How chiropractic is performed

Typically, your first chiropractic session will involve an assessment of your general health and medical history, and a physical examination.

The treatment that follows usually involves hands-on manipulation techniques, which focus on the spine.

You may also be given other treatments and advice on exercise, diet and lifestyle (see below for more).

Sessions typically last between 15 and 30 minutes.

You can learn more by reading the General Chiropractor Council leaflet: "What can I expect when I see a chiropractor? (PDF, 104kb)" .

The length of a course of treatment will depend on the type and severity of symptoms. In the case of persistent lower back pain, NICE recommends that treatment should include up to nine sessions. These can take placefor up to 12 weeks.

Initial assessment

As part of this assessment, a chiropractor will normally:

• ask about your symptoms
• ask about your general state of health and previous health conditions
• carry out a physical examination that may involve an examination of your spine and posture, and where relevant an attempt to find the source of your discomfort or pain

They may alsoarrange for X-ray of your spine to be taken.

If your chiropractor discovers or suspects that you have a serious health condition, they should advise you to see your GP or go to hospital. Do not use a visit to a chiropractor as a substitute for a visit to a GP.

Once this assessment has been carried out, you should be given a care plan. This describes the chiropractors diagnosis and outlines the suggested treatment.

Initial assessments typically last between30 and 60 minutes.

Treatments

Your chiropractor will advise you on treatments intended to address your health condition, and help you to manage or avoid it in the future.

This may involve manipulation of your muscles, bones and joints, often in the spine. This kind of treatment is sometimes called "manual treatment".

It may also involve massage or manipulation of soft tissue, as well as advice on diet, exercise and lifestyle, and a rehabilitation programme for you to follow in your own time.

Spinal manipulation

The treatmenttechniquemost often associated with chiropractic is spinal manipulation. The chiropractor uses their hands to apply force to the muscles, bones and joints in and around your spine.

During the session, you will be asked to sit or lie down. You will usually be asked to remove your upper body clothing so the chiropractor can access your spine. If you are asked to undress, you should be offered a gown.

Chiropractors use a wide range of manual techniques, including:

• short, sharp thrusts applied to the spine (intended to remove joint restrictions and improve the range of movement)
• gradually moving joints through a range of different positions (intended to reduce tension within a joint)
• pulling or stretching muscles in a certain direction (intended to strengthen the muscle and improve its range of movement)

Chiropractic treatment is not usually painful. If the chiropractor is treating an injury that is painful or inflamed, there may be some minor pain or discomfort. If you experience any pain or significant discomfort while having chiropractic treatment, tell your chiropractor immediately.

During spinal manipulation, you may experience a popping sensation in your joints and hear a popping or cracking sound. It is thought this is caused by gas bubbles in the fluids that surround your joints this is a normal part of spinal manipulation and other manual treatments.

Other elements of treatment

Some chiropractors can make other treatments available, as well as manual therapy.

These can include advice on exercise, diet and nutrition, which is intended to help improve, manage or avoid the recurrence of your health condition, and to improve your general health.

They can also include rehabilitation programmes in which you are taught exercises that are intended to help you recover from your health condition, and prevent it recurring.

Some chiropractors may also offer other complementary and alternative treatments, such as acupuncture .