Q. What is chiropractic?
A. According to The Association of Chiropractic Colleges, "Chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs and surgery. The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health."

Q. Will it hurt? What's that "popping" noise?
A. We can't make any guarantees, but it probably won't hurt. Chiropractic adjustments do not typically hurt, in fact some people get adjusted and start feeling better almost immediately. Other times it will not happen so fast.
As for that noise, it's just nitrogen and other gases 'escaping' from the joints of the spine as they are moved and the pressure in the joint is released. Think of it like opening up a soda can and letting the pressure out.

Q. Can you fix it? How long will it take? How much will it cost?
A. Those are the three questions people want answered when they come in, and those three questions will all be answered following a complete examination by the doctor. We don't believe in cookie-cutter approaches, and can't really tell you what condition your spine, nerves and muscles are in until we see you in the office. You're welcome to call or stop by to set up an appointment.

Q. Is it dangerous?
A. Statistically, chiropractic is very safe. Research widely supports the safety of chiopractic adjustments, showing that chiropractic spinal adjustments are "extremely safe" when performed by chiropractors. Current research also shows that chiropractic adjustments are among the safest treatments for the majority of problems of the back and neck. According to the 1993 Ontario Ministry of Health-commissioned study,

"There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low-back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low-back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low-back pain."

Lead investigator of the study, Pran Manga, Ph.D., however, did warn that spinal adjustments performed by health care professionals other than qualified doctors of chiropractic were potentially harmful and less effective:

"Indeed, several existing medical therapies of low-back pain are generally contraindicated on the basis of the existing clinical trials. There is also some evidence in the literature to suggest that spinal manipulations are less safe and less effective when performed by nonchiropractic professionals."

On December 8, 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released clinical practice guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of the diagnostic and treatment methods used for acute low back pain. Their findings included:

The risk of serious complications from lumbar spinal manipulation is rare;

Conservative treatment such as spinal manipulation should be pursued in most cases before considering surgical intervention; Prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.

Q. Is it true that chiropractors lack proper or extensive education?
A. No, it's not true. Chiropractors must complete their bachelor's degree before enrolling in chiropractic school, then go through 4 year of intense training and education. The educations of medical doctors (MD) and doctors of chiropractic (DC) are different in areas like pharmacology and surgical methods, but are similar in more ways. Chiropractic school does not emphasize those topics because chiropractic is a health profession based on natural methods not involving drugs or surgery. Conversely, medical school does not focus really at all on natural health, manipulative techniques of the spine, and biomechanics of the human body. Medical doctors are very good at knowing what drug treats what condition, but they are typically not at all good at recognizing the different causes of low back pain, and have no tools in their toolboxes when it comes to treating lower back pain, headaches, or neck pain without drugs or surgery.

Chiropractic education involves in-depth analysis of human anatomy, physiology, pathology, and neurology, as well as radiology, differential diagnosis, chiropractic adjustive techniques, biomechanics, and other health-related studies.

Towards the end of those years in chiropractic school the student must perform hundreds of adjustments, take dozens of case histories, perform numerous radiological studies, manage treatment and progress of patients, and to then gain enrollment in an externiship program doing real-world clinical chiropractic over the course of six months. Then, a grueling 4-Part National Board Exam Series must be passed, as well as the passing of a Physical Therapy National Board exam if the student plans on utilizing physical therapy methods in practice. Licensure in Maryland is among the more competitive of states, including increased credit hour requirements for physical therapy privileges. Following successful completion of the 4 National Board Exams, the prospective chiropractor then has to pass a State Licensing Exam. Once licensed, the chiropractor must complete 48 hours of continuing education courses every two years to maintain licensure.

A successful chiropractor, just like any successful doctor, never stops learning and expanding his or her knowledge. One thing that separates our office from a typical doctor's office is that we don't wear white jackets, we spend more than 2 minutes with you, and we don't really care about your weight and height.

Q. What's the difference between medical and chiropractic treatments for neck or back pain?
A. Medical doctors are educated and trained to react to symptoms. Chiropractors are educated and trained to discover the cause of the problem, not to respond to the symptoms the problem is causing. This is a huge, fundamental difference between these two branches of healthcare. At Park Bench Chiropractic we utilize some pain-control methods but usually rely on adjusting the spine to restore proper function and utilizing physical therapy to speed recovery and avoid reinjury.

Q. What are the 7 "Myths" of Low Back Pain?
A. Low Back Pain, despite being very common (a large majority of people will experience lower back pain during their lives - most of them will experience it repeatedly), is still very misunderstood. Even today, with all of our medical advances, the treatment of lower back pain by modern medicine is largely a failure.

Here are 7 common misconceptions about low back pain - and even today's non-chiropractic doctors are misinformed:

• If you have a slipped disc (also known as a hernatied or ruptured disc), you must have surgery
• Radiographs (x-rays) and newer imaging tests (ex. CT Scan and MRI) can always identify the cause of pain
• If your back hurts you should take it easy until the pain goes away
• Most back pain is caused by injuries or heavy lifting
• Back pain is usually disabling
• Everyone with back pain should have a spine radiograph
• Bed rest is the mainstay of therapy

How many of these statements are true and which are correct?
All are false, but most of them are believed by most people. In fact, most family doctors or general practitioners also believe some or all of these myths.

Sometimes when a person comes in with excruciating back pain, and they have felt bad for weeks or months, they are surprised and even a little uneasy when we do not order x-rays, or when we don't think an MRI is necessary before beginning care.

About hammers and nails: when you are a hammer, you tend to see nails sticking up all over the place. When a person with intense low back pain walks into an orthopedic doctor's office, that doctor is predisposed to ordering up advanced imaging like MRI in order to get a real good look at the area in question. They look at the imaging to see if there are any obvious problems (fractures, cancer, etc) and also to see if there are any problems that make surgery out-of-the-question. If there are signs of a disc injury causing your pain then this doctor is predisposed to ordering you to go through a trial phase of physical therapy. Following that, surgery will quite possibly be recommended. A hammer hit the nail in exactly the manner as could be expected of a hammer.

Come into a chiropractor's office and they will examine your spine to see the problem, to determine if the problem is one that a chiropractic adjustment may help. Perhaps we are hammers and we see nails, as well. Our hammer is our hands, and they leave no scars or stitches, they require no rehabilitation program, no extensive physical therapy regimen, and do not involve anesthesia or addictive painkilling drugs. If someone was going to hit me with a hammer, I know which one I would choose.
The "Myths" of Low Back Pain: Spine Volume 29, 2004, Number 16, pp 1818-1822