Chiropractor: What They Do

What does a chiropractor do?

American chiropractic is a manual treatment method from the field of alternative medicine, which is now scientifically recognized in many countries. The focus is on disorders of the musculoskeletal system and their consequences on the nervous system – especially in the area of the spine. This encloses the spinal cord, which together with the brain forms the central nervous system and acts as a mediator of nerve signals between the brain and the rest of the body.

The chiropractic approach assumes that most physical ailments are due to what are called subluxations. Chiropractors define these as functional and/or structural and/or pathological joint changes (e.g., blockages or misalignments of joints such as the vertebral joints) that affect the integrity of the nervous system (neurointegrity), potentially affecting functions of the body and overall health. As a result, for example, discomfort, back pain, dizziness or diseases such as migraine may develop.

Conventional medicine understands subluxation to mean something different – namely an incompletely “dislocated” (luxated) joint. In this case, the joint surfaces are still partially in contact. You can read more about this here.

Complaints due to subluxations

Various complaints can accompany a subluxation in the spine. What these are depends on which section of the spine is affected:

In the area of the cervical spine, headaches and neck pain, dizziness, hearing and vision problems can result. Subluxations in the middle section of the spine can result in shoulder and back pain, high blood pressure and digestive problems. If the lower part of the spine is affected, patients often complain of pain in the hip, abdomen, or legs and feet.

Diagnosis by the chiropractor

The goal of chiropractic diagnosis is to identify and localize subluxations and, based on that, develop an individualized treatment plan. The first step is to take a medical history (anamnesis). For example, the following information is of interest to the chiropractor:

  • Are you limited in your mobility? In what way and for how long?
  • Have you already been diagnosed with certain diseases?
  • What do you do for a living (one-sided stress, sitting or standing, physical work, etc.)?

Next, the chiropractic analysis is on the agenda, which may involve several examination procedures. The focus is on manual palpation, where the chiropractor examines you with his hands to track down possible subluxations.

In addition to manual palpation, other chiropractic examination methods may be used. For example:

  • Postural analysis: using a plumb bob alignment, the chiropractor checks patients for postural abnormalities that may indicate a subluxation.
  • Bilateral and four-quadrant scales: These devices can be used to determine uneven weight distribution, which is typical in spinal misalignments.
  • Inclinometry: With a so-called inclinometer, the chiropractor can measure the mobility of the spine.

In addition, the chiropractor must rule out possible fractures or diseases such as osteoarthritis, herniated discs or tumors as the cause of the complaints (differential diagnosis). Because such causes cannot be treated with the help of the Chirotherapie. On the contrary, chiropractic can even aggravate the associated complaints!

Various examination procedures can be used for differential diagnostics, for example:

  • X-ray
  • Computer tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Temperature measurement devices
  • Electromyography
  • Blood pressure measurement
  • Blood tests
  • Electroencephalography (EEG)
  • Electrocardiography (ECG)

Treatment by the chiropractor

Once the chiropractor has identified a subluxation (in the chiropractic sense), he or she develops an individualized treatment plan. The goal is to eliminate the subluxation manually or, if necessary, with the assistance of chiropractic instruments (“adjusting”):

The chiropractor can resort to various treatment methods for the adjustment. Most have their origin in American chiropractic, which has a long tradition. Commonly used methods include:

  • Chiropractic Instrument Technique (CIT): Here, subluxations are treated with a so-called activator. With this small instrument, the chiropractor applies targeted impulses to eliminate misalignments or blockages. The method is considered very gentle and is therefore popular with children and older patients.
  • Flexion-Distraction (Cox disc technique): Special chiropractic treatment tables help the chiropractor to open the disc spaces and treat the vertebral joints.
  • Full-Spine-Specific Technique (FSST): this purely manual treatment method attempts to directly release blockages in the spine or pelvis.
  • Thompson-Terminal-Point Technique (TTPT): Here the chiropractic treatment table plays a major role. With the help of so-called drops, it can be adjusted in sections so that the chiropractor can apply targeted impulses to individual parts of the body.

What side effects are possible after treatment?

In the past, treatment by a chiropractor was considered quite dangerous by some people – practitioners were preceded by the reputation of being “bone breakers”. This was certainly due to the jerky, rather rough setting methods practiced. Today’s chiropractors are much more careful and gentle, so that there is little need to worry about undesirable side effects.

When used properly by a trained practitioner, side effects are rare. Sometimes – especially after the initial treatment – a slight muscle ache or a feeling of tension may occur in the treated part of the body. But this so-called initial aggravation after a chiropractic treatment usually improves by itself after one or two days.

In very rare cases, complications such as nerve loss symptoms (e.g., numbness or paralysis) occur if the chiropractor works improperly. Even less common is damage to the vessels in the cervical spine when it is chiropractically adjusted. The vascular damage can lead to the formation of blood clots and thus strokes.

When not to use chiropractic

The chiropractor can only treat complaints with a functional cause. This means that chiropractic treatment may not improve organic changes such as osteoarthritis or herniated discs, and in the worst case may even worsen them. Therefore, it is important to rule out such pre-existing conditions before chiropractic treatment.

Chiropractic should also not be used in cases of acute injury or processes that destroy bone and/or connective tissue, such as cancer tumors, bone metastases, osteoporosis and collagenosis (connective tissue disease).

Chiropractors should treat women who are pregnant with caution. Generally, pregnant women should first talk to their doctor or midwife before seeking alternative medical methods.

What does the treatment cost and who bears these costs?

Chiropractic treatment by a panel doctor with appropriate additional training (chiropractor) can be paid for by the statutory health insurance. Chiropractic treatment by a private doctor, on the other hand, must be paid for by those with statutory health insurance.

Most private health insurances cover the chiropractic costs, especially if the treatment is performed by a doctor trained in chiropractic.

In Austria, chiropractic treatment by an appropriately trained physician or physiotherapist is not covered by public health insurance. However, private health insurance often covers it under certain conditions.

The same applies to Germany and Austria: Before starting treatment, check with your insurance company to see if and under what conditions they will cover chiropractor costs.

Chirotherapy: meaning, development, delimitation

Chirotherapy – what is it exactly? The term comes from the Greek and means “to practice with the hands”. According to this definition, chirotherapy therefore means the manual therapy of health disorders (manual medicine).

The definition of the World Chiropractic Association is broader. It describes chiropractic as “a health profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health.”

Chiropractic originated in the United States, with the first chiropractic methods emerging there in the 1890s. Until about 1950, chiropractic was limited to North America, and it was not until the 1960s and 1970s that it gained wider recognition and acceptance, including in the conventional medical field. Today, chiropractic is an integral part of the repertoire of medical or remedial diagnostic and treatment methods in many countries around the world.

What is a chiropractor?

In some places, so-called chiropractors also offer their services. These have completed (mostly in the U.S.) several years of university studies with a subsequent practical phase in the field of chiropractic. In Germany, however, there is no legal basis for this profession, so that chiropractors in this country can only operate as non-medical practitioners.

Doctors are also allowed to offer chirotherapeutic treatments in Germany, if they have completed additional training in “manual medicine”. They may then call themselves chirotherapists. The additional training is offered in Germany (and some other countries such as Austria and Switzerland) by recognized professional associations. It concludes with an examination before the medical association.

In Austria, only physicians and physiotherapists with appropriate additional training are allowed to work as chiropractors.

Difference between physiotherapy and chiropractic

Physiotherapy includes a wide range of active and passive therapy methods such as exercise therapy, electrotherapy, hydrotherapy – and manual medicine (manual therapy). Chiropractic is also a manual treatment method. In fact, the terms “manual medicine”; “chiropractic” and “chiropractic therapy” are often even used interchangeably – there is often confusion around these terms.

Difference between osteopath and chiropractor

Osteopathy and chiropractic are similar in some aspects – they are both manual methods from alternative medicine. However, there are differences in the underlying approach:

Chiropractic, on the other hand, as described at the beginning, attributes most physical complaints to subluxations such as vertebral joint blockages, which disrupt the transmission of signals via nerve pathways.