New Patient Procedure
The first visit to a chiropractor
Good chiropractors do everything in their power to help relieve their patient’s back pain or sciatica as fast as possible with as few treatments as necessary, and also give advice on how to avoid future episodes of back pain. Here’s some of what to expect at the first chiropractic visit, during which the chiropractor will complete a thorough consultation lasting 45 minutes or more:
- Full patient history
- Chiropractic physical examination
- Diagnostic studies (when indicated)
- Chiropractic treatment plan
In preparation for consultation with the chiropractor, an individual will be asked to fill out forms that provide background information about the symptoms and condition. Types of questions the chiropractor might ask include:
- When and how did the pain start?
- Where is it located?
- Is it a result of an injury?
- What activities/circumstances makes it better?
- What activities/circumstances makes it worse?
Patients are also 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.
A thorough chiropractic examination may include 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 partMuscle toneMuscle strengthNeurological integrity
Further chiropractic tests may be necessary to assess the affected area (such as having the individual move in a specific manner, posture analysis, or chiropractic manipulation of the affected body part).
Based upon the results of the history and chiropractic examination, diagnostic studies may be helpful in revealing pathologies and identifying structural abnormalities that can be used to more accurately diagnose a condition. Diagnostic studies are not always necessary.
The most common diagnostic studies used by chiropractors include:
- X-ray exam
- MRI (Magnetic Resonance Imaging) scan
- Other laboratory tests
Many chiropractic offices can perform basic X-rays, but an MRI scan and more extensive imaging studies may be referred to an outside center.
History, physical examination and any diagnostic studies lead to a specific diagnosis. Once the diagnosis is established, the chiropractor will determine if the condition will respond to chiropractic care.
The chiropractor will explain a 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. Chiropractic treatment 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
- Exercises to improve muscles balance, strength, and coordination
- Patient education to improve posture and motor control
- Other treatments such as massage, heat/cold application, and education on nutrition
Importantly, at this point the chiropractor will establish specific goals for a patient’s individual chiropractic treatment plan:
- Short-term goals 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, the chiropractor will prescribe a specific number of chiropractic visits, such as 1 to 3 chiropractic visits/week for 2 to 4 weeks, followed by a re-examination.
At the re-evaluation, the chiropractor 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 manipulation is a recognized and popular pain relief treatment, with an estimated 250,000 chiropractic visits each year. Knowing what to expect from the first chiropractic visit can help an individual receive the maximum benefit from chiropractic treatment.
Because chiropractic is a profession with an unusually large variety of practice philosophies and techniques, individuals should feel comfortable asking all the questions necessary to understand the chiropractic examination, diagnosis, and treatment program.