Where to Start
Dr. Jay here. Whether I’m lecturing on treatment and prevention of sports injuries, or buying groceries at the store with my Kaizo Health shirt on, inevitably this question comes up: “How do I know if a chiropractor is good or not?” It’s a really good question! There are some very good articles out there. One that’s very in depth is from Spine-Health.com (http://bit.ly/JfVw4g).
I came up with the five key questions you should ask a chiropractor to know whether they fit YOUR values. It’s important to understand that chiropractors have different philosophies on how to apply the science and art of chiropractic. Just like two orthopedic surgeons might differ on how they approach repairing a torn ACL knee ligament, chiropractors differ in how they approach spine care. As the patient, it is most important to find a chiropractor who aligns with your values, AND has evidence-based approaches. So, if you’re ready to find a the best chiropractor for you, here are the questions you want to ask.
1. Can you tell me about your treatment philosophy?
The answer to this question will depend on how a chiropractor sees the world and their place in it. Additionally, their answer will determine what type of practice philosophy they employ. The words you are looking for in the answer are “evidence based.” This means they are providing treatments supported by the literature and prevailing opinions within the field of chiropractic. If a chiropractor says a simple, overgeneralized answer, they are not considered an evidence-based DC. For example, “the state of your health is due to a misalignment of the spine,” is not specific enough.
What does the evidence say? Strong evidence exists for spine related pain. A multimodal approach to care-manipulation/mobilization, soft tissue treatment, behavior modification, and rehabilitative exercises works best. Find a doctor that uses these tools to help eliminate your pain and improve your biomechanics and movement patterns.
2. Can you tell me about your post-graduate training?
The answer to this question will tell you a lot about the intent of the chiropractor. I’ve been in practice over 20 years, and currently I have to learn more, and learn faster, than ever before in my life. The information age changes, and improves healthcare, at break-neck speed. It is important for every chiropractor to keep up with the literature, acquiring new certifications and post graduate degrees. With up to date education, experiences and knowledge, you can trust him/her to help you regain your health.
3. Can you tell me not just my diagnosis, but the functional issues that caused my diagnosis?
The garbage can diagnosis in chiropractic is, “you have a subluxation.” Even with good intentions, telling a patient he/she has a subluxation alone, is not the same as telling the key facts. To know you are getting the best treatment, your chiropractor needs to know 2 key questions.
(1) What is the pain producer?
(2) What functional/biomechanical issues caused the pain in the first place?
For example, evidence-based chiropractors will be able to tell you what’s causing your pain, subluxation/joint fixation at L5-S1. Furthermore, they can explain the cause by a functional lower cross syndrome. This consists of weak abdominals, tight low back muscles, weak gluteal muscles and tight hip flexors.
4. Are you able to tell me what percentage of your patients have the same condition, and how many of those patients resolve 100%?
The first part of this question tells you how much experience AND expertise the chiropractor has treating your condition. The second part of the question gives some insight to their integrity and credibility. If 15% or more of their patients have a similar condition/injury, they are a good fit. If their diagnosis and functional assessment is accurate then they’ve got the right treatment plan for you.
It is important to be aware of the chiropractors who treat a lot of patients with the same condition/injury you have. And, more importantly, that those patients see to a full recovery. If a chiropractor has never treated your condition/injury before, it is important to question their approach, treatment plan and experience. If you see some back pedaling and squirming, it may be time to backpedal out of their office.
5. Can you provide the scientific evidence that supports your treatment recommendations?
Most evidence-based providers can cite the clinical guidelines where it be on demand. Chiropractors take a lot of pride in their work and ensuring the outcomes reach the goals. There are both treatment duration guidelines and treatment frequency guidelines. If the chiropractor is making a recommendation to you and they can’t cite the literature from which the recommendation came, you may need to dig deeper.
A chiropractor may also tell you that the recommendation is based on experience, and that’s ok. While it’s always patient and condition dependent, there is a balance here as well. If it takes 72 visits to get you better, the chiropractor is probably not that good at their job. On the flip side, if they say we’re going to fix you within 4 visits, and you’ve had this problem for at least 4 weeks, they may be treating you purely symptomatically, and not really getting to the functional cause.
The clinical guidelines for spine care for your typical acute neck or back pain patient should be out of pain and have significantly improved function within 12-18 visits. Chronic conditions, and patients with other health disorders and co-morbidities (arm/leg pain/weakness/numbness/tingling) may take a little longer to improve and resolve.
While there are a lot of important questions to ask your doctor, these 5 will at least shed some light on selecting a chiropractor who can help you regain your health. Chiropractic is an amazing field. We help people naturally, and the overwhelming preponderance of evidence and clinical guidelines supports what we do.
If you would like to know more about evidence-based treatment plans and get the 100% recovery you deserve, schedule an appointment with us today!
Our team is extremely passionate about the field and is happy to provide more information to help you stay educated and get back to living a healthier, happier lifestyle!