Chiropractors. Those are the guys who crack your back, right?
Not so fast.
Nothing is that simple, and neither is chiropractic care, which has been around since time immemorial yet still suffers stigmatization. “Some patients have told me, ‘My mom won’t go, my dad won’t go, because they think chiropractors are quacks,’” says Nelson S. Ong, D.C., of Universal Chiropractic & Functional Rehabilitation and a provider for Sutter Center for Integrative Holistic Health. As someone who had his first chiropractic treatment as a high-schooler, when an auto accident left him with multiple spinal injuries and a bruised sternum, Ong understands that it often takes a firstperson experience to become a believer.
Are you a believer? Regardless, it’s a good idea to get your facts straight instead of rushing to judgment. To that end, we asked three local chiropractors to address some of the more commonmyths and misunderstandings surrounding their profession.
Chiropractors treat only back pain. Hardly. Get this: About half of David S. Gunther, D.C.’s, patients come in for non-back-related issues, he says. “Feet, knees, hips, ankles, shoulders, elbows—I see patients with joint and soft tissue conditions in all these areas,” says Gunther, who has a private practice in midtown. Similarly, Justin C. Lau, D.C., of Elite Spinal & Sports Care in Sacramento, says he sees a lot of runners with shin, knee and hip injuries. Ong adds that you may be surprised by the range of things chiropractors can help with, such as migraines, carpal tunnel syndrome and TMJ. Who knew?
All they do is spinal manipulation (aka “adjustments”). Not necessarily. But it is the most common therapeutic procedure used by chiropractors, according to the American Chiropractic Association website, acatoday.org. In a nutshell, the goal of adjustments is to relieve pain and restore mobility in joints that are restricted in movement, usually (but not always) due to injury. (Lifting a refrigerator, as one of my friends recently did, likely will do it.) But not all chiropractors are all about adjustments. Lau, for example, says spinal manipulation accounts for only 5 to 10 percent of his work. He spends most of his time treating dysfunctional soft tissue—muscles and tendons, for example—restoring function and movement and addressing the root cause. Gunther is in the same camp, combining traditional chiropractic with soft tissue work. He and Lau both say their approach is not typical and separates them from many. “Chiropractic has traditionally focused on the joint/adjustive part, but not focused on the soft tissue part, which is hugely important in my eyes,” says Gunther. It’s also time-intensive work, says Gunther, whose sessions run 30 minutes. “Much of that time is soft-tissue work,” he says. “Adjusting does not take much time.” Gunther and Lau are not the only two in town stepping outside the boundaries of traditional chiropractic. Ong, too, incorporates other therapies, including postural stabilization and manual therapy. Bottom line: Don’t assume chiropractors are one-trick ponies. But don’t assume they’re not.
Spinal adjustments hurt. Adjustments rarely cause discomfort, according to the ACA. But as Gunther points out, it really depends on what shape you’re in. “If someone is in an acute state, that’s different from someone who’s coming in for a tune-up,” he says. Taking time to do soft tissue work also makes a difference, he says. “If I do no soft tissue work and I lay you down on the table and go whack!, that’s not going to feel good.” Similarly, Ong says that if you’re hurting when you walk in the door, “there’s always some degree of discomfort. Everything you do will cause pain. A massage could hurt.” On the upside: If things go well, he says, you might walk in with pain and walk out pain-free.
It’s only for adults. Nope. In fact, it’s a good idea to take your child for a chiropractic exam during the first year of life, according to the International Chiropractors Association’s Council on Chiropractic Pediatrics. Why? The logic goes like this: Spinal trauma can occur during birth and also can result from improper lifting or tumbles taken while learning to sit or walk. Plus, the spine grows dramatically in the first year of life, so the sooner a problem is caught, the better. Ong, who treats infants to adults, offers this up-close-and-personal story. “When my son was born, he had trouble turning his neck from left to right. I was worried about a brachial plexus injury. When I felt his neck, I could detect neck spasms. So I adjusted him, and he was fine.” For such mobility issues, gentle pediatric chiropractic care seems to make sense. But turning to a chiropractor for your child’s asthma, colic or other medical conditions is something else entirely, and findings are mixed. In a scientific review published in a 2008 issue of Chiropractic & Manual Therapies, the authors concluded that the use of manipulation as a health care intervention for such pediatric conditions were supported by “only low levels of scientific evidence.” More rigorous scientific studies were needed, they said, to prove the value of such treatment. On the other hand, a controlled clinical trial found short-term chiropractic care to be more effective than the medicine dimethicone in treating colicky children.
It’s dangerous. Pop the neck, have a stroke? Yes, such tragic outcomes can and have happened. But not as often as you may think. According to webmd.com, there have been cases in which neck manipulation led to stroke or spinal cord injury, but it’s rare. As long as you are a good candidate for treatment—meaning you don’t have such health issues as osteoporosis, inflammatory arthritis or spinal cord compression, to name a few—and are in the hands of a qualified chiropractor, it shouldn’t be dangerous. But do be honest and thorough with your chiropractor about your health history, urges Ong.
Once you start, it never ends. We’ve all heard stories of chiropractors pressuring patients to sign up for the lifetime plan. But an ethical chiropractor won’t do that, says Lau. “Whether a patient is getting better or not, some chiropractors ask them to keep coming in,” he admits. “But it’s impossible to tell a patient, ‘You need 25 visits.’ It’s not possible to know that.” Chiropractic is generally divided into three categories of care, explains Gunther: acute care to relieve pain; a course of care (usually just a few more visits) to more fully resolve the issues that led to the symptoms; and maintenance, to keep things moving properly. It’s this last category that seems to give chiropractic a bad name, suggests Gunther, who says it’s completely up to the patient to decide whether to continue with regular tune-ups. “I’ll get them where they want to be in as few visits as possible, and it’s up to them to decide whether they want to continue,” he says. If you feel your chiropractor is coercing you into a lifetime partnership, run, don’t walk, to a new practitioner.