How to Choose a Chiropractor

The road to chiropractic care can be tricky to navigate, with a variety of issues causing concern for patients. It simply comes down to the fear of the unknown for some, as chiropractic adjustments are often misunderstood.

There are many misconceptions about chiropractors that tend to give the whole profession a bad rap; however, it is important to bear in mind that in many cases, these are just myths or fall into the “one bad apple spoils the bunch” category.

Imagine having a bad experience with one bad dentist: would you never have your teeth cleaned again? You would simply seek out a better dental practice, asking friends and family for recommendations.

The same holds true when it comes to chiropractors: recommendations from trusted friends, family members, or neighbors go a long way toward finding the right one.

Beyond those recommendations, there are also a variety of important items you should include on your chiropractor checklist, and we have included all of them in this comprehensive guide.

Bear in mind that you should always discuss serious medical concerns or emergencies with your primary healthcare provider. (The best chiropractors will also know when your issue is beyond the scope of their practice and will refer you back to a specialist who can treat your concerns).

What Is Chiropractic Medicine?

Before choosing the best chiropractor for your needs, it is important to understand what chiropractic medicine is, how it works, and how there are different types and approaches within the field.

In general, chiropractic medicine connects the alignment of your spine to your overall health and the way your body functions and heals itself. The theory of chiropractic care is that by correcting issues with your spinal alignment, you may see general improvements in health that stem beyond the relief of back pain (though that is certainly a big one and the reason many patients start chiropractic treatment in the first place).

In addition to alleviating back pain, chiropractic treatment could also reduce headaches, improve digestion, increase energy levels, improve quality of sleep, and a whole host of other health benefits.

Chiropractic medicine is a hands-on style of medicine. The very word comes from the combination of “cheir” and “praxis,” Greek for “hand” and “practice.” A chiropractor is trained to use her own hands (as well as some equipment) to manually manipulate a patient’s spine.

Extensive training is required to practice as a licensed chiropractor, which is an important point regarding the many myths surrounding the field. While chiropractors do not earn the same medical degree as practicing physicians, they have to complete at least three years of a bachelor’s program focused on science and four years of chiropractic training.

When you consider that some of the nursing assistants and associate nurses who (capably) treat you in a health care setting by performing routine tasks such as drawing blood have training periods that can be less than one year, you may rethink whether chiropractic providers are adequately trained.

In addition to the work a chiropractor does to manually manipulate your spine, their care may also include:

• X-rays and scans of your spine to diagnose and treat issues
• Recommendations for dietary changes to promote a healthy spine
• An analysis of your sleep hygiene to determine if you need to adopt new sleeping habits to promote a healthy spine

While they are not medical doctors and are not licensed to prescribe medication or equipped to diagnose problems beyond the spine, chiropractors are extremely knowledgeable about health and how our bodies heal themselves.

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Who Should Use a Chiropractor?

Many people can receive a wide variety of benefits from chiropractic care, though in some cases, it may not be appropriate due to specific health conditions, diseases, injury, or age.

Perhaps the widest population of people suited for chiropractic care are those who suffer from chronic pain. Back, neck, and shoulder pain are common health concerns that affect people of all ages and all walks of life, and this kind of pain can range from a mild nuisance to completely debilitating.

Coupled with that pain is the dangerous risk of addiction that comes with prescription medication used to treat it, making chiropractic care a safer alternative for many.

If your back or neck is the source of constant agony after sitting for hours at a desk or hunched over a computer, you may be the perfect candidate for spinal alignment. Perhaps you have pain from an old sports injury in your younger years, or your neck feels stiff due to the physical demands of your job (or even because of the way stress is manifesting in you physically).

In general, the groups named below may benefit from chiropractic treatment (though this may not be exhaustive):

• Patients who experience chronic back, shoulder, neck, or knee pain that is not determined to be osteoarthritis
• Patients who experience muscle or joint pain or numbness with issues such as carpal tunnel syndrome
• Patients who experience frequent migraine headaches
• Patients who are struggling with digestive issues or decreased energy

You should also discuss these concerns with your primary medical doctor and consider chiropractic care as an option.

There are certain patients for whom chiropractic care may not be an appropriate option, and those include:

• Patients with osteoarthritis
• Patients with slipped or herniated discs
• Patients with untreated injuries (such as a bone fracture) or injuries that have not fully healed
• Patients of advanced age or in seriously declining or delicate health

If in doubt, ask your medical doctor whether your specific health conditions and symptoms make you an unsuitable candidate for manual spinal alignments and chiropractic care. Also, chiropractic care should never be considered an appropriate substitute for emergency medicine. Any patient in serious distress should seek emergency medical attention at the nearest local hospital or call 911.

Chiropractic Techniques: 15 Commonly Used Methods

Chiropractors will use different techniques based on their training and backgrounds and a patient’s individual needs. Outlined below are 15 of the most commonly used techniques, and you can expect to find your chiropractor using a variety of these methods.

1. Activator Methods

While many chiropractic adjustments are done by hand, sometimes a chiropractor will use an instrument to manipulate the spine, as in the case of activator methods. A spring-loaded instrument provides a force or thrust that is quicker than what a chiropractor can do by hand. Some patients prefer this to manipulation by hand.

2. Adjustive Instruments

In addition to the activator method, chiropractors use other instruments that help control their own force and precision. An instrument can remove the need for the chiropractor to focus as much on his own stance and posture while adjusting a patient.

3. Applied Kinesiology

In this approach, a chiropractor would combine manipulation of the spine and adjustments with specific nutrition strategies and massage techniques. The massage would be focused on neurovascular and neurolymphatic points in the body.

4. Cox Flexion/Distraction

For some patients who need increased mobility, a special chiropractic table is used for Cox Flexion/Distraction. This technique combines manual manipulation and the table’s movement to traction the spine and flex it forward.

5. Cranial Technique

Chiropractors combine several techniques to adjust the joints of the skull by manipulation.

6. Diversified

One of the most common styles of chiropractic care is referred to as Diversified. Most chiropractic schools focus on these procedures, and most chiropractic patients think of them as the ones where the back or neck is “cracked.” Diversified adjustments combine a low-amplitude thrust with high velocity, and the result often includes a popping or cracking noise.

7. Extremity Manipulating/Adjusting

Sometimes chiropractors will make adjustments to areas of the body other than the spine. For example, a chiropractor might adjust the patient’s wrist, shoulder, or elbow (such as in cases where the chief complaint is carpal tunnel syndrome) or make shoulder, hip, knee, or ankle and foot adjustments. Some of these extremity manipulations can be particularly helpful when it comes to correcting gait or posture issues.

8. Gonstead

The Gonstead technique differs from rotary adjusting in that it focuses on P-A adjusting, but it is still done by hand. The chiropractor may use temperature gradient readings and X-rays to determine what manipulations are needed using the Gonstead technique.

9. Logan Basic

The use of light pressure on the ligaments of the sacrum is key to the Logan Basic technique used by some chiropractors. This technique helps patients not only with pain management but also helps to improve muscle balance. Chiropractors working with children often opt for this gentle technique.

10. Meric System

While this refers to a system and not a specific technique, we have included it here as this is a common way chiropractors make decisions about how to adjust a patient. In this system, the spinal areas are adjusted to correspond to the nerves related to the patient’s symptoms.

11. NIMMO/Receptor Tonus

The NIMMO technique includes pressure on specific trigger points, followed by a few seconds of “rest” for the muscle to relax. It is based on the notion that muscles cause abnormal joint function.

12. Palmer Upper Cervical

Chiropractors often use X-rays to determine how to best apply this technique, which is often used to address joint dysfunction in the upper cervical spine. The technique uses a variety of manual thrusts or instrument force to correct the spine and, in theory, address problems that occur throughout the rest of the patient’s body because of the spine.

13. Pierce-Stillwagon

Chiropractors use a drop table to make pelvic and cervical region adjustments. Thermographic and/or X-ray analyses are typically used first to help the chiropractor determine the specific adjustments.

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14. Sacro Occipital Technique

When chiropractors employ the Sacro Occipital Technique, they will place blocks in the shapes of triangles under a patient’s pelvis. This technique focuses on the relief of lower back pain and addressing joint problems. This technique can be used on its own or combined with other chiropractic techniques.

15. Thompson Technique

The Thompson Technique involves the use of a table with segments (or drop pieces) that can be lifted and then dropped when the manual thrust is delivered. The dropping motion is designed to “open” or “distract” the joint when the adjustment occurs.

What to Expect in a Chiropractic Treatment Plan

While each chiropractic office will have its own approach to patient care, there are some general things you can expect across the board.

It is common for many chiropractors to begin treating a patient and making adjustments during their first visit. The chiropractor will assess the patient’s overall health and needs and formulate a plan to address those needs.

Usually, chiropractors will suggest a minimum of one visit per week (or even 2 or 3) for the first month of care, after which they will assess whether the plan is working effectively to address the patient’s needs.

Chiropractic adjustments are not a “quick fix” – patients need to understand that to feel better, they might feel worse temporarily.

If this is your first time using chiropractic care, your body will be in for a shock. The needed spinal adjustments can and will take time to work on the various aches and pains you may be experiencing, and the adjustments themselves can certainly cause some soreness.

Part of an effective treatment plan will include thorough patient education, where your chiropractor takes the time to walk you through what you can expect in each phase of your treatment.

For some patients, a 4-to-6 week course of treatment is ample time to provide relief; for others, it could take up to 3 to 4 months. Your plan could include techniques (including those we outlined above), nutritional intervention, and specific exercises.

It is important to discuss any and all health concerns with your chiropractor before you begin treatment, including past injuries and surgeries, any medications you are taking, allergies, and lifestyle factors (for example, an occupation that requires heavy lifting).

How to Choose Your Chiropractor: The Ultimate Checklist

Finding the right chiropractor for your needs starts with research. There may be 20 chiropractic offices within a 10-mile radius of your home or office, but you should take a closer look at some important details before you begin chiropractic care.

Education and Licensing

While it’s true your chiropractor will not have a medical degree; she should have a degree from a chiropractic college and a license to practice in your state.

Do not just assume these things are in hand: do your homework and check the provider’s credentials.

Once a chiropractic student completes their degree, they must achieve a passing score on a four-part test administered by the National Board of Chiropractic Examiners to be licensed. Every state has this requirement, and a chiropractor is only licensed in one state.

Beyond passing the board exams to earn a license to practice, chiropractors also take a state-level exam, which covers that state’s scope of practice limitations, and submit to a criminal background check.

If you need a specialty within chiropractic medicine, you should also consider a provider who has earned additional certifications in particular practice areas. For example, chiropractors can earn post-doctorate certifications in areas such as neurology and radiology.

Some are also specialized in acupuncture, and you will even find some chiropractors with additional training for veterinary chiropractic!

The provider’s education and other credentials should be easy to find on their website and if you cannot locate the information, ask them directly before choosing that office.

Reviews and Recommendations

Do not just take one person’s word for it when it comes to a chiropractor. Take the time to read multiple reviews and ask around.

There are plenty of ways to find reviews about any doctor these days, including chiropractors. Google reviews alone should have plenty of material to get you started, and you can also check out Yelp or sites such as Healthgrade.com.

If you see 50 positive reviews and one negative, this could be an anomaly. But a mixed bag might tell you it’s time to keep looking!

Treatment Costs and Insurance

The cost of a provider’s treatment will be a major factor in your decision. While we would never suggest when it comes to spending on your health that you should “go for the best price” (sometimes a cheap price means cheap quality of care), you also do not want to go with a chiropractic provider who is grossly overcharging for services.

First things first on pricing: let’s talk about insurance. Do not assume the provider can answer these questions or do this work for you. It is your responsibility to look at your own health insurance plan and discuss whether your plan covers any level of chiropractic care with your insurance provider.

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The good news is that many major health insurance providers offer coverage for chiropractic care. But there is also some “fine print” you need to consider, including these possibilities:

• Your health insurance provider may require that you have a physician referral to a chiropractor as a stipulation in covering such services.
• Your health insurance provider may limit the number of chiropractor visits they cover in a year (or possibly per month).
• Your health insurance provider may cover chiropractic care for a specific period of time but not for a long-term or ongoing period of “maintenance.”
• Your chiropractor may not file directly with your insurance; rather, they may provide billing statements that you can submit directly to the health insurance company for reimbursement.
• Your health insurance provider may require that you visit certain chiropractors within their network.
• Your health insurance provider may not apply your out-of-pocket expenses at a chiropractor toward your deductible.

Costs for chiropractic care will vary based on everything from your specific treatment needs to your location. You can surely expect to see a higher chiropractic bill in San Francisco than in Salina, Kansas.

There are also so many factors involved in cost that vary from patient to patient, including equipment and techniques used to the way a patient responds to treatment. In general, an average of around $65 per visit is what you might consider as you think about a budget for chiropractic care.

Ask the chiropractor’s office for detailed pricing information ahead of time, and be sure to find out about any penalties for canceled or missed appointments.

Don’t Overlook These Red Flags

As you evaluate and consider different chiropractic offices in your area, you may feel a bit uneasy about a particular provider’s approach to care. Trust your gut! If you get a bad feeling about a particular chiropractor, she is not the right one for you.

On the other hand, it is also important, especially if you are seeking chiropractic care for the first time, to try and remain open to a new way of managing your health.

Sometimes chiropractors have to deliver the hard truth about how our lifestyle choices affect our bodies’ functions, and they may recommend changes that seem outside of your “comfort zone.”

You might also be reluctant to allow someone to manually adjust your spine. This is a reasonable fear you will need to overcome to receive the benefits of chiropractic care.

The red flags you should never ignore as you evaluate chiropractors are:

• Aggressiveness or “Pushiness” about a Plan. If the chiropractor seems to be forcing something on you that you are uncomfortable with or pushing you to commit to a plan quickly, take this as a red flag pointing right to the exit door. You should never feel pushed into anything; a good chiropractor will make you feel comfortable and welcomed, not threatened, insulted, or pressured.
• Rushed Visits. If a chiropractor rushes you through an initial evaluation (or any visit), you should take this as a warning sign that you may not be receiving the best quality of care. Especially in the cases of new patients, chiropractors should spend plenty of time reviewing patient questions and concerns. Also, a chiropractor needs to spend a good amount of time talking with you about your health history, injuries and illnesses, symptoms, and lifestyle factors to develop a personalized and effective treatment plan. You would not want your dentist drilling after only taking a “quick peek” in your mouth; you certainly do not want a chiropractor making adjustments to your spine after only a brief evaluation.
• “One visit” Guarantees. If anyone in a chiropractic practice tells you they can “fix” something in one visit; you may as well believe someone who guarantees you will win the lottery by purchasing one ticket. Chiropractic care is not an overnight fix, and it is not a “one size fits all” type of magic. To effectively address the pain you are experiencing, a chiropractor will need to make adjustments over a period of time, which could be a few weeks or a few months. A truly skilled and experienced chiropractor will be able to give you a general guideline of how long it will take after a thorough initial evaluation.
• Criticism Without Constructiveness. No one should feel “body-shamed” by a chiropractor. Indeed, they are trained to help patients understand how we can make better choices to improve the health of our spines and our bodies overall. However, a chiropractor who makes derogatory comments toward a patient about her physique is another red flag you should not avoid.

Chiropractic FAQs

As you evaluate chiropractors in your area and consider chiropractic adjustments, you may come up against some frequently asked questions from potential patients.

Is it Safe to Receive Chiropractic Care if I am Pregnant?

The rule to remember here is to check with your Ob/Gyn first, but it is generally safe for most women to receive chiropractic care during pregnancy. This is a good topic to discuss with a new provider if you anticipate becoming pregnant in the near future.

Ask whether they treat pregnant patients and if your treatment plan would change if you become pregnant while under their care.

Back and leg pain is extremely common in pregnant women, so more than ever, chiropractic care may be needed during pregnancy.

Is it Safe for Kids to Receive Chiropractic Care?

By treating kids from an early age, chiropractors can change the course of their health for the better. Childhood adjustments could help prevent pain later in life, and it is safe for kids to receive chiropractic care.

However, just as a pregnant patient is advised to check with her Ob/Gyn first, a parent should always consult the child’s pediatrician before utilizing chiropractic care.

Kids’ treatments may also help with the pain younger patients are experiencing in their wrists, shoulders, neck, and back from long periods of time on handheld devices.

A chiropractor may also help teach children about the benefits of good posture, whether that means avoiding a hunched over neck while looking at a phone, a slumped back in a school desk, or even the correct ways to stretch and warm-up for various sports.

Chiropractors can also help kids understand the links between nutrition and health, helping them to adopt some lifelong healthy habits.

Can’t I Just Crack My Back on My Own? Why Do I Need a Chiropractor?

While it is certainly possible for an individual to (inadvertently or intentionally) make adjustments to her spine, it is always ill-advised. Consider the fact that a chiropractor has extensive training and can also manipulate your spine in ways you simply cannot, as they approach our bodies with the full force and range of motion of their own hands.

It is also possible to cut your own hair, pull your own damaged tooth, or stitch your own wound. In most cases, we pay someone else to do these things – for a good reason!

Isn’t Chiropractic Care Dangerous?

This is, of course, the most common misconception about chiropractic care, that it is dangerous and patients risk injury. And, of course, there is always a level of risk involved, just as you often sign waivers and agree to the risk involved in everything from a minor cosmetic procedure to an organ transplant.

In some rare cases, chiropractic adjustments can lead to herniation or an increase in pain, but in most cases, they are successful with limited side effects. A good chiropractor will be honest and upfront about what you should expect, and they will often tell you, “You are going to feel a little worse before you get better.”

For example, the day after a treatment, you may be particularly sore. Your chiropractor will tell you the best course of action after treatment, whether that simply means rest, alternating heat and ice, using a special pillow for your neck, or even using a TENS unit to help with pain management.

Is it Okay to Have Spinal Adjustments after Surgery?

While it is typically safe to resume chiropractic care after you have recovered from a surgical procedure, check with your physician first to determine when it is safe to do so.

You should always keep an open line of communication with your chiropractor about any changes to your medical history; something as simple as switching to a new medication could affect how your body responds to adjustments.

Let your chiropractor know whenever you experience an injury or illness that may affect your treatment.