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Chiropractic

Chiropractic is a manual therapy mainly used to treat back pain, and other problems with your bones, muscles and joints.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important you follow your chiropractor's advice.

Chiropractic is a type of manual therapy, in which chiropractors use their hands to make adjustments to your joints, concentrating particularly on your spine. This is called manipulation.

Chiropractic works on the theory that manipulation can improve the efficiency of your body's nervous system and enable natural healing. Chiropractors claim to take an integrated approach in their treatment that doesn't focus only on the symptoms of a condition. It also takes into account your medical history, lifestyle and personal circumstances.

Chiropractic is most commonly used to treat back pain and neck pain. Some chiropractors also claim to treat a variety of other health conditions, both related and unrelated to your muscles, bones and joints. However, there isn't good evidence to support the use of chiropractic in all these conditions (see 'Is chiropractic effective?' for more information). There is also a range of conventional treatments for any of these health conditions. Ask your GP for advice.

Chiropractic isn't suitable for everybody. For example, it isn't suitable if you have osteoporosis or bone cancer, or if you have a condition that affects your spinal cord. It's also best not to have chiropractic while you're taking certain medicines, such as those that thin your blood (anticoagulants) or some types of steroids. Ask your doctor if chiropractic is suitable for you.

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Details

  • Finding a practitioner Where can I find a chiropractor?

    All chiropractors in the UK must be registered with the General Chiropractic Council. You can contact them through their website or by phone to find a chiropractor in your area.

    If you're considering chiropractic, it's important to visit your GP first. Your GP can help to diagnose your condition and will ensure that you understand all the treatment options that may be available to you.

  • The therapy About the procedure

    During your first appointment with a chiropractor, he or she will ask about your medical history, diet and lifestyle. Your first appointment will last between 30 minutes and one hour. Your chiropractor will need to ask a number of questions to get a whole picture of your current health and circumstances. He or she will also examine you. Your chiropractor may request that you have an X-ray or a MRI or CT scan to help make a diagnosis.

    Once you have agreed on a course of treatment with your chiropractor, each session will last around 20 minutes. The number of sessions you will need and how often you have them will depend on your particular condition.

    Your chiropractor will usually treat you while you lie down in various positions. Chiropractors often use a manipulative technique on your spinal column or joints, consisting of short, rapid forceful movements or ‘thrusts’. These are designed to ‘realign’ your spine and correct any problems in your spine that may be related to your condition. This technique may result in a sound you can hear – a click or pop similar to when you stretch your knuckles.

    Your chiropractor may carry out treatments using ice, heat, ultrasound and acupuncture. Some chiropractors offer active rehabilitation exercise programmes that focus on improving your fitness and endurance aimed at improving your symptoms.

    Your chiropractor may suggest having regular maintenance therapy after your initial problem has got better. Chiropractors claim this reduces the chances of falling ill again. However, there is little good evidence for the effectiveness of this type of treatment.

    Your chiropractor will discuss carrying out further investigations or may refer you to your GP if your condition doesn't improve. Chiropractors don’t prescribe medicines or carry out any surgery.

  • Benefits Is chiropractic effective?

    There is some evidence that chiropractic can help if you have low back pain. The National Institute for Health and Care Excellence (NICE) recommends chiropractic for this if you've had it more than six weeks, but under a year.

    A review of the research on chiropractic and other manual therapies found that such treatments may help people with migraine, neck-related headaches and neck pain. However, there is considerable debate about these claims.

    Researchers have also looked at whether chiropractic can help other conditions, including fibromyalgia, sciatica, period pain, asthma and high blood pressure. There has been no good evidence that chiropractic helps period pain, asthma and high blood pressure. Whether chiropractic is useful for other conditions is uncertain – the evidence is limited.

    The research is often conflicting and although symptoms of some illnesses improve after chiropractic, the best evidence generally fails to prove that chiropractic cures illnesses. Even though there is a lack of evidence, many patients are happy with their treatment and chiropractic treatment is accepted by many conventional medical practitioners.

  • Health and wellbeing for all

    You don’t need to be a Bupa member to access the range of health services available at our Bupa Health Centres, including physiotherapy, health assessments and GP appointments.

  • Risks What are the risks?

    As with every treatment, there are some risks associated with chiropractic. We have not included the chance of these happening as they are specific to you and differ for every person. Ask you chiropractor to explain how these risks apply to you.

    Chiropractors believe that spinal manipulation is safe. However, there is some debate about this and research is ongoing to determine the safety of chiropractic.

    Side-effects

    Side-effects are the unwanted but mostly temporary effects you may get after having the treatment.

    Side-effects of chiropractic include discomfort or mild pain at the point of manipulation, or stiffness and tiredness. Mild side-effects are very common. However, these shouldn't last more than a day.

    Complications

    Complications are when problems occur during or after the treatment.

    Spinal manipulation, particularly when used on the upper spine (neck) has been associated with severe complications, such as damage to an artery and stroke. However, this is very rare and may only be more likely to happen if you’re already at risk of the condition. A definite link between having chiropractic and a stroke hasn't been established.

    If you have any concerns about the risk of stroke from chiropractic, speak to your chiropractor.

  • FAQs FAQs

    How much training do chiropractors have before practising?

    Answer

    All UK chiropractors must undergo at least four years training at an institution accredited by the General Chiropractic Council. After qualifying, they must register with the council before they are legally allowed to practise.

    Explanation

    It's important that you ensure that your chiropractor is fully trained and qualified. Don't agree to any chiropractic procedure unless your chiropractor has fully explained it and discussed all the risks and complications involved. Your chiropractor should also examine you thoroughly and obtain your full consent before he or she starts any chiropractic care.

    Can chiropractic be used to treat whiplash?

    Answer

    Chiropractic is often used to treat whiplash. However, not enough research has been done to show whether or not it's really effective for treating this condition.

    Explanation

    Whiplash injuries are caused when your neck is over-extended, often as a result of a sudden impact forcing your neck forwards. It's a common injury and often occurs as a result of rear-end car crashes. However, whiplash can also be caused by having a fall or any other sudden movement.

    Whiplash injuries damage your muscles, ligaments, nerves and bones in your neck, forcing them closer together. This can lead to pain and stiffness. Whiplash injuries can vary and the most severe forms can lead to more serious complications.

    It's important to try to start moving around and return to your normal activities as soon as you feel able. Chiropractic is often used to treat whiplash. However, there isn't enough evidence to show if it’s effective for treating whiplash injuries.

    Is spinal manipulation safe?

    Answer

    Chiropractors insist that spinal manipulation is extremely safe. However, there is some evidence to suggest it may be harmful.

    Explanation

    Research has shown that mild side-effects, such as headaches and tiredness, are very common after spinal manipulation. These are usually mild and only last around a day. Spinal manipulation on the neck has led to serious complications in some people, including stroke and severe damage to arteries.

    However, a stroke is very unlikely to happen unless you’re already at risk of the condition. A definite link between having chiropractic and a stroke hasn't been established.

    Before you see a chiropractor, check that he or she is registered with the General Chiropractic Council.

  • Resources Resources

    Further information

    Sources

    • Information for health-care professionals. British Chiropractic Association. www.chiropractic-uk.co.uk, accessed 20 August 2013
    • About. British Chiropractic Association. www.chiropractic-uk.co.uk, accessed 20 August 2013
    • Ernst E, Gilbey A. Chiropractic claims in the English-speaking world. N Z Med J 2010; 123(1312):36–44. http://journal.nzma.org.nz
    • Chiropractic treatment. Cancer Research UK. www.cancerresearchuk.org, reviewed 16 January 2013
    • Chiropractic: an introduction. National Center for Complementary and Alternative Medicine (NCCAM). www.nccam.nih.gov, published February 2012
    • Walker BF, French SD, Grant W, et al. Combined chiropractic interventions for low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 4. doi: 10.1002/14651858.CD005427.pub2.
    • Research. British Chiropractic Association. www.chiropractic-uk.co.uk, accessed 20 August 2013
    • The general chiropractic council. General Chiropractic Council. www.gcc-uk.org, accessed 20 August 2013
    • What can I expect when I see a chiropractor? General Chiropractic Council. www.gcc-uk.org, published March 2010
    • Visiting a chiropractor. British Chiropractic Association. www.chiropractic-uk.co.uk, accessed 20 August 2013
    • Taylor DN. A theoretical basis for maintenance spinal manipulative therapy for the chiropractic profession. J Chiropr Humanit 2011; 18:74–85. doi:10.1016/j.echu.2011.07.001.
    • Low back pain: early management of persistent non-specific low back pain. National Institute for Health and Care Excellence. www.nice.org.uk, reviewed May 2009
    • Bronfort G, Haas M, Evans R, et al. Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat 2010; 18(3). doi:10.1186/1746-1340-18-3.
    • American Heart Association. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease. J Am Coll Cardiol 2011; 57(8):e16–e94. doi: 10.1016/j.jacc.2010.11.006.
    • Headaches: diagnosis and management of headaches in young people and adults. National Institute for Health and Care Excellence. www.nice.org.uk, reviewed September 2012
    • Education. General Chiropractic Council. www.gcc-uk.org, accessed 21 August 2013
    • Cervical sprain and strain. Medscape. www.emedicine.medscape.com, published 4 September 2012
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    Produced by Rachael Mayfield-Blake, Bupa Health Information Team, October 2013.

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