How to select the best chiropractor

Introduction to selecting a chiropractor
Similar to selecting any health care practitioner, finding the right chiropractor can be a complex decision. Finding a good chiropractor can be particularly difficult because chiropractic is a profession with an unusually large variety of practice philosophies and techniques.

A good place to start is to ask a primary care physician for names of chiropractors who appear to be competent and trustworthy. It is also beneficial to ask friends, co-workers and neighbors for recommendations. It is best to exercise some caution, however, because one person’s definition of a good chiropractor may be quite different another’s. In general, if multiple resources recommend the same chiropractor, chances are good that the chiropractor is reliable.

While recommendations can be quite valuable, it is also important to find a practitioner who can meet one’s own specific needs. Asking the right questions can help ensure that there is a good fit. Below are guidelines of questions to ask when interviewing a chiropractor than can help assess the skills, qualifications and style of the chiropractor. Before starting treatment with a chiropractor, it is usually best to conduct a telephone interview or request an office consultation to find out how he or she practices.

Chiropractor technique
There are many different approaches to treating a person through chiropractic. Some chiropractors adjust with their hands, while others use various instruments. Additionally, some chiropractors adjust “deeper” while others have a lighter touch. This is a very individual preference by both the doctor and the patient. Some patients prefer the immediate feeling of relief offered by the “joint popping” type of manipulation while others cringe at the mere thought, and request a low-force type of technique.

Questions to ask:

What techniques does the chiropractor use and why?
Does the chiropractor use his or her hands or an instrument for the manipulation?
Does the chiropractor employ deeper, joint-popping adjusting or low force adjusting?
How much experience does the doctor have with patients who have the same types of problems as yours?

It should be a warning sign to stay away if any practitioner claims to be the only one with a “special new technique” that no other chiropractor can use. Also, if after the first visit, the Chiropractor claims to be able to “cure” various conditions such as diabetes, cancer, or some other long-term, chronic condition, another choice may be appropriate. Similarly, if a long term treatment plan such as 3-time per week adjustments for 6-12 months, 2 times per week for another 6-12 months, and 1 time a week for 6-12 or more months, this is a strong warning sign of unrealistic forecasting.

Chiropractic case management
Depending on the nature and extent of the specific back problem, a few visits to the chiropractor should help the patient feel noticeably better. Within one to four weeks, the pain should be typically be reduced by 40 - 80%, and the frequency of visits should decrease as the patient’s pain and function improves.

Good chiropractors do everything in their power to help their patients feel better as fast as possible with as few treatments as necessary, and also give advice on how to avoid future problems by implementing an exercise approach and weaning care to an as needed plan. In general, in the absence of progressive worsening of a condition in spite of care, a common treatment plan is 3 times per week for 2 to 4 weeks and re-evaluate. If improvement is noted, a tapering of treatment frequency is appropriate while introducing a self-help, home-based exercise program. If the patient is not getting relief after the first 4 to 8 weeks, depending on the specific case, the chiropractor should recommend a referral to another practitioner – either another chiropractor or another type of spine specialist, such as a physiatrist, physical therapist, pain medicine specialist or spine surgeon.

Questions to ask the chiropractor:

What is the chiropractor’s typical practice pattern or treatment program?
What services does the chiropractor offer? Some chiropractors offer additional services such as massage, exercise instruction, rehabilitation and strength training, and nutritional counseling.
What is the chiropractor’s recommendation if the treatment doesn’t seem to help? A good chiropractor will recommend that the patient consult another practitioner if these or other methods of treatment (such as medications or surgery) are indicated.

It is advisable to avoid practitioners who tend to find the same thing wrong with every patient and treat every patient identically. Also, beware of any chiropractor who recommends a lengthy (e.g. 3, 6, or 12-month) treatment plan after the first or second consultation.

Chiropractor education and qualifications
Doctors of chiropractic undergo a four year degree program, and most states now require an undergraduate bachelor’s degree in science prior to admission to chiropractic university. In chiropractic universities, the first two years are focused on basic sciences coursework, after which the training focuses on diagnosis related courses (pathology, pathophysiology, etc.) and manual medicine or manipulation (use of hands) as an alternative to drugs or surgery.

Some chiropractors also pursue post-graduate diplomat programs in various specialties, such as orthopedics, sports medicine, rehabilitation, neurology and other disciplines.

Chiropractors need to be licensed to practice in their state, and need to have completed the National Board examinations. In addition to Part 1 and Part 2, Part 3 of the National Boards is necessary if the chiropractor plans to use physiological therapeutics in practice. Part 4 of the National Boards tests three practical skill areas, including diagnostic imaging, chiropractic technique and case management. In some states, Part 4 may be utilized in place of a state-specific practical examination.

Questions to ask:

What chiropractic school did the chiropractor graduate from?
Does he or she have a bachelor’s degree?
Where did he or she complete undergraduate/prerequisite schooling?
How many years has the chiropractor been in practice?
Does the chiropractor have a post-graduate specialty?
Has the chiropractor completed National Boards through level 2 (or 3) and become licensed in the state?