FAQ | Toth Chiropractic

What kind of licensing and training does a chiropractor receive before practicing?

After completing an undergraduate program chiropractors undergo four years of postgraduate training at one of several highly specialized chiropractic colleges in the country. During the time they spend in chiropractic school they receive education in anatomy, physiology, biochemistry, pathology, differential diagnosis, radiology, laboratory testing, research statistics etc. etc. In the last year and a half students rotate through a clinical internship where they are supervised in the management and treatment of actual live patients from the public. They are examined regularly throughout the internship for competence. There are four national board examinations, a state x-ray examination and a state jurisprudence examination before licensure in any state in the United States. All doctors of chiropractic have been fingerprinted and documented as primary health care providers in the state of California. The Board of Chiropractic Examiners (www.chiro.ca.gov) is the supervising agency for all members of the profession in each state and every chiropractor must pay $250 each year along with completion of 24 hours of continuing education to maintain their license. There is a national association (www.acatoday.org) as well as a professional association (www.calchiro.org) in each state to help support excellence in the standard of care in chiropractic.

Is chiropractic scientific?

Chiropractic manipulative therapy is perhaps one of the worlds most thoroughly researched and proven treatments in peer reviewed medical journals. In fact there exist several peer review journals dedicated to the sole investigation of manual medicine and manipulative therapy, the most well known and respected of which are the journal, Spine and the journal, JMPT. However, the majority of medical treatments currently recommended by conventional medicine have yet to be scientifically proven to be effective. In fact the British Medical Journal (BMJ 2007 Clinical Evidence) reviewed approximately 2,500 conventional medical treatments and found 46 percent were unknown whether they were efficacious or harmful. It is comforting to know that chiropractic has been the subject of rigorous scientific study for the past few decades.

Is chiropractic alternative medicine?

Chiropractic is both a broadly accepted form of healthcare that specializes in addressing the neuro-musculoskeletal system of the body and an alternative to the mainstream convention of drugs and surgery. The methods of treatment for a chiropractor specifically includes joint manipulation, physiotherapy, rehabilitation exercises, as well as diet and nutritional advice. This may also have profound effects upon symptoms expressing in other systems of the body like vertigo, ear infections, and digestive complaints. Chiropractic is also a benefit included in the lists of services offered by most health insurance companies in the United States, however, just like any specialist, your plan may or may not include chiropractic in your coverage. Many great relationships exist between chiropractors and medical doctors; good health care includes the ability to refer to other health professionals when a patient must go elsewhere for treatment. People include chiropractic in the category of complementary and alternative medicine (CAM) mostly because chiropractors do not use drugs or surgery for treatment with their patients, and they believe that the body has a powerful ability to heal itself when proper structural balance exists. Chiropractors have a vitalistic view of health and emphasize natural forms of healthcare for their patients.

What is the popping sound that my joints make?

Certain motion applied to the joint will increase pressure enough to force certain gases to spontaneously release from solution inside the joint. This chemical reaction causes a popping sound. Within a few minutes the gases are re-absorbed into the fluid in your joints and you can pop the joint again. This event is also a side effect of correcting alignment when you get an adjustment from your chiropractor. It is not an indication that a good correction of alignment has been accomplished since you can pop your joints at home, and you can have a perfect correction of alignment without ever hearing a popping sound at all. So it is not wise to gauge the success of your chiropractic adjustment based on how much noise your joints make! However, there is also a mild therapeutic effect of the popping phenomenon because the chemical reaction causes a small temporary release of endorphins and also stimulates the neurological proprioceptors around that joint. This can create a modest opportunity for your brain to break the pain cycle and reset its parameters for that joints pattern of functional movement. If the joints in your spine are popping excessively on their own or you are popping your own joints excessively this can be an indication that you are out of alignment and need to see your chiropractor.

Sometimes it is not gases releasing from the synovial fluid but a tendon rolling over a bone or rolling over another tendon and making more of a clicking sound. This can be irritating to the tendon and cause soreness. Tendons do this usually because alignment is not balanced or muscles are either too tense or too weak in that area.

Crackling and crunching (crepitus) noises when you move a joint can either indicate excessive rubbing from misalignment or indicate arthritis has eroded cartilage in the joint so that it grinds together with motion. In this case an evaluation of your alignment by a chiropractor and possibly a simple xray as well can help determine the cause of this sound in your joints.

Why do my joints hurt more when the weather changes?

Changes in the weather often involve changes in atmospheric pressure which affects the pressure inside our joints. Our joints have a high density of proprioceptors which make them particularly sensitive to any movement or stretching. If we have any arthritic condition involving a joint then we may be more sensitive to changes in the weather since they are already a sensitive structure in the body.

Is it bad to crack my own back?

Popping and cracking of joints is a natural part of what our bodies do with normal motion and activity throughout the day. There is no research nor is there clinical evidence to suggest that cracking or popping your joints is harmful in any way. However, self manipulation can disrupt the body’s alignment and create imbalances that could lead to musculoskeletal problems related to improper biomechanics. Chiropractic objectively investigates and corrects misalignment of the body to maintain and restore the body’s health. Do-it-yourself chiropractic is not advised because we cannot objectively assess our own alignment. Aggressive self manipulation can cause injuries and is not recommended.

Also, excessive popping and cracking of our joints with normal daily activity usually indicates some level of misalignment that needs to be corrected by a professional. This is especially true if you find yourself trying to self manipulate. When we try to pop and crack our own joints its usually because we are uncomfortable or sense some imbalance that we are trying to correct ourselves. Mostly this gives temporary relief and we repeat the popping ritual until we compensate somewhere else.

What if I can’t relax for an adjustment?

I coach all of my patients to relax when they are getting adjusted but sometimes people just can’t completely relax when they are laying on the table. This is totally normal and we can work with any patient even if they are having difficulty relaxing. We have many techniques for delivering a good adjustment even when a patient is guarding and protective. We never force anything and patient comfort is our top priority, so if the body doesn’t want to relax we have alternative ways to correct the alignment without manipulation. Trigger point release, drop table, and instrument adjusting are all effective ways of balancing alignment without manipulating the joint.

Why are my adjustments only giving me temporary relief?

If you are getting temporary relief there are a couple of important things to consider. First of all, any positive response to chiropractic care is a good thing, it means your body is willing to change! However, our problems are often the result of years of misalignment that have accumulated until we start to really break down and suffer. At a certain point the compounding strains on our body lead to some kind of pain or other neurological symptom. At this point, the body’s alignment often needs to be retrained with an intensive period of treatment where you need to come two to three times a week. This intensive phase of care is meant to actually stabilize the bodies alignment so that you fix the foundation of the body, and that takes work. However, once this phase of rehabilitation has been completed then fundamental changes have taken place and you are ready to end intensive treatment. Some peoples bodies make a complete recovery while other people have more profound injuries and degeneration and depend on chiropractic to keep them from serious relapses. The next phase of treatment is either wellness adjustments for those who have made a complete recovery, or maintenance adjustments for those people who need chiropractic on a regular basis to keep them out of pain.

Do I need insurance to see a chiropractor?

No, you can pay out of pocket and see a chiropractor without insurance. We have reasonable rates and even provide packages to help reduce the cost if you need more extensive treatment. Some insurance plans cover chiropractic and some do not, we will verify your health benefits when you arrive for your initial visit.

Do I need a referral to see a chiropractor?

No, you can see any chiropractor without a referral. And typically insurance will cover chiropractic services without a referral. Very occasionally an insurance company will require a referral before they will pay for your treatment, we will confirm all your insurance benefits when you come for your initial visit. If you need a referral you will need to get authorization from your primary medical doctor.

What about chiropractic for kids?

Yes, children can develop injuries and musculoskeletal imbalances that can be treated by chiropractic as well. These imbalances can show up as pain and discomfort now or later in life as time passes. Either way its never too early for kids to get adjusted so that they have the best chances in life as they grow older. Chiropractic adjustments are modified for a smaller more delicate body and are even safe for infants and babies!

Is chiropractic safe?

Generally chiropractic is considered extremely safe. Some soreness may present after a chiropractic adjustment as a normal part of the corrective process. However, this soreness is temporary and should resolve within 12-24 hours. Malpractice in chiropractic is mostly from reports of sexual misconduct, but reports of improper diagnosis of osteoporosis have occasionally resulted in fractured ribs. Studies have shown that there is no more risk of getting a stroke after a neck adjustment than there is after seeing your primary care doctor (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271108/) and (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470078/). Reports of paralysis from a chiropractic adjustment are slim to none. Chiropractic is extremely safe.

Is chiropractic care expensive?

Our out of pocket rates are reasonable if you do not have insurance coverage for treatment in our office. We offer competitive rates proportional with the standard of practice in our area. We also provide package rates if you need intensive care requiring extensive treatment.

How often do people need to visit the chiropractor?

Every person’s body is different and has a unique set of needs. I will do a thorough evaluation and make recommendations for treatment based on the conditions the patient wishes to address and the goals they want to set for outcome. The patient and I will come up with a plan together Often intensive treatment is required to fix the initial complaint and stabilize the structure so that the body does not have a relapse. After the intensive treatment is finished the treatment will be completed for that condition. However, if the patient wishes to maintain their body’s alignment and keep their body balanced and they do not have a complaint then I recommend wellness care. Wellness care helps the body stay healthy instead of fixing it when its injured. I generally recommend an adjustment about once per month for wellness care.

What are your success rates?

In my estimation 90-95% of my patients experience relief and benefit from treatments in our office. Chiropractic always has a scale of results because the goals of the patient range from person to person. Our approach is to rehabilitate the alignment of the body so proper healing can occur. Results also depend largely on patient compliance to recommendations. I always recommend patients make lifestyle changes, do specific stretches and exercises or home therapies with their chiropractic care.