Introduction

Chiropractic is concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and the effects of these disorders on the function of the nervous system and general health.  There is an emphasis on manual treatments including spinal manipulation or adjustment (World Federation of Chiropractic, 1999).

 By restoring normal function to the musculoskeletal system chiropractors can play a major part in relieving disorders and any accompanying pain or discomfort arising from accidents, stress, lack of exercise, too much exercise, poor posture, illness and the daily wear and tear that everyone is subject to. 

 The chiropractic approach to health care is therefore an holistic evaluation of the whole body in the context of a person's medical history, life experience, mental state, occupation, sporting history, hobbies and so on. The forces and pressures from outside acting on the body are identified (eg. gravity, sport, gym, posture, ergonomics); and the adaptive capacity of, and dynamics within the body to these outside forces assessed and considered;  from which appropriate treatment may then be applied.

Brief history

Chiropractic has evolved over many hundreds of years. It's origins lie in the various hands-on techniques used by ancient and medieval  physicians and healers ("bonesetters" and the like)  and became named as a distinct entity in 1895 in the United States. The Greek word "chiro" means "hand" and "praktikos"  translates loosely as  "done by". As suggested in the name itself,  no drugs or medication are involved and as such, this type of healthcare is quite literally hands-on. Neuro-musculoskeletal manipulative research, technique and therapy continues to strengthen and develop - and this is the stuff that really matters.

In 1925 the British Chiropractic Association (BCA) was formed and remains the predominant professional body of UK chiropractors. In 1965 the Anglo-European College of Chiropractic (AECC) was founded in Bournemouth, followed in 1997 by the Welsh Institute of Chiropractic (WIoC) in Glamorgan. In 1994 the Chiropractors Act was ratified in Parliament, bestowing Royal Assent to the profession and in 2001, the General Chiropractic Council (GCC) was established, validating the profession and protecting the title of "chiropractor" to only those who have undertaken the appropriate education and training. Like the General Medical Council for GPs, the GCC also acts as the regulator of the profession and serves to protect the public from miscreant chiropractic practice.

Chiropractic is now incorporated (in the UK) within the guidelines/diagnostic triage and referrals for GPs  for back pain care - as prescribed by the NHS-based National Institute for Clinical Excellence (NICE). 

 Scope of practice, education, techniques, safety and outcomes... 

There is a reasonably wide scope of practice and individual chiropractors may favour particular styles, techniques,  avenues of treatment and clinic protocols, depending on their own ability and experience. Some chiropractors may prefer to treat children and infants (paediatrics), some are strictly oriented towards sports injuries while others may specialise in elderly (geriatric) care. Most chiropractors, however, are well-versed in all of these and other areas of  practice (such as cranio-dental and obstetrics) as they comprise an integral part of the fundamentals/basic training at college and thereafter as postgraduate Continuing Professional Development (CPD). Prospective chiropractors study full time for up to five years, gaining a BSc (Hons) degree and MSc in Chiropractic studies. This is followed by a year's internship, following which the full "Doctor of Chiropractic" title is finally bestowed.

Chiropractors are trained to prescribe, take and interpret Xrays  and MRI scans to assist  with diagnosis. If appropriate, a patient may be required to undergo further diagnostic  Xray or MRI screening before any further treatment is considered.

 Common techniques that a patient may become familiar with include spinal manipulative therapy (or "adjustments") - involving low-amplitude, high velocity thrusts to designated intervertebral segments, or "motion units" of the spine (or other joints) to restore and maximise movement. Performed skillfully, these are generally painless but the process may feel slightly awkward at first (a patient would be introduced to this gently!). Some temporary discomfort may follow for some hours afterwards - which is not unusual - as the body takes a little time to get used to new positions and changed muscle tone. 

Chiropractic treatment delivered in skilled hands can be applied safely to humans (and animals!) of any age and condition (infants to geriatrics, rugby players to pregnant ladies).

Where there is a joint, surrounded by soft tissue, ligaments, cartilage and muscle; and a brain and nervous system to coordinate movement  and provide sensation (amongst other useful things!), there is the potential for responsible and appropriate chiropractic  treatment.

The scope of chiropractic care is therefore not limited only to backs and necks, but invariably includes shoulders, arms, elbows, hands, hips, knees, ankles, feet... not least because most of these are involved in the overall chain of movement of the entire body.

It is very important for both patient and chiropractor to understand that some cases may take a while to recover; as many years' buildup of ingrained, abnormal, dysfunctional body movement patterns need to be "undone" - and the patient may initially experience a series of different aches and pains over the course of treatment. In general, the longer the condition has existed, the longer the regime of treatment may take. Some conditions will never be "cured", but rather palliative management and control over the condition attained. Once again, the degree, intensity and duration of any treatment regime will largely depend  on each individual's condition - which will always be discussed in detail and delivered only subject to that patient's agreement and consent.