The following describes the initial in office clinical exam, which generally includes 3 areas:
1. Patient History and Symptoms
In preparation for the chiropractic consultation, the patient will be asked to fill out forms that provide background information about his or her symptoms and condition. Types of questions typically include:
- When and how did the pain start?
- Where is it located?
- Describe the pain – is it sharp, dull, searing/burning, or throbbing? Does it come and go, or is it continual?
- Did the pain start as a result of an injury?
- What activities/circumstances makes it better or worse?
Patients are usually asked to provide information on family medical history, any pre-existing medical conditions or prior injuries, and previous and current health providers and treatments.
2. The Chiropractic Exam
A thorough chiropractic exam includes general tests such as blood pressure, pulse, respiration, and reflexes, as well as specific orthopedic and neurological tests to assess:
- Range of motion of the affected part
- Muscle tone
- Muscle strength
- Neurological integrity
Further chiropractic tests may be necessary to assess the affected area, such as having the patient move in a specific manner, posture analysis, or chiropractic manipulation of the affected body part.
3. Diagnostic Studies
Based upon the results of the patient’s history and chiropractic exam, diagnostic studies may be helpful in revealing pathologies and identifying structural abnormalities to more accurately diagnose a condition.
Diagnostic studies are not always necessary during the chiropractic exam, and should only be undertaken if the chiropractor has a good reason to believe that the X-ray or other test will provide information needed to guide the patient’s treatment program.
The most common diagnostic studies during chiropractic exams include:
- X-ray exam
- MRI (Magnetic Resonance Imaging) scan
- Other laboratory tests
Patient Diagnosis after the Chiropractic Exam
Findings from the combination of the above described history, physical examination and any required diagnostic studies lead to a specific diagnosis. Once the diagnosis is established, the chiropractor will click here determine if the condition will respond to chiropractic care.
At the end of the patient’s initial visit, the chiropractor will explain the patient’s:
- Diagnosed condition
- Individualized chiropractic treatment plan (or other treatments)
- Anticipated length of chiropractic care
Most chiropractors begin treatment during the patient’s first visit, although some may wait until the next appointment at the chiropractic clinic.
Chiropractic treatment goals and recommendations may include some or all of the following:
- Adjustments to key joint dysfunctions
- Modalities to improve soft tissue healing and pain control, such as ultrasound, electrical stimulation, and traction
- Strengthening and/or stretching exercises to improve muscle balance, strength, and coordination
- Patient education to improve posture and motor control, as well as possibly reduce anxiety
- Other treatments such as massage, heat/cold application, and education on ergonomics and nutrition.
Goals of Chiropractic Care
The chiropractor will establish specific goals for a patient’s individual plan for treatment:
- Short-term goals typically include reducing pain and restoring normal joint function and muscle balance
- Long-term goals include restoring functional independence and tolerance to normal activities of daily living.
To reach these goals, a specific number of chiropractic visits will be recommended.
For most types of lower back pain, a treatment recommendation of 1 to 3 chiropractic visits per week for 2 to 4 weeks will be prescribed, followed by a re-examination by the chiropractor.
Chiropractic Evaluation of the Treatment
At the re-evaluation, the chiropractic doctor will measure the response to treatment and determine whether to:
- Continue chiropractic treatment, if appropriate
- Release the patient from chiropractic care, if treatment goals have been met
- Refer the patient to another health care specialist if treatment goals have not been fulfilled.
Chiropractic adjustment (also referred to as spinal manipulation) is a recognized and popular pain relief treatment for many types of lower back pain, sciatica, and neck pain. Knowing what to expect from the first chiropractic visit can help an individual receive the maximal benefit from chiropractic treatment.