How to Choose the Right Chiropractor

A read­er asked me how she could find a good chi­ro­prac­tor in her city.

That’s a good ques­tion.

A good chi­ro­prac­tor can be an impor­tant mem­ber of your health team.  Noth­ing can get to the root of cer­tain health issues as quick­ly and effec­tive­ly as chi­ro­prac­tic.

In fact, I believe that if we are to find a solu­tion to the health care morass we’ve got­ten our coun­try into, it would entail weav­ing the guid­ing prin­ci­ples at the core of chi­ro­prac­tic (and the safe, proven tech­niques used to imple­ment them) into the foun­da­tion of health care deliv­ery.

Unfor­tu­nate­ly, the actu­al ways that chi­ro­prac­tic ideas are imple­ment­ed in dif­fer­ent chi­ro­prac­tic prac­tices are extreme­ly var­ied.  There are vir­tu­al­ly no “stan­dard” chi­ro­prac­tic meth­ods.

There are some real­ly great chi­ro­prac­tic doc­tors out there.  I won’t share with you the sec­ond half of the pre­ced­ing sen­tence – you can guess.

Since I have a high opin­ion of my own health care approach, and thir­ty suc­cess­ful years in prac­tice, I’d like to offer you some tips on how to find a good chi­ro­prac­tor in your com­mu­ni­ty.  I’ll sug­gest some ques­tions you can ask your prospec­tive chi­ro­prac­tor before or dur­ing your first vis­it, and how you can eval­u­ate the response you get.


“How will we know that the treat­ment is help­ing me?”

There should be an ongo­ing plan to eval­u­ate your response to the treat­ment and the oppor­tu­ni­ty to mod­i­fy the treat­ment approach if it isn’t work­ing.  The mon­i­tor­ing plan should include feed­back from you about improve­ment in pain and dai­ly func­tion­al­i­ty.

In addi­tion, your chi­ro­prac­tor may want to use “objec­tive” tests in addi­tion to your self-report, and include such meth­ods as mea­sur­ing range-of-motion, test­ing mus­cle strength, or one or more of many oth­er pos­si­bil­i­ties as they are rel­e­vant to your sit­u­a­tion.

How long will it take to fig­ure out if the treat­ment is help­ing or not?”

The answer should be longer than one day and short­er than 3 weeks and sound rea­son­able based on the sever­i­ty and chronic­i­ty of your prob­lem.

If the treat­ment doesn’t seem to be help­ing, what type of fur­ther refer­ral might you typ­i­cal­ly make?”

There should be at least a hypo­thet­i­cal men­tion, how­ev­er remote the like­li­hood, of refer­ral to anoth­er type of med­ical pro­fes­sion­al.

What val­ue do you see in X-rays for a case like mine?”

There are two basic ways that Xrays are used in chi­ro­prac­tic prac­tice.

One way of using Xray is as a diag­nos­tic screen­ing tool that par­al­lels the use of Xrays in med­ical prac­tice.  My expe­ri­ence is, if Xrays are used for this “med­ical” pur­pose, they’re only rarely nec­es­sary in chi­ro­prac­tic prac­tice.

But there are many chi­ro­prac­tors who have a dif­fer­ent pur­pose in mind for tak­ing Xrays – to reveal details of spinal align­ment.  Pre­sum­ably, the infor­ma­tion about spinal align­ment can then be used in plan­ning the chi­ro­prac­tic treat­ment approach.

My opin­ion is that this is a bad rea­son to take Xrays.

Because the radi­a­tion in Xrays caus­es harm (to a tiny degree, but it’s harm nonethe­less), the bur­den of proof is on the prac­ti­tion­er to show that the infor­ma­tion on the Xray leads to improved results.

I’m skep­ti­cal that chi­ro­prac­tors who use Xrays to reveal the details of spinal align­ment achieve bet­ter clin­i­cal results on aver­age than chi­ro­prac­tors who don’t.

How rel­e­vant do you feel the fun­da­men­tal chi­ro­prac­tic con­cept of ‘spinal sub­lux­a­tion’ is to my sit­u­a­tion?”

Some chi­ro­prac­tors use the term “sub­lux­a­tion” to refer to areas of spinal joint mechan­i­cal dys­func­tion or mis­align­ment that also cre­ate neg­a­tive feed­back cir­cuit­ry in the ner­vous sys­tem.

There are doc­tors of chi­ro­prac­tic who believe that the sole pur­pose of chi­ro­prac­tic is to iden­ti­fy and cor­rect these spinal sub­lux­a­tions.

In my view, the con­cept of “sub­lux­a­tion” has some use­ful­ness (though I pre­fer the term “spinal joint dys­func­tion”).  But elim­i­nat­ing sub­lux­a­tions as the one and only pur­pose of chi­ro­prac­tic? That’s over­sim­pli­fied.

What about the role of ther­a­peu­tic exer­cise?”

The answer should empha­size the impor­tance of reha­bil­i­ta­tive exer­cise as an indis­pen­si­ble part of main­tain­ing health (though there are cas­es in which the patient should avoid exer­cise in the short run).   The chi­ro­prac­tor doesn’t nec­es­sar­i­ly have to get involved in the exer­cise pre­scrip­tion himself/herself, but there should be some lev­el of respect for – even insis­tence on — doing the right exer­cis­es in the long run.

Hope this helps you gain con­fi­dence in the doc­tor of chi­ro­prac­tic you ulti­mate­ly choose.  She can make a pos­i­tive dif­fer­ence in the future of your health.  Here’s a link to my prac­tice web­site where you can learn more about the way I prac­tice.

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About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website, askdrlavine.com, provides more information about his approach.

Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.

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One Response to How to Choose the Right Chiropractor

  1. When look­ing for a chi­ro­prac­tor, a good place to start is to ask your pri­ma­ry care physi­cian or spine spe­cial­ist for the names of chi­ro­prac­tors who appear com­pe­tent and trust­wor­thy. It also helps to ask friends, co-work­ers and neigh­bors for rec­om­men­da­tions.

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