Frequent Asked Questions and Scientific Evidence
How can chiropractic treatment benefit you?
-Help you to reduce and manage back pain, neck pain, joint pain and headaches
-Help you to return to normal activities and sports
-Avoid recurrence through patient empowerment
-Promote good health and wellbeing
What should I expect in the first visit with the Chiropractor?
The consultation can take up to an hour. Please, read more...
Chiropractors are concerned with the framework of bones and muscles that support the body (‘the musculoskeletal system’). Some problems of the musculoskeletal system can be caused by accidents, stress, lack of exercise, poor posture, illness and every day wear and tear. These problems may cause pressure on the nerves in the body.
Depending on your condition, the chiropractor may manipulate parts of your spine or joints and give you advice on exercise, self-help, diet and lifestyle. Some chiropractors also offer rehabilitation programmes. Manipulation involves precisely handling or moving joints, or parts of the spine, sometimes moving them further than they would normally move. (Extract from the pamphlet ‘What can I expect when I see a chiropractor?’ published by the General Chiropractic Council). Please, read more...
Increasingly, GP’s are recognising chiropractic as an effective complementary treatment, particularly for back pain. You do not need a GP’s referral to visit a chiropractor.
Some GP’s purchase chiropractic treatment for their patients on the NHS. Many health insurance companies will now pay for chiropractic treatment. Claudio Merkier is registered with most private medical insurances including AXA and BUPA.
These are common, general terms used to describe a multitude of conditions. Our chiropractor will make a more specific diagnosis and explain your condition to you.
Chiropractic treatment is usually painless unless an area is inflamed, in which case treatment will be modified. You may experience some temporary reaction to treatment, such a slight increase in discomfort, or tiredness for a day or so.
This will depend on your particular condition, how severe it is, how long you have the condition, your response to treatment and how much of your chiropractor’s advice you follow.
Chiropractic is remarkably safe when treatment is carried out by a properly qualified practitioner. Your chiropractor is trained to recognise conditions which require referral elsewhere, and can treat you even after surgery.
There is a range of evidence demonstrating that chiropractic care is effective for low back pain, neck pain and other conditions. Summaries of some of the most significant evidence, with detailed documents and articles can be found in the following links:
Clinical and cost-effectiveness of manual therapy for the management of a variety of musculoskeletal and non-musculoskeletal conditions: a systematic review and narrative synthesis (2013)
The Effectiveness of manual therapies: the UK evidence report (2010)
26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions (Back pain, neck pain or joint pain), four types of chronic headache and nine non-musculoskeletal conditions. They identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.
Early Management of persistent Low Back Pain: NHS National Institute for Health and Clinical Excellence: CG88 (2009)
They concluded to consider to a course of manual therapy, including spinal manipulation, comprising up to a maximum of nine sessions over a period of up to 12 weeks for patients suffering for persistent low back pain.
European Commission Research Directorate General (2004) European Guidelines for the management of acute non-specific low back pain in primary care
They recommended to give adequate information and reassure to the patient, to not prescribe bed rest as a treatment, to advise patients to stay active and continue normal daily activities including work if possible, to prescribe medication, if necessary for pain relief; preferably to be taken at regular intervals; first choice paracetamol, second choice NSAIDs, to consider adding a short course of muscle relaxants on its own or added to NSAIDs, if paracetamol or NSAIDs have failed to reduce pain and finally to consider to be referral for spinal manipulation for patients who are failing to return to normal activities.
European Guidelines for the management of chronic non-specific back pain (CLBP)
For conservative treatment they concluded that Cognitive behavioural therapy, supervised exercise therapy, brief educational interventions, and multidisciplinary (bio-psycho-social) treatment can each be recommended for non-specific CLBP. Back schools (for short-term improvement), and short courses of manipulation/mobilisation can also be considered.
UK BEAM Trial Team (2004) United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectiveness of physical treatments for back pain in primary care. BMJ 329:1381
Spinal manipulation is a cost effective addition to "best care" for back pain in general practice. Manipulation alone probably gives better value for money than manipulation followed by exercise.
RCGP (1999) Clinical Guidelines for the Management of Acute Low Back Pain
The evidence of this guidelines concluded that spinal manipulation can provide short-term improvement in pain and activity levels and higher patient satisfaction. Also, the risks of manipulation are very low in skilled hands. Therefore they recommended to consider manipulative treatment for patients who need additional help with pain relief or who are failing to return to normal activities.
Meade et al (1995) Randomised comparison of chiropractic and hospital outpatient treatment for low back pain: results from extended follow up. BMJ 311; 349-351
This follow up trial conducted in 1995, again funded by the MRC, confirmed the findings of the earlier report - patients with low back pain treated by chiropractors derive more benefit and long term satisfaction than those treated by hospitals.
Meade et al (1990) Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment. BMJ 300; 1431-1437
This large UK trial funded by the Medical Research Council (MRC) compared chiropractic and hospital outpatient treatment for managing low back pain of mechanical origin. Outcome: chiropractic treatment was 30% more effective than hospital outpatient management, mainly for patients with chronic or severe back pain.
More evidence and effectiveness of chiropractic care can be found at the Anglo-European College of Chiropractic Research and the Royal College of Chiropractors Research Unit.
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