Chiropractic care is a fantastic remedy for many aches, pains, and conditions. It's an effective, multipurpose therapy for integrative medicine doctors that can be implemented without surgery or drugs, and a doctor can suggest it as a primary or complementary therapy for a patient. Unfortunately, many myths about chiropractic care still circulate, which may cause hesitation about trying it as a therapy. At Temecula Center for Integrative Medicine (TCIM), we provide and educate people about health strategies that work without needing medication or surgery, and chiropractic care is one of our favorites because it is versatile, effective, and inexpensive.
What is Chiropractic Care?
A chiropractor is a trained professional who works with a patient's spine, connective tissues, tendons, muscles, joints, and other body parts in multiple ways for therapeutic purposes. Chiropractic care is a general term for all the therapies and health strategies in which these doctors are trained. Chiropractors may perform a physical manipulation of the spine called an "adjustment," manipulate or put therapeutic pressure on connective tissue, or assist a stretch of specific muscles. Chiropractic adjustments aim to align the body's musculoskeletal structure, particularly the spine, to enable the body to heal itself without surgery or medication.
Chiropractors may employ a variety of strategies. Sometimes, a patient will be taught exercises to bring the spine and tissues of the body back to a healthy state. Nutritional strategies may be taught with the aim of changing certain body parts, for example, eating foods or taking nutrients that increase joint mobility. Equipped with devices that massage or activate nerves and muscles, special exercise machines, and body tape that supports holding a particular position, chiropractors are trained in various therapies, techniques, and devices to help a patient.
Benefits of Chiropractic Care
Many people seek the care of a chiropractor, especially after car accidents (due to whiplash) or bodily injuries. Those suffering from headaches, arthritis, sciatica, pain, or joint malfunctions also quickly find their way to a chiropractor for relief. Because chiropractic therapy benefits the system as a whole, it can be a primary or complementary (secondary) therapy for many different conditions! Chiropractic care provides many benefits (1).
Balancing the nervous system's activity improves the system as a whole (2). Specifically, the impact of spinal adjustments includes stimulating the nervous system to release various chemicals and hormones that regulate blood pressure and flow, calm the brain, and reduce inflammation (2). Because chiropractic care can help the whole body through the nervous system, many conditions and symptoms can be improved directly and indirectly, such as (1-3):
Stiff or aching muscles, inflexibility
Pain, especially neck, muscular, and lower back
Headaches
Migraines
Resolve injuries to the spine or neck, such as whiplash
Modify and correct posture
Increase the range of motion of joints or the spine
Issues with joints (malfunctioning joint, pain)
Arthritis
Sciatica (pain in the sciatic nerve that splits near the lower spine and goes down each leg)
Fibromyalgia (characterized by musculoskeletal pain)
Low white blood cell count (stressed or weakened immune system)
Balance the autonomic nervous system (help those stuck in "fight or flight" mode
Increase general well-being (positively affects the whole system)
Updated Information about Chiropractic Care
Like many fields of health, chiropractic techniques, devices, and applications have grown and improved over the years. Here, we explore some common misconceptions of chiropractic care and give a status update with current information.
Misconception #1: Chiropractic care is only for back pain from an injury.
Status Update: As mentioned above, chiropractic care can benefit overall health and well-being and address many specific conditions, as well as some diseases, mental health, and mood.
Misconception #2: Chiropractors are not "real doctors."
Status Update: Chiropractic therapy is a regulated healthcare practice in the United States. In California, chiropractors must take four years of classes at a board-approved college (after a minimum of two years of pre-chiropractic study) and pass stringent tests to get a Doctor of Chiropractic (DC) degree.
The National Board of Chiropractic Examiners administers a series of tests (at the national level) that must be passed to receive state licensure (4). These tests ensure that all who pass them have mastered a particular set of subject knowledge and skills, including anatomy, physiology, pathology, microbiology, diagnosing (general, neuromusculoskeletal, imaging, imaging interpretation), physiotherapy (mobility, function), and principles, practices, and clinical studies in chiropractic (5-10).
A practical exam is the last exam, which allows the practitioner to be observed as they interview, examine, diagnose, and treat a patient. The practitioner is also asked to perform specific techniques so they may be evaluated. Finally, like many health professionals, DCs must take classes (continuing education) to keep their licensure after passing their classes and boards. Continuing education ensures their knowledge is updated with information from new studies, devices, and techniques.
Misconception #3: Chiropractors only manipulate the spine (do spinal adjustments).
Status Update: Although Chiropractors incorporate spinal manipulation, they also treat many conditions that affect the nervous system and musculoskeletal system and are taught to evaluate injuries or symptoms and respond by selecting the appropriate treatment or combination of treatments to address the situation in the spine and soft tissues (1):
Spinal adjustments: These are compressions performed on the spine that change the relative positions of the vertebra.
Cox® Technic: This technique is a gentle, non-force technique for adjusting the spine, which is less risky to perform in cases of a herniated disc or spinal stenosis (the narrowing of bone tissue or the arrangement of ligaments and discs that causes pressure on nerves or the spinal cord) (11).
Myofascial release (trigger point therapy): This therapy consists of manipulating or applying pressure to connective tissue that triggers the relaxation of connective tissue tension (12).
TENS therapy: Using transcutaneous electrical nerve stimulation (TENS) devices allows the delivery of a very low dose of electrical current, which disrupts pain signals (13).
Nutritional therapy: DCs often suggest certain nutrients, such as collagen or omega-3 fatty acids, to help strengthen tendons and joints or reduce inflammation.
Exercise or stretching therapy: DCs may suggest stretching or exercises (2) that can strengthen weak muscles, ease joint or spine pain, increase circulation, or improve range of motion.
At TCIM, you also have the benefit of working with our entire team of practitioners as needed.
Misconception #4: Science doesn’t support chiropractic care.
Status Update: Many studies verify the positive effects of spinal manipulation. A search in the National Library of Medicine (PubMed) shows over 5,000 studies and reviews when searching for the term "chiropractic manipulation." Studies have shown that patients receiving chiropractic care for back pain used fewer opioids (a type of pain medication) (14), had pain-relieving benefits similar to non-steroidal anti-inflammatory medications (such as ibuprofen) (14), and showed better endurance and strength (15).
Misconception #5: Chiropractic care is expensive.
Status Update: Chiropractic care is usually less expensive than medical management for alleviating spinal pain, particularly if the chiropractor (DC) was used early in the history of treatment. Creating a study that matches apples to apples is difficult because people get different chiropractic therapies depending on their needs. In 2015, a review of medical literature determined that "costs were generally lower among patients whose spine pain was managed with chiropractic care” (16). More recently, a 2024 study attempted this evaluation again (using studies already performed and published), asking the question, "Is chiropractic management of spine-related musculoskeletal pain in US adults associated with lower overall healthcare costs as compared to medical care” (17)? The researchers summarized the costs of chiropractic care versus other types of care (surgery, medication, others) and found (17):
Studies in the years 2009 to 2024 show that chiropractic care had lower costs and less frequent need for additional services.
When chiropractic care was not used first or very early in the history of treatment, more costs were incurred over time due to the repeated need for additional services.
Regarding additional costs, diagnostic imaging, opioid utilization, surgery, hospitalizations, injection procedures, specialist visits, and emergency department visits were all reduced when chiropractors were involved early in the case history.
Can I Adjust Myself?
Unfortunately, it is almost impossible to make correct spinal adjustments on oneself. It takes precise pressure in specific places from an outside force to achieve a realignment of the spine. Twisting the spine (as in some yoga poses) can result in some popping and cracking of the spine, but that is not the same as a spinal adjustment from a trained professional. Also, if a joint has weakened muscles or ligaments, more injury could occur by attempting to manipulate that area, so clinical assessment is highly suggested to prevent additional injury.
Who Is Not a Good Candidate for Chiropractic Care?
Since chiropractic care usually affects the spine, which is the highway for nerve signals going to and from the brain, it must be treated with a high degree of knowledge, skill, and care. Because chiropractic care involves moving and pressing of body parts, including the spine, some people are not good candidates for spinal adjustments, although other therapies are often still beneficial. Some examples are people with (18):
Extreme cases of osteoporosis - the bones may be fragile and not able to withstand pressure
Symptoms of nerve damage in the arms or legs (areas of the body that feel numb, tingle, or lack strength)
Spinal cancer - manipulating the spine may present risks of dislodging tumors or damaging bones
High risk of stroke - spinal adjustments can increase risks of a certain kind of very rare stroke, so if one already has a high risk for strokes, this may not be the best therapy
Certain bone deformation of the upper neck - a chiropractor can determine if someone has this attribute that would be a contraindication for spinal compressions near the neck
Are There Ever Complications From Chiropractic Care?
Chiropractic care has some rare but severe complications, so effort must be made to reduce risks (listed below). The rare but serious negative repercussions could be (18):
Disk herniation - the case where the spongy cushion between the spinal vertebra either comes apart or slips out of place.
Nerve compression - the case where the nerves entering and leaving the spine get squeezed, disrupting the flow of communication between the brain and a body part
Vertebrobasilar stroke - a scarce type of stroke that happens as a result of a vertebral artery dissection, which is a particular type of trauma to a specific artery (19)
Reducing Risks
Even though it is rare to have a severe negative result from chiropractic care, taking certain precautions can lower the risks even further. What actions can be taken to reduce risks?
1. Choose a licensed chiropractor who works in a medical setting.
2. Using a non-force chiropractic technique such as the Cox® Technic can reduce the odds of damaging disks, tissues, circulation, and nerves.
3. Report all symptoms to the chiropractor, even if they don't seem related. A knowledgeable practitioner can spot subtle signs that may increase a patient's risk of a negative outcome.
4. Provide a complete medical history, even if a health condition does not seem related. The chiropractor may understand an underlying connection that is not commonly known.
How Chiropractic Care Works at TCIM
TCIM uses an integrative medicine approach to chiropractic care. Both a medical doctor and a chiropractor (Dr. Hazen) will meet with you for about 10 minutes to perform a first-pass assessment. This initial assessment ensures that the specifics of your treatment are customized from the full range of TCIM resources. The presence of the MD signals to the insurance company that you have a reason to be evaluated and treated by a chiropractor, and evaluation can be accomplished in one visit rather than two. Having two medical professionals assess your situation is done to choose the best treatment plan for your health from the very beginning. Chiropractic care may be suggested to complement another therapy or as the primary therapy, depending on the circumstances. There may be a need for X-rays and other types of imaging before proceeding with a therapeutic round of chiropractic care. After assessment, some patients may immediately be referred to a different specialist or told that chiropractic care is unnecessary!
When chiropractic care is necessary and appropriate for patients, they tend to improve quickly and thrive under our care. They may need to return occasionally to maintain optimal health. However, some rare individuals may require different assistance. If that's the case, one of the doctors will refer the patient to another specialist. We want what is best for our patients - even if it means we will no longer be treating them!
Summary
We hope you will never need chiropractic care, but if you do, we hope you choose TCIM. We are constantly amazed by the positive results of chiropractic care and are pleased to offer this powerful and effective tool for health care. Our integrative assessment by two medical professionals can lead you to a quick recovery, saving you time, money, and unnecessary treatments. TCIM is always ready to partner with you to help you achieve your best health!
Dr. Lee Hazen graduated Cum Laude from Cleveland Chiropractic College of Los Angeles in 1989. After a short post-ceptorship in Burbank, Ca, he was invited to become a resident in Dr. James Cox's clinic.
From 1989 until 1998 he was co-director and resident in Ft. Wayne Indiana with Dr. Cox. While there, he attended and completed a 400 hour post-graduate Chiropractic Orthopedics training sponsored by National University of Health Sciences. Dr. Hazen has been serving the Murrieta-Temecula area for 15 years.
951-383-4333
Sources
1. Professional CCM. Chiropractic adjustment [Internet]. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/treatments/21033-chiropractic-adjustment
2. Kiani AK, Maltese PE, Dautaj A, Paolacci S, Kurti D, Picotti PM, Bertelli M. Neurobiological basis of chiropractic manipulative treatment of the spine in the care of major depression. Acta Bio-medica : Atenei Parmensis [Internet]. 2020 Nov 9;91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023121/
3. Surprise: Chiropractors can treat these 5 conditions [Internet]. [cited 2024 Jun 28]. Available from: https://health.usnews.com/health-news/patient-advice/articles/2015/11/30/surprise-chiropractors-can-treat-these-5-conditions
4. Chiropractic: in depth [Internet]. NCCIH. Available from: https://www.nccih.nih.gov/health/chiropractic-in-depth
5. National Board of Chiropractic Examiners. Links to NBCE exams - National Board of Chiropractic Examiners [Internet]. National Board of Chiropractic Examiners. 2024. Available from: https://www.nbce.org/links-to-nbce-exams/
6. National Board of Chiropractic Examiners. NBCE Part I Exam - National Board of Chiropractic Examiners [Internet]. MyNBCE. 2024. Available from: https://www.mynbce.org/part-i/
7. National Board of Chiropractic Examiners. NBCE Part II Exam - National Board of Chiropractic Examiners [Internet]. MyNBCE. 2024. Available from: https://www.mynbce.org/part-ii/
8. National Board of Chiropractic Examiners. Part III - MyNBCE [Internet]. MyNBCE. 2024. Available from: https://www.mynbce.org/pt-iii/
9. National Board of Chiropractic Examiners. Physiotherapy (PHT) exam - National Board of Chiropractic Examiners [Internet]. MyNBCE. 2024. Available from: https://www.mynbce.org/physiotherapy/
10. National Board of Chiropractic Examiners. Part IV Exam - MyNBCE [Internet]. MyNBCE. 2023. Available from: https://www.mynbce.org/part-iv-2/
11. 11. Abs C. Spinal and back pain Relief Chiropractic | Cox Technic [Internet]. Cox Technic. Available from: https://www.coxtechnic.com/
12. Professional CCM. Myofascial release therapy [Internet]. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/treatments/24011-myofascial-release-therapy
13. Professional CCM. Transcutaneous electrical nerve stimulation (TENS) [Internet]. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/treatments/15840-transcutaneous-electrical-nerve-stimulation-tens
14. Corcoran KL, Bastian LA, Gunderson CG, Steffens C, Brackett A, Lisi AJ. Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis. Pain Medicine [Internet]. 2019 Sep 27; Available from: https://academic.oup.com/painmedicine/article/21/2/e139/5575223?login=true
15. Vining R, Long CR, Minkalis A, Gudavalli MR, Xia T, Walter J, Coulter I, Goertz CM. Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial. The Journal of Alternative and Complementary Medicine/Journal of Alternative and Complementary Medicine [Internet]. 2020 Jul 1;26(7):592–601. Available from: https://pubmed.ncbi.nlm.nih.gov/32543211/
16. Dagenais S, Brady O, Haldeman S, Manga P. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC Health Services Research [Internet]. 2015 Jun 1;15(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615617/
17. Organization CR. Cost of Chiropractic Versus Medical Management of Adults ith Spine-Related Musculoskeletal Pain: A Systematic Review [Internet]. 2005 Chiropractic Resource Organization. Available from: https://chiro.org/Cost_Effectiveness/Cost_of_Chiropractic_Versus_Medical.shtml
18. Chiropractic adjustment - Mayo Clinic [Internet]. 2022. Available from: https://www.mayoclinic.org/tests-procedures/chiropractic-adjustment/about/pac-20393513
19. Ahn SH, Kim H, Kim DK, Kim SW. Vertebral artery dissection following anterior cervical decompression and artificial disc replacement. Diagnostics [Internet]. 2023 Feb 6;13(4):595. Available from: https://ncbi.nlm.nih.gov/pmc/articles/PMC9955507/