Your visit to the chiropractor

During the first visit, the chiropractor can present its profession and explain to you how he's gonna proceed. He'g gonna ask you the reason of your consultation, determine if your management is in his jurisdiction, then propose you an adapted treament plan.
Like every health professionnal, he must present the risks linked to its practice and obtain an informed consent (legal obligation applicable for each health practionner, not only surgians).

The 4 phases of a chiropractic consultation

-clinical examination
-chiropractic examination

The anamnesis is a medical questionning
it includes:
1 - general information (civil status, lifesyle)
2 - reason for consultation
3 - medical and family background

At the end of this part, the practionner must evaluate:
_The nature of your lesion.
_The red flags: all of the clinical signs thatalert the practionner on the possibility of an undergoing severe pathology and/or the necessity for complementary medical exams ( radiographies, MRI, biological analyzes)
_ Pathologies requiring an imperative medical or surgical treatment
_ Potential pathologies outsides of the scope of practice (ex: fracture, CVA, etc...).
NB: In those cases, the chiropractor will refer his patient towards a medical doctor of his choice (GP, radiologist or other specialist.)

Clinical examination:
_It includes the observation ( posture, curvature, swelling, rashs...)
_Specific medical tests if necessary: blood pressure, pulmonary auscultation...
_Orthopedic tests: specific physical manoeuvres realised by the practionner or the patient in order to reproduce your pain and whose positif outcomes lead to a known lesion.
_Neurologic tests: evaluation of muscle strength, sensitory and deep tendon reflexes in order to determine if and with level of nerves are compromised.
_Range of motion evaluation: painfull positions and articular elasticity.
_Evaluation of soft tissu: muscles, tendons, ligaments.

The chiropractic exam
Once the legal and medical requirements established, the chiropractor lets his hands do the talking and proceed to a professionnal physical exam shared by each therapist:
He will palapte and mobilise your articulations, your vertebrae in order to determine a general listing of blocages (example: L5 PL = 5th lombar blocked posterior and left).
Evaluate the restrictions of mouvement and the areas of muscle tension on painfull spots or distantly.
Observe the imbalances (short leg, anterior shoulder, rotation of feet...)

Some practionners can use, in addition to those examination techniques, others techniques suiting their sensibilities:
Perform specific muscles testing (Applied Kinesioloy)
Evaluate respiratory amplitudes ( Network technic)
Realise neuro-postural réhabilitation tests, motor or cerebral (NOT, chiropractic neurology)
Use a posturometer: devise with wires or numerical who evaluates imbalences within the shoulders, hip, knees.

The treatment
Each chiropractor has acquired a base of care techniques shared by each chiropractic school.
The professional uses the transmission of his peers experience and his own. Whitch allows him several care techniques.
The worth of chiropractic resides in its technical plurality.

Some notions of chiropractic jargon
The adjustment, adjust: application of controled force, manual or instrumental, thrut of high velocity and low amplitude, on a specific articulation, whith short lever arm and appropiate line of drive.

Basic techniques

Biomechanical techniques ( Diversified, Gonstead):

The adjustements (manipulation): fast manual pressure, precise and contoled on a articular segment that can be accompanied with a cracking noise (gaz bubbles that dissolve).

Mobilisations: manual pressure soft and slow.

Soft tissue work: firm manual pressure, short and deep on muscle ache.

Additional techniques

Instrumental technique and mechanically assisted:

Multiarticulated tables: often provided with drops, kind of cleat with gentle pressure absorbing manual thrusts, and electric systems for elevtion.

Graston/facial edge: roundish intrument in steel or aluminium allowing friction and cicatrization of adherences consecutive to inflammation (tendinitis, contracture).

Neurostim, Activator or Arthrostim: slow or fast striker of with the speed can be adapted be it a child, a senior or an athlete, that stimulate an articulation in the proper direction; an alternative to manupulations.

Kinésiotaping: application of multicolor stapping in order to correct a mouvement or a muscle, or releave an articulation
(technique developped by a japanese chiropractor that we see more and more on top athletes).

Sacro-Occipital Technique:
technique for the regulation of meningeal tensions (fibrous membranes surrounding the brain and spinal cord, that attaches inside the cranium and the vertebral canal), that focus on balancing tensions of the pelvis and cranium, especially using blocks slipped under the hips.

Physiotherapy: application of heat/cold, massage device or any other non-ionizing instrument.

Therapeutic exercices: postural or fonctional readaptation program for prevention purposes in order to maintain optimal and perennial care.

Emotionnal/Energetic techniques: mind-body techniques based on respiration with gentle mobilisations.

What you can feel after a session:
For some, muscle ache, pain or exacerbated symptoms. Those manifestations are linked to a normal physiological reaction due to neurological and muscle work generaly not excedding two days.
Others, will feel an immediate relief, a feeling of lightness.

Treatment plan
Duration of treatment or numbers of sessions depends of 7 factors:
1-Age of the patient and his health.
2-Age of symptoms
3-Consequences of eventual previous treatments sustained by the patient (surgerie, prothesis)
4- Fonctional or evolutionary nature of the problem
5- Rythm and lifstyle of the patient (quality of sleep, stress, sédentarity)
6- Strict respect of treament plan and advice given (strenghtening exercices, mouvement and posture).
7- Aptitude and experience of the therapist.

Often, the patient presents himself to the chiropractor after weeks or months of suffering. Expect several visits, giving the time to the chiropractor to balance and untie all of the biomechanical patterns acquired during this period of suffering.
We can compare pain with the tip of the iceberg and all the contributing factors to the submeged mass (lifestyle, repetition of mouvements, accidents, etc.)
Each patient is unique, each session will be particular an the therapist will adapt its technique and adjustments in fonction of different blocages that will discover the professional as the treatment plan progress.
The chiropractor will conduct its investigation in order to quickly resolve your problem.