Chiropractic Overview Chiropractic is non-surgical, drug-free therapy that seeks to treat the "total person". It includes spinal manipulation and non-manipulative therapies such as electrical stimulation, massage and ultrasound. If a patient's spine is stable without nerve root impingement, chiropractic care may be an option. Chiropractic is not recommended to treat spondylolisthesis, abnormal spinal curvature or disc herniation. Chiropractic Philosophy Doctors of Chiropractic (DC) believe that good health is dependent on

• The central nervous system (CNS) is critical to the body's overall health
  
  
• It is essential to treat the cause of illness, not just the symptoms
  
  
• Prevention and early intervention (e.g. diagnosis) is key

Further, chiropractic emphasizes the importance of proper nutrition, daily exercise, and lifestyle modification to promote good physical and mental health.

Examination
Chiropractors follow the same diagnostic course as medical doctors. The consultation includes a thorough review of the patient's history, current symptoms, physical examination, and x-ray or other imaging studies, and lab tests. In addition, mobility and positioning of spinal joints, muscle function, posture, and overall range of motion are evaluated.

Manipulative Therapies
Manipulation
In chiropractic terms, the word subluxation is used to mean joint dysfunction. Subluxations can cause pain, numbness, dizziness, a feeling of pins and needles, and other neurologic symptoms. Manipulation adjusts the spinal joints to correct subluxation(s).

Using his hands, the chiropractic applies specifically controlled pressure directly to a joint or muscle. Successful manipulation may release a joint back into correct position and/or alleviate muscle spasms causing spinal nerve irritation.

Flexion Distraction
Flexion distraction combines chiropractic manipulation with gentle adjustments made while the patient lies on a specialized treatment table. The features of the table allow it to slowly move up and down, side to side, and to rotate. The table movements mimic flexion/extension, lateral flexion, and circumduction. Distraction manipulation does not cause pain.

Non-Manipulative Therapies
Electrical Stimulation
Electrical stimulation is also known as Transcutaneous Electrical Nerve Stimulation (TENS). TENS delivers a painless electrical current through the patient's skin to specific nerves. The current produces mild heat that works to relieve stiffness and pain and helps to improve range of motion (mobility).

This treatment is non-invasive with no known side effects. It may be used to control acute pain and chronic pain.

Massage
There are many types of massage including acupressure ("Shiatsu"), deep tissue ("Swedish Massage") and myofascial release. Massage may benefit patients with sprains or strains and other soft tissue conditions.

• Acupressure
  The practitioner uses his hands and fingers to apply steady pressure to specific body points (meridians, acupressure points). Acupressure theory claims that it opens blockages allowing energy (Qi, "chee") to freely flow. This type of massage also stimulates circulation to help remove toxins and promote healing.
  
  
• Deep Tissue Massage
  Deep tissue massage works to increase the flow of lymphatic fluid. Overuse and injury can cause pain, stiffness, and numbness. The practitioner uses his fingers, thumbs and elbows to work into the muscles and connective tissue. The lymphatic fluid helps to maintain the body's fluid balance and protect against infection.
  
  
• Myofascial Release
  Fascia is a sheath of connective tissue that supports muscles, bone, and organs. Stress from injury or poor posture causes the fascia to tighten. As the fascia constricts, muscles and bones may be pulled out of place causing pain. The practitioner uses his fingers, palms, elbows and forearms to firmly and gently stretch the fascia.

Ultrasound
Ultrasound is a common non-invasive therapy used to treat back and neck pain, tendon and ligament injury, muscle spasms, joint problems and other spine related conditions. Besides chiropractors, ultrasound is also used by physical therapists in rehabilitation facilities.

The practitioner applies gel to the patient's skin to create a friction free surface and the ultrasound probe is gently swirled over the area. Ultrasound uses high-frequency sound waves to deliver heat deep into tissues (eg muscles). This therapy promotes circulation and healing, relaxes muscle spasm, decreases inflammation and helps to alleviate pain.

Conclusion
Chiropractic care is growing in popularity and acceptance in the United States. At CCSI we recommend chiropractic care for some conditions, especially those that involve soft tissue strains and sprains. However, we do not recommend chiropractic manipulation for disorders that involve significant nerve impingement.