While a good chiropractor can help you cope with back and neck pain, don’t assume that just any chiropractor is the right one for you. As in all professions, there are many levels of quality and competence; and choosing, in this case a chiropractor, also has its challenges. In general, look for an evidence-based chiropractor—one who uses methods that are backed by quality research.
The following suggestions will help you to both find the right chiropractor and get the most out of your visits.
- Ask friends and family for a recommendation. If you’re looking for a babysitter or a restaurant, you ask the people you trust the most for recommendations. Finding a chiropractor can have a similar starting point.
- Get insider information. Physicians may have the advantage of insider information. Don't be afraid to ask your physician or other health care professional what they have heard about a particular chiropractor and ask if they have specific recommendations.
- Google the chiropractor. Hopefully, all you will find are mostly good reviews and perhaps some fun news items or pictures. If something pops up in the search that gives you cause for concern, just move on to another chiropractor on your list.
- Check if the chiropractor is licensed to practice by your state . Before a chiropractor can become licensed to practice, he or she must pass rigorous state and national exams. Go to healthguideusa.org to look up a chiropractor by name.
- Check to see if he or she is accredited by the Council on Chiropractic Education (or a similar association in countries outside the U.S.): cce-usa.org.
- Look into whether he or she been disciplined by the state. There are enough chiropractors to choose from. If the one you are considering has been disciplined by any board, find someone else: healthguideusa.org.
Once you’ve narrowed down the list, plan to ask your prospective chiropractor these questions:
- Do you offer free consultations? Ask the person who is making your appointment if the chiropractor offers a free consultation. This provides you the opportunity to ask questions to determine if this may be a good fit at no expense to you. If your chiropractor does not offer a free initial consultation, it is not necessarily a reason to cross him or her off your list but many offer this service, and it never hurts to ask.
- Do you treat conditions other than neuromusculoskeletal problems? Be on guard for any chiropractor who claims he or she can cure ear infections, colic, asthma, and any other systemic problems. There is currently no high-quality evidence to support spinal manipulation in treating non-musculoskeletal conditions. 1 Concalves G, Le Scanff C, Leboeuf-Yde C. Effect of chiropractic treatment on primary or early secondary prevention: a systematic review with a pedagogic approach. Chiropr Man Therap. 2018 Apr 5;26:10. doi: 10.1186/s12998-018-0179-x , 2 Salehi A, Hashemi N, Imanieh MH, Saber M. Chiropractic: Is it efficient in treatment of diseases? Review of systematic reviews. Int J Community Based Nurs Midwifery. 2014; 3(4):244-54. , 3 Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat. 2010;18:3. doi:10.1186/1746-1340-18-3 , 4 Clar C, Tsertsvadze A, Court R, Hundt GL, Clarke A, Sutcliffe P. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropr Man Ther. 2014; 22:12. doi: 10.1186/2045-709X-22-12 , 5 Driehuis F, Hoogeboom TJ, Nijhuis-van der Sanden MWG, de Bie RA, Staal JB. Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique and outcomes. PLoS One. 2019;14(6):e0218940. doi:10.1371/journal.pone.0218940
- Did you acquire any post-graduate degrees? If your chiropractor has a post-graduate degree or special training in treating your condition, it's a good sign that he or she may be well-qualified to treat your specific problem.
- How much experience do you have treating my particular condition? As noted in point #4 above, all chiropractors must pass National and State board examinations to obtain licensureb but realize that each chiropractor is unique and may vary greatly in their individual practice style and approach to patient management. In addition, there is a wide range of experience between providers of chiropractic. If you are not happy with the service, technique, or approach a particular chiropractor utilizes, try another.
- Which techniques do you use? Some chiropractors may prefer to utilize a more forceful approach to manipulation, while others may prefer to use a more gentle approach. Neither technique is necessarily better, but you may be more comfortable with one or the other. Always discuss your preference as most chiropractors are well-versed in both approaches.
- Will you respect my preferences for a treatment plan? For example, you may prefer spinal mobilization (the “non-cracking” type) to spinal manipulation (techniques producing the cracking sound, technically called joint cavitation). The ultimate decision is usually mutually agreed upon by a combination of the patient’s preference and the treating chiropractor’s recommendations. Be wary of a chiropractor who is forceful or non-negotiating about the proposed treatment plan.
- How much experience do you have using the technique you are recommending? If your chiropractor is recommending a specific or unique technique such as cold laser therapy, Graston Technique, or Activator Method Technique, ask about the training that they have received.
- How long will my treatment last? Be wary of chiropractors who put you on a strict and lengthy treatment plan that includes an extended timeline of how long they think your treatment will take to obtain a satisfying result. This may be a sign that they are more focused on making multiple appointments than helping you obtain a favorable, satisfying outcome in the shortest timeframe possible. Also, be aware of any chiropractor who asks for an upfront lump-sum payment as this is not standard practice.
- Do you take x-rays in the office only when necessary? Be wary of chiropractors who take x-rays in the office on all patients, regardless of the problem.
- What services do you provide? Ideally, the chiropractor can provide adjunctive therapy such as massage therapy, physical therapy, and nutritional counseling under one roof. If these services are not available in a particular chiropractic clinic, ask the chiropractor if he or she works with other healthcare professionals in these areas, and if they will provide help coordinating your care.
- What are the top 3 things I can do to get the best results? A good chiropractor will have an effective, personalized treatment plan designed just for you. This plan usually includes pain management strategies through the use of manual therapies, physical therapy modalities, soft-tissue therapies, nutritional counseling, and more; in addition to active care or exercise-specific protocols. Hence, your participation and compliance by following your chiropractor’s advice is very important to obtaining a prompt, effective outcome. Make sure your chiropractor has your best interest in mind by asking him or her to outline a specific and detailed plan of action.
- What are the estimated costs? Before you agree to the chiropractor's treatment plan, ask him or her to estimate the total cost. It can be difficult to decide whether or not the costs are competitive, but at least you will know what you can expect to pay. Consider calling around to other clinics to compare costs. Most clinics will try to determine your insurance coverage, deductible, and/or limits in chiropractic visits per year by calling the insurance company for you, though you can also do the same prior to making your appointment, which is wise.
- How is billing handled? You may have to submit your own claims, which can become cumbersome. Some insurance will only cover certain procedures. If a procedure is not covered, many clinics will offer discounts for cash payments or a specific cash payment program. Ask how the clinic will handle procedures that are not covered by your insurance.
- Do you have references? Don't be afraid to ask the chiropractor to give you references. Any professional who is proud of his or her work will be happy to offer you the opportunity to speak with satisfied clients. Follow up with phone calls to the patients to ask about their experience with the particular chiropractor. (According to HIPAA, it is illegal in the United States for any doctor to give out names of patients, but he or she can ask patients to sign a release.)
- Under what circumstances would I need to see a different practitioner or spine specialist? If your symptoms do not improve under the chiropractor's care, you will probably need to see a specialist. Does your chiropractor acknowledge this and agree? At what point will he or she decide it is time to refer you to a specialist? The decision to refer you to an allied healthcare professional for further tests and/or treatment options is usually mutually decided between you and your chiropractor. This decision can occur at any point during the course of care.
A little extra work can go a long way when you are choosing a chiropractor and ensuring that your doctor-patient relationship is strong and secure. These practical guidelines can set you in the right direction for making the best choice.
How To Select The Best Chiropractor
- 1 Concalves G, Le Scanff C, Leboeuf-Yde C. Effect of chiropractic treatment on primary or early secondary prevention: a systematic review with a pedagogic approach. Chiropr Man Therap. 2018 Apr 5;26:10. doi: 10.1186/s12998-018-0179-x
- 2 Salehi A, Hashemi N, Imanieh MH, Saber M. Chiropractic: Is it efficient in treatment of diseases? Review of systematic reviews. Int J Community Based Nurs Midwifery. 2014; 3(4):244-54.
- 3 Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat. 2010;18:3. doi:10.1186/1746-1340-18-3
- 4 Clar C, Tsertsvadze A, Court R, Hundt GL, Clarke A, Sutcliffe P. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropr Man Ther. 2014; 22:12. doi: 10.1186/2045-709X-22-12
- 5 Driehuis F, Hoogeboom TJ, Nijhuis-van der Sanden MWG, de Bie RA, Staal JB. Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique and outcomes. PLoS One. 2019;14(6):e0218940. doi:10.1371/journal.pone.0218940