Doctor of Chiropractic (DC)
Chiropractic care (which comes from the Greek word meaning "done by hand") dates back to 1895. It was developed by Daniel David Palmer, a self-taught healer in Davenport, Iowa. Palmer wanted to find a cure for disease and illness that did not use drugs. He studied the structure of the spine and the ancient art of moving the body with the hands (manipulation).
Palmer first treated a local janitor who complained of deafness after performing heavy labor in a stooped position. When he examined the man, Palmer noted a lump on the janitor's back that he believed was caused by a displaced bone of the spinal column (vertebra). Shortly after Palmer manipulated the janitor's back, his hearing was restored.
Later Palmer claimed to successfully treat a man's heart condition using spinal manipulation. Based upon his success with these two cases, Palmer concluded that disease can be the result of a poorly aligned spine.
As more people began to seek Palmer's care, he refined his theory to state that many ailments were caused by the vertebrae pressing on the nerves of the spine. Palmer called such interference with normal nerve signals "subluxations." He believed that manipulating or adjusting to correct the alignment of the vertebrae would restore normal brain and nerve transmission and help the body's natural ability to recover from illness.
Today, most practicing chiropractors mix spinal adjustments with other therapies, such as hot or cold treatments, nutritional counseling, and exercise recommendations. They also often use new technologies to find and treat subluxations.
Chiropractors take a medical history in the same way as other health care providers. They then examine patients, looking at:
- Muscle strength versus weakness
- Patient's posture in different positions
- Spinal range of motion
- Structural abnormalities
They also use the standard set of neurologic and orthopedic tests common to all healing professions.
The chiropractor may order lab tests, x-rays, MRIs, and other tests to help make a diagnosis.
The chiropractor's main method of treatment is through adjustments (spinal manipulations). Two common techniques are the recoil thrust and the rotational thrust. For the recoil thrust, the patient lies face down on a special table that moves slightly downward as the chiropractor makes thrusts to adjust the spine. During the rotational thrust, the patient lies with the upper body twisted in the opposite direction of the pelvis. The chiropractor then applies short, fast thrusts to the spine.
REGULATION OF THE PROFESSION
To become a chiropractor in the United States, students typically begin with several years of undergraduate studies focused on biology and science. They then complete a 4 - 5 year program at a chiropractic college.
Some states require that you have a bachelor's degree and a chiropractor's degree to practice. Chiropractic colleges are accredited by the Council on Chiropractic Education, a branch of the U.S. Department of Health, Education, and Welfare.
Courses at chiropractic colleges include:
- Adjusting techniques
- Bones and joints (orthopaedics)
- Disease (pathology)
- Function of the body (physiology)
- General chiropractic analysis
- Nervous system (neurology)
- Physical and lab diagnosis
Students are expected to complete an internship at an outpatient clinic owned and run by the chiropractic college.
Chiropractors are regulated at two different levels:
- Board certification is conducted by the National Board of Chiropractor Examiners, which creates national standards for chiropractic care.
- Licensure takes place at the state level under specific state laws. Licensing and the scope of practice may differ from state to state. Most states require that chiropractors complete the National Chiropractic Board examination before they get their license. Some states also require chiropractors to pass a practical examination. All states recognize training from chiropractic schools accredited by the Council of Chiropractic Education (CCE).
Most states require that chiropractors complete a certain number of continuing education hours every year to keep their license.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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