Because this profession has an
unusually large variety of practice philosophies and chiropractic techniques,
individuals should feel comfortable asking all the questions necessary to
understand the chiropractic examination, diagnosis, and treatment program.
This article explains what patients can expect during the first chiropractic consultation. This initial
consultation involves the chiropractor completing a thorough chiropractic exam
lasting 45 minutes or more.
Some people conduct an initial
interview with the chiropractor either over the phone or in person that is
focused on discussion (e.g. about the chiropractor's philosophy, expertise and
general approach, and the patient's preferences) and does not include a
clinical exam.
The following describes the
initial in office clinical exam, which generally includes 3 areas:
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.
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.
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 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:
Individualized chiropractic
treatment plan (or other treatments)
Anticipated length of
chiropractic care
Some chiropractors will also
provide the above information in written form, so the patient may take it home
and think about it and conduct their own research.
In treating the back an
adjustment in a particular area of the back or neck may be performed once or
repeated a few times during the session to ensure the adjustment is fully
achieved.
By: Peter J. Schubbe, DC
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