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About this site (1)

Yes, we aim to answer a whole bunch of them, and any others you can buy an answer for (the first one is Free!).

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Chiropractic Styles (4)

Network Chiropractic is a non-mainstream, proprietary and esoteric system of management that involves chiropractic but also specialized light touch to specific areas as well as psychological reinforcement. Network chiropractors often follow the techniques of Network Spinal Analysis (NSA), a proprietary technique begun by Donald Epstein, DC. NSA chiropractors promote the philosophy that the spine is a channel of energy that connects individual consciousness to planetary consciousness, an idea not shared by mainstream chiropractic. Network chiropractic doctors believe that proper gentle “corrections” to the spine done in a proper order will assist the body to “self-correct” and move by itself in response, for example, to the adjustment of the first spinal segment. Network chiropractors are said to value the reduction of stress on the body and mind of the patient. Network Chiropractic is a proprietary technique and is not taught in the curriculum of many chiropractic colleges, typically being taught on a seminar basis and learned as an addition to chiropractic training.

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Graston Technique is a method of instrument-assisted soft tissue mobilization (IASTM)  that is practiced by a wide range of practitioners, and is not specifically associated with chiropractic, although Chiropractors can and do become certified in IASTM.  Graston involves the use of  patented and specialized curved metal instruments, blunted but with a slight bevel, that are drawn along or across muscle fibers in order to break myofascial adhesions and potentially improve muscle health and function. Graston Technique is supported by its own research, but IASTM in general also has research. This is a powerful and popular technique.

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Originally conceived by an Osteopath, Craniosacral Technique has been applied within Chiropractic treatment plans, complements chiropractic manipulative therapies and has significant implications when added to Wellness Plans. The technique involves manipulating the cerebro-spinal fluid flows by gently shifting the spinal and skull structures from the vertex of the head to the tip of the sacrum. It is typically considered a non-force technique and is often favored by sensitive patients. Because the results and applications of this modality are esoteric and difficult to objectively assess, it is controversial and often attacked as “quackery” on sites like Wikipedia. In contrast, click here. We have seen significant results with this therapy being combined with other therapies in balanced treatment plans. See also SOT (Sacral-Occipital Technique)

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Diversified Technique (DT) or simply “Diversified” is considered the most commonly used manipulative technique by chiropractors.[1] We have heard it considered a core technique. Like many chiropractic and osteopathic manipulative techniques, Diversified is characterized by a high-velocity low-amplitude thrust. Diversified is often described as the most general chiropractic manipulative technique and is differentiated from other techniques in that its objective is specifically to restore proper movement and alignment of spine and joint dysfunction.[2] . Diversified technique remains the principle system taught at National University of Health Sciences, New York Chiropractic College, Southern California University of Health Sciences, and Northwestern College of Chiropractic[citation needed], and is one of the core techniques taught at University of Western States [3]

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General Questions (55)

You might be able to “make something “pop”, but you cannot  “self-adjust”. Manipulative therapy or “adjusting” is a complicated process involving leverage, vectors of direction, specific amounts force (high velocity with low amplitude), a purpose, a plan, indications and contraindications and most of all, restraint and control. Even the best chiropractor cannot truly “adjust themselves” because it requires forces and controls from outside, and for the body to be completely relaxed. Also, and very importantly Knowing “what to do” is quite a different thing from knowing “when or when not to do it”.  Don’t do it; let a skilled professional do it.

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Don’t do it any more than you are told is ok by a Doctor of Chiropractic, if you have to do it at all.  I tell my patients to let me do it for them, and not to hypermobilize their joints. If you do this anything more than “rarely” it is probably too much, and an indicator of another type of problem – perhaps ligamentous laxity –  or something a chiropractor could help you stabilize. In this case, “more is not best”. Technically, you could put yourself in danger or even cause a stroke if done a certain “wrong” way

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Graston Technique is a method of instrument-assisted soft tissue mobilization (IASTM)  that is practiced by a wide range of practitioners, and is not specifically associated with chiropractic, although Chiropractors can and do become certified in IASTM.  Graston involves the use of  patented and specialized curved metal instruments, blunted but with a slight bevel, that are drawn along or across muscle fibers in order to break myofascial adhesions and potentially improve muscle health and function. Graston Technique is supported by its own research, but IASTM in general also has research. This is a powerful and popular technique.

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Good Question! Not a short answer. The best response is probably going to be “Some of that will be up to me and this treatment plan, some of that will be up to you, and some of that will be up to reality. “ We have to be careful both asking and answering this question – it’s like asking “how long will it take to get where I am going?”. We really need some more information for the question to make any sense. In this instance, that would be “where is it you are trying to get to?” and also perhaps “are you going to stop along the way, or drive straight through?”  Before we answer this more specifically, remember that it realistically takes one visit to get a diagnosis, and set up a physical medicine treatment plan and get it documented, another visit to repeat that treatment and then a third at a minimum to review the results and make changes neccessary to reinforce those results. From the patient side, you can’t learn everything you need to know r do in one visit either, espescially when you are in pain.  When I meet a person who hopes to see me once for a 30 minute visit to “cure” something that has been bothering them for six weeks/six months/six years (pick one) I know we are going to have a challenge. At the same time, a patient who has experience with chiropractic care can probably get faster results.

Chiropractic can work effectively to get many results – the more appropriate question is, what are the results we are asking for? Since we don’t want to treat just the symptoms, but instead get to the root cause, it takes a series of visits, sometimes repetitive, to get results that your body can hold. In some cases, that means helping the patient train new activities and movements, and reinforcing lifestyle changes that will make a difference. How long is a series? Different doctors and different treatment plans will be longer or shorter depending on the results requested.Newer injuries, if treated appropriately and immediately, may respond to fewer visits assuming that major tissue injury has not occurred. Many of these first time injuries can be effectively managed in as few as 3 to 4 visits. Conditions that have been present for greater than 3 months and recurring conditions are generally more stubborn and difficult to manage. Resolution may require 12 visits or more.  There is an actual time it takes for certain things to recover or develop. Can you hope to get six pack abs after one 30 minute trip to the gym?

The chiropractic approach is actually more conservative and realistic. Is it more conservative to see a patient once and “assume” that the everything will then be fine? I actually don’t think that’s conservative at all. Deep down I think a lot of people are saying “just make it stop hurting and then I will deal with it myself” – but will they really? On the other side, what the chiropractor is trying to do is build lasting results. Can we do that in one visit? Probably not. Can we do that in three visits? Maybe. A lot of that is up to you, your body, your lifestyle, diet, and physical demands, maybe genetics, and usually a combination of all of the above.

Having said all this, there are guidelines for care of specific injuries, and some of these even vary by state. Often insurance carriers set up unrealistic guidelines in order to reduce costs; your chiropractor will work with this and attempt to help you expand your benefits. Ask them about that, and also, see “Treatment Guidelines” on this site. If you have been seeing a chiropractor on a treatment plan and there is “no end in sight”, look up “Episodic Care versus Clinically appropriate Care” on this site, and also “Questions you can ask your doctor”.

When you talk to your doctor, you can ask them instead, “how long will it take to get results for decreasing this pain, when will it start to feel like I can lift, and when will I actually be healed? On the day I feel better, will my core be strengthened and will I be protected for future injury? How soon do you think you will be able to release me to a maintenance program? Now THERE’s the question to ask your doctor. The best response is probably going to be “Some of that will be up to me and this treatment plan, some of that will be up to you, and some of that will be up to reality. “

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Second opinions are interesting subject. The most important thing to decide about getting a second opinion, is the reason the second opinion is being requested. Is the second opinion being requested to confirm or refute a diagnosis? Another words, are you quite convinced that you need a hip replacement, but you just want to make sure? Quite the contrary is the case where you are thinking there is something wrong with the initial diagnosis, and you want a different treatment plan. I think it’s important to come to grips with that question, so that you know before you approach the second opinion doc best second opinion will be one where you do not indicate any preference towards an outcome . In this case, you would say “before I get this surgery, I want to see if you confirm this decision my doctor made”. If you are actually shopping for a particular and different opinion, that may reflect a lack of trust in your doctor; in that case, the proper question you might research is “should I change doctors?*” Or, go back to your original doctor and get clear what other alternatives might be. Remember, there are often many other alternative treatment plans, occasionally including “do nothing at all”. Your original doctor should already have made those choices clear to you. If not, ASK.

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It is, perhaps, a little bit complicated. First of all Medicare has to be billed no matter what. If you have Medicare, then Medicare has to be billed for every treatment, even if you pay cash. There are legal guidelines about what the clinic can bill and how much they can charge you. You will have to sign an agreement called an ABN*, showing that you have agreed to pay out-of-pocket, and showing that you have been told why this is happening. You will probably pay more than a regular Medicare treatment, because the clinic will still have to bill medicare, even though they will not get paid byMedicare. What you want to do is find what’s called a participating provider*for Medicare.

 

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Board Certified” is a credential that can refer to an additional certification by a licensing board, such as the Academy of Chiropractic Orthopedics (ACO), a postgraduate certification. Most of these certifications require significant additional school time, rigorous testing, dues and additional continuing education. Technically, all doctors are ” board certified” by a licensing board. However, there are excellent additional credentialing bodies that train and certify doctors as advanced professionals with a higher level of skills and exposure to the most modern techniques and material. So if additional professional board certification is important for you, you should do some research to find out what the requirements of that board are. Some board certifications can actually be purchased, and do not require additional study, however they do require maintenance of that license by paying dues. That board certification would be considered less valuable and respectable than an actual exam – credentialed board. Often front desk and scheduling staff would not be able to answer this question for you – you might have to hear it from the doctor directly.  You might be able to ask if a “Board Certification” is a state board or a private credentialing body that uses an exam, or what the Doctor does to maintain their certification.  This will get you the most accurate information, and most reasonable physicians would probably gladly tell you how hard they work to maintian their credentials.

 

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It’s quite possible that your doctor told you that he saw a mole that was suspicious, or transitional. Diagnosis of cancer should probably be left to after a biopsy, or a specialist consultation, however, chiropractors are trained to recognize the specific telltale signs of suspicious lesions. Any skin lesions are suspect because of their color, shape, or texture characteristics. It’s probably best to take this seriously, until you can relax and leave it be, and schedule an appointment with the dermatologist as soon as possible to have this checked out. It will be a short appointment, if everything is okay. Your chiropractor should be able to offer you a referral to a dermatologist. There are also dermatologist providers, that work with chiropractors and can except the referrals, on listed on ask about Chiropractic.com.

 

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Chiropractors can diagnose skin rashes, especially if it is their focus to handle primary care. However, basic chiropractic education includes dermatology rounds, and chiropractors have been trained to recognize the standard skin conditions that typically present in ambulatory care clinic. At the same time, it is quite possible that a chiropractic clinic will not recognize a fair a rare form of a skin disease that is just been imported from a foreign country on an airplane, but then again, many of these things are entering into the training daily. The most important thing that the chiropractor can do is give you a referral, so you can get proper treatment, or treat you specifically for the diagnosis condition. Always ask your chiropractor what his confidence level is with that diagnosis. Doctors should be willing to give this at all times.

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All diagnoses given to the patient are “differential”, in that they are subject to change, when more information is arrived. However, sometimes diagnoses are “suspect”, tentative. Ask your doctor what their confidence level is with the diagnosis, especially if it is a complicated one. The chiropractor should be willing to tell you that. It is important that the chiropractor become a dent with that diagnosis. If they are not confident, then they can refer you to someone who specializes in that.

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Certainly. A chiropractor is a doctor. Chiropractors can take all the standard lab tests that are taken in a healthcare clinic, including cholesterol, blood urine sugar, CBC, complete blood cell count, platelets, HIV testing, even stools sampling. Some chiropractors may choose to not take these tests, because they are specialists in another field.

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 No, not specifically, although people speculate about this all the time. It really depends on what kind of treatment you are receiving. Chiropractors treat the common cold, they can treat skin rashes, or they can adjust a sprained joint, or diagnose a broken bone. Typically, people going to a chiropractor when they are hurt and often when their problem is worsening. Areas that are sore sometimes become more sore while they are being altered. However, specifically, a chiropractic adjustment in and of itself is not painful and does not create soreness.

Another thing to remember, is that often when you go to a provider who deals with drug – medicine, as opposed to physical – medicine, the drug – medicine completely masks any feelings of pain or soreness, and so even though you still have the problem, you do not feel them. Conservative care like Chiropractic, which favors a drug – free, conservative and non-– surgical first approach to care, suggests often not masking the pain with pain relievers, or muscle relaxants, and of approaching things conservatively, and working through them. Often, chiropractic clinics will have access to Gempler pain relievers, natural substances or homeopathic’s, designed to support healing rather then mask symptoms.

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A chiropractic doctor is defined as a chiropractic physician, a physician level provider. Many chiropractors practice physical medicine, which has many similar similarities to physical therapy many physical therapists also do manipulative therapies, massage, exercise, and physical therapy modalities like ultrasound electrical stem, and Grasston therapy. Also many physical therapists have obtained a “Dr. of physical therapy” qualification, which is an educational degree that gives them the ability to self – refer. However, this is not a physician level endorsement, although it is a fine certification. In many cases a physical therapist Clinic will be following the orders of a medical doctor, who may not be on premises. That will often create a delay or a disconnect between the patient and the treatment plan. Typically, in a chiropractic clinic, the doctor is on site, and therefore the trip treatment plan can change as the treatment progresses, often in the same day. About a further referral, or an exchange of information, and a required update to a treatment plan.

 

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PCP is a primary care provider, who treats the basic healthcare needs, including diagnosing the 60 standard elements that are listed as the basic primary care presenting conditions. Being a primary care provider is included in the definition of chiropractic, and it is approved in the chiropractic education, as a core criteria. The federal definition of chiropractic physician thus includes being a primary care provider. New courses have been created to bring chiropractors up to new standards of the modern primary care, and new graduates from school are already operating with current PCP standards. Once again, a primary care provider is different from a specialty provider. It is might be important that the clinic have a focus on primary care, versus a focus on specialty care. Check the level of focus that the clinic has on what you are requesting. This is a very simple request that you can make it to a front desk operator. Likewise, chiropractors who are certified as primary care providers as a result of a modern certification program, are listed on ask about Chiropractic.com. I’m not aware of any other way this time that you can search for a selection of certified primary care focused chiropractors.

Note also that prior to the creation of the affordable care act “Obamacare”, and the non-– discrimination provisions that were specifically written into the code, prevent insurance companies from discriminating against chiropractic physicians, insurance companies could have refused to define a chiropractors as primary care providers. However, this is now not the case, and chiropractic clinics can bill for the same services as medical and osteopathic physicians.

 

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Chiropractic doctors can take on many different health issues, depending on the focus of their practice. Some chiropractic clinics in focus on galvanic non-– surgical reduction of hemorrhoids, sometimes in a jet Tdition to doing manipulative therapy, or sometimes a very specialized focus. Typically speaking, treating hemorrhoids is not a chiropractic technique. It’s just a doctor technique. As always, find out the level of specialization, and often the level of focus the doctor has on this technique. If you want a specific type of treatment it’s probably best to find a clinic that focuses on that specifically.

 

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This really depends on the clinic, however typically chiropractic clinics are ambulatory care facilities, not specifically set up for urgent or emergency needs. It is ideal to be aware of a network of urgent care facilities that can work with your chiropractor, or refer you directly to a chiropractor. You might want to scope some of these out in your area, and ask their reception what their policy is about working with the chiropractor, or consult on ask about Chiropractic.com, since I know they have a directory there.

There are some chiropractors that are functioning in Multiple- disciplinary clinics, some of which actually focus on urgent care. Again, it depends on the level of specialization

Depends on the level of focus on the specialization that you think you want to tolerate. When I go to an urgent care clinic that’s all I want them to do – urgent care. Do some research.

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One of the things we really like to ask a doctor is what is their level of focus on a particular specialty service or specialization. So for example, even though a procedure is in the scope of practice, how often does the doctor do this, and how many of their other recent patients have they been treating for this? As an issue becomes less common in that particular clinic, the doctor perhaps has a challenge as to being cutting edge and truly “specializing” in that service. Feel free to ask your doctor’s office how many patients they actively treat with that problem, and even, how many have they treated in the past month or year. I think this is a good way to establish level of focus, and the level of confidence we can have with a particular provider.

 

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There are many opinions and definitions on this, that will vary under different styles of chiropractic. The most well accepted answer is probably that a chiropractic adjustment can be used to treat, reposition, mobilize, decompress, even stabilize a joint between two bones or a region of the body that relies on the mechanics of that joint. Chiropractic Adjustments or manipulative Therapy can also apply to the nerve supply or circulation surrounding a joint complex (all the different boney joint surfaces involved with the region) or the biomechanics of a region –  like the shoulder, for example. Some Classical Chiropractic theories also suggest that chiropractic can be used to signal the autonomic nervous system, or trigger the non-specific immune system for certain issues – many of this is still under observation and/or research.

 

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Did you mean “Can a Chiropractor treat”? Sometimes people mistakenly think of chiropractors as only one type of treatment – as in hands-on adjustments, or joint manipulation – and so they describe “chiropractic” as only being that. Chiropractic is so much more. Chiropractic is a robust and full spectrum healthcare system at the Physician/Doctor level, complete with diagnostics and treatment for all of the most common ailments and many types of physical injuries that afflict the human being. This includes the ability to appropriately refer to and collaborate with all different types of providers.  Very few “Chiropractors” only hand out “Chiropractic adjustments” all by themselves. My guess is your DC will do a lot more than that.

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You could also look at the question involving “Chiropractic” versus “chiropractors”. Many people tend to think of chiropractors as only one type of treatment as in hands on, joint manipulation. Chiropractic is so much more, and chiropractic doctors can certainly treat Herpes Simplex, Herpes Genitalis or Herpes Zoster infections- but to answer your question, aside from helping to stimulate the non-specific immune system, by some chiropractic theories, there are no specific chiropractic manipulations that exist by themselves to treat herpes. My guess is your DC will do more than that.

 

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Remember that a Chiropractic doctor can take on many different health issues, depending on the focus of their practice. Chiropractors certainly make diagnoses and he can set up treatment plans for herpes infections, which could include oral herpes, genital herpes, or even herpes zoster. The chiropractor can help you eat the right foods, with an appropriate lysine/Arjean balance, set you up with supplements that can help you, or refer you to a provider who can make a prescription for stronger antiviral drugs. If your infection needs specialty diagnosis, the chiropractor can refer you to dermatologist who can test you.Some clinics have multi-disciplinary in-house, and can handle many aspects of Herpes infections.

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Chiropractors can manage many aspects of a hand fracture, including diagnosis, x-rays, building a treatment plan, coordinating collaborative providers (like possibly orthopedic surgeons and occupational therapists…) and rehabilitation – but it really depends on the stage of your injury and what you are requesting. With hands, it’s often intensive and if a joint is involved, a chiropractor often refers out for an orthopedic surgeon consultation.  I personally would not make myself the “portal of entry”* (the first provider) on the case for a new patient with a hand fracture  – I would invite you back to me later on in your recovery.

 

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They can, although a bias has tended to exist in the medical profession against chiropractors, and this has existed since day one, back in 1895. Medicine’s licensure program was created before the Chiropractic profession had one, and so it was challenging to define “Chiropractic Doctor” or “Chiropractic Physician”. Medical Doctors believed they owned both words “doctor” and “physician”. In order to create a chiropractic doctor, cracking into doctor market, it involved risking being accused of practicing medicine – which is like infringing on a patent. Chiropractors were actually arrested and imprisoned in the early 1900s. In the latter part of the 20th century, licensure was far more widespread Chiropractic was recognized as a physician level provider. Some chiropractors feel that Medical Doctors have been unfairly competitive and as a result, have adopted a separatist philosphy. Others work alongside medical doctors in collaborative practices.

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Some chiropractors in the United States do have admitting privileges in hospitals, depending on individual hospital rules.

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Scope of Practice rules define the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency. Each jurisdiction has laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice. (source – Wikipediahttp://en.wikipedia.org/wiki/Scope_of_practice 1 Apr 2014)

 

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A chiropractor first takes a medical history, performs a physical examination, and may use lab tests or diagnostic imaging to determine if treatment is appropriate for your back pain.

The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counseling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.

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Cure is a very loaded word. Chiropractic tries to be clear that it works with the human body and does not so much CURE as it does support the natural healing process.  Chiropractic will help the body cure. There are times that more is needed for a cure – for example, if there is something, like an immunity element missing, that will have to be added in for a “cure”. If you have a disease that you don’t have an antibody to fight, for example, the chiropractor can support your non-specific immune system, while referring you out to get what you need. As far as “curing pain”, I suppose you could say we are often an important adjunctive care to accomplish that. We work with pain.

 

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No, and the popping sound itself is only of questionable significance. Only adjustments that involve high velocity low amplitude (HVLA*) thrusts*, (a Flick – like movement of the hands relative to each other) move the joint in such a way as to cause a popping sound. These adjustments would be considered intended to increase range of motion*. Other adjustments might be considered simply resettle an articulation* (joint), or to help align the fibers in a joint. These and other adjustments, such as an indirect* adjustment, might be intended to stabilize* a joint rather than increase the motion of the joint.

 

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No. Some chiropractic adjustments are just about having proper movement, or normalize movement. In some instances a chiropractor might do just one joint to create movement, which would decrease movement at another joint. This would be considered an indirect adjustment.           Likewise, a joint can be moved in a shallow fashion within its resting range, to activate the supportive ligaments and muscular structures in the area, in order to encourage stabilization.

 

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There could be several answers to this one. First of all, insurance does change – have you read that fine print? You may not be aware that your insurance coverage has changed since the last time your prior chiropractor verified your coverage; it may be time to call your insurance company and confirm this. Alternatively, there may have been a reason, or even an error, that might have caused that chiropractor to not charge you a co-pay. The new chiropractor should be charging you the right amount, according to what the insurance company told them when they verified your insurance coverage. If you have any doubts about this, call your insurance company and verify your coverage yourself. See above, “know your coverage”. Also, in reference to the prior chiropractor not charging you a co-pay you might have owed, you might also consider reading “signs of unhealthy practices”.

 

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According to sources like the Mayo Clinic, an average healthy adult living in a temperate climate, needs roughly 13 cups or 3 Liters (3L) total beverages a day for adequate fluid  intake – although for a women it’s really 9 cups or 2.2 L of total beverages per day. Some sources suggest drinking eight 8-ounce glasses of water a day, as a general rule, but that’s just a popular “shorthand” idea. This 8 x 8 rule isn’t really supported by hard evidence, but it is popular because it is easy to remember. It should probably be reframed as drink at least eight (8) 8-ounce glasses of fluid today, because all fluids count toward the daily total.

The truth is food provides about 20% of our total water, and many fruits and vegetables such as watermelon or tomatoes are about 90% water by weight. Our factors that influence water needs, like exercise, environment, illnesses, or pregnancy/breast-feeding. All of these increase the requirement for hydration.

A minimum guideline would be at least a full large glass of water or other calorie free/low-calorie beverage with each meal, and one between each meal. Water before, during and after exercise or exertion is also a guideline, depending on how much exertion and how much you sweat. If your fluid level is correct, in many cases you will rarely feel thirsty and you’ll produce about 6 cups of colorless or light yellow urine per day. Bright yellow urine, may mean a state of relative early dehydration. To correct this, drink at least two more glasses of water per day or consult a physician .

There are all sorts of recommendations, about how much water to drink each day, but the bottom-line is you do need water. Even mild dehydration can drain your energy and make you tired. Dehydration robs your body of the fluid it needs for important processes, blood volume, kidney function, and can even cause death. Long term low-level dehydration can have effects, but you can correct that problem right now, and keep it corrected.

All beverages that are fluid will count. Many beverages, including milk and juice, contain water. Even beer, wine, and caffeinated beverages such as coffee tea or soda can contribute, but they should not make up a major portion. Alcohol increases the production of ADH hormone, which causes your kidneys to release more water. So, for each ounce of alcohol in your beverage (shot or cocktail, or per volume in beer or wine) your body will release 120 ml more water. So essentially, that’s why you feel dehydrated when you have a hangover.

If you are willing to listen to the Coca-Cola Company Beverage Institute for Health and Wellness Expert, (working for a company which sell soft drinks) caffeinated beverages can contribute to your daily water needs.  According to the Mayo Clinic, while caffeinated drinks may have a mild diuretic effect, meaning that they cause the need to urinate, they don’t appear to increase the risk of dehydration, in a normal situation. Remember that caffeinated drinks can cause headaches and insomnia, water is the best bet to stay hydrated – and it is calorie free, caffeine free, inexpensive, and readily available.

Hyponatremia… can happen if you drink too much water

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The definition of “Chiropractic” is evolving. Basically, Chiropractic is a healthcare discipline; technically, it’s an entire  “healthcare delivery system” – a system of “Complementary and Alternative Medicine”. The most recent professionally agreed-upon definition is that chiropractors emphasize manual and manipulative therapies – as an alternative tomedications andsurgery for neuromusculoskeletal disorders[6] –  while also managing or assisting in the management of general health concerns. Definitions are hard to come by and always under debate. A recently agreed-upon definition for chiropractic is as follows:

 

‘Chiropractic’ is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the human body with emphasis on the role of the neuromusculoskeletal system, its specific conditions and their effects on general health.[1][2] (cited from Wikichiro http://en.wikichiro.org/index.php?title=Chiropractic on 2014 Mar 29.)

 

Chiropractors are generally regarded as primary contact, portal of entry health care providers (Portal of Entry mening you can walk in to a chiroractor without requiring a referral).  Although all chiropractors have many attributes ofprimary care providers,  the practices of the largest population of Chiropractors typically have more attributes of more limited, focused physical medicine specialties like physiatry. This is constantly changing and expanding.

Currently, chiropractic medicine is regulated and practiced in over 100 countries, however chiropractors are most prevalent inNorth America,Australia and parts ofEurope. The majority of mainstream health care and governmental organizations classify chiropractic as traditional or complementary alternative medicine.[2]  Chiropractic is the third largest doctoral profession, behind medicine and dentistry[3] and, in North America, are the largest complementary alternative medical (CAM) profession.[4]

 

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According to the Merriam Webster Dictionary, to “complement” something, as a verb, is “to complete something else or make it better”. As a noun, a complement is “a thing that completes or brings to perfection.” So, basically, chiropractic is an alternative to general medical care, adds to healthcare and makes it even better by adding options. I think that’s a “perfect” definition – but basically, adding a chiropractic component just serves to make healthcare better.

 

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The focus is different. Briefly, the course material is the same, with classroom hours in anatomy, physiology, pathology, chemistry, microbiology, diagnosis, neurology, x-ray, psychiatry, obstetrics, orthopedics, and others. The breakdown of classroom hours totaling for the above subjects, – not counting “other”, is 3065 for Chiropractic, 2706 for Medical classroom hours. Both require a college degree level credits as pre-requisites and both are “graduate level”. Both provide a “Doctorate”.  A Chiropractor graduates from chiropractic college as a “Doctor of Chiropractic”. A medical provider graduates from medical school as a “Doctor of Medicine”. All other usages, such as “Chiropractor”, or “MD”, are essentially slang.

 

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You might have spotted some debate and argument, doubt and criticism out there regarding chiropractic. If not – that’s ok, too. But, despite any such negativity, minimal reimbursements, dramatic over-competition, and media and legal persecution, chiropractic has survived. Today, chiropractors are the third largest group of health care providers, after physicians and dentists, who treat patients directly. Source: Rand http://www.rand.org/pubs/research_briefs/RB4539/index1.html)  . Is it because chiropractors are great businessmen? I assure you, they are not. It’s not because pharmaceutical industries pump life into the profession, either and buy them trips to Cabo – they don’t. It’s not because chiropractors are wealthy and make huge endowments – they don’t and they can’t. It’s probably because of two things – that chiropractic actually does create value results for the human body as a healthcare discipline – and people that use it actually feel it – and because chiropractors know this and it fuels them to keep going.

 

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They really aren’t anything so different or special, but perhaps they do have an open mind and a vision. I have heard some people say that effective healers have some form of a “gift”, but I don’t necessarily know about that. I think that a person in any healing profession just has to have made a decision to be responsible for assisting with the health of their fellow human being, and then have some basic characteristics.  So what makes a “good chiropractor”?

They typically are..  Comfortable working with people .

Physically fit   Active learners (they seek out information rather than letting it just come to them). Organized; clear communicators;  Sympathetic; are  good listeners.

For success, they should have…Excellent interpersonal skills,  High ethical standards  Excellent attention to detail ;  Critical thinking skills , Good communication skills,   Excellent decision-making skills, and good initiative.

Generally,  some 80,000 Doctors of Chiropractic (DCs) are state licensed  and nationally certified  in the United States.  There are approximately 10,000 chiropractic students  in 18 nationally accredited, chiropractic doctoral graduate education programs  across the United States with 2,500 Doctors of Chiropractic (DCs) entering the workforce every year.   An estimated 40,000 chiropractic assistants (CAs)  are in clinical  and business management roles for chiropractic practices across the United States.  Doctors of Chiropractic (DCs) treat over 27 million Americans (adults and children) annually. (Source, ACA Membership Director Kelly McGillis Email April 2014)

So who are they?

-intuition.

At one point in time my wife wanted to remind me that, in her experience, all of her friends had a least one experience of a chiropractor was like a “used car salesman”. I think that this kind of example, exists in every profession, and of course these people really stand out. Doctors that do what you expect them to do fade into the gray, while the oddballs really get notice. I suppose there may be a larger number of oddballs inside the chiropractic profession, because our powered paradigm is off to the left of center, if you will, to begin with. My concern is that the kind of patient-centered provider that gets people feeling like they are really being listen to, tends to be an intuitive provider. In other words, it’s not all about statistics, mathematics, and laboratory tests… Sometimes it’s about intuition. One of the problems with intuition, is people can get passionate about intuition and one of the problems about passion, is it is often illogical and subjective. I’m not saying there’s anything wrong with passion, however I am saying that a good doctor is a balance of a number of things. And a solidly patient oriented chiropractor, who is an effective professional, is going to get balance of a number of things, including science, art, empathy and intuition.

 

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So, what is it about this popping sound? Why does a joint pop when it gets adjusted (sometimes)? A lot of people have tried to explain this really briefly, and sometimes it’s that “briefly” portion that causes some trouble. There’s some confusion out there. I’m going to try to do that confusion some justice.

One type of adjustment, and only one type, is a range of motion adjustment with what we call “distraction”. That distraction word is this find elsewhere, but it does not mean to change your attention span. What it means is to traction the joint apart gently, and open the joint space. Gently or briefly.

Sometimes this type of adjustment is done with a flick of the wrist or a quick countermovement between one hand and the other. With this type of adjustment, when the joint is traction to park in a high velocity, shallow amplitude, the joint pressure will change inside the joint, causing gas which is in solution in the joint to bubble. The bubble goes from liquid to gas to liquid so fast that it makes a rapid “snapping” sound. That’s all it is. This has been thoroughly and physically worked out via looking at fluoroscopic photos of joints, so I’m not about to elaborate it here. But the bottom line is that there’s nothing snapping and nothing cracking by way of actually breaking (although boy it sure does sound like that, doesn’t it).

Different joints will make different types of sounds and different levels of injury will have more or less sounds, and then most importantly remember some adjustments make no sounds at all. You’ll probably feel like something is physically going on there (we hope so) but the changes will be less physical more subtle.

The types of adjustments that do not involve range of motion, (and many of them do not) probably fall into this no pop category which will probably make a lot of you happy.

Back to the sounds, the official term for which is “cavitation release”, I tend to like the term “pop” or “release”. I don’t particularly care for “snap” or “crack”, because I think that those terms conjure up negative responses in the mind. I don’t like things “snapping”.  Besides, there is another health issue that involves tendons actually hanging up on boney spurs and making “snapping” sounds like a rubber band every time you move, which is entirely different – but guess what – chiropractors can treat that too.

 

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Most modern insurance policies do provide coverage for chiropractic care, and you should call and check your benefits. New insurance rules giving all providers equality to perform doctor services have made chiropractic care accessible to millions, including those covered by the “Obamacare” or Affordable Care Act policies.

Generally, the clinic should probably suggest that you  contact your insurance company and learn about your own coverage, rather than take the responsibilty for telling you what your coverage is. If they get it wrong, or you don’t understand the explanation, or the info they got was wring int the frist place, this sets up a spiral of trouble. People should only trust what they are told directly by their insurance company, although the clinic or provider can help explain it to them.

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This has nothing to do with the chiropractor, but more about what is going on for you. There are guidelines for proper practices, some which change with the state or locality, but all of which are connected with your diagnosis. Do you have a diagnosed problem? There is a number of times per week or month to treat for that diagnosis, for a recovery period, and then you should be released from that diagnosis, or the diagnosis modified, and the frequency changed. In the absence of a diagnosis or “problem”, you may request wellness care, and the guidelines for this frequency will also vary. Check the guidelines on this website, for “Healthy Practices”. The state association of chiropractors for your state, also accessible from this website, can also help you with this quickly and privately.

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CHIROPRACTIC IS AN ENTIRE HEALTHCARE PLATFORM. The point of Chiropractic, is to manage the health of the human body, and to treat common problems, conservatively, without immediately resorting to prescription drugs or surgery. So, asking what conditions a chiropractor “Can treat” is perhaps less specific the question then what conditions a chiropractor does treat.

The other reality is that everyone is so focused on the title “chiropractor”, that they typically don’t realize – public and professionals alike – that we have specializations. So, a generalist chiropractor can manage the patient’s overall health and treat the common cold, just like a PCP. Specialist chiropractor can work with a torn rotator cuff, or even a postsurgical shoulder adhesion, or endometriosis. A lot of chiropractors, perhaps all of them, get called on as natural pain management consultants. When reality is our patient numbers are not as high as some of our medical brethren, where the lines are out the door… And so we end up seeing a wide range of patients in our offices. I believe that this gets confusing, and I’m in favor of offices identifying upfront what their specializations are. You should ask your chiropractor what they specialize in. If you’re sitting in the waiting room with three different types of patients simultaneously, I would guess that might seem confusing – both to you, and maybe even to the chiropractor and the staff. Get hooked up with an office the treats patients similar to you. Diversity is great. And so is focus.

So, back to the question, her purchase can treat health management issues in the human body, including wellness and primary care. They can treat pre-and post surgically. They can even refer patients to surgeons that need work, but it won’t be what they do on the first day, most likely. If you walk into my office and it seems like you have pneumonia, I’m sending you to provider who can prescribe antibiotics Were going to work you together, to get you well.

 

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This one is as easy as asking the front desk staff when you call. If they can’t answer this question, perhaps that’s a questionable response. In other words, if the person seated at the front desk doesn’t know what the chiropractors focus of specialization is, or can’t connect you to someone who dies, perhaps you can inquire at another clinic. A bad start to the relationship can create a lot of confusion, and both you and the doctor could be wasting their time. You can read further about “Questionable practice” in the other chapter.

Sometimes the style that the chiropractor practices will indicate what they treat. Styles are listed in the styles chapter. However, the doctors website website should clearly indicate their focus. I’m wary of chiropractic clinic that say they treat everything under the sun. I know from 20 years experience the Chiropractic is really great, it’s not the first choice for everything. And while I say that, remember, you can choose comanagement at any time. Like the back to your question… The doctors website or description of services they perform should clearly identify their focus.

On our website, when you do a search for a chiropractor, we have asked the chiropractors we feature to limit themselves to only four “specialties”.

In this way, we are asking Clinic’s that can shine in particular areas to allow themselves to shine, and cutting down on the number of clinics you have to search through, that treat “everything under the sun”.

– I went to the chiropractor, had a treatment, and now I have more pain, is that bad? What could it mean? What should I do?

– I have gone to the chiropractor for a series of treatments but I am not getting better. What does it mean? What should I do?

– How can I get a second opinion? What is a second opinion?

– Is chiropractic safe?

In the hands of a trained provider licensed to perform chiropractic, chiropractic is safe. This is a rational, level-headed, non-biased opinion, based on the actual data. I will give you references to it at the end of the book, and you can actually read the studies on askaboutchiropractic.com. But let’s spend another moment and ask – is a screwdriver safe? If you poke someone with a screwdriver, it can hurt; and if you overtighten a screw you can strip it and damage things. My point is that chiropractic is a technique of applying healthcare. If we have established that the concept behind chiropractic is sound – and it’s certainly not dangerous – then the practical application of chiropractic techniques are just like using a tool. Using a tool properly is not dangerous – but there are risks inherent to even turning a screwdriver. And for the patient, having the right expectations and asking their doctor if it is the right time for the application of the tool will certainly help get the desired outcome (if you tell your chiropractor you are planning to go to Yoga again tonight, they may adjust you differently). You and your chiropractor should be communicating so you know what you are about to receive. For example, when I go in for brain surgery, it’s valuable for me as a patient, to ask “what’s the success rate of this procedure” –  if my doctor does not tell me up front.

 

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Patients should really be willing provide information with exhausting detail, without fear of “TMI” (Too Much Information). Showing up and saying, “I really don’t have time because I am so busy, would you just pop my neck please?”  – really does not work.  No doctor should allow that. Throughout the course of my 19 year practice there have been countless instances,  more often than not, where my patients would tell me critical background information, only after multiple treatment visits, and after I had asked questions two or three different ways. They simply did not think it was relevant (examples… I was dizzy yesterday but you are not a dizziness doctor) just like seeking any healthcare provider, or any type of prover for anything – all background information  related to your health, lifestyle., daily practices, including your mental and emotional history and status – is all both relevant and critical to you receiving the care you need.   I recommend that patients make a personal private healthcare journal to help them remember things. So, you went for an X-ray three years ago – what pictures did you get? And why? I can’t tell you how many times people can’t remember what they went in for. Leaving this kind of information out of your profile when talking to any doctor, no matter what type – actually may even put you at some risk. I recently applauded a patient who brought me in a lovely health history printout going all the way back to when they were a teen. You can update this at any time. THese days, electronic health records help doctors access this material and make it work for you.

Here is what I suggest you tell your doctor (and they should ask you, as well (at a minimum):

- What’s going on for you in your body. Everything.

- How it effects you (I can’t sleep, or parallel park my car, even “I can’t poop!”.

- How long has it been going on for, and is it getting worse, better, or staying the same?

- When do you think it began and what brought it on?

- Have you been treated before for this and how did that work for you?

- Do you exercise?

- Do you take any medications for this or anything else? What did you take today? Yesterday?

- What kind of special needs do you have, can you work, for example?

It would also be good to discuss anything else that might be going on, even if it seems unrelated, like your migraine headaches, or even skin rashes. All of the above will get you good results. Oh, by the way, also check out the entry on “Self-Manipulation” (popping your own neck, back or body).

 

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Basically, that’s a marketing technique or trick about trying to attract patients. It’s really not the best idea either for the patient or the doctor. For the patient, what this represents have is a chiropractor trying hard to sell themself, which is not bad, but it’s not so great either. As a patient, you’re not truly engaged yet in a doctor-patient relationship, and therefore the doctor is not officially on the line, and has more room to say things that he is not legally bound by. I tend to think that the information you get in free consultations is less valuable than what you actually pay for. That’s kind of the litmus test and I know that’s probably not what you’re going to want to hear.

And for the doctors, I think that if they talk to their malpractice insurance company, they will find the free consultations are probably out of the scope of their policy. A lot of doctors have gotten burned from this, and so maybe the wiser ones avoid it. Unless a formal doctor-patient relationship is begun, which involves some level of financial accountability on the part of the patient – in exchange for the services of the provider, then healthcare information should not be exchanged, prognosis and diagnostic information extended, other than  perhaos a tour of the facility. Now don’t get me wrong. If you’re invited to a talk where chiropractor talks about the services they provide and the history of great results they have had, demonstrates his or her excellent facility and talks about specific conditions, we are all for that. Is actually great community service and of value to the public. Suggesting free quick fix answers and one-size-fits all treatment plans probably is not.

After the presentation, information that you may exchange with that doctor, in the lobby or over the free cookies (and cool-ade(™)), should probably be limited to “great – I would love to talk to you about that, I’ll see you on Monday morning.” Further information, consult “signs of a healthy practice”  in this book, and more at Askabout Chiropractic.com, or “code of ethics”, at GoodChiropractic.org

 

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Unfortunately, what we have there is Problematic, and depending on who you ask, could be a violation of laws, statutes, regulations my depending on your state. This does not fit our definition of “Healthy Practices” (see the chapter “Signs of Good Chiropractic”.  Even offers like “no out-of-pocket expense” for motor vehicle accident injuries are probably inappropriate, especially because the patient is always ultimately financially responsible for expenses, if not paid by an insurance company.  See chapter “An Insurance Primer” for that one.

In any event, we have seen chiropractors get into big trouble about this one. Generally, it is not the something that a top-tier practice does.

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I think it’s probably true that there are levels of chiropractic practices. If we set up a tier system, with number one, tier one being the top of the heap, the tier one practice is going to have high levels of ethics, not indulge in guerrilla marketing, not chase ambulances, and The doctor will probably be credentialed by groups like GoodChiropractic.org, meaning that they are members of both their state international organizations, and have verified their claims. Way down the ladder, I suppose there’s a tier “six” or so, where Is chiropractors are one step ahead of the board of regulators and doing a lot of unsupervised and perhaps less then savory practices, making a lot of large offers about healing that they may not be able to back up. . You need to know is this occurs in every single profession, and you read about them in the news every day.

 

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Yes, there are definitely healthy chiropractic practices and “less healthy” practices. We are not talking about the number of patients per day or the income of the doctor; actually, there are other measures. See the chapter “Signs of Good Chiropractic”

 

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The treatment plan can sound really good, and it can contain good components, but sometimes it is lacking in something such as a way to measure progress, or a limitation of time, after which the plan must be reevaluated. The treatment plan should be specific to a diagnosis, not specific to “maintaining wellness”; a wellness management plan is simply something different. To that extent, you should probably also consider the definitions of “clinically appropriate care”, and medically necessary care”.

The treatment plan should be written down, and the chiropractor should be able to print it out and hand you a copy of it at any moment. Our new electronic software, provides for this.

The chiropractor should discuss the treatment plan with you at every single visit, and you should know the name and reason for every single therapy you are receiving prior to receiving it. In my clinic, I review what we’re going to do on every session, prior to putting our hands on the patient. I tell my staff, that if we don’t say the words treatment plan least three times and every single appointment, we are not properly doing our job the good news is that you can fix this in an instant, if it’s been lacking… Just ask your doctor about the treatment plan. They respond will tell you what you need to know. If you are confused, you can have your treatment plan reviewed, and to that extent check out “second opinions”, at Ask about Chiropractic.com.

 

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Every treatment provided to every patient should correspond to a diagnosis. Technically, even “wellness” is a diagnosis. Getting adjusted “just because it feels good”, is perhaps a reasonable (but uninformed)  motivation by a patient, however it  is completely invalid for a provider. Delivering a chiropractic adjustment “just because a patient asks you too”, would probably be a risk of malpractice, even if it was not a particularly dangerous technique. It certainly confuses the patient and minimiozes the power of what the doctor is doing. Everything that a doctor does is done for reason and with an expected and desired effect – it’s all part of a treatment plan. I’m not suggesting that you should not get an adjustment so that you can feel good – I am suggesting that you find out exactly what it is you are accomplishing by getting that adjustment period. I promise you that this justification exists, and a skilled provider can tell you exactly why you are asking for that service. If you are asking for it, it is probably because there is a diagnosis in your body telling you that you need it – some appropriate diagnosis.

So, what is a differential diagnosis? Actually a diagnosis is more like a temporary bookmark. It’s a living thing, and it is constantly changing; a diagnosis is designed to shift, as the doctor finds out more information about you. Take for example “wellness”. The diagnosis of “being well”, would be a differential, because as soon as we find out additional information, we might change that. So, if I give you the definition of “the common cold”, that differential might then change to”pneumonia”, if we get new information – another reason why you should keep your doctor informed. Similarly, the descriptors mild, moderate and severe answer enter into every diagnosis – and anyone with a description of, for example “a sprain and strain”, should know whether it is mild, moderate, or severe. So, what may look like a severe sprain on day one, may actually recover so quickly that it becomes a differential diagnosis of strain sprain. Additionally, what might initially be the best way to describe an injury, such as a “sprain and strain of a desk”, might be better described as a compressed nerve, which is perhaps a more important and more specific way to describe the problem. Such is the concept of differential diagnosis. Ask your doctor, and they can tell you all about it – it’s from day one of “doctor school”.

 

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Chiropractors are doctors, and this is inherent in our postgraduate degree designation “Doctor of chiropractic”.  Chiropractors are not “medical doctors” or “doctors of osteopathy” – we are “doctors of chiropractic”. Without belaboring the issue here, I will tell you that the number of hours spent at chiropractic college, and the material studied, including the laboratories, subjects, and critical training, definitely meet and in some cases exceed, the average training of a medical doctor in the United States. Actual analysis of these hours and comparisons are available on AskAboutChiropractic.com however, beleive me, they exist. While medical doctors continue their studies while working in hospitals as residents, chiropractors work as interns in Clinic’s usually associated with the colleges and universities. Chiropractors have training in toxicology, while medical doctors have training in pharmaceuticals. Many modern chiropractic programs have training in pharmaceuticals, especially in states where chiropractors are able to prescribe, such as in Arizona. Many medical doctors expand their knowlege of pharmaceuticals through relationships with the pharmaceutical industry, which is just fine, but chiropractors do not have that nor are they insisting on having that as of 2014. There is some campaining in chiropractic state licensure for drug prescription privileges and perhaps I will have more to tell you about that in another edition of this book, or on the website AskAboutChiropractic.com. It’s certainly neither a done deal or “a dead issue.”  

Having said that, are chiropractors “physicians”?  The definition of physician typically includes the word “practicing medicine”, but then again, chiropractors have traditionally been averse to describing what they do as “chiropractic medicine”. The title physician, depends on the body defining the title. Chiropractic doctors are chiropractic physicians, in the following states…. The federal definition of “physician”, does not currently include chiropractor, who are technically listed as “other healthcare provider”. However recent changes in the federal insurance plans provided for public employees, list chiropractic doctors as one of the top three, with Dr. of medicine, Dr. of osteopathy, and Dr. of chiropractic, listed as the only physician level providers. Again, this is going to vary based on state law.

 

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Again, see the discussion as to how the title of physician varies based on both federal law and state definition. Also, consider the reality that Primary Care Physician, or “PCP” is often an “insurance term” and the usage of that title is then defined by your particular insurance company. This is currently under heated debate in various state legislatures Having said that, it’s important to restate that Chiropractors emphasize manual and manipulative therapies – as an alternative tomedications andsurgery for neuromusculoskeletal disorders[6] –  while also managing general health concerns. Chiropractors are generally regarded as primary contact, portal of entry health care providers.  Although all chiropractors have many attributes ofprimary care providers,  the practices of the largest population of Chiropractors typically have more attributes of more limited, focused medical specialties like physiatry,

To answer the question, Chiropractors a could definitely function as primary care providers, or Primary Care Chiropractic Physicians. . As of this date, there are currently coordinated care organizations or CCO’s, in which chiropractors are functioning as primary care providers. Chiropractors are generally regarded as primary contact, portal of entry health care providers. Although all chiropractors have many attributes ofprimary care providers,  the practices of the largest population of Chiropractors has more attributes of a  limited medical specialty like physiatry,  dentistry orpodiatry.

The State of Washington, in January 2014 declined the Washington State chiropractors permission to perform physical examinations for student athletes and commercial drivers, which are typically in the scope of primary care providers in that state.

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First of all, we want to make sure we are distinguishing between “worse” and “still” or even “again”. We also have to define whether you simply continued to get worse, or your complaint abated but then resumed. In 19 years of practice, talking deeply with my patients, we determined that many people, if they still feel a symptom, may use the words “worse”, because they “still” feel it. When asked direct questions, we find out it has actually improved – as in, the headache is now not blinding, but it is still there and that means it is “worse”. Worse really needs to mean an increase or a significant expansion…four fingers instead of one finger, diarrhea constantly instead of occasionally, etc. At the same time, know that I understand that it is very difficult to continue to feel discomfort or pain – we are not minimizing this. Another thing that we have seen happen is that if something resolves for a while –  even goes away completely – but then returns, the patient seems to invariably describe this as “worse”; perhaps because they are reacting to it having returned. On analysis, once again, this time perhaps it is only one finger as opposed to four fingers, and so we have to be careful about using that “Worse” descriptor. Either way, you should work through this with your doctor. If that’s not a possibility, then you should consider getting a second opinion. There are doctors who will offer you a second opinion without having to completely transfer clinics or become one of the patients that they treat.

 

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Originally conceived by an Osteopath, Craniosacral Technique has been applied within Chiropractic treatment plans, complements chiropractic manipulative therapies and has significant implications when added to Wellness Plans. The technique involves manipulating the cerebro-spinal fluid flows by gently shifting the spinal and skull structures from the vertex of the head to the tip of the sacrum. It is typically considered a non-force technique and is often favored by sensitive patients. Because the results and applications of this modality are esoteric and difficult to objectively assess, it is controversial and often attacked as “quackery” on sites like Wikipedia. In contrast, click here. We have seen significant results with this therapy being combined with other therapies in balanced treatment plans. See also SOT (Sacral-Occipital Technique)

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Diversified Technique (DT) or simply “Diversified” is considered the most commonly used manipulative technique by chiropractors.[1] We have heard it considered a core technique. Like many chiropractic and osteopathic manipulative techniques, Diversified is characterized by a high-velocity low-amplitude thrust. Diversified is often described as the most general chiropractic manipulative technique and is differentiated from other techniques in that its objective is specifically to restore proper movement and alignment of spine and joint dysfunction.[2] . Diversified technique remains the principle system taught at National University of Health Sciences, New York Chiropractic College, Southern California University of Health Sciences, and Northwestern College of Chiropractic[citation needed], and is one of the core techniques taught at University of Western States [3]

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As to Autoimmune Disease (AD), because a chiropractor is a physician/doctor, they can certainly work on or around an autoimmune disease issue. Autoimmune disease is in the Chiropractor’s training, they can recognize them, diagnose them, and even build treatment plans around them. Autoimmune diseases have many manifestations, and typically cross different specialties, such as rheumatology, Endocrinology,hematology, neurology, cardiology, gastroenterology and dermatology. Whether a particular chiropractor’s practice has a significant-enough focus on a particular aspect of your autoimmune problem, is a question you could find out in advance. A very reasonable “Front Desk Question” (“FDQ” -see this definition elsewhere in the index), would be, “How often does Dr. X treat a patient with “ABC autoimmune problem”? How many patients with this are they treating at this moment?” (Wait for the answer, and make sure you are satisfied by it).  Autoimmune disease refers to a varied group of illnesses that involve almost every human organ system. Given the complexity of the question, I think it would be perfectly reasonable, as a “front desk question”, to ask to speak to the doctor directly, to find out how comfortable they are treating you with respect to, for example “Crohn’s disease”. You can ask them what the treatment plan is going to be (treatment, goals, and frequency/duration), and then you can choose that, or not. If what you are hearing is a “generic wellness plan”, then of course you could choose that – or you could opt for something with a more specific focus. Typically, we suggest that you go to a clinic that specializes in your problem, and there may well be a chiropractic specialist that will handle some aspect of your Issue. With Autoimmune Disease (AD), it seems less likely that one provider can cover all of the bases; it’s typically a team approach – so you might consider selecting an integrative provider. (See definition elsewhere in this index).

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Chiro-Trust appears to be a new organization soliciting a pledge from chiropractors that they will not practice any “long term therapies”.   Simultaneously, the lead spokesperson for the group’s Linkedin page advertises the concept of attracting and creating “lifetime” chiropractic patients.  Chiro-Trust. org was recently taken over by a California chiropractor who has been involved in quite a few marketing programs over the last decade.   Their description of treatment plans is essentially absent, and the concept may be overly simplified. We are watching this and have our “Sniff Test” sensors on high alert, although this perhaps could be of value. This would initially seem like a similar concept as GoodChiropractic.org®, but unlike GOOD, the TRUST site does not speak of professional collaboration – at least as of this edit.

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Insurance Questions (2)

A deductible is the amount that an insured patient is responsible for during the calendar year before the health insurance benefits will begin. The deductible is calculated by insurance approved amounts, not the actual charges. See also Insurance Approved Amounts.

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Most modern insurance policies do provide coverage for chiropractic care, and you should call and check your benefits. New insurance rules giving all providers equality to perform doctor services have made chiropractic care accessible to millions, including those covered by the “Obamacare” or Affordable Care Act policies.

Generally, the clinic should probably suggest that you  contact your insurance company and learn about your own coverage, rather than take the responsibilty for telling you what your coverage is. If they get it wrong, or you don’t understand the explanation, or the info they got was wring int the frist place, this sets up a spiral of trouble. People should only trust what they are told directly by their insurance company, although the clinic or provider can help explain it to them.

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