sure you don't get it and if you do, they will help you get over it.

Bernard Preston books

If you find this site helpful and interesting then  my Bernard Preston books are worth a consideration. The paperback versions are available only in North America but you can instantly download the ebooks onto your eReader, smartphone or tablet for a fraction of the price. These are the unusual stories that you can read about whilst consulting a chiropractor.

Useful links

• Sacroiliac joint anatomy is a common cause of Lower Back Pain.
• Sometimes the examination conflicts with the history. Frog in my Throat reviews opens with a chapter with just such unusual back pain. The cause? A long forgotten IUD that prevented her from falling pregnant.
  
• Chicken bones extract ... a proven cure for some forms of ARTHRITIS.
  
• Chiropractic Research; is this all hot air, or is there a solid foundation to the claims made on this page?