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Snap, krackle, and pop. We’re not talking about Rice Krispies here, we’re talking about the most common connotation with chiropractors – adjustments. Adjustments, or joint manipulations, often happen in the spine, but can occur in many more joints in the body as well. The problem is they may not be all they’re cracked up to be. Your chiropractor is probably lying to you. We’re going to discuss WHY and HOW to find one that won’t!
Before we get started, I will point out that I feel as if I’m quite qualified to write this article. For those of you who don’t know, I’m a licensed doctor of chiropractic. I have a Masters in Sports Science and several manual therapy certifications and coaching/training credentials. I see over 100 patients a week, but I don’t necessarily adjust all of them. As a chiropractor, I don’t consider myself a “back cracker” as so many misinformed people do. What am I trained for first and foremost, through graduate school and beyond, is to assess and manage musculoskeletal injuries. This is not just limited to “back pain”. Unfortunately, the majority of chiropractors are liars and do not operate the same way.
Why your chiropractor is lying to you
There has been a disturbing occurrence that I come across, especially seen in my new patient population. Their previous (or current) chiropractor is lying to them! It is easy to see that they’ve been to chiropractors before, because they KNOW that “something is out” and they’ve come to ME to put it “back in.”
Here’s where your chiropractor is lying to you – you are never “out of alignment.” Your bones don’t go “out of position” and your chiropractor isn’t putting them “back in place” for you. An x-ray does not show “malposition” of joints that the chiropractor is going to very carefully “reposition” for you over the course of the next 129 treatments.
Using an elementary approach, if it were so easy to put very little pressure and direct a joint to go “back in place,” what do you think would happen if you were to trip and fall to the ground? Following the logic of joints easily going in and out of position, you’d likely be immediately paralyzed. This clearly doesn’t happen. Your joints do not slip or “go out”, and if they did, you would know it.
If your chiropractor says your joints are going out of place, they are lying to you. If they say they can magically put them back into position for you, they are lying to you.
So what is that “pop”?!
Here’s another lie your chiropractor probably tells you, the “popping” of the joints, it doesn’t mean anything. When you get adjusted, you may feel a pop or crack. This is not indicative of a successful treatment, however. It does not mean your chiropractor “got it back in” or didn’t. All it means is that tiny little gas bubbles that accumulate in your joints didn’t escape quickly or forcefully.
To illustrate my point, let’s try something out here. Go ahead and crack one of your knuckles. Okay, try again. Did you get another crack? No. But you did the same thing, with the same range of motion, right? Try again in 15 minutes and tell me what happens. We will expound on this phenomenon and why this doesn’t mean it is a good idea to be running around snapping your own neck all day in a separate post.
Many chiropractors will tell you an adjustment or pop of the spine did or did not “hold”, and this is why you should be going in to see them. This is unfortunately due to one of two conclusions: the chiropractor either believes your joints easily slip in and out of position, wreaking havoc on your nervous system, or is trying to over treat you to pay for his mortgage on his vacation home. Fortunately, not all chiropractors think this way.
So why get adjusted or even see a chiropractor ?
Now do not get me wrong and don’t misquote me in this article. I also think, especially for either sedentary or athletic populations (hmm, that’s a lot of people), being worked on by a quality chiropractor and getting adjusted can be an extremely beneficial treatment modality EVEN if there aren’t symptoms of pain or discomfort.
Just because you are not moving bones in and out of place doesn’t mean that adjusting or manipulation is not an effective treatment. There are still plenty of reasons why joint manipulation is beneficial, including increased range of motion, proprioception, stimulation of mechanoreceptors, increased local blood flow, and more.
Also, when adjusting/manipulation is combined with corrective exercises, soft tissue work and other treatment modalities, it can be an incredibly powerful treatment. But to be clear: when treatment is based on the flawed philosophy that the chiropractor’s job is to position your bones for you, you are in the wrong place.
In truth, a great chiropractor should not be known just for his or her adjustments. Joint manipulation can be an effective tool in the toolbox, but how good is the carpenter who has only a hammer?
That being said, a trip to your local qualified chiropractor may also be good for the following: pain or soreness (in any of your joints or soft tissues), movement analysis, corrective rehabiltation, manual therapy (with use of hands or tools), tissue recovery (by use of stim machines, soft tissue work, taping), and more.
I also think there is value in quality chiropractic care WITHOUT having symptoms. The majority of soft tissue injuries and musculoskeletal problems can be prevented with proper self maintenance (mobilization, stabilization, correct movement), however there are some things you’re not going to be able to do yourself. Just like brushing your teeth and flossing on a daily basis is a phenomenal idea and a great display of self maintenance, you still go to the dentist regularly for cleanings, whitening, cosmetic correction, etc. BEFORE you have excruciating pain in your teeth. The same should be done with the rest of your body.
So, clearly I’m an advocate for chiropractic care. Just not the adjust first, ask questions later, bones-out-of-place, x-raying everyone type.
How To find a chiropractor that is worth seeing
At this point, the lagging question of the entire article remains, how do you find a qualified chiropractor in your area? The answer is, it is complicated.
A somewhat seemingly simple way on the surface is to evaluate certifications. The more alphabet soup behind the name, the better the practitioner, right? As someone with many of these qualifications (A.R.T., FMS, SFMA, Graston, CKTP, etc), I will be the first to tell you that they don’t always mean someone is qualified. There are a lot of chiropractors, PTs and LMTs that pile up certifications so people will go to them. It is a step in the right direction to look for advanced training, although not a foolproof method.
The short answer is that you’re going to need to do some dirty reconnaissance work. You need to get in the trenches, call around, browse websites, even ask some hard questions on the philosophy of the treating chiro.
In summary, looking for the following qualities can be a good start in how to find an excellent chiropractor:
1 – Assesses more than just the area of the pain
Many times dysfunction elsewhere in the body can cause pain in other areas. Without a thorough assessment, you’re going to waste time with a faulty diagnosis and incorrect treatment. This leads to frustration and pain and a waste of time and money. Make sure the chiro does a full body assessment.
2 – Spends more than 2 minutes with you
This excludes if they set you up on passive machines. It doesn’t really matter what the chiro does with/to you for treatment, it is not going to be effective if it there is no time spent in treatment/follow up. Just like an MD who spends 2 minutes with a patient to write them a prescription that won’t do any good, a chiro is no different. Make sure the chiro is willing to spend some solid face to face time with you.
3 – Does much more than adjust you
If adjusting/manipulation is more than 5-10% of the treatment, look elsewhere. Soft tissue work, cupping, instrument assisted manual therapy, corrective exercise, nutrition work, etc. should all be tools in the tool bag. If many of these things are missing and the toolbox is relatively empty, look elsewhere.
4 – Treatment changes/ends for problem based care
As I’ve stated earlier, I think most anyone could benefit from comprehensive chiropractic care, even for non-symptomatic reasons. However, treatment plans for problem based care should end. If your pain or symptom is not changing for months and your treatment also not changing, you need to find someone else. Something is not working. Time to get a new diagnosis or a new treatment (or a new chiropractor).
5 – They don’t image you unless it is medically necessary
Diagnostic imaging is just what is says it is – diagnostic. If your chiro is using x-rays on everyone their first visit, look elsewhere. They don’t need to “see the alignment” of your spine, because they can’t correct it by adjusting you 283 times. If imaging will help with the diagnosis or possibly change the treatment, then it may be warranted. If the chiropractor includes FREE xrays in your initial treatment or has a unit in their office, you should probably look elsewhere.
6 – Looks at the bigger picture
If your chiropractor doesn’t talk to you about what is going on outside of the office, time to move on. Even if the visits are an acceptable 20-40 minutes a couple times a week, what do you think is happening that other time period? Your life. And probably the reason why you’re in pain. Think nutrition, lifestyle, working out, desk set up, etc. A great chiro will help you navigate the errant parts of your life and not just focus on the time in the office.
Let repeat myself to make my point very clear here. Not all chiropractors think alike. There are huge differences between the “joint out of place” chiropractor, and the evidence-based, musculoskeletal system focused chiropractor. Unfortunately, the subluxation based chiropractor is more of the norm, where most of the disrespect comes from, and that disrespect is generally blanketed over the entire profession. There are a lot of bad chiropractors but there are also PLENTY of excellent chiropractors. Use the tips above to find the latter.
I hope you learned something and either now think twice about your chiro or consider researching for a good one for a problem you may have. If your chiro already checks off all of the boxes, congrats! Stay with them. Just like if you want cheaper and more accessible grass fed meats at your local grocery stores, the best way is to vote with your dollar! Find a quality and non-scammy chiropractor and you’ll be glad you did.
If you have any questions or concerns, please let me know! Reach out in the comments or email me at [email protected]. Chances are I know someone in a major city if you need a recommendation. Let me know!
Do you like learning how to take care of yourself from a food and fitness standpoint? Excellent! You can find more awesome resources for taking your movement and physical performance to the next level each week over at The Movement Fix by Dr. Ryan DeBell with Movement Fix Mondays.