Chiropractic Education and Practice
The chiropractor spends four academic years after college to gain their doctorate degree in chiropractic. The chiropractic college is separate and distinct from the medical schools. This education follows somewhat the medical school model for the first two years including cadaver dissection, physiology, and pathology.
Biomechanics, Spinal Manipulation, Physical Therapy
The education differs from the traditional allopathic model in that they also learn biomechanics, manipulation of the spine (the chiropractic adjustment), and physical therapy modalities. Herbal and diet therapies accompany their education.
After four academic years, he or she must pass the national and state boards and then open their own private practice. Chiropractors can diagnose and treat many spinal disorders and are trained in x-ray usage and understanding to augment their diagnosis.
Some chiropractors take a postgraduate degree. The specialties include orthopaedics, neurology, sports medicine, and even internal medicine. Chiropractors do not have prescriptive medication rights and, therefore, cannot write for medications. The mainstay of chiropractic treatment is the manipulation of spinal segments. For patients with restriction of motion, this treatment can be very effective. Many utilize rehabilitation procedures to augment their manipulation skills, and education is important.
Diagnosis and Treatment
Most mainstream chiropractors pursue the modern diagnostic systems. Following the typical degenerative cascade that occurs in many individuals, there is asymmetric and faulty motion that occurs in the vertebral segments. This restriction of motion can cause adhesions, compensatory muscle straining, and "capsular catching" of the lining of the facet joints.
- The "adjustment" used by chiropractors breaks the vacuum seal of the facet joint. The causes the distinctive "pop" heard and felt by the patient. This move allows increased motion that may give significant relief of pain. Muscle spasm may also be relieved by this manuever.
Using office and home exercise, a chiropractor will attempt to increase the spine's motion and strength. Modalities such as heat, ultrasound, electrical muscle stimulation, and massage are used to relax the patient and help with muscle spasm.
Some chiropractors still believe that misalignments of the spine cause disease and treat the spine as the source of many other disorders. These chiropractors are a special subset and won't be discussed in this section.
Donald S. Corenman, MD, DC is a practicing orthopaedic spine surgeon and chiropractor in Vail, CO and the author of Everything You Wanted to Know About The Back, a consumer's guide to the diagnosis and treatment of lower back pain. Click here for more information about the book.