Living and Wellness When to See a Chiropractor By Center for Integrative Medicine, June 2, 2016 More people and health systems are embracing integrative medicine — and chiropractic care. In fact, chiropractic care is the third largest health care discipline in the western world, right behind traditional medicine and dentistry. But there’s still misunderstanding about what a chiropractor does and when you should visit one. “As family physicians serve as the gatekeepers for access to traditional medicine, chiropractors sit poised to be the gatekeepers of integrative medicine,” said Daniel Shawn Miller, DC, staff chiropractor at the UPMC Shadyside, Center for Integrative Medicine, one of the top hospital-based integrative medicine centers in the country. “A close working relationship between family physicians and chiropractors is crucial,” Dr. Miller said. “This melds the best of traditional and integrative medicine and is creating a whole new healthcare paradigm, one in which the patient is the ultimate winner.” When Should I See a Chiropractor? Chiropractors treat musculoskeletal problems, with the most common complaint being low back pain and sciatica, followed by neck pain and headaches. Millions of Americans have low back pain, and it’s the second most common cause of disability in the country. It’s also the No. 1 reason why people miss work. Dr. Miller said that musculoskeletal problems including back pain have three main causes: Disuse, or being inactive Overuse, or overdoing it when you played basketball with the kids last weekend Trauma, such as with a car accident, a fall, or work injury Spinal manipulation, also called an adjustment, done by a chiropractor is a safe, effective way to relieve back pain. It’s also pretty affordable compared to traditional medicine. Dr. Miller explains how an adjustment works: The tiny vertebrae in your back can shift slightly out of place. This can inflame the nerve or surrounding tissue. This nerve irritation leads to muscle spasms and swelling in the surrounding areas. The spasm and inflammation keeps the problem “stuck,” which causes you to have ongoing pain. What to Expect During Your Visit to a Chiropractor On your first visit to a chiropractor, he or she will do a comprehensive history and examination on your main problem, like lower back pain, for example. The chiropractor will find the vertebrae that may be causing your trouble and, unless the doctor feels that further tests are needed, he or she will gently twist and push on the specific bone and surrounding muscles. Often you will feel a “pop,” which is a rapid pressure change in the joint as it moves back into its proper position. “Often, the combination of gentle spinal manipulation techniques or ‘adjustments’ and anti-inflammatory medicines from your primary care physician leads to the fastest recovery,” Dr. Miller said. “Even faster improvement can occur if we incorporate physical therapy or core muscle strengthening exercises into the treatment plan.” Some people worry about hearing their back “pop,” but Dr. Miller assures patients that chiropractic medicine is safe. “Most people notice no pain or side effects, just pain relief,” Dr. Miller said. “If there are any side effects, it’s most often a temporary minor stiffness or soreness at the area that was treated. This clears up within a day or two.” How to Choose a Chiropractor As with any health care provider, it’s important to understand your chiropractor’s approach, philosophy, and experience. Don’t be afraid to ask detailed questions before making an appointment. Dr. Miller recommends making sure the chiropractor performs gentle spinal manipulation, because that’s what research has shown to be the most effective. This is what sets a good chiropractor apart: the adjustment. If your chiropractor is not “popping” and realigning the structure, Dr. Miller recommends finding another, no matter how “high tech” they claim to be. “Also, make sure the doctor believes in short term duration of care,” he said. “For acute sprains and strains, a natural recovery time is about 6 weeks. If the chiropractor wants you to see him or her for months on end, reconsider.” In addition to spinal manipulation, a good chiropractor will instruct you on lifestyle changes and exercises you can do to get well faster. Learn more by visiting the UPMC Center for Integrative Medicine webpage.