Chiropractor Examination and Diagnosis

In many regards, a chiropractic examination is very similar to standard examination procedures administered by all health care providers. With that said, how chiropractors examine the structure and function of the spine and then determine specific chiropractic treatments separate chiropractic care from other disciplines.

An initial chiropractic exam for back pain will typically have three parts: a consultation, case history, and physical examination. Following the consultation and case history, a physical examination that may include laboratory analysis and x-ray examination will be performed in accordance with the chiropractor’s clinical judgment.

Chiropractic Exam of Lower Back Pain

The initial chiropractic exam includes the following:

1. Consultation. The patient meets with the chiropractor and provides a brief synopsis of the lower back pain, such as:
• Duration and frequency of symptoms
• Description of the symptoms (e.g. burning, throbbing)
• Areas of pain
• What makes the pain feel better (e.g. sitting, stretching)
• What makes the pain feel worse (e.g. standing, lifting).
2. Case history. The chiropractor identifies the area(s) of complaint and the nature of the back pain by asking questions and learning more about different areas of the patient’s history, including:
• Family history
• Dietary habits
• Past history of other treatments (chiropractic, osteopathic, medical and other)
• Occupational history
• Psychosocial history
• Other areas to probe, often based on responses to above questions.
3. Physical examination. A chiropractor may utilize a variety of methods to determine the spinal segments that require chiropractic treatments, including but not limited to static and motion palpation techniques determining spinal segments that are hypomobile (restricted in their movement) or fixated. Depending on the results of the above examination, a chiropractor may use additional diagnostic tests, such as:
• X-ray to locate subluxations (the altered position of the vertebra)
• A device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation.

Many chiropractors utilize a holistic, biomechanical concept of treating the bipedal structure in its entirety, in an attempt to balance the structure from the feet upward.

Holistic Chiropractic Care

Identifying weak links in the kinetic chain, sometimes quite distant from the area of complaint, the chiropractor treats the given area. This chiropractic process may include both articular manipulation as well as muscular balancing through strengthening of under-active muscles and/or inhibiting over-active muscles to acquire a balanced structure.

Exercise is also a primary component of many chiropractic treatment approaches, especially exercises that strengthen the weak, underactive muscles of the trunk and pelvis and stretching of any overly tight muscles.

Pelvic stability can also be achieved by the use of corrective, arch supports prescribed by the chiropractor. This chiropractic treatment is typically used when ankle pronation, pes planus (flat feet), and/or subtalar instability are present.

A combination of any of these chiropractic treatment approaches along with back exercises that strengthen the weak, underactive muscles of the trunk and pelvis and stretch the tight, overactive muscles usually results in a more beneficial, long term result.

• Article written By:
• Steven G. Yeomans, DC

October 7, 2009

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