Doctors of Chiropractic (DCs) are primary care professionals for spinal health and well-being. The practice of Chiropractic focuses on the relationship between the body’s main structures – the muscles, the skeleton, and the nerves – and the patient’s health. Chiropractors improve and preserve patients’ health and quality of life by making adjustments to these structures, particularly in the spinal column, thereby reducing neural stress and optimizing both healing potential and overall health. Chiropractors do not prescribe drugs or perform surgical procedures, although they do refer patients for these services if they are medically indicated.
Chiropractic has its roots established in ancient China and Greece, where techniques based on manipulation of the body were used to improve health. Even Hippocrates, father of the Hippocratic Oath, wrote of its importance: “Get knowledge of the spine, for this is the requisite for many diseases.”
Chiropractic as it is known today was established as a profession in 1895 by Daniel David Palmer in Davenport, Iowa. Palmer was well read in medical journals of his time and had great knowledge of the developments in anatomy and physiology that were emerging throughout the world. In 1897, he established the Palmer School of Chiropractic, which still continues to be one of the most prominent chiropractic colleges in the world.
Today more than 100,000 chiropractors practice worldwide in more than 85 countries.
Doctors of Chiropractic in the US: More than 70,000
|Examples of Use||Education & Certification||References|
Examples of Use:
Primary Wellness and Prevention
Sometimes mistaken for treatment therapies like physical therapies or acupuncture, chiropractic is essentially preventive in nature. DCs are most concerned about the potential ill effects on the nervous system that may come from spinal misalignment or dysfunction (defined as vertebral subluxation). These misalignments may exist without the appearance of symptoms, but over time they may be the cause of a variety of ailments related to the central nervous system. By correcting subluxations and other misalignments in the body’s main structures –- muscles and skeleton, all controlled by the nervous system — DCs improve and preserve patients’ health. Reducing stress on the nervous system therefore optimizes both healing potential and overall health.
DCs often refer to this preventive and wellness quality of their work as salutogenic, from salutogenesis, which means to “give birth to health” (and so the opposite of pathogensis the development of disease.) DCs are also thoroughly trained to manage disease and chronic ailments, but their primary care goal is to empower patients to lead salutogenic lives. In other words: to pay attention to and actively support their own best health.
Chiropractors focus on the nerve system via the neuromusculoskeletal system. More than 65% of the care provided by chiropractors addresses low-back, mid-back and pelvic pain; or for neck, facial or headache conditions. DCs report that the majority of their patients come to them after suffering injury, or repetitive motion and overuse injuries, or from everyday pains that come with recreation and routine living. Since the wars in the Middle East, chiropractic has seen increased use among returning veterans who are still coping from combat wounding or injury and sustained emotional stress.
As with other integrative disciplines, chiropractic professionals work to strengthen the body’s innate self-healing mechanisms. When the normal function of the nervous system is disrupted through musculoskeletal problems, psycho-emotional consequences can arise and then linger over time, often for years, thus negatively affecting patient perceptions of their own health and hindering normal functions. The chiropractor’s task is locate and correct the sources of such disruption.
Some chiropractic care plans can include specific exercises, ergonomic training, posture support aids, mattress and pillow needs, diet & supplement needs, however these techniques are ancillary to the practice of chiropractic.
Women and Children
Chiropractic care has been proven to be safe and effective for all age groups, including children as young as infancy. Evidence also supports the safety and importance of chiropractic care in correcting pelvic spinal dysfunction during pregnancy. Chiropractic care for the pediatric patient has been shown to be gentle, safe and effective.
Chiropractic care includes a variety of techniques, including “High velocity, low amplitude” (HVLA) that may be contraindicated for patients who are also dealing with existing fractures, dislocations, tumors, infections, or other conditions that weaken or soften bone in the area where the HVLA procedure is applied. In these cases, the Chiropractor can employ low-force treatment options.
Here is a good summary source for contraindications:
World Health Organization: Guidelines on basic training and safety in chiropractic
Education, Training and Certification
Currently, chiropractic candidates are not required to have a bachelor’s degree before entering chiropractic school. However, a minimum of 90 semester hours of undergraduate coursework is required for acceptance into a chiropractic program.
The chiropractic course is typically a total of four years, but some programs vary in length. The focus of the classroom coursework, like many other health careers, entails courses in the sciences such as anatomy, physiology, biology, biochemistry, and pathology. In addition to classroom requirements, lab and clinical training are required components of the chiropractic education. Sixteen accredited chiropractic programs are in operation across the US. The typical chiropractic curriculum exceeds medical curricula in hours spent in anatomy, nutrition, spinal biomechanics and technique.
The following chart breaks out the hourly requirements in each subject area:
Emergency management: 25
Obstetrics & Gynecology: 66
Environmental Health: 25
Substance abuse/toxicology: 45
Functional restoration: 22
Spinal analysis, biomechanics: 250
Practice competency: 250
Practice/Business Mgmnt: 250
Advanced Clinical: 65
Clinical Practice: 1200
Emergency management: 25
Licensure is required on a national level and is obtained by passing a four-part test by the National Board of Chiropractic Examiners (NBCE). As with most health careers, continuing medical education (CME) is required to keep licensure current. Some state boards require additional testing, but most recognize the national test.
Chiropractic care is a covered service by most health insurance programs, including Medicare and Medicaid. Along with all state-licensed health care practitioners, chiropractors enjoy freedom from discrimination under Section 2706 of the Affordable Care Act.
References for Chiropractic
International Chiropractors Association – A global professional organization, ICA maintains and promotes chiropractic’s unique identity as a non-therapeutic, drugless and surgical-free health science, based on its fundamental principles and philosophy.
International Chiropractic Pediatric Association — organized for chiropractic professionals, ICPA provides education, training and research relating to chiropractic care in pregnancy and throughout childhood and includes information for parents and families.
Chirobase — a listing of national and international professional chiropractic associations, initiatives and collaborations.
Certification and Regulatory
Schools of Chiropractic and Careers
Association of Chiropractic Colleges — ACC advances chiropractic education, research and healthcare services. Its members are the accredited chiropractic educational programs in North America, plus affiliate member institutions worldwide.
General reference: Careers in Chiropractic
Practice Analysis of Chiropractic 2010 — a report that summarizes the practice of chiropractic in the United States based on the responses of approximately 2,400 full-time chiropractors from all 50 states and the District of Columbia. The report includes a summary of chiropractic research from around the world and data from previous surveys conducted in 1991, 1998, and 2003.
The Index to Chiropractic Literature is a resource for individuals seeking specific research papers.
At the International Chiropractic Pediatric Association:
The Journal of Pediatric, Maternal & Family Health, Chiropractic
At the National Center for Complementary and Alternative Medicine (NCCAM)
Introduction to Chiropractic: Practice and Research