The most common questions about chiropractic manual therapy treatment and research.
The consultation can take up to an hour. Read more about your first visit.
Chiropractors are concerned with the framework of bones and muscles that support the body (‘the musculoskeletal system’). Some musculoskeletal problems can be caused by accidents, stress, lack of exercise, poor posture, illness, and everyday 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.) Read more about chiropractic and exercise rehabilitation.
Increasingly, GPs are recognising chiropractic as an effective complementary treatment, particularly for back pain. You do not need a GP’s referral to visit a chiropractor.
See the costs for City of London Chiro-Practice and for Friern Barnet and North London Chiro-Practice.
Some GPs purchase chiropractic treatment for their patients on the NHS. Many health insurance companies will now pay for chiropractic and physiotherapy treatments. Our chiropractors are registered with most private medical insurers, including AXA and Bupa.
These are common, general terms used to describe a multitude of conditions. Our chiropractors will make a more specific diagnosis and explain your condition to you.
Chiropractic treatments are usually painless unless an area is inflamed, in which case treatment will be modified. You may experience some temporary reaction to treatment, such as 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 had 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. Our practitioners are 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. See the research and guidelines below.
Summaries of some of the most significant evidence, with detailed documents and articles, can be found in the following links.
The National Institute for Health and Care Excellence (NICE) produces guidelines for health professionals, helping them provide the most effective care for their patients. NICE guidance is based on evidence and is reviewed regularly. Low back pain is one of the most common reasons for visiting a chiropractor, and the NICE Low Back Pain and Sciatica Guideline NG59 provides clear recommendations for managing low back pain with or without sciatica, which always includes exercise and may include manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) as part of a treatment package, with or without psychological therapy.
Mobilisation and soft tissue techniques are performed by a wide variety of practitioners, whereas spinal manipulation is usually performed by chiropractors or osteopaths, and by doctors or physiotherapists who have undergone additional training in manipulation. The evidence base for the care chiropractors provide is common to that for physiotherapists and osteopaths in respect of musculoskeletal (MSK) conditions. Thus, like physiotherapists and osteopaths, chiropractors provide care for a wide range of MSK problems.
Opens the report as a PDF.
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.
They concluded to consider 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 from persistent low back pain.
They recommended giving adequate information and reassurance to the patient, not prescribing bed rest as a treatment, advising patients to stay active and continue normal daily activities including work if possible, and prescribing medication, if necessary, for pain relief, preferably to be taken at regular intervals: first choice paracetamol, second choice NSAIDs. They also recommended considering a short course of muscle relaxants on its own or added to NSAIDs if paracetamol or NSAIDs have failed to reduce pain and, finally, considering a referral for spinal manipulation for patients who are failing to return to normal activities.
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 or mobilisation can also be considered.
BMJ 329:1381
Cost-effectiveness of physical treatments for back pain in primary care. 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.
Our clinic director, Dr Claudio Merkier, has a keen interest in clinical research in sports chiropractic care. His Professional Doctorate research thesis has been performed in three sequential phases.
