1. Wellness or maintenance treatment. This is a good way for a chiropractor to make extra money, and a common reason many medical doctors don't refer to chiropractors. There is no scientific evidence that when you feel good chiropractic treatment can prevent or maintain anything. If you feel good and your chiropractor still wants to see you, get a second opinion before continuing care.
2. Questionable diagnostics. If your chiropractor tests your muscles, notes they are weak, and diagnoses an internal problem, the DC should refer you to an internist. On the other hand, if you have weak muscles because you are out of shape, a good chiropractor will refer you to a therapist, a gym, or design a strengthening program for you. If your muscles are weak due to a serious disease, nerve problem or serious structural problem, your DC should refer you for a second opinion with a neurologist or orthopedist. Muscle testing alone should not be the reason your chiropractor wants to continue to treat you if there is no pain.
3. Silly marketing gimmicks. Health fairs, swap meets, and shopping malls often have chiropractors giving free spinal examinations. There are a variety of gimmicks designed to procure you as a patient. The most common one is a postural analysis. If you have poor posture and no pain, a chiropractor should not want to manipulate you, but instead should design a workout or exercise program for you, or refer you to a therapist or trainer for such a program.
4. Treating areas that don't hurt. When you receive treatment, three things happen: You get better, you get worse, or you stay the same. If you feel good, only two things can occur: You stay the same or you get worse. If you go to a chiropractor with lower back pain, the DC should not manipulate your neck unless you also have a neck problem. There is no evidence that performing neck manipulation can help your lower back or vice versa. If your chiropractor insists on manipulating areas that don't hurt, get a second opinion before continuing care.
5. Excessive supplementation. Chiropractors take many nutrition classes in school. Beware of any chiropractor who says his vitamins are the only ones that work. Beware of any chiropractor that wants to sell you large amounts of supplements without referring you to a retailer or health-food store for comparable products at a considerably lower cost.
6. Excessive x-rays. Beware of any chiropractor who uses x-rays for any reason other than to rule out a fracture, dislocation, or bone disease. X-rays should only be taken if you have sustained a recent traumatic injury and are in considerable pain and discomfort; are undergoing a history and examination indicate a possible bone disease such as arthritis; or have long-standing pain in an area that has not responded or resolved with care. No person is perfectly symmetrical; no one's spine is perfectly straight and balanced. If you are pain-free and your chiropractor wants to continue treatment because of what an x-ray shows, get a second opinion before you continue care.
7. Excessive visits. When a chiropractor treats you, you should feel better. It is not normal to be worse after treatment. Depending on the nature and extent of your problem, after a few visits you should notice considerable improvement. After one to four weeks, your pain should be reduced by 40-50 percent, depending on how severe and how extensive your original problem. Beware of any chiropractor who recommends a three, six or 12-month treatment plan based on your first or second visit.
8. Unwillingness to work with other professionals. If you are not getting relief, you should not have to ask for a referral; your chiropractor should have already recommended one for you.
A Good Chiropractor
Good chiropractors do everything in their power to get you better as fast as possible with as few treatments as necessary. A good chiropractor will give you advice on how to avoid future problems without a costly maintenance treatment plan. A good chiropractor will only x-ray when necessary and will not use x-rays as a marketing tool to have you continue care. A good chiropractor will give you sensible nutritional advice concerning supplementation and a healthy diet without excessive pressure to purchase vitamins. A good chiropractor will have a strong working relationship with allied professionals of all specialties, including family practice physicians; orthopedists; neurologists; physiatrists; physical therapists; and athletic trainers.
Have a great 2002!
G. Douglas Andersen, DC,DACBSP,CCN
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