Chiropractic
Chiropractic Treatment
At Haslemere Chiropractic Clinic in Haslemere Surrey, we treat a wide variety of muscle, joint and nerve problems. These include:
- Back and leg pain
- Neck and arm pain
- Stiff & aching joints
- Shoulder and elbow pain
- Muscle spasms & cramps
- Prevention of migraine
- Sciatica
- Headaches arising from the neck
What Does A Chiropractor Do?
Chiropractic is a regulated primary healthcare profession. Chiropractors are trained to diagnose, manage and prevent disorders of the musculoskeletal system (bone, muscles and joints), especially those of the spine, and the effects that they have on the nervous system. Chiropractors have a specialist interest in neck pain and back care, but when they assess patients they take their entire physical, mental and social well being into account.
At Haslemere Chiropractic Clinic, we will look at your symptoms and assess what is causing your discomfort or pain. Our aim is not only to relieve your symptoms, making you as comfortable as possible, but also to help you understand your complaint to prevent further problems. Our aim is to provide effective pain relief and then to enable you to maintain your improvement by managing your joint and back treatment program.
You can find further information about chiropractic, and what to expect when you visit a chiropractor on the British Chiropractic Association (http://www.chiropractic-uk.co.uk) and General Chiropractic Council (http://www.gcc-uk.org) websites.
What Does Chiropractic Involve?
Chiropractors use a range of techniques to improve joint mobility and relieve pain. These include manipulation and mobilisation of joints, massage, pressure point therapy and muscle relaxation techniques. We also give our clients exercises and advice on posture and ergonomics. Where appropriate, we will provide health and lifestyle counseling, and may offer acupuncture as an option for some conditions.
On your first visit, the Chiropractor will discuss with you in detail the problems that you are experiencing, and will also take a thorough medical history which will be combined with the information that you have already provided if you have had a chance to complete the online “Care Response” questionnaire before you come (see below). The Chiropractor will then carry out a careful examination which will include orthopaedic and neurological assessments, in order to understand your symptoms. This may require you to undress to your underwear, but ladies will always be offered a gown, and men are welcome to bring shorts to change into if they prefer. At this stage the Chiropractor will explain their findings and agree a plan of treatment with you, taking into account the treatment options available and what you hope to get out of the treatment.
By creating an individual plan for each patient we aim to provide maximum benefit from our care and to take into account personal preferences about treatment. Many people assume that if you visit a chiropractor you will be “clicked”. Whilst spinal manipulation, known by chiropractors as “adjustment”, is an effective intervention that chiropractors are specialised in, we are also skilled in many other therapeutic techniques. If you are not keen on the idea of manipulation, or it is not an appropriate treatment for you, don’t worry! There are many other ways in which we can help you.
The Initial Consultation usually includes some treatment, because we understand that having consulted us you probably want to get some relief from your symptoms as quickly as possible. Occasionally, someone may prefer to use the time available for treatment to have an advice session instead. If we consider that after the history and examination stage our treatment is not appropriate for you, or that we require further information before we can start, we will let you know.
In order to monitor your progress and to give you the chance to give us feedback how you are doing, we use an online system called “Care Response”. After you’ve made your first appointment with us, you’ll receive an email* with a short online questionnaire asking you questions about your problem and rating your pain. This gives us some very useful background information about your complaint and allows us to plan the right course of action for you. You’ll receive further emails from Care Response after 2 weeks, 1 month and 3 months which allow us to monitor your progress, map your improvement and if necessary modify your care. You’ll also receive a short satisfaction questionnaire after 1 month as we care about your experience and are always looking for ways in which to improve our service.
*Don’t have email? – don’t worry! We’ve got paper forms in the clinic that you can fill in on the day of your appointment.
How Much Treatment Will You Need?
The number of treatments required varies from one person to another and is influenced by factors such as the nature of your back or joint problem and how long you have had it for. For most people, a relatively uncomplicated problem may need between four to six sessions. Conditions where there is evidence of a ‘trapped nerve’ usually take longer to heal, typically needing between eight to twelve sessions.
Your chiropractor will discuss your care programme on your first visit, including an estimate of the number of treatments that you are likely to require. You will be regularly reassessed to ensure that the treatment is working for you. In most cases, even if your condition is not fully resolved, we will be expecting to see a significant improvement after four treatments. Our online Care Response system also provides an opportunity for you to update us on your progress by email if you wish to do so.
Some clients find that they benefit from regular ‘maintenance’ visits to keep problems at bay once their initial symptoms have been addressed, or rehabilitation sessions to monitor and develop their exercise programmes over a longer period of time. We will discuss these option with you if we feel one of them may appropriate for your condition, but it is very much your choice as to whether you wish to make use of these services.
Research Evidence For Chiropractic
A summary of research demonstrating the effectiveness of chiropractic can be found on the Royal College of Chiropractors website (http://rcc-uk.org/evidence-for-chiropractic/).
A number of studies have found chiropractic care to be useful for the treatment of mechanical low back pain, neck pain and some types of headaches. Various medical guidelines have also recommended chiropractic as a suitable treatment for low back pain, and this has been reflected in guidelines produced by NICE (National Institute for Health and Clinical Excellence).
In recent years there have also been research studies demonstrating the benefits of chiropractic manipulation for lumbar disc herniations and sciatica. In 2010, the major conclusion of a study (McMorland et al) comparing the effectiveness of micro-discectomy versus spinal manipulation for lumbar disc herniation patients who have failed at least 3 months of non-operative medical management, including treatment with analgesics, lifestyle modification, physiotherapy, massage therapy, and/or acupuncture, was that they should consider chiropractic spinal manipulative treatment, followed by surgery if unsuccessful.
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The study found that 60% of the lumbar disc herniation patients who had failed to respond to non-operative medical management, showed siginificant improvement with chiropractic manipulation and did not require surgery. For those who did require surgery, there was no detrimental effect from having received chiropractic manipulation before progressing to surgery.
Another study, published in November 2013 (Peterson et al), compared the comparative effectiveness of high-velocity, low-amplitude spinal manipulative therapy and imaging-guided lumbar nerve root injections for patients with sciatica caused by a lumbar disc herniation (shown on MRI). There were no significant differences between groups, both nerve root injections and spinal manipulation produced statistically significant and clinically important improvements in pain and perceived change in symptoms after 1 month of treatment. This demonstrates that spinal manipulation can be an effective way of managing sciatica.
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How Safe Is Chiropractic?
Chiropractors are highly trained and their treatment is very safe. At Haslemere Chiropractic we hold a Quality Mark relating to Clinical Management (CMQM). One of the criteria for qualifying for this award is to demonstrate that the practice takes patient safety very seriously, and has an effective risk management strategy in place.
The most common side effect to chiropractic treatment is soreness. Headache and fatigue can also occur. These symptoms are usually relatively mild and only last only a short time (up to 48 hours).
As with almost any treatment, serious side effects have occurred but these are extremely rare. Neck manipulation has been linked with a rare form of stroke, and from time to time this gets attention in the media. However, many research studies suggest manipulation was probably NOT THE CAUSE and that these individuals were likely to have suffered the event regardless of any treatment they received. Many studies have shown that risk of such an event occurring is even less likely than 1 in a million. In other words, the risk of a serious reaction happening due to taking non-steroidal anti-inflammatory medication is much higher. Back treatment and manipulation is extremely safe, with a very low rate of complications.
Rarely people who have had spinal manipulation can develop arm or leg pain if one of the discs between the vertebrae begins to irritate a nerve. This is most unlikely and manipulation is not thought to cause this, although it could potentially exacerbate a pre-existing problem. Many patients come to us with nerve pain in their arm or leg and we can often help treat this type of pain. By far the most likely effect from manipulation is that you will feel an improvement in your movement and reduced pain.
People with poor bone density (osteoporosis) can be at an increased risk of fracture. For this reason, manipulation is unlikely to be a suitable treatment for patients with osteoporosis, but chiropractors have plenty of other techniques that are suitable. If you suffer from osteoporosis, appropriate treatments will be discussed to minimise any risk of complications.
Manipulation can be contra-indicated if a patient is taking anti-coagulant medication, although the risks are largely theoretical with virtually no support in the literature. Because there is a potentially increased risk of bleeding, as a precaution a conservative approach is generally taken for patients who are on anti-coagulants. Again, appropriate treatments will be discussed in order that we can put a suitable treatment programme in place.
Dry needing, or Western acupuncture, is another technique sometimes used at Haslemere Chiropractic. Fine needles being inserted into muscles have been shown by numerous scientific studies to relax knotted and tight muscles and to reduce pain and stiffness. Side effects like minor bleeding or bruising occur in fewer than 3% of treatments and more serious side effects occur in less than 1 in 10 000 treatments. Because the needles used are so fine they are much less likely to damage blood vessels or nerves than needles used for injections. The clinician always takes great care to needle in a direction away from organs like the lungs. The needles are sterile and only ever used on 1 person; after use they are disposed of.
Please talk to one of our chiropractors at any time if you require further information about of any aspect of your treatment.