Red Flags to be Aware of when Searching for a Chiropractor
Choosing the correct chiropractor can seem like a daunting task. Much like the variety of apples there are numerous ways to treat as a chiropractor. We all have our own flavor and consistency which is all our own unique take. It was once described to me by a professor that it is like we’re all artists sitting in a circle around a bowl of fruit. Each artist’s perspective will be different, but at the end of the day we are all creating a picture of a bowl of fruit.
This variety is great, but can create a tough situation for you, the consumer. In order to practice we all have passed the right courses, tests, and seminars. However, not all chiropractors perform under the same moral business practices. Some chiropractors choose predatory tactics which can be more focused on their bottom line and less on you. It is unfortunate, but true. You may not choose to work with us, but we want to make sure the public is well educated on predatory tactics out there.
Here are some aspects of chiropractic to be on the lookout for when choosing the chiropractor best for you:
Unnecessary imaging
A chiropractor will not treat you unless they have an x-ray of your spine. This is seen most commonly in traditional, or more antiquated, chiropractic and has been proven to be unnecessary and even harmful to patient outcomes (1). This is not to say imaging is unnecessary, but that imaging is necessary when clinical red flags are present. These red flags are found and discussed during the initial examination and history.
Long cookie cutter treatment plans
These are often very overwhelming to the patient and can seem to be excessive and expensive. Current clinical guidelines for most ailments coming into the office are to be managed in no more than four week increments with re-evaluation every two weeks. If the patient does not improve after four weeks it is best practice to refer the patient out, or order imaging (2). With that being said, in some instances patients can be seen up to twelve times in the four weeks to obtain best clinical improvement. If improvement is seen in the first four weeks then care can be extended until maximal patient improvement is reached. At which time the patient is transitioned to maintenance care.
They can cure everything!
This has long been an issue amongst my chiropractic cohort. Terms like quackery, magic, and snake oil salesmen have been thrown around for decades. To be honest, those terms are not far off for some of the claims being made in the chiropractic world. We as a profession have great supporting evidence for musculo-skeletal ailments. However, there are many claims being made that we can affect, without a doubt, ailments like autism spectrum disorder, GI disorders, ADHD, etc… There may be low level evidence, or in some cases hearsay, but these are not strong enough studies to work from. There have been some miraculous cases helped with chiropractic care, but it is a predatory practice to make grand promises for ailments outside of the spine, muscles, and joints (3)
Large payments up front
This is one of the worst predatory practices out there! It grinds my gears that professionals who took an oath to do no harm would require sums of money (sometimes up to $10,000!!) up front or they won’t treat someone. We as a profession are held to a standard of always having the patient’s best interest in mind. Please do not fall into the trap of thinking you need to pay someone large sums of money up front in order to meet your health goals.
Not treating on the first day
Unfortunately, this is a growing tactic in the world of chiropractic. Withholding care to someone in need seems counterintuitive to me, but some clinics do. In some cases care cannot be given due to the need of imaging or a referral. However, as stated earlier the need for imaging is not necessary for every patient and care can, and should be, given the day of your initial examination.
Predatory supplement claims
While I sell supplements, and only sell those that I deem worthy for my patients, there is no place in our profession to withhold care because the patient won’t purchase a provider’s supplements. Some professionals in our field will do just that. They will most likely have you utilize a machine that will tell you what supplements you require (I would be leery of these unverified machines). I am all for supplementation to bridge the gaps of health. However, there are a million and one places to buy supplements and you have every right to buy supplements wherever you please. Are all supplements/companies equal in morality and quality? No, but it is your right to choose what you want to do for your health.
Your [fill in the blank bone] is “out” of place
It was first thought when chiropractic was first pioneered in America that bones were “out of place” and were being put “back into place”. This has been deemed incorrect numerous times throughout the past century (4). You might then ask, what the actual heck is going on?! In most cases, the adjustment you are receiving is targeted to a joint with less than stellar motion. When this occurs there is a cascade of events causing the brain to, for lack of a better phrase, freak out a little. When the joints don’t move like they should the brain interprets this as damage, injury, pain, stiffness, tightness, etc… We as chiropractors assess the spine and surrounding musculature to find areas of decreased joint motion. We adjust these areas and help them to move more as they should. This process can take some time. It may help immediately, and we like this a lot, but don’t be discouraged if it takes a few sessions to notice change. It took time to get where you are and unfortunately it will take a little time to get out of it, but I believe in you!
In closing, I hope you have found this red flags article enlightening and thought provoking. There are many fantastic chiropractors out there who have your best interest in mind. However, be careful and know that you have every right to do whatever you want with your health and healthcare. Your greatest advocate for health is yourself!
Jenkins, H. J., Downie, A. S., Moore, C. S., & French, S. D. (2018). Current evidence for spinal X-ray use in the chiropractic profession: a narrative review. Chiropractic & manual therapies, 26, 48. https://doi.org/10.1186/s12998-018-0217-8
Globe, G., Farabaugh, R. J., Hawk, C., Morris, C. E., Baker, G., Whalen, W. M., Walters, S., Kaeser, M., Dehen, M., & Augat, T. (2016). Clinical Practice Guideline: Chiropractic Care for Low Back Pain. Journal of manipulative and physiological therapeutics, 39(1), 1–22. https://doi.org/10.1016/j.jmpt.2015.10.006
Salehi, A., Hashemi, N., Imanieh, M. H., & Saber, M. (2015). Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews. International journal of community based nursing and midwifery, 3(4), 244–254.
Cramer, G. D., Cambron, J., Cantu, J. A., Dexheimer, J. M., Pocius, J. D., Gregerson, D., Fergus, M., McKinnis, R., & Grieve, T. J. (2013). Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding. Journal of manipulative and physiological therapeutics, 36(4), 203–217. https://doi.org/10.1016/j.jmpt.2013.04.003
