CHIROPRACTIC

What is Chiropractic?
Chiropractic is a branch of the healing arts which is concerned with human health and disease processes. Doctors of Chiropractic are physicians who consider man as an integrated being and give special attention to the physiological and biochemical aspects including structural, spinal, musculoskeletal, neurological, vascular, nutritional, emotional and environmental relationships.

The practice and procedures which may be employed by Doctors of Chiropractic are based on the academic and clinical training received in and through accredited chiropractic colleges and include, but are not limited to, the use of current diagnostic and therapeutic procedures. Such procedures specifically include the adjustment and manipulation of the articulations and adjacent
tissues of the human body, particularly of the spinal column. Included is the treatment of intersegmental aberrations for alleviation of related functional disorders.

Chiropractic is a drug-free, non-surgical science and, as such, does not include pharmaceuticals or incisive surgery. Due regard shall be given to the fact that state laws, as well as the nation's antitrust laws, may allow Doctors of Chiropractic to utilize ancillary health care procedures commonly referred to as being in the common domain.

History of Chropractic Care
The roots of chiropractic care can be traced all the way back to the beginning of recorded time. Writings from China and Greece written in 2700 B.C. and 1500 B.C. mention spinal manipulation and the maneuvering of the lower extremities to ease low back pain. Hippocrates, the Greek physician, who lived from 460 to 357 B.C., also published texts detailing the importance of chiropractic care. In one of his writings he declares, "Get knowledge of the spine, for this is the requisite for many diseases".

In the United States, the practice of spinal manipulation began gaining momentum in the late nineteenth century. In 1895, Daniel David Palmer founded the Chiropractic profession in Davenport, Iowa. Palmer was well read in medical journals of his time and had great knowledge of the developments that were occurring throughout the world regarding anatomy and physiology. In 1897, Daniel David Palmer went on to begin the Palmer School of Chiropractic, which has continued to be one of the most prominent chiropractic colleges in the nation.

Throughout the twentieth century, doctors of chiropractic gained legal recognition in all fifty states. A continuing recognition and respect for the chiropractic profession in the United States has led to growing support for chiropractic care all over the world. The research that has emerged from " around the world" has yielded incredibly influential results, which have changed, shaped and molded perceptions of chiropractic care. The report, Chiropractic in New Zealand published in 1979 strongly supported the efficacy of chiropractic care and elicited medical cooperation in conjunction with chiropractic care. The 1993 Manga study published in Canada investigated the cost effectiveness of chiropractic care. The results of this study concluded that chiropractic care would save hundreds of millions of dollars annually with regard to work disability payments and direct health care costs.

Doctors of chiropractic have become pioneers in the field of non-invasive care promoting science-based approaches to a variety of ailments. A continuing dedication to chiropractic research could lead to even more discoveries in preventing and combating maladies in future years.

Education of Doctors of Chiropractic
Doctors of Chiropractic must complete four to five years at an accredited chiropractic college. The complete curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. Approximately 555 hours are devoted to learning about adjustive techniques and spinal analysis in colleges of chiropractic. In medical schools, training to become proficient in manipulation is generally not required of, or offered to, students. The Council on Chiropractic Education requires that students have 90 hours of undergraduate courses with science as the focus.

Those intending to become doctors of chiropractic must also pass the national board exam and all exams required by the state in which the individual wishes to practice. The individual must also meet all individual state licensing requirements in order to become a doctor of chiropractic.

An individual studying to become a doctor of chiropractic receives an education in both the basic and clinical sciences and in related health subjects. The intention of the basic chiropractic curriculum is to provide an in-depth understanding of the structure and function of the human body in health and disease. The educational program includes training in the basic medical sciences, including anatomy with human dissection, physiology, and biochemistry. Thorough training is also obtained in differential diagnosis, radiology and therapeutic techniques. This means, a doctor of chiropractic can both diagnose and treat patients, which separates them from non-physician status providers, like physical therapists. According to the Council on Chiropractic Education DCs are trained as Primary care Providers.

What is a Doctor of Chiropractic?
The proper title for a doctor of chiropractic is "doctor" as they are considered physicians under Medicare and in the overwhelming majority of states. The professional credentials abbreviation " D.C." means doctor of chiropractic. ACA also advocates in its Policies on Public Health that DCs may be referred to as (chiropractic) physicians as well.

Chiropractic Philosophy
As a profession, the primary belief is in natural and conservative methods of health care. Doctors of chiropractic have a deep respect for the human body's ability to heal itself without the use of surgery or medication. These doctors devote careful attention to the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health. A Doctor of Chiropractic is one who is involved in the treatment and prevention of disease, as well as the promotion of public health, and a wellness approach to patient healthcare.

Scope of Practice
Doctors of Chiropractic frequently treat individuals with neuromusculoskeletal complaints, such as headaches, joint pain, neck pain, low back pain and sciatica. Chiropractors also treat patients with osteoarthritis, spinal disk conditions, carpal tunnel syndrome, tendonitis, sprains, and strains. However, the scope of conditions that Doctors of Chiropractic manage or provide care for is not limited to neuromusculoskeletal disorders. Chiropractors have the training to treat a variety of non-neuromusculoskeletal conditions such as: allergies, asthma, digestive disorders, otitis media (non-suppurative) and other disorders as new research is developed.

A variety of techniques, treatment and procedure are used to restore healing which will be the topic of future education releases.

Chiropractic Research
Evidence for the Effectiveness of Chiropractic

Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective. Many other studies have shown that chiropractic care can contain costs and get workers back on the job in less time than other treatments. The following are excerpts from a few of the more recent studies:

For Acute Low-Back Problems:
"For patients with acute low-back symptoms without radiculopathy, the scientific evidence suggests spinal manipulation is effective in reducing pain and perhaps speeding recovery within the first month of symptoms." - Clinical Practice Guidelines, AHCPR (1994)

For Long-Term Low-Back Problems:
"There is strong evidence that manipulation is more effective than a placebo treatment for chronic low-back pain or than usual care by the general practitioner, bed rest, analgesics and massage." - Spine, Van Tulder and Bouter et al. (1997)

"...improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear." - British Medical Journal, Meade et al. (1995)

"Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after 12 months." - British Medical Journal, Koes et al. (1992)

For Pain:

"...patients suffering from back and/or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments, thus reinforcing previous results showing the benefits of chiropractic treatment for back and neck pain." - Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)

"...for the management of low-back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system." - The Manga Report (1993)

For Headaches:

"Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache." - Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001)

"The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values." - Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)

For the Elderly:

"[Elderly] chiropractic users were less likely to have been hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs." - Topics in Clinical Chiropractic, Coulter et al. (1996)

For Containing Costs and Getting Workers Back on the Job:
"The overwhelming body of evidence" shows that chiropractic management of low-back pain is more cost-effective than medical management, and that "many medical therapies are of questionable validity or are clearly inadequate." - The Manga Report (1993)

First contact chiropractic care for common low back conditions costs substantially less than traditional medical treatment and "deserves careful consideration" by managed care executives concerned with controlling health care spending. - Medical Care, Stano and Smith (1996)

Back Pain Statistics

Although doctors of chiropractic (DCs) care for more than just back pain, many patients visit DCs looking for relief from this pervasive condition.

Thirty-one million Americans have low back pain at any given time (1). One half of all working Americans admit to having back symptoms each year (2). One third of all Americans over age 18 had a back problem in the past five years severe enough for them to seek professional help (3). And the cost of this care is estimated to be a staggering $50 Billion yearly--and that's just for the more easily identified costs! (4).

These are just some of the astounding facts about Americans and their miserable backs! Is there any wonder why some experts estimate that as many as 80% of all of us will experience a back problem at some time in our lives? (5).

Because back problems are this common it's probably going to happen to you too! Shouldn't you find out what to do about it before it happens rather than after? Why wait until you're hurting to learn about your treatment options?

When you're hurting you may not give this important decision the time and attention it needs to make the best choice. Here are the facts about manipulation as a treatment for back problems:
Manipulation is one of several established forms of treatment used for back problems. Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today's growing emphasis on treatment and cost effectiveness, manipulation is receiving much more widespread attention. In fact, after an extensive study of all currently available care for low back problems, the Agency for Health Care Policy and Research--a federal government research organization--recommended that low back pain suffers choose the most conservative care first. And it recommended spinal manipulation as the ONLY safe and effective, DRUGLESS form of initial professional treatment for acute low back problems in adults! (6). Chiropractic manipulation, also frequently called the chiropractic adjustment, is the form of manipulation that has been most extensively used by Americans for the last one hundred years. (7). Satisfied chiropractic patients already know that DCs are uniquely trained and experienced in diagnosing back problems and are the doctors most skilled in using manipulation for the treatment of back pain and related disorders (8). As a public service, the American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about the federal government's recommendations and how chiropractic manipulation may help you, contact a Doctor of Chiropractic in your area.

Frequently Asked Questions back

Q. How many doctors of chiropractic (DCs) are in my state? What is the ratio of DCs to the population in my state? Which states allow DCs to practice a particular modality?
A. Contact the Federation of Chiropractic Licensing Boards (FCLB) for more information. Phone: 970-356-3500. Web site: www.fclb.org
o FCLB maintains statistics on the licenses issued by state.
o FCLB also includes a synopsis of each state's Scope of Practice in its directory, which is available online.

Contact the chiropractic association in your state for more information as well. Click here for a list of state associations: http://www.acatoday.com/about/state_assoc.shtml

Q. How many doctors of chiropractic practice in the US?
A. According to a December 1997 report produced by the Agency for Health Care Policy and Research titled, "Chiropractic in the United States: Training, Practice and Research," there were approximately 50,000 doctors of chiropractic licensed in the United States in 1994. A recent study estimated that the number of chiropractors will double by the year 2010 to over 100,000 - far exceeding the 16 percent increase projected for medical doctors.

Q. How many Americans visit doctors of chiropractic per year?
A. According to results of a survey published in the November 11, 1998 issue of the Journal of the American Medical Association, approximately 11 percent of the population had visited a doctor of chiropractic in the previous year.² According to the US Census Bureau, today there are approximately 288 million people in the United States.³ Assuming the 11% annual figure has remained unchanged, the number of people who visit a chiropractor every year is now approximately 31.6 million.