Chiropractic and Functional Rehabilitation
Sutter Center for Integrative Holistic Health
Chiropractic, which loosely means "to treat by hand," is a type of manipulative therapy that has been practiced in the U.S. for over 100 years. This discipline is based on the premise that function of the joints and muscles around the spine can have a profound effect upon health. Through a complex relationship with the nervous system, problems with vertebral (spinal) joints can result in local neck and back pain and even cause pain to be felt in the head, arms, and legs ("referred" pain). Chiropractors identify these problems in specific joints as chiropractic "subluxations" or "joint dysfunctions. Chiropractic manipulation or adjustments seek to restore normal function to the spine and other joints. Typically, this entails the chiropractor applying a specific, highly-controlled treatment directly to a joint or muscle with his or her hands. When successful, this often reduces or eliminates both local and referred pain, allows muscle spasms to relax, and is thought to remove irritation from the nervous system, which may result in other health benefits.
Chiropractors (referred to as chiropractic physicians in some areas) serve as portals of entry into the healthcare system. This means that a patient may choose to see a chiropractor before seeing any other practitioner. 6 Consequently, chiropractors are trained to perform the same standard orthopedic, neurologic, and physical examination procedures as those performed in traditional allopathic medicine. This enables them to screen their patients for fractures, cancers, and other serious diseases requiring medical treatment.
In addition, chiropractors do a further evaluation of the motion and positioning of spinal and extremity joints, the functions of muscles, and an overall evaluation of posture and movement. Chiropractors usually identify subluxations by carefully evaluating a number of factors. This approach may include assessing points of tenderness, subtle movements of individual joints, the amount of joint "springiness" in response to gentle pressure, altered muscle tone (such as a spasm), and any asymmetry in the feel of the bone or other tissue beneath their fingertips.
Most chiropractors share a philosophy that medications and surgery should be saved as treatments of last resort for many conditions. Chiropractic care also has a history of blending nutritional and other alternative therapies with a natural approach to promoting health through lifestyle modification and exercise. Many modern chiropractors receive additional training in physical rehabilitation and specific exercise therapy that can be useful when treating patients with whiplash injuries, shoulder or knee injuries, or stubborn low back pain. Others make nutritional analysis, botanical therapy, and in some states even acupuncture a significant part of their practices. Other treatment options that chiropractors may employ include traction, supports and braces, and electrotherapies, such as ultrasound, muscle stimulation, and TENS (transcutaneous electrical nerve stimulation).