FREQUENTLY ASKED QUESTIONS


Chiropractic

  • What is Chiropractic?
  • The Goal of Chiropractic
  • How Chiropractic Works
  • What Chiropractors Do

What is Chiropractic?

According to The Association of Chiropractic Colleges, “Chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs and surgery. The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health.”

The Goal of Chiropractic

Because chiropractic treatments are primarily applied to the spinal region, many individuals incorrectly assume that chiropractors treat only back and neck ailments. While we do quickly and effectively eliminate back and neck pain, it’s not the only goal. The objective is to restore and optimize human health. In fact, according to a statement from The Association of Chiropractic Colleges, “The purpose of chiropractic is to optimize health.”

How Chiropractic Works

You may be wondering… how can the same chiropractic treatment which effectively treats my back pain also optimize my health? The answer can be found by looking into the relationship between the spine and the nervous system. The nervous system is the master controller of all living cells, tissues and organs; orchestrating and coordinating all cellular functions. The spinal column encases the nervous system (spinal cord and nerve roots) and is responsible for its protection. Because of this intimate relationship, biomechanical and structural problems in the spinal column can irritate parts of the enclosed nervous system.

This irritation can result from inflammatory biochemicals released during tissue injury or may result from direct mechanical pressure. In short, because the body’s innate recuperative powers are affected by and integrated through the nervous system, correcting spinal abnormalities which irritate the nervous system can lead to a number of favorable results in patients suffering from various, seemingly non-spinal health conditions.

What Chiropractors Do


Chiropractors are primarily concerned with locating and treating vertebral subluxations. A vertebral subluxation is a complex of functional and/or structural and/or pathological articular (joint) changes that compromise neural integrity and may influence organ system function and general health. Using a number of unique and highly refined skills, the chiropractor checks the patient’s spine for any misalignments, fixations or other abnormalities (vertebral subluxations). If subluxations or other abnormalities are detected, the chiropractor will correct them. Chiropractors use many specialized techniques to identify and treat these spinal abnormalities and optimize overall health.

Adjustments

The adjustment is a safe, natural, noninvasive procedure used by the chiropractor to restore and improve health. Chiropractic doctors are the only health care professionals trained to deliver the chiropractic adjustment.
  • What Is A Spinal Adjustment?
  • When Should Spinal Adjustments Be Given?
  • What Do Spinal Adjustments Do?
  • The Non-Spinal Adjustment
  • Did You Know…
What Is A Spinal Adjustment?

In basic terms, the spinal adjustment refers to the process in which the doctor of chiropractic skillfully applies controlled force into one or more “subluxated” vertebrae of the spine. The adjustment is also frequently used in the pelvic region to normalize the sacroiliac joints. The adjustment is usually delivered using the hands or through the use of a specialized mechanical tool.

When Should Spinal Adjustments Be Given?

Spinal adjustments are applied to certain vertebrae of the spine which are no longer in their proper position or where functioning has become impaired. Vertebrae which lose their normal position or proper motion are commonly termed vertebral subluxations. The chiropractor uses a number of unique tests and procedures to determine which, if any, vertebrae are subluxated. Subluxations, like cavities, are not always painful during the initial stages, even those who are not experiencing back or neck discomfort should receive periodic spinal checkups.

What Do Spinal Adjustments Do?

Adjusting helps correct vertebral subluxations. Correcting subluxations reduces pain and inflammation, reduces muscle spasm and tension, normalizes spinal biomechanics and more importantly, can remove nerve irritation and interference which can improve overall health and wellness of the individual. Chiropractic adjustments are the only way to eliminate vertebral subluxations and only the chiropractor is trained to detect subluxations and deliver the chiropractic spinal adjustment to correct subluxations.

The Non-Spinal Adjustment

In addition to adjusting the spine and pelvis, almost every other joint of the body can be adjusted by the chiropractor. This includes the joints of the hands and feet, wrists and ankles, elbows and knees, shoulders and hips, ribs and the jaw.

Like the joints of the spine, joints in the extremities can also become misaligned and fixated. Chiropractic adjustive techniques can restore and enhance extremity joint functioning which can increase the life of the joint and keep wear and tear to a minimum. This is of special interest to athletes who generally demand optimal joint performance from highly stressed joints. Adjusting provides an immediate increase in joint range of motion and also supplies the joint with nutrients, as motion is the only way to bring nutrients into the joint cartilage and flush wastes products out.

Did You Know…

Did your mother ever warn you that “cracking” your knuckles would give you arthritis? If she did, we’re sorry to say that she was wrong! Research has actually shown that individuals who habitually “crack” their knuckles over their lifetime actually lower the incidence of arthritis in their knuckles compared with those who do not. Researchers believe the knuckle “cracking” increases joint nutrition and maintains joint motion, both of which are essential for a healthy joint.

Conditions Treated

  • Common Musculoskeletal Conditions Treated
  • Common Injuries Treated
  • Non-Musculoskeletal Conditions Treated
Common Musculoskeletal Conditions Treated

Chiropractic has provided effective relief to millions of individuals suffering from back and neck ailments. Chiropractic has also provided relief from many other musculoskeletal complaints ranging from knee and ankle problems to carpal tunnel syndrome and tennis elbow. In fact, musculoskeletal pain or discomfort in any area of the spine or extremity is a candidate for safe, natural, noninvasive chiropractic care. However, most patients suffering from musculoskeletal complaints can and are successfully treated with chiropractic every single day.

Common musculoskeletal conditions treated:

• Low back pain and stiffness

• Neck and upper back pain and stiffness

• Mid back pain and stiffness

• Headaches and migraines

• Leg pain, weakness, numbness and tingling

• Arm pain, weakness, numbness and tingling

• Extremity joint pain and dysfunction

• Carpal tunnel syndrome

Common Injuries Treated

Chiropractors commonly treat all types of injuries and recognize the unique findings associated with each. For example, it’s important to understand that auto injuries often involve a delayed onset of symptoms which commonly surface weeks and even months post-accident. In work injuries, chiropractors routinely look beyond the actual injury and address such things as work station setup, ergonomically correct equipment, and proper work techniques. For sports injuries, chiropractors often check for biomechanical and muscle imbalances as a routine part of the treatment plan. Treating the whole person and optimizing health is what chiropractic is all about.

Common injuries treated:

• Automobile accident and whiplash injuries

• On-the-job and lifting injuries

• Sports/athletic injuries

• Slip and fall injuries

Non-Musculoskeletal Conditions Treated

In addition to musculoskeletal problems, chiropractic treatments have also been shown to benefit many individuals suffering from “medical” ailments such as chronic ear infections in children, menstrual pain in women, and arthritis in the elderly. Although chiropractic care is not a specific form of treatment for such conditions, research has shown that many “medical” conditions can be caused or aggravated by irritation to spinal nerve roots which share an intimate relationship with the spinal structures. By restoring proper nerve functioning some individuals suffering from these “medical” ailments can obtain partial and in some cases, full relief.

Non-musculoskeletal conditions which studies have shown benefit from chiropractic:

• Asthma

• Attention deficit hyperactivity disorder (ADHD)

• Dizziness and dysequilibrium

• Dysmenorrhea

• Infantile colic

• Low energy levels

• Otitis media (ear infection)

Frequently Asked Questions

  • What’s Wrong With Me?
  • How Long Will It Take?
  • How Much Will It Cost?
  • Do I Have To Keep Coming Back For Treatments?
  • Are Chiropractic Treatments Safe and Do They Hurt?
What’s Wrong With Me?

Accurately identifying the cause of spinal pain or other discomfort almost always requires a thorough consultation and examination. Individuals should not assume their pain stems from the same problem, for example, their neighbor had, and thus what has helped their neighbor will help them. Just as every individual is unique and different from the next, so too are the health conditions they suffer and the treatments they require.

Chiropractic doctors are highly trained in the diagnosis and treatment of soft tissue injuries and abnormalities common to the spine, extremities and rest of body. Rest assured that if you are suffering from back or neck problems, extremity problems or other health related ailments chiropractic can provide you with the effective professional relief you demand. If your condition is out of the chiropractic scope or would be more appropriately managed by another health care specialist, we will gladly and promptly make the necessary referral.

How Long Will It Take?

While treatment lengths vary somewhat from person to person and from condition to condition, there are a few rules of thumb you can follow. First, newer injuries, if treated appropriately and immediately, tend to respond to fewer visits assuming that major tissue injury has not occurred. Conditions that have been present for greater than 3 months and recurring conditions are generally more stubborn and difficult to manage.

For those of you who believe in just waiting for the problem to “go away” on it’s own – understand that the longer your condition has been around, the more treatments it will eventually require to resolve.

How Much Will It Cost?

Costs vary and generally depend on the number of treatments required to effectively treat your condition. A number of studies have shown that chiropractic care is extremely cost effective when compared to other “medical” forms of care for similar conditions. According to the 1993 Manga Report, “There would be highly significant cost savings if more management of low-back pain was transferred from physicians to chiropractors. Users of chiropractic care have substantially lower health care costs, especially inpatient costs, than those who use medical care only.”

Do I Have To Keep Coming Back For Treatments?

You may have heard the notion that once you go to a chiropractor you have to keep going back. Before we answer that question, ask yourself how many times you have visited a dentist? Like most people, you’ve probably gone dozens of times. Why? Quite simply, to prevent your teeth from literally rotting out of your head.

Once we have eliminated your pain and rehabilitated the injured tissues we do recommend that you maintain a schedule of periodic spinal checkups. Like your dentist and like many of the medical experts are now recognizing, prevention is the key to reducing recurrences of existing health conditions and minimizing new injuries in the future.

So the answer is yes, we want you to keep coming back, but just periodically. Periodic chiropractic care minimizes spinal and nerve stresses, reduces recurrences of old injuries, prevents new injuries from developing, minimizes degenerative processes, which enhances overall health and wellness.

Are Chiropractic Treatments Safe and Do They Hurt?

Chiropractic treatments are extremely safe for individuals of all ages – from infants to 100 year olds. Our treatments are safe because we only use natural and noninvasive methods of care. Research consistently shows that care from chiropractors is among the safest care available and is literally light years ahead of traditional medical care in terms of “safeness”.

The treatments themselves are generally not painful. In fact, most patients look forward to their treatments as many experience instantaneous relief immediately afterwards. Individuals who present with moderate to severe pain may experience some minor discomfort for obvious reasons, however, care is always gentle, safe and noninvasive.

Chiropractic Myths

  • You’ll Have To Continue Chiropractic Care For The Rest Of Your Life
  • Chiropractors Only Treat Back Pain
  • Do You Know That Chiropractic Care Is Second To None?
You’ll Have To Continue Chiropractic Care For The Rest Of Your Life

Most doctors of chiropractic promote a preventative type of lifestyle which has been construed by adversaries to mean that chiropractic care requires a lifetime of commitment. Actually, recommending that patients return for periodic spinal care is no different that what dentists recommend to their patients in order to prevent cavities and gum disease. Just as it would be ludicrous to believe that visiting a dentist once per lifetime would ensure permanently healthy teeth and gums it’s equally as silly to think that visiting a chiropractor a few times will ensure a lifelong healthy spine. Our spinal tissues undergo daily bombardment of stresses originating from bad postural habits, suboptimal work environments, psychological stress, and hectic lifestyles just to name a few.

For these reasons, after the resolution of acute problems patients are given the option to receive periodic spinal checkups which acts to minimize the likelihood of future recurrences or development of new problems. The preventative approach in health care has been gaining much recognition as of late and there has been a large push in the medical community and health insurance industry to incorporate preventative programs into mainstream medicine. It’s really that simple. Periodic care to prevent future problems – safe, natural, convenient care now to avoid nasty and complex problems later.

Chiropractors Only Treat Back Pain

Chiropractors provide effective treatment for all types of soft tissue disorders and not just back and neck ailments. This includes conditions of the joints of the extremities like the ankle, knee and shoulder.

What you may not be aware of is chiropractic’s success in treating a number of non-soft tissue conditions like dysmenorrhea (painful menses), ulcers, migraine headaches, and ear infections in children. While we cannot claim to cure these conditions, we believe that many of these problems can be mimicked, aggravated and some times caused by disruptions in the nervous system as a result of spinal abnormalities. By correcting these spinal abnormalities like the vertebral subluxation, chiropractic has helped thousands of individuals overcome these conditions and regain control of their lives.

A number of studies have also supported these findings. In one such study, spinal manipulative therapy was compared with standard medical treatments in the treatment of duodenal ulcers. The researchers Pikalov, MD, and Kharin, MD, found those subjects receiving spinal manipulations took an average of 16 days to heal vs. 26 days to heal in the standard medical treatment group.

Do You Know That Chiropractic Care Is Second To None?

According to a study conducted by Ontario’s Ministry of Health, “…for the management of low- back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government’s health care system.” The same study also found, “…injured workers … diagnosed with low-back pain returned to work much sooner when treated by chiropractors than by physicians.”

According to the British Medical Research Council Study, spinal manipulation performed by chiropractors was found more effective than alternative treatments for low-back pain. According to medical researcher TW Meade, M.D. “…chiropractic is a very effective treatment, more effective than conventional hospital outpatient treatment for low-back pain, particularly in patients who had back pain in the past and who got severe problems”.

1. The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) – University of Ottawa, Canada.
2. Low Back Pain of Mechanical Origin: Randomized Comparison of Chiropractic and Hospital Outpatient Treatment. Meade, TW et al British Medical Journal – 1990;300:1431-1437.

Interesting Facts and Statistics

  • Interesting Facts and Statistics
Interesting Facts and Statistics

The popularity of chiropractic is at an all-time high, 80% of Americans will suffer from back pain at some point in their lives.

Back symptoms are the most common cause of disability for individuals under the age of 45.

20% of all American military medical discharges are due to low back pain.

More than 20 million Americans will seek chiropractic care this year.

Chiropractic has been around for more than 100 years.

Today there are approximately 50,000 chiropractors in the United States; 10,000 in Japan; 5,000 in Canada; 2,500 in Australia; 1,000 in the U.K.; and, 100-500 in each of: Belgium, Denmark, France, Italy, Norway, Sweden, Switzerland, New Zealand, South Africa, The Netherlands.

In the western world 85% of people will be disabled by back pain at some point in their lives. Spine 12(3):264-268.

1992 costs associated with low back pain in the U.S. were estimated to be $60 billion. The Manga Report – 1993.

Nearly 30% of the U.S. population aged 18 and older have used chiropractic. The Gallup Organization – 1991.

WCB studies indicate a 45-55% saving in overall costs when treatments are provided by a chiropractors instead of a medical doctors.

9 out of 10 chiropractic users feel their treatment is effective. The Gallup Organization – 1991.

58% of those using chiropractic considered it an essential part of their heath insurance package. The Gallup Organization – 1991.

“Chiropractic patients were 3 times more satisfied with their care than patients of family practice physicians.” Western Journal of Medicine – 1989.

“Chiropractors are now accepted as a legitimate healing profession by the public and by an increasing number of physicians.” The Manga Report – 1993.

“Chiropractic is a growing component of the health care sector, and it is widely used by the population.”

The College of William and Mary, Williamsburg, Virginia, and Medical College of Virginia, Richmond, Virginia, January 1992.

94% of all spinal manipulations are performed by chiropractors. RAND Corporation.

Stages of Care

The typical patient will encounter 3 stages of care. The first stage focuses on symptomatic relief such as reduction of pain and other discomforts. The following stage addresses tissue healing and function normalization. The final stage consists of periodic spinal care to prevent the formation of new injuries, minimize future flare-ups of old injuries, and prevent degenerative spinal processes from occurring.
  • Relief Care
  • Corrective Care
  • Wellness Care
Relief Care

Relief care is the first stage of care for most patients. The primary goal during this initial stage is to provide the individual with symptomatic relief. Treatments focus on those techniques and therapies which most quickly and effectively reduce pain and other discomforts. This will allow the majority of individuals to continue their activities of daily living. Patients are generally recommended to “take it easy” but are encouraged to stay mobile and functional so long as there is not a risk of further injury or tissue damage. Therapies that reduce inflammation and muscle spasm are also used during this stage when present.

Corrective Care

The second stage of care consists of correcting the problems which caused and contributed to the condition and healing and rehabilitating the injured tissues. Unless these events take place, a favorable outcome is unlikely and future recurrences of the problem are likely. It is extremely important that the patient comply with and follow the instructions given by the doctor during this stage of care. Tissues and structures that are not fully healed and rehabilitated are prone to future problems. Sticking to appointments, complying with home exercises and instructions and following all other recommendations will help insure this occurs. Patients should also be aware that once pain and discomfort have subsided, tissue healing and functional correction is many times still incomplete and will often require additional treatments.

Wellness Care

Once the spinal tissues are healed and spinal biomechanics have normalized the patient will be recommended to continue with periodic spinal checkups. For some this might mean once per year, for others this may mean once per month or more. Chiropractic spinal checkups provide similar benefits to the spine that dental checkups provide to the teeth. Namely, catching minor problems and disturbances before they have the opportunity to cause pain, discomfort and irreversible tissue changes. Just like with cavities and heart attacks, irreversible tissue damage has generally occurred before the symptoms of spinal pain and discomfort become apparent.

Subluxations

  • What Is The Vertebral Subluxation?
  • What Is The Subluxation Complex?
  • What Causes Subluxations?
What Is The Vertebral Subluxation?

The vertebral subluxation is the term applied to a vertebra which has lost its normal position and/or motion in relation to neighboring vertebrae. Vertebrae which do not function properly within the spinal framework generate mechanical stress. This accelerates the wear and tear on the surrounding spinal muscles, ligaments, discs, joint and other spinal tissues. Pain, palpatory tenderness, inflammation, decreased spinal mobility, and muscle spasm and hypertonicity will eventually follow.

Additionally, because of the direct mechanical and physiological relationship between the spinal column and the spinal nerve roots, vertebral subluxations as well as other spinal abnormalities have the potential to impair proper nerve functioning. Once nerve functioning is compromised, communication within the body becomes less effective jeopardizing the overall health and wellness of the individual.

What Is The Subluxation Complex?

Through extensive research and study chiropractors have identified 5 components of the vertebral subluxation. Collectively, these elements are known as the “subluxation complex”.

1. Kinesiopathology – the loss of normal vertebral positioning and motion in relation to neighboring vertebrae.

2. Myopathology – pathological changes occurring in the spinal musculature which includes hypertonicity, spasming, fibrosis, weakness and improper or inappropriate functioning.

3. Neuropathology – irritation or injury to spinal nerve roots through compression, stretch or more commonly chemical irritation from nearby spinal structures.

4. Histopathology – pathological changes which occur to the spinal tissues such as abnormal bony growths off the vertebral bodies and joints, fibrosis and adhesions of spinal muscles and ligaments, as well as dehydration and degeneration of spinal discs.

5. Pathophysiology – the biochemical changes taking place in the spinal region which include inflammatory biochemicals from injured tissues and biochemical waste products.

Each component of the subluxation must be eliminated for proper healing to occur and for the rehabilitation process to be successful. While full understanding of all components is not necessary, you should be aware of the complexity involved. Patients should also be aware that pain is but a small element of most diseases and disorders. Pain is a very poor indicator of your need for further treatment as pain generally subsides well before tissue healing and mechanical normalization has completed.

What Causes Subluxations?

Vertebral subluxations have a great number of different causes all of which the average individual is exposed to daily. These causes can be described in terms of physical, chemical, and emotional causes.

Physical causes include acute trauma to the body, repetitive motions affecting the spine, bad postural habits, improper workstation habits and design, and weak or imbalanced spinal musculature.

Chemical causes include poor dietary and nutritional practices, drug and alcohol use and abuse, and the ingestion of chemical toxins in the foods we eat, air we breath, and water we drink. Chemicals which are harmful to the body decrease the body’s ability to function optimally and reduce the ability to successfully adapt to and withstand internal and external stresses – making us more susceptible to spinal subluxations and the consequences of these subluxations.

Emotional causes refer to stress. Excessive stress or inadequate stress management skills can deplete the body of the ability to sustain normal functions. The impact of emotional stress on physical health is well documented in the medical research and can have devastating effects on the immune system, making the body susceptible to injury and disease.

Chiropractic Treatments

Although chiropractors main method of treatment typically consists of the spinal adjustment (spinal manipulation), chiropractors also employ many adjunctive therapies and applications in order to provide the most effective and efficient relief from neuromusculoskeletal disorders.
  • Primary Therapy
Primary Therapy

The chiropractic spinal adjustment represents the cornerstone of the chiropractic treatment. Spinal adjustments are used successfully to treat a variety of different soft tissue disorders as well as a number of other health problems. Chiropractic doctors are the only health care professionals trained to deliver the chiropractic spinal adjustment.

Spinal adjustments or spinal manipulation is the process of applying a quick but gentle pressure to “subluxated” vertebrae in a corrective manner. Many years of study and practice are necessary to acquire the skills of providing an effective and safe spinal adjustment. Research has shown spinal adjustments to be the most effective treatment in numerous conditions including back pain. This is because spinal adjustments correct many of the structural, biomechanical and neurological abnormalities of the spine which cause or contribute to a high number of back, neck and other non-spinal ailments.

Adjunctive Therapies

  • Soft Tissue & Massage Therapy
  • Therapeutic Exercise
  • Physical Modalities
  • Nutritional Counseling
Soft Tissue & Massage Therapy

There are a number of soft tissue therapy techniques which can be successfully employed to assist in the reduction of pain and muscle hypertonicity and spasm. Some of these include massage therapy, trigger point therapy, somatic therapy, proprioceptive neuromuscular facilitation, acupressure point therapy, and rolfing. The need and benefits of these therapies vary from patient to patient. Depending on your condition and response to treatment we may incorporate one or more of these therapies into your treatment plan.

Therapeutic Exercise

Therapeutic exercises for the neck, back, and extremities are an essential part of the rehabilitative process following injury. Chiropractic doctors commonly prescribe specific strengthening and stabilizing exercises and stretches for their patients with back, neck and extremity problems.

Exercises provide many benefits during the healing and preventative stages. Early on, exercise prevents muscle deterioration and promotes joint health. Later on, exercises increase strength, proprioception and stability to protect from new injuries and recurrences of past problems.

Therapeutic stretching is important to prevent scar tissue and adhesion formation following injury. Stretching is most effective when initiated early on in the treatment plan before scar tissues become permanent. Maintaining a regular stretching program once the rehabilitation stage of treatment has been completed will help keep tissues flexible and loose, increasing mobility and preventing the development of new injuries.

Physical Modalities

There are some physical modalities which in certain cases can provide additional pain relief and accelerated healing. Some of these more common modalities include muscle stimulation, interferential stimulation, therapeutic ultrasound, and diathermy (deep heating modality).

Nutritional Counseling

Dietary and nutritional imbalances are responsible for and contribute to a great number of disorders and illnesses which are prevalent in today’s society. The top killers such as heart disease, stroke, diabetes and cancer have all been linked in numerous ways to diet and nutrition.

Doctors of chiropractic receive thorough training in the areas of human diet and nutrition. We can design a personalized dietary or nutritional program to minimize the risk of developing these killer conditions and to assist your body in achieving and maintaining optimal health and superior wellness.

Good health is much more than the absence of pain or discomfort. Health exists along a very wide scale and where you lie on that scale largely depends on the lifestyle choices you make on a daily basis. Years of many small unhealthy choices can manifest into very serious health problems. Unhealthy choices include habitual poor posture, improper lifting techniques, excessive alcohol consumption, smoking, excessive reliance on medication, excessive soda and coffee consumption, excessive saturated fat consumption, lack of nutritious fruits and vegetables, and excessive mental stress. These slowly chip away at your good health. We can help you sort through and identify those unhealthy decisions and provide you with practical strategies to deal with and effectively manage them.

X-rays

  • Chiropractors Often Utilize X-ray Studies
  • X-rays Are Safe and Provide Valuable Information
Chiropractors Often Utilize X-ray Studies

Based on the nature of your condition as well as a number of other factors, x-ray studies of your spine or injured body part may be indicated. Doctors of chiropractic receive over 300 hours of x- ray studies in college prior to graduating and thus are fully trained to take radiographs and identify subtle abnormalities of the spine as well as more serious pathologies.

X-rays Are Safe and Provide Valuable Information

X-rays are a relatively safe and cost effective way to view the structure and general condition of the spine. They can reveal spinal regions under high stress and expose areas of degenerative change. This can often provide essential additional information which correlates history and examination findings allowing for a more accurate spinal analysis and a more individualized and effective treatment plan. X-rays are also useful in assessing the appropriateness of chiropractic care as they can help to rule out the existence of more serious pathological processes such as spinal fractures, tumors and infections which require immediate emergency medical intervention.

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