When I am out promoting my clinic at networking events around Madison, Wisconsin, there are many questions that I answer in regards to my chiropractic clinic, as well as the chiropractic profession in general. One question I get asked a lot is “are all chiropractors the same?” Short answer: no. All chiropractors are the same in that they use spinal manipulative therapy as treatment, however, the way the chiropractor figures out and treats what is going on with any pain and/or dysfunction is different. There are multiple reasons to why not all chiropractors practice the same, just like how not every medical doctor practice the same.
Areas of Focus
Chiropractors practice differently based off their experiences, training, and interests. Some chiropractors got into the profession because they were treated by chiropractor while growing up, and the way the chiropractor practiced resonated with that person and they wanted to mimic that practice. Other chiropractors pursue certain areas that interest them. For interest, chiropractors that love working with children can specialize in pediatrics, while chiropractors who love working on athletes can specialize in sports chiropractic.
My Chiropractic Techniques
Personally, I utilize several different techniques in chiropractic, because I believe I should tailor my treatments to the patient, rather the other way around. The chiropractic techniques that I utilize are diversified, applied kinesiology (AK), activator, and sacral-occipital technique (SOT) primarily. I also utilize soft tissue and nutritional therapies for more of a holistic approach. Soft tissue therapies include Functional and Kinetic Treatment with Rehab (FAKTR) and a wide array of other muscle releasing techniques. Nutritional therapies range from dietary changes to implementation of supplements and medical foods. The therapies are dependent on what’s going on with the patient, as well as any results from blood, saliva, urine, and stool testing that could be ordered to help figure out the root cause of any pain and/or dysfunction.
It All Depends
That is a brief description of what I do, and not every chiropractor is going to practice in a more holistic way that I do. Certain chiropractors and their respective techniques may be super effective with one patient, and not as effective with another. It just depends on the patient preferences. If you are one of the patients that don’t see ideal results from one chiropractor, I would suggest trying out a different chiropractor (with different techniques as well). Another thing to keep in mind, there are good chiropractors out there, and there are bad chiropractors. Just like any other profession, there are just some people that are bad at their job. This isn’t a blanket statement by any means (so take this with a grain of salt), but the lower quality chiropractors tend to be the cheaper ones that require ridiculously high patient volumes, with many patient visits for an extended period of time in order to stay open, and only spend only a couple minutes with their patients (i.e. not very thorough). Don’t get me wrong, that works for some people and there’s nothing wrong with that. But I do have a good portion of my patients who have tried those chiropractors and weren’t pleased by that sort of chiropractic care. Unfortunately with chiropractic, if someone goes to a bad chiropractor, that could ruin them going to another chiropractor for the rest of their life and think all chiropractors are quacks or witch-doctors. That isn’t the case, because there is more and more research coming out on spinal manipulative therapy (chiropractic specifically) and how it’s becoming first line therapies for low back, mid back, and neck pain. Don’t believe me? Check out the resources that contain published articles that are peer-reviewed.
References:
Bialosky JE, Bishop MD, Robinson ME, Zeppieri G Jr, and George SZ. Spinal manipulative therapy has an immediate effect on thermal pain sensitivity in people with low back pain: a randomized controlled trial. Phys Ther. 2009 Dec; 89(12): 1292-1303.
Bronfort G, Haas M, Evans R, Leininger B, and Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat. 2010; 18:3.
Bronfort G, Haas M, Evans R, Kawchuk G, and Dagenais S. Evidence-formed management of chronic low back pain with spinal manipulation and mobilization. Spine J. 2008 Jan-Feb; 8(1): 213-225.
Bronfort G, Haas M, Evans RL, and Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004 May-Jun; 4(3): 335-356.
Cagnie B, Vinck E, Beernaert A, and Cambier D. How common are side effects of spinal manipulation and can these side effects be predicted? Man Ther. 2004 Aug; 9(3): 151-156.
Cherkin DC, Sherman KJ, Deyo RA, and Shekelle PG. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Ann Intern Med. 2003 Jun 3; 138(11): 898-906.
Chou R, Huffman LH, American Pain Society, and American College of Physicians. Nonpharmacological therapies for acute and chronic low-back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2; 147(7: 492-504.
Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, and Owens DK. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2; 147(7): 478-491.
Dagenais S, Tricco AC, and Haldeman S. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Spine J. 2010 Jun; 10(6): 514-529.
Elder Jr WG, King M, Dassow P, and Macy B. Managing lower back pain: you may be doing too much: new guidelines call for a measured approach to imaging and medication, while emphasizing psychosocial evaluation. J Fam Practice. 2009 Apr 1; 58(4): 180-187.
Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, Maher CG, and Refshauge KM. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial. Pain. 2007 Sep; 131(1-2): 31-37.
Ferreira ML, Ferreira PH, Latimer J, Herbert R, and Maher CG. Efficacy of spinal manipulative therapy for low back pain of less than three months’ duration. J Manipulative Physiol Ther. 2003 Nov-Dec; 26(9): 593-601.
Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, Cherkin D, Gagnier J, Ammendolia C, Ansari MT, and Ostermann T. Complementary and alternative therapies for back pain II. Evid Rep Technol Assess. 2010 Oct; 194: 1.
Hoiriis KT, Pfleger B, McDuffie FC, Cotsonis G, Elsangak O, Hinson R, Verzosa GT. A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain. J Manipulative Physiol Ther. 2004 Jul-Aug; 27(6): 388-398.
Hurwitz EL, Morgenstern H, Kominski GF, Yu F, and Chiang LM. A randomized trial of chiropractic and medical care for patients with low back pain: eighteen-month follow-up outcomes from the UCLA low back pain study. Spine. 2006 Mar 15; 31(6): 611-621.
Kinkade S. Evaluation and treatment of acute low back pain. Am Fam Physician. 2007 Apr 15; 75(8).
Machado LA, Kamper SJ, Herbert RD, Maher CG, and McAuley JH. Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials. Rheumatology. 2009 May; 48(5): 520-527.
Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004 Mar-Apr; 27(3): 197-210.
Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, and van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database Syst Rev. 2011 Feb 16; (2):CD008112.
Ruddock JK, Sallis H, Ness A, and Perry RE. Spinal manipulation vs sham manipulation for nonspecific low back pain: a systematic review and meta-analysis. J Chiropr Med. 2016 Sep; 15(3): 165-183.
Santaguida PL, Gross A, Busse J, Gagnier J, Walker K, Bhandari M, and Raina P. Complementary and alternative medicine in back pain utilization report. Evid Rep Technol Assess. 2009 Feb; 177(Jan): 1-221.
Swait G and Finch R. What are the risks of manual treatment of the spine? A scoping review for clinicians. Chiropr Man Therap. 2017; 25: 37.
Van Tulder MW, Koes B, and Malmivaara A. Outcome of non-invasive treatment modalities on back pain: an evidence-based review. Eur Spine J. 2006 J; 15(Suppl 1): S64-S81.
Wheadon JM, Song Y, Mackenzie TA, Philips RB, Lukovits TG, and Lurie JD. Risk of stroke following chiropractic spinal manipulation in Medicare B beneficiaries ages 66-99 years with neck pain. J Manipulative Physiol Ther. 2015 Feb; 38(2): 93-101.
