It is important to know how to choose a chiropractor correctly.
The two main types of chiropractor are straight and mixed. Patients may want to consider this when they choose a chiropractor. To give a brief history, straight chiropractors practice “objective straight” chiropractic (OSC), and they don’t mix the chiropractic with anything else. There are also “traditional straight” chiropractors and all straight chiropractors fell into that category until about the 1970s. The traditional straight chiropractors followed the “precepts of D.D. Palmer and B.J. Palmer until that point, when they added some other approaches, including diagnosis. OSCs, on the other hand, define their objective as correcting “vertebral subluxations because they interfere with the full expression of life” by lowering the ability of the “innate intelligence of the body to coordinate function through the nerve system”. OSCs, in other words, correct subluxations that impede the body from functioning optimally, and they would consider anyone who uses other approaches as being “mixed”. “Mixers”, on the other hand, “split from the founding principles” and incorporate some medical and other practices into their treatments.1 Mixers may borrow many different treatment approaches from medicine, osteopathy, and chiropractic, as well as physical therapy, stretching, exercise, massage, electrical muscle stimulation, ultrasound, moist heat, ice packs, and some alternative medicine (homeopathy, herbs, biofeedback, supplements, and acupuncture). The majority of chiropractors are mixers.2
Different chiropractors use different chiropractic tools and chiropractic techniques. One of the chiropractor tools is the chiropractic Activator. The Activator methods use a tool to make gentle adjustments and the techniques have been through clinical trials.3 After the Diversified Technique, which uses the high-velocity low-amplitude thrust (HVLA), the instrument-assisted Activator Adjusting Instrument (AAI) is most commonly used approach. Often, it is used to substitute for HVLA for patients who need a more gentle technique. There are other instrumental approaches, including Upper Cervical techniques and Torque Release Technique (using the Integrator tool), as well as newer instruments. Patients for whom instrument adjustments are more appropriate include children, those with osteoporosis, patients who fear touch, or patients who are “fearful of manipulative procedures that result in joint cavitation” or the cracking/popping noise. AAI has been found to be beneficial to patients with trigger points and spinal pain, in 8 clinical trials, although it is not necessarily better than HVLA or trigger point therapy. This leaves patients with a choice regarding preference about whether instruments or other manual therapies are used when they choose a chiropractor.4 There are some specialized chiropractic treatments, as well, such as Active Release Techniques, Graston Techniques, Cold Laser Therapy, Spinal Decompression, and Manipulation Under Anesthesia.5 In general, the manual adjusting methods are Diversified, Gonstead, Chiropractic BioPhysics, Sacro-Occipital Technique, Thompson, Cox Flexion-Distraction, and Logan Basic. Instrument methods include Activator and Torque Release/Integrator, Impulse, pro-Adjuster, Arthrostim, and Graston Soft Tissue. Upper cervical methods include Blair/Palmer Specific, Atlas Orthogonal, NUCCA/Grostic, and Knee-Chest.6
Some patients may have a philosophical preference about how to choose a chiropractor (straight or mixer). Others might need one with experience in nutritional supplementation. Some require a chiropractor who uses gentler approaches, while other patients may prefer the HVLA thrust. Chiropractic adjustments can be done with a special table as well. No matter what the technique, there are some approaches that are questionable when selecting a chiropractor. If a chiropractor has a “special new technique” that no other chiropractor may use, that may be a red flag. If they claim to be able to “cure” conditions that are chronic (diabetes, infections, etc.) or require a “long-term treatment plan” with a specific schedule over several months, that may be a reason to select a different chiropractor. Any prepayment for a long-term treatment plan, or treatments that are the same for every patient, might also need to be avoided. Perhaps the right chiropractor is not the one who says care should continue “ad infinitum”. It may be best to choose a chiropractor who has methods that are tailored to the individual, with set goals, instead.7 To find a chiropractor, patients can rely on friends’ and family members’ referrals. If they are new to the area or are unfamiliar, however, they may wonder, “How do I find chiropractors near me?” or “What is the best chiropractor near me?” There are many directories available online, including one on this site.8 Some patients may benefit from researching chiropractors and reading reviews online, on sites such as “Facebook, Google+, Yahoo! Local, Yelp, MerchantCircle, and many others”, like Angie’s List. This is sometimes referred to as “electronic Word of Mouth (eWOM)”.9 Online reviews can be positive or negative, and not every chiropractor is best for every patient. Patients have the right to look for treatment elsewhere if they are not happy with the results, and it pays to shop around to find the right fit in terms of personality and chiropractic techniques. Treatment alone does not necessarily resolve the physical complaints, however, as it is also the patient’s responsibility to utilize the supplements or to make the dietary and lifestyle modifications, and to perform the prescribed stretches and exercises to make the most of their experience. Medical and chiropractic care might be a partnership. Patients may be referred to a chiropractor by their primary medical doctor after traditional treatments have not resolved the issue, or a chiropractor could also refer a patient back to a medical professional for certain conditions.10
Insurance coverage for chiropractic care varies, based on many factors. Some companies cover it for short-term conditions, or copays may be required. For longer term conditions, some plans do not cover wellness or maintenance. This may impact a patient when they choose a chiropractor. The three stages of chiropractic care are as follows: Stage 1 (to relieve pain and restore mobility), Stage 2 (rehabilitation and preventing relapse), and Stage 3 (periodic wellness, maintenance, and lifestyle changes).11 Treatment costs can vary from $30 to $200 per session, and each treatment methodology costs a different amount. Another factor determining the cost of care is the chiropractor’s experience. The American Chiropractic Association notes that chiropractors must undergo about four years of pre-med coursework, as well as 4-5 years of “specialized training” in “chiropractic methods, human musculoskeletal anatomy, health science, and more”. Practical work takes at least a year, as well, and after the program (about 4,000 hours of work), a chiropractor can become accredited. Chiropractors who have practiced for more years may charge more because their skills are refined and they have a “stable base of clients” already. They may have also completed more courses and training others, and these experienced chiropractors have invested more time and money into their practice. The location of the clinic also varies the costs. Some chiropractors have a sliding scale while others allow for financing. There is one advantage to having insurance not cover a chiropractor: that the patient can choose a chiropractor, not limiting the choices to what insurance will allow. However, it is important not to just choose a “discount” chiropractor who may be unqualified and could cause harm. Online reviews are another way to research a chiropractor. Some treatments may cost additional money, such as radiography, MRI scanning, thermography, electromyography (EMG), diathermy, hydrotherapy systems, computerized adjusting instruments, ultrasound therapy, laser treatment, roller tables, electrical muscle stimulation, and adjustment tables. These pieces of equipment are expensive, and advanced therapy could add to the treatment cost, so patients should ask their chiropractors about the recommended treatments in advance.12
Learn more about choosing a chiropractor.