When it's safe to visit a chiropractor for back or joint pain

• Chiropractors are considered doctors but do not go to med school like an MD or DO.
• Chiropractors undergo 3 to 5 years of training, and can safely treat musculoskeletal conditions.
• However, unlike doctors, chiropractors cannot prescribe medicine or perform surgeries.

Over 85% of people experience back or neck pain at some point in their lives. Because these conditions can be debilitating and make daily tasks difficult, many seek help from chiropractors.

Chiropractors are healthcare practitioners that specialize in issues related to muscles, bones, tissues, and joints. They treat musculoskeletal conditions, such as the back, neck, or joint pain, as well as migraines and, depending on the state, nervous system conditions like headaches and migraines.

Some people are nervous or skeptical of chiropractic care because chiropractors don't have medical degrees like an MD or DO. Therefore, chiropractors are not physicians or medical doctors, says Julia Louisa Iafrate, DO, a sports and dance medicine physician at Columbia University Medical Center. Instead, licensed chiropractors have a doctor of chiropractic degree (DC).

Here's what you need to know about chiropractic training and whether chiropractic care is safe.

Chiropractic training requirements

While chiropractors are not medical doctors, they do undergo a significant amount of training to become licensed, usually 3 to 5 years, including undergrad.

Important: An important difference between medical doctors and chiropractors is that chiropractors cannot perform surgeries or prescribe medications, such as prescription-strength pain relievers.

According to Paul Quarneri, DC, a board-certified chiropractic neurologist and founder of the private practice Neurolink Chiropractic, chiropractors who earn their DC must:

• Take an undergraduate degree with pre-med courses, like exercise science and kinesiology
• Enroll in a 3 to 4-year graduate program which includes up to a year of residency, at an accredited chiropractic university
• Pass four national board exams
• Pass ethics or jurisprudence exams, which are required by some states
• Complete certain courseworks and/or trainings every year to qualify for license renewal, as required by their state

Additionally, Quarneri says chiropractors may choose to pursue post-doctoral diploma certificates through the American Chiropractic Association, in subspecialties like:

• Neurology
• Orthopedics
• Radiology
• Nutrition
• Pediatrics
• Sports medicine

What to expect during a chiropractor visit

According to Quarneri, here's what you can expect when you visit a chiropractor for the first time:

1. The chiropractor will ask for a detailed medical history and examine your spine and/or the areas where you're experiencing pain by assessing factors like range of motion, muscle strength, and reflexes.
2. Some practitioners might request X-rays of your spine, to check whether you have any underlying health conditions, such as arthritis.
3. The chiropractor will diagnose your condition and outline a treatment plan. Examples of conditions that chiropractors diagnose and treat include whiplash, tendinitis, and tennis elbow.

In general, a visit to the chiropractor can take 30 to 60 minutes. Initially, you may have to see your chiropractor two to three times a week for several weeks. As you start to feel better, the frequency may be reduced to once a week.

What's the cost? The cost of a chiropractic visit can vary considerably, says Quarneri. In general, he says the bill for a new patient examination may be between $250 to $700 while an adjustment may cost $40 to $80.

Some of the treatments a chiropractor may offer you include:

• Adjustments, which realign joints and improve range of motion.
• Soft-tissue therapy, which relieves muscle tension and reduces spasms.
• Kinesio taping, which involves taping strained joints and muscles, to support them until they heal.
• Stretches and exercises, which improve flexibility, mobility, and range of motion.

Chiropractors treat patients with their hands or with specialized instruments. For example, a chiropractor may apply a sudden, controlled force to your joints, pushing them beyond their normal range of motion. This can cause the joints to crack or pop audibly back into place. Chiropractic treatments are not usually painful and often provide immediate relief from symptoms.

Are chiropractors safe?

Chiropractors are safe as long as they are licensed practitioners. The chances of experiencing side effects or complications are higher if you are treated by a person who isn't trained and licensed, such as an assistant or technician in a chiropractor's office.

"Chiropractors have excellent knowledge of the musculoskeletal system and can provide relief - sometimes short term, sometimes longer - to patients," says ​​Iafrate.

A small 2018 study involving US military personnel with back pain found that compared to those who only received medical care, those who received chiropractic care in addition to medical care for six weeks reported:

• Lower pain intensity
• Greater improvement in mobility and less disability
• Less use of medication
• Higher satisfaction with treatment

However, some may experience mild side effects such as muscle stiffness or pain after a chiropractic visit. These symptoms should resolve in a few days, as your muscles adjust to the corrected alignment.

Yet, some people do experience serious complications from chiropractic care. Although extremely rare, complications include:

• Nerve compression in the spine
• Herniated discs
• Stroke
• Paralysis

According to a 2017 study, having other pre-existing conditions increases your risk of developing complications from chiropractic care. Therefore, you should not be adjusted by a chiropractor if you have:

• Severe osteoporosis
• Spine cancer or myeloma
• Increased risk of stroke
• Bone abnormalities in the upper neck
• Loss of strength, tingling, or numbness in an arm or leg

Insider's takeaway

Chiropractors specialize in the treatment of muscles, joints, bones, and tissues.

While they are not medical doctors, licensed chiropractors go through extensive training that can last almost a decade. Therefore, the average healthy adult can safely seek treatment from a chiropractor for pain in their back, neck, and joints.

But, if you suspect your pain is due to an underlying condition like osteoporosis or bone abnormalities, seek advice from an MD or DO first.

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