Chiropractic treatment

Chiropractors diagnose, treat and prevent disorders of your bones, muscles, ligaments, tendons and joints. It has its roots in bone setting, a traditional manipulation therapy, used several thousand years ago. Chiropractors believe that gentle adjustment (manipulation) of the spine and other joints helps the body to heal itself. This is based on the idea that a healthy spine and nervous system are directly related to general good health and a feeling of well being.

Chiropractors use a wide range of treatments as part of their care and these may include

• Excercises for you to do
• Ultrasound or similar treatments
• Using their hands to manipulate your bones and muscles, particularly those of your spine

Chiropractors don’t use drugs or surgery. Manipulation puts the bones and joints back into their natural place - you might hear this called spinal manipulation. Spinal manipulation is also sometimes used as part of osteopathy.

Chiropractors are trained to diagnose physical problems and so are more likely to call themselves primary healthcare practitioners than complementary therapists. Some GP surgeries provide chiropractic treatment within their service. Chiropractic treatment in the UK is regulated by law, which means that only people who met the regulator's high educational standards and yearly registration requirements can be listed on the legal register of chiropractors. It is illegal for people to practise as a chiropractor unless they are on the register.

One of the main reasons why people with cancer use chiropractic treatment is to help control pain, headaches and tension. There is some scientific evidence to suggest that chiropractic therapy may help relieve pain, especially headaches and back pain. But there is no evidence to suggest that it helps to prevent, treat or cure cancer and chiropractors would not claim to be able to cure cancer.

There is more general information about why people with cancer use complementary therapies in our about complementary therapy section.

Trials have looked at spinal manipulation techniques (including chiropractic treatment) as a treatment for various conditions, including back pain, headaches and neck pain. Researchers have looked at these trial results together and published their findings as systematic reviews. But unfortunately, they don’t always agree.

Some reviews show that spinal manipulation can help treat low back pain, neck pain and headaches. One review found that spinal manipulation was better than sham (fake) therapy for lower back pain. Another review says there is some evidence to suggest that spinal manipulation is more effective. Overall all the reviewers recommend further research before we know whether or not chiropractic treatment has any long term benefits for people with lower back pain.

There is also evidence to suggest that using spinal manipulation in combination with other treatments helps neck pain. But it did not help pain when used on its own. And there have been a small number of trials suggesting that manipulative chiropractic treatment is helpful for people with headaches, including migraine.

Further clinical trials will help to show whether chiropractic treatment works, and which conditions it might be used to treat. Trials may also tell us more about possible side effects. It is important to make sure that any side effects of treatment don’t outweigh potential benefits.

It is important to remember that none of these studies were specific for people with cancer. We don’t have any evidence to show that it helps treat people who have cancer. And it’s important that some people shouldn’t have chiropractic treatment if they have certain conditions.

On your first visit to a chiropractor they will ask you some general questions about your health and lifestyle. Their aim is to find the exact cause of your symptoms. They will want to know about any muscle or bone injuries you have had, your work, where and how often you have pain, and maybe even the type of bed or mattress you have. They will want to do a physical examination, which will include checking your heart rate, blood pressure and breathing pattern. They may suggest that you have an X-ray of your spine.

They sometimes need to speak to your GP. This is just to check that your doctor is happy for you to go ahead and use chiropractic treatment. In general, it is rare that your doctor will say no. But there may be situations where your doctor recommends that you don’t use chiropractic treatment.

To have chiropractic treatment you may need to take off your clothes, except your underwear and will be given a gown to wear. But often you can keep your clothes on. You will usually lie on a couch (table) to have the treatment. The chiropractor will use their hands to manipulate (realign) your spine or joints. Sometimes they use a rapid ‘thrust’ type action, which can cause a ‘popping’ sound due to the sudden change of pressure in the joint space. This is not dangerous and shouldn’t be painful. Some chiropractors may also use other techniques, such as massage, hot and cold treatment, physical stretches and exercises as part of the treatment. They may also use equipment such as electrical currents or ultrasound.

Most chiropractic sessions last about 15 to 20 minutes. During your treatment it is important that you tell your chiropractor if you are in any discomfort or want them to stop. The number of treatments you will need will depend on the problem you have. After treatment your chiropractor may suggest exercises that you can do at home to help or prevent further problems. You may need treatments once or twice a week or only once every few weeks.

Chiropractic treatment can have some side effects. Immediately after treatment, between 25 and 50 out of every 100 people (25 to 50%) feel mild pain or discomfort, slight headache or tiredness. But this usually passes within 24 hours. If it doesn’t, you should contact your chiropractor for advice.

There have been some concerns about the possible risk of having a stroke because of manipulation to the neck. The British Medical Journal’s clinical evidence website claims that between 1 and 3 out of every 1 million people who have manipulation to their neck are at risk of having a stroke. But your chiropractor will follow strict guidelines set out by their regulatory body to prevent them from using specific manipulation techniques on people at high risk of having a stroke. It may also help to know that a research review comparing the risks associated with using spinal manipulation for neck pain and the use of non steroidal anti inflammatory drugs found that manipulation was much safer than using the drugs.

If you have cancer it is important that you let your cancer specialist know before you have chiropractic treatment. And also let your chiropractor know that you have cancer. In most cases you will be able to go ahead with treatment. But most doctors and chiropractors wouldn’t recommend treatment for people who have

• Any type of bone cancer (primary bone cancer or secondary bone cancer)
• Diseases affecting the spinal cord
• Diseases of the bone marrow, such as leukaemia and myeloma
• Broken bones
• Severe osteoporosis

You also shouldn’t have chiropractic treatment if you are taking drugs to help thin your blood (anticoagulants) or if you are on some types of steroids. There may be other medical conditions for which your doctor would not recommend chiropractic treatment, so always ask them before going ahead.

If you have chiropractic treatment privately, it will usually cost between £30 and £45 for a session. Some GPs will refer you for chiropractic treatment on the NHS, although this varies between primary care trusts. And if you have private health insurance your policy might cover chiropractic treatment.

The best way to find a chiropractor is to

• Contact the General Chiropractic Council and ask for a list of chiropractors in your area.
• Ask the chiropractor how many years of training they've had, how long they've been practising and if they have treated cancer patients before

For more general information about finding a reliable therapist and the questions you should ask look in our about complementary therapies section.

In the UK the chiropractic profession is one of only two complementary therapies regulated by law. The other is osteopathy. The professional regulatory body for chiropractors is the General Chiropractic Council. Anyone who refers to themselves as a chiropractor must be registered with this organisation. This means that they have to meet the correct set of standards for training, professional behaviour and skills. And they must have insurance. About 2,500 chiropractors registered with the General Chiropractic Council. You can find information about their code of practice on their website.

General Chiropractic Council
44 Wicklow Street
London WC1X 9HL
Phone: 020 7713 5155
Email: enquries@gcc-uk.org
Website: www.gcc-uk.org