Facts for Consumers: Chiropractors

December 12, 1999

This document, downloaded from the State of Massachusetts Web site, illustrates how an agency that is supposed to protect the public, exaggerates what chiropractors have to offer.

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Board of Registration of Chiropractors


Board of Registration of Chiropractors

The Board of Registration of Chiropractors regulates the practice of chiropractic in the Commonwealth of Massachusetts. The Board works to maintain high standards of practice and to protect the health and welfare of the public by establishing qualification requirements for licensure, reviewing applicant credentials, and administering licensing examinations.

The Board also monitors the practice of its licensees to ensure compliance with state laws and the Board’s rules and regulations. The Board resolves consumer complaints against licensees by investigating charges and taking appropriate disciplinary action when necessary.

The Chiropractor

The human spine is an extraordinarily complex structure composed of 33 individual bony units, or vertebrae, stacked upon one another like a column of lined-up napkin rings. Disks of shock-absorbing cartilage and a lubricating joint fluid separate the vertebrae from each other. Encased within this hollow stack of vertebrae are hundreds of nerve fibers that transmit information between the brain and various organs and limbs. There are a hundred different things that can go wrong with all these moving parts: the muscles supporting the spine can become strained; the ligaments that bind muscle to bone can get stretched or torn; the joints of the vertebrae can wear away; the list goes on.

Given the sheer magnitude of things that can — and do — go wrong with the spine, it’s no wonder that millions of people turn to chiropractors for help. Add to that chiropractic’s excellent safety record, only a handful of serious injuries have ever been reported out of many millions of adjustments.

Chiropractic has an ageless place in health care. Hippocrates, the “father of modern medicine” utilized “manipulation” in his treatment techniques. The early Chinese are also said to have included “manipulation” thousands years ago. Chiropractic has been practiced in America for over 100 years.

Chiropractors provide health care services to consumers for musculoskeletal and neuromuscular conditions. They are concerned with improving and maintaining the integrity of the biomechanical systems of the body.

A number of studies over the past few years, including the United States Department of Health and Human Services’ Agency for Health Care Policy and Research (AHCPR), the Manga Report, funded by the Ontario Administry of Health, and the Rand Study on Low Back Pain, all expound on the effectiveness of spinal manipulation as performed by chiropractors.

The role of chiropractic in our health care system is well established. Chiropractors are licensed in all 50 states with many accredited chiropractic universities nationwide.

Chiropractic diagnosis and treatment are focused on reducing pain and improving function of the neuromusculoskeletal systems of the body. Chiropractors provide a complete physical examination with subsequent examinations as needed. Chiropractors may also prescribe procedures such as radiological X-rays and clinical laboratory services as part of the diagnostic process.

The primary treatment service utilized by chiropractors is manipulation, to mobilize and adjust the joints and tissues of the spine and extremities. Chiropractors also use adjunctive therapeutic procedures or modalities, including ultrasound, cold packs, and electrical muscle stimulation.

Consumer Tips

  • You may want to start with a referral from a friend or family member who has been satisfied with a specific chiropractor.
  • Be sure the chiropractor is licensed to practice in your state.
  • Find out if he/she has attended an accredited chiropractic college.
  • Ask the chiropractor’s office to describe what techniques the chiropractor uses, his thinking about chiropractic and health care.
  • Make sure the chiropractor would be willing to make a referral to other medical providers when appropriate. In cases of low-back pain, it’s not necessary to see a medical doctor first, as long as the person treating you is knowledgeable and open minded enough to refer you to a physician when necessary. Among the rare, but serious medical problems that can underlie back and neck pain and require intervention from a physician or surgery are fractured vertebrae, infections and tumors. Forceful spinal manipulation is not recommended for people with severe spinal injuries accompanied by numbness or tingling the limbs or with bone weakening disease, such as osteoporosis.
  • Seek a chiropractor who acknowledges differences in tissue (connective, epithelial, muscle, nerve)
  • Seek a chiropractor who when asked, “What techniques do you practice” says that their treatment will depend on what’s wrong with you.
  • Seek a chiropractor who uses x-rays and orders them to rule out fracture and/or gross pathology as indicated by the case history and medical (not chiropractic) exam.
  • Seek a chiropractor who may or may not choose to treat, and who emphasizes patient empowerment by teaching you how to take better care of yourself.
  • Let your symptoms be your guide. If you feel better, you probably are.
  • You can evaluate a chiropractor by talking to his/her patients about these criteria:
  • Interpersonal manner
  • Technical quality
  • Effectiveness of care
  • Accessibility and convenience
  • Financial issues
  • Continuity
  • Physical environment
  • Availability

What to Expect

  • Chiropractors take a complete health history of the patient and discuss his/her specific problem as well as overall lifestyle.
  • Common questions concern family history, dietary habits, prior treatment received, job duties and others to determine other important health information.
  • If necessary a complete health examination is performed, which includes X-rays, measurement of blood pressure, laboratory analysis or other accepted specific tests to determine general health condition and any specific problems. Also, a careful spinal examination will be performed to detect any structural abnormalities that might affect a patient’s particular health condition.
  • Chiropractors may find a significant connection between a bump, jar or fall that a patient experienced many years ago and the patient’s present health problem.
  • Only after a chiropractor determines that your condition could be helped with chiropractic does he or she initiate care. Specific procedures are determined by careful evaluation of the patient’s X-rays, laboratory test and physical findings.
  • Care often involves corrective spinal adjustments; however, adjunctive therapies may be used to supplement the adjustments.

Questions for the Chiropractor

  • What type of treatment in terms of frequency and duration should you expect, based on experience treating patients with similar conditions?

    The typical chiropractic approach to health problems is to outline a course of treatment over a one-month period. Most patients respond to treatment within weeks. The doctor should discuss this with you and change the treatment if you do not feel as though you have improved.

  • Does the chiropractor have contact with other health care providers to whom he/she refers for consultation?

    In the event that you need non-chiropractic treatment, you should expect a referral to another medical specialist within your health plan.

  • What specific procedures would the chiropractor use to treat your condition?

    Most chiropractors will recommend an adjustment/manipulative treatment. This treatment is used to restore normal joint function, to decrease pain, swelling and muscle spasms, as well as to improve range of motion. The chiropractor may also choose to use physical modalities such as ice, heat, electrical muscle stimulation, or ultrasound. Whichever treatment the chiropractor recommends, you should be informed of the benefits and risks in language that you understand.

  • Will the chiropractor suggest exercise or lifestyle changes to help improve and strengthen the area of complaint?

    It is important in any recovery that you are actively involved in your treatment and rehabilitation. You should expect to be given instruction and education on the proper exercises needed to improve your problem. Additionally, it may be recommended that you use ice, heat, or other home-based treatments.

  • Will you be required to have an x-ray taken?

    An x-ray is a tool a doctor may use to confirm your diagnosis. An x-ray is not always required to start treatment. The chiropractor may want to take an x-ray after completing a thorough history and examination to rule out bone disease, fracture or dislocation.

In closing, you should expect the doctor’s office staff to treat you with courtesy. When you call, do they assist you in a prompt and professional manner in answering your questions and making an appointment? Assess the personality of the office staff. Will you be comfortable working with them?

After asking these questions and meeting the chiropractor and office staff, assess their answers and determine for yourself if the chiropractor’s personality and approach seem reasonable. You should feel comfortable that you have made an informed choice.

Filing a Complaint

While the majority of licensees conduct themselves as true professionals, the Division of Registration will take action against those who fail to maintain acceptable standards of competence and integrity.

In many cases, complaints are made by dissatisfied consumers – but, dissatisfaction alone is not proof of incompetence or sufficient grounds for disciplinary action.

If you have a serious complaint against a licensed chiropractor, call or write the Division’s Office of Investigations and ask for a complaint form. Or download a copy of the complaint form from our website.

Division of Registration
Office of Investigations
239 Causeway Street, Suite 400
Boston, Mass. 02114
(617) 727-7406

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This page was posted on December 12, 1999.