New backing for chiropractic medicine

What is it?

Chiropractic is a natural, holistic form of healing that employs neither drugs nor surgery. It treats the nervous and muscular skeletal systems for disorders that include sore necks, backaches, insomnia, carpal tunnel syndrome, and headaches.

Chiropractors use some 100 techniques, ranging from massage and soft tissue manipulation to spinal manipulation and electrical stimulation. The key, say practitioners, is to restore health through proper alignment of the spinal column. The goal of the natural treatments they emphasize -- which can include dietary supplements and various kinds of stretching and ergonomic suggestions -- is to make sure that your problem doesn't recur after it has been successfully treated.

This doesn't mean that chiropractors don't realize there are times when drugs or surgery are necessary, points out Dr. McClelland. Some states even allow chiropractors to write prescriptions for non-prescription drugs -- allowing their patients, for example, to get a 400 mg ibuprofen rather than the 200 mg that is sold over the counter. Rather, more advanced pharmacology and surgery are alternatives that chiropractors simply aren't trained to offer, in much the same way a dentist doesn't take out a ruptured appendix.

"Chiropractic," he says, "is more of an opportunity to help you heal yourself. You're more involved with the treatment, because you're doing more than taking pills."

In the United States, relations between medical doctors and chiropractors have not always been amicable, although they have improved over the past decade. Says Scott Haldeman, a neurologist who is both a medical doctor and a doctor of chiropractic: "Ten years ago, if you practiced manipulation... you couldn't get published and were never invited to meetings. Now I can't keep up with the invitations."

One reason for this change in attitude can be traced to the changes in health care over the past decade, and especially the movement to managed care. Chiropractic care, say several studies, is not only less expensive than traditional medical care (by as much as one-half in some cases), but involves fewer lost days among patients - in some cases, as many as one-third less. And with an overall renewed interest in alternative health, chiropractic care is poised to shed it's "step-child" reputation.

Today, you'll find chiropractors in a variety of fields, from sports injuries to occupational health to orthopedics, and neurology. The American Chiropractic Association estimates that its 40,000 members treated 18 million people in 1996.

In fact, save for their differences over medication and surgery, medical doctors and doctors of chiropractic have a number of things in common. Chiropractors, like medical doctors, must be licensed by the state in which they practice, must pass a state board examination, and intern at a chiropractic clinic. Licensing requirements for chiropractors include a four-year degree from a chiropractic college and a specified number of hours of continuing education.

A new perception of chiropractic treatment

There are also similarities, says Dr. McClelland, in the way the two groups diagnose and treat patients. When you arrive at a chiropractor's with a sore neck, the doctor will:

• Take a complete history, in an attempt to find the underlying cause for the pain. You can expect questions such as: Have you had the pain before? What does it feel like? How long has it lasted in the past? Other questions pertaining to your lifestyle will also be asked, in an effort to determine activity, habits, etc.
• Perform a physical exam, focusing on the area of concern. The exam is similar to one that any health professional would use, including X-rays. In addition, it features a postural and spinal analysis unique to chiropractic.
• Recommend treatment. This can include any of the aforementioned courses, as well as ultrasound, taping and strapping, braces, casts, or even traction.
• Follow up. Like a medical doctor, a chiropractor keeps an eye on your treatment, recommends another treatment if the first doesn't work, and may suggest that you see another medical specialist.

"The chiropractor's goal is to offer the the highest quality, professional health care," says Kurt Hegetschweiler, D.C., past president of the American Chiropractic Association, " and to teach patients how to maintain physical well-being and a healthful lifestyle."

What to expect

"Chiropractic and Medical Costs of Low Back Care" in the March 1996 issue of Medical Care, a journal of the American Public Health Association, details some surprising findings. The study found that chiropractic treatment was not only less expensive than traditional methods, but seemed to be more effective.