Chiropractic is a safe, nonsurgical, and drug-free approach to health care. Chiropractors use hands-on manipulation of the musculoskeletal system to enhance the body's healing abilities and prevent disease. They focus on the relationship between the brain, spine, and the nervous system, together called the central nervous system. The musculoskeletal system and the central nervous system are interrelated, and problems in one area can cause dysfunction in the other. Communication between the brain, spine, and nervous system is essential for health, and interference in this communication is believed to cause health problems and their resulting symptoms. The goal of chiropractic is to adjust the body and spine to remove interferences and bring the spine and central nervous system into alignment. This allows the body to heal and sustain health.
Philosophy
"I am truly blessed and couldn’t imagine doing anything else. I get to work with people and the product we sell is life and health. There are no gimmicks or gadgets, and what we are selling is life from within."
-Ann Bleuball, D.C.
Chiropractic was founded in 1895 by Dr. Daniel Palmer. Through his extensive study in anatomy and physiology, he proposed that there was an interrelationship between the musculoskeletal system and the central nervous system and that each relied on the other for health. Chiropractic philosophy holds that health depends on the normal functioning of the central nervous system-it is seen as the life force of the body. According to Palmer, every disease is at least partially affected by the nervous system's ability to flow freely, reach, and energize that area. Injury to the spinal nerves can result in problems in organs or tissues that are connected to those nerves. Injuries, misalignment, pressure, or compressions on the spinal nerve are called subluxations. Subluxations cut off nerve flow and affect bodily functions and cause symptoms. Chiropractors work to eliminate interference between the central nervous system and body joints and organs. By increasing freedom and flexibility in the spine, nerve flow is reestablished and symptoms can be improved or alleviated.
Chiropractors use a holistic, vitalistic philosophy that looks at the whole person in terms of life and health, rather than focusing on disease. They believe in the body's innate intelligence to heal and work to facilitate this intelligence, rather than treat disease directly. They recognize that a problem or symptom in one area of the body may be coming from another area of the body. Thus, chiropractors don't focus on a specific symptom of illness, but look at the underlying causes. Chiropractors also look at the whole person-body, mind, and spirit-to understand a patient's health. They acknowledge that physical, emotional, psychological, and social traumas or stressors can cause health problems, and they emphasize the use of natural, nondrug, nonsurgical alternatives to health care. Any illness can benefit from chiropractic care.
Types of Clients and Problems
"This is confusing to consumers, who wonder why we are treating neck pain, ear infections, and asthma. What we really look at is the central nervous system which is the brain and spinal cord." - Ann Bleuball, D.C.
The greatest strength of chiropractic is in the treatment of low back pain, which has been supported by numerous research studies. Chiropractors are also well known for treating neuromuscular problems; head, neck, and arm problems; migraines; and knee, wrist, ankle, and other joint problems. Chiropractors do not prescribe medication, perform major surgery, or treat fractures or emergency trauma conditions.
Most people think chiropractors only treat neck and back pain, but they actually treat a wide array of health problems. Chiropractic treatment focuses on neuromusculoskeletal conditions and problems in the central nervous system. Problems in this system can result in a variety of health problems that may or may not appear to have to do with the spine. Chiropractors don't just treat back problems but problems that are the result of injury, pressure, or misalignment of the spine. Since they work to treat the underlying causes of problems, they see patients with a wide variety of symptoms caused from central nervous system dysfunction.
Chiropractors can treat anything because they work from the inside out by looking at the central nervous system for the cause of problems. When assessing a patient, if they don't find any dysfunction in the central nervous system, they may decide that the patient is not appropriate for chiropractic care. A patient may not have a misalignment of the spine even if he or she has neck pain. In these cases, chiropractors may provide counseling and make referrals.
Chiropractors work with all types of people, from infants to the elderly. The length of treatment varies from patient to patient, although treatment usually involves a series of visits. Some patients can be helped in one or two sessions, while others need a series of visits.
Chiropractors use many standard methods of diagnosing problems. They take x-rays, order blood work and laboratory tests, and conduct physical, neurological, and orthopedic exams. Their physical exams are similar to exams of traditional doctors. The initial visit plays an important role in diagnosing problems. Chiropractors take a detailed health history and description of symptoms. They also ask questions to assess other physical, emotional, and lifestyle factors that may influence health. In addition they complete an analysis of a patient's posture and spine.
The technique unique to chiropractic care is the use of chiropractic adjustments. Chiropractic is derived from Greek words meaning "done by hand." A chiropractic adjustment is the manually applying of directed and controlled pressure to the spine and joints. Some adjustments are light reflex adjustments; others are deep concentrated adjustments to the spinal column. The goal of an adjustment is to remove subluxations; restore normal joint, nerve, and spine function; and increase mobility. Adjustments are not painful if done correctly.
In addition, chiropractors use supportive therapies to enhance the healing process and the benefits of chiropractic adjustments. Such additional techniques include: hot/cold compresses, hydrotherapy (use of hot/cold water), infrared and ultraviolet light, cranial manipulation, ultrasound, baths, electrical stimulation, traction, and heat therapy. Most chiropractors use various forms of massage therapy. These additional methods enhance the connection between the body's nerves and its organs and tissues. Other supportive measures include the use of heel or sole lifts, braces, straps, tapes, rehabilitative exercises, and physical therapy.
Chiropractors also provide general counseling to patients. They listen to their concerns and offer counseling on nutrition/dietary changes, sleep habits, personal hygiene, posture, work, and stress management. They support their patients in making changes to healthier lifestyles. They may suggest nutritional supplements, specific dietary regimens, or other activities that would enhance the body's natural ability to heal.
There are variations within the field of chiropractic. Most chiropractors are generalists who incorporate multiple healing methods into their care. This includes chiropractors who include nutrition, homeopathy, massage, or other healing methods in addition to chiropractic adjustments. A second, smaller group of chiropractors do not use outside healing modalities and limit their care to chiropractic adjustments and spinal subluxations. These chiropractors refer to themselves as "straight" chiropractors. Finally, some chiropractors develop a specialty limiting their practice to specific health problems, and others work closely with allopathic physicians.
The primary employment setting for chiropractors is individual or group private practice. Group practices are typically with other chiropractors, but some include other health practitioners. Chiropractors also have the option to do research, write, work at hospitals, or teach at colleges of chiropractic. Once licensed, chiropractors have the option to work in the capacity they desire.
As entrepreneurs, chiropractors have the flexibility to design their own work environment. They work in professional, comfortable settings and have the freedom to set their own hours. To meet the needs of patients, some choose to work evenings or weekends, but they typically work the traditional schedule of weekdays. A typical chiropractor in private practice works thirty-seven hours a week. Chiropractors also set their own goals for their practice. They decide their fee scales, finances, and how many patients to see each week.
Like any self-employed professional, chiropractors have the responsibility for running a business. In addition to seeing patients, chiropractors are responsible for marketing and advertising, billing patients and insurance companies, keeping records, and managing the office. Most chiropractors have office employees working for them and are responsible for supervising their staffs as well.
The Profession
There are approximately 45,000 chiropractors in the United States. It is the second largest of the three primary health care providers in the nation-medicine, chiropractic, and osteopathy. Of the holistic health care providers, chiropractic is the largest profession. Chiropractors are found everywhere in the United States, from small towns to major cities, with all fifty states, the District of Columbia, Puerto Rico, and the Virgin Islands recognizing and regulating chiropractic. Chiropractic is also well known and respected throughout the world. It is available in sixty-two countries, and there are schools of chiropractic in Australia, New Zealand, South Africa, Great Britain, Denmark, and Japan. It is one of the most accepted holistic health care professions by the traditional medical system. Chiropractic care is available through Medicare and Medicaid and is covered by almost all insurance companies.
Training and Qualifications
There are currently sixteen accredited schools of chiropractic in the United States. Students must have completed a minimum of two years or sixty semester hours toward a bachelor's degree in arts and sciences to be eligible for admission. Some states require a bachelor's degree for licensure (Florida, Maryland, North Carolina, Rhode Island, and Wisconsin), and some schools require it for admission. Students must have no lower than a "C" grade in laboratory courses in biology, inorganic chemistry, organic chemistry, and physics. In addition to the science courses, students must have taken courses in English, psychology, and social sciences. Students from all majors are eligible to apply if prerequisites are met.
The degree earned after completing chiropractic school is a doctor of chiropractic (D.C.). Most schools take four years to complete. During the first two years students take basic science courses such as anatomy, physiology, neuro-anatomy, pathology, biochemistry, nutrition, radiology, geriatrics, gynecology, and pediatrics. They also take courses on chiropractic philosophy and principles. In the second year of training students begin to learn palpitation and adjustment techniques.
In the third and fourth year students gain clinical skills by working under the direct supervision of a chiropractor and learn to examine, diagnose, and adjust patients. Students gain practical training by working in college clinics or with selected chiropractors in private practice. In the final year students receive training on business management and learn to set up practices, manage finances, and use advertising techniques.
Some chiropractors decide to specialize in certain areas of interest after receiving their degree. The American Chiropractic Association offers postgraduate certification programs leading to a diplomat status in areas such as orthopedics, nutrition, sports injuries, internal disorders, and radiology.
To be successful both in school and as a practicing chiropractor, students need strong manual skills, hand dexterity, the ability to work independently, attention to detail, time management skills, and the ability to handle a high level of responsibility. They must have a deep interest in helping sick people. And as with all helping professions, empathy, understanding, patience, tact, adaptability, and emotional maturity are qualities needed to successfully work with patients.
Upon graduation from chiropractic school, chiropractors must pass national boards to obtain licensure. Most states recognize the exam administered by the National Board of Chiropractic Examiners, but some states require passing additional state exams. Requirements vary from state to state. Many states have reciprocal agreements, so once licensed it is easier for chiropractors to move from state to state. In addition, most states require continuing education to maintain licensure.
Job Outlook and Salary
Chiropractic is a growing field with excellent opportunities for new professionals. With new attitudes toward preventive health care and the high cost of medical treatments, both individuals and insurance companies are turning to chiropractic. Ten to fifteen percent of the population now uses chiropractic, and virtually all health insurance companies cover the cost of chiropractic care. The growth of this field can be attributed to recent scientific research supporting the benefits of chiropractic care, patient testimonials, a growing public awareness of health care issues, and the demand by the public for medical alternatives.
According to a 1994 survey in Jobs Rated Almanac, established chiropractors earn an average of $87,781 a year. As with any new business it takes time to build up a practice, so new graduates earn much less at first, but they have the potential to quickly increase their salaries. Earnings can be influenced by the qualifications of the chiropractor, patient satisfaction, the number of years in practice, and geographic location.
