First appointment

• Reception: the patient will be asked to fill in a case form detailing previous medical history and the presenting complaint
• Consulting room: discussion, questions and history-taking to understand the complaint as much as possible
• Examination will commence - involving a variety of standard orthopaedic, neurological and chiropractic-specific tests                                                                            including postural assessment and overview
• Discussion - at which point initial findings, a "working diagnosis" and outline of the next steps will be given:                 

                    -  these may be:     1.  immediate treatment, if appropriate and with your consent

                                                 2.  referral elsewhere for further diagnostic tests - usually Xrays or MRI scans

                                                 3 . referral elsewhere if the condition is unsuitable for chiropractic treatment

                                      Advice relevant to the condition will always be offered and a positive way forward suggested.

Duration

This first appointment will last approximately one hour. Please arrive five minutes earlier to fill in the case form which will allow more time for discussion and examination later.

Clothing - what to wear

As one is likely to undergo a full examination/assessment, please wear appropriate undergarments. Clinic gowns are available and are usually worn for the initial assessment. If preferred, the patient is invited to bring his/her own comfortable examination-friendly clothing (gym-wear or shorts/vests). The same applies for subsequent treatment visits.

Subsequent Treatment

By the end of the initial consultation we will have arrived at a starting point for therapeutic intervention .
 
It is common to commence a "trial" period of roughly two to four sessions, based on the "working diagnosis" during which further fine-tuning of the diagnosis can be made. In addition, treatment techniques  can be tailored to that patient's specific condition and body type. A picture is built up based on the patient's responses to each treatment (in the context of the particular condition and it's history).

It is therefore important for the patient to provide feedback at each subsequent session, bearing in mind that "real life" and it's particular stresses and pressures cannot always be reproduced in a clinic environment.

Over this initial period, we will get a good idea as to how much treatment may ultimately be necessary and which techniques will suit best.

In conjunction with the treatment, it is common for a simple programme of rehabilitative exercise (or "homework")  to be prescribed. These help to support and consolidate the treatment received in the Clinic and slowly begin the process of self-management, with the goal of improving body awareness, confidence and strength. 

Some conditions will inevitably take longer than others to resolve. There may be numerous individual factors involved which will influence the outcome. These factors will be continuously under consideration and the dialogue between patient and practitioner is always ongoing. No treatment will be delivered without consent and the patient is free to terminate treatment at any time.

Duration

The subsequent treatment sessions last between fifteen minutes to half an hour, depending, once again, on the nature of the condition.

Moving forward...

As a rule of thumb, there are three broad "phases" of treatment:

               1) Initial phase - symptomatic relief and progressive understanding of the condition (as outlined above)

               2) Consolidation phase - working through and beyond the symptomatic expression  of the condition and treating the underlying cause;                                                          increased emphasis on rehabilitation, exercise and moving towards improving patient resilience and                                                                      confidence

               3) "Maintenance" - at the patient's discretion, intermittent visits to manage the condition and prevent relapses. This phase                                                                  is not for veryone and is distinctly different in terms of the nature of the condition, age of the patient,                                                                     body type, history and so on. Common sense usually dictates what is best at this point.

Communication and cooperation, leading to mutual trust and working together are the key factors in moving forward. Ultimately, we aim to engage the patient into taking responsibility for their health and therefore encourage a proactive  approach, with a view towards minimising a patient's dependence on chiropractors, osteopaths, physiotherapists, painkillers, anti-inflammatories...