Only a few years ago, it seemed like chiropractic care and allopathic medicine (that’s the kind provided by licensed physicians) were in two entirely different worlds, and the two would never meet.

Chiropractors saw mainstream doctors as too aggressive and too eager to intervene with drugs and surgery; mainstream doctors thought chiropractors were fringe practitioners with no science behind their beliefs.

Today, although that’s still the case to some degree on both sides, there’s no doubt that chiropractic care has entered the mainstream in ways that wouldn’t have seemed possible in the 1980s or early 1990s. Chiropractors are on staff at many Veterans Administration (VA) hospitals, for instance, and several VA hospitals have even partnered with chiropractic colleges to sponsor training rotations for chiropractic students.

Chiropractors are also on staff, have privileges, or have other professional affiliations with hospitals in a number of states, and since 1995, dozens of chiropractors have practiced in military hospitals—first as part of the Chiro-practic Health Care Demonstration Project and now as an ongoing part of the health care system for active-duty military personnel.

This is all a far cry from the days in the 1960s and early 1970s when the American Medical Association actively tried to drive chiropractors out of business, engendering a massive class-action lawsuit that took decades to resolve.

And as chiropractic medicine gains more legitimacy among the health professions, it’s also gaining popularity among patients. Various surveys have found that around one-third of the U.S. population has sought chiropractic care at some point in their lives, and these surveys also show that people who see chiropractors tend to be very satisfied with the care they receive.

But the history of the chiropractic field is not without its warts. There have long been—and still are—some practitioners who make farfetched claims about chiropractic’s efficacy, insisting that “adjustments” can do everything from treating attention deficit hyperactivity disorder (ADHD) to improving children’s intelligence to treating cerebral palsy.

As with any health professional, always ask to see (if they’re not prominently displayed) current certificates of licensure to practice. Chiropractors are licensed by state boards, which are members of the national Federation of Chiropractic Licensing Boards. If you have questions about a chiropractor’s licensure, go to www.fclb.org to find your state’s board (see the left-hand menu link to “chiropractic boards”).

Watch Your Back

So if you’re interested in seeking chiropractic care, how can you make sure that the doctor you’ve chosen is one of the many good, legitimate practitioners, rather than one of the fringe providers? Here are a few questions to ask.

Q: What kinds of conditions do chiropractors treat?

A: Chiropractic care is about the musculoskeletal system. So if your chiropractor tells you he treats back pain, neck pain, hip pain, leg pain, sports injuries and so on, that’s legitimate. If he starts telling you that he can treat your heart disease or kidney stones, then look for another provider.

Q: Under what circumstances would you refer me to a medical doctor?

A: Legitimate chiropractors acknowledge there are conditions that they are not qualified to treat. If your doctor hedges about when and whether he would refer you to a mainstream practitioner, that can be a warning sign.

Q: What modalities of care do you offer?

A: In addition to spinal manipulation, many chiropractors also offer heat and cold therapy, soft-tissue treatments, ultrasound, exercise and strength training, as well as other techniques similar to those offered by physical therapists. These are legitimate therapies. If your chiropractor discusses more farfetched tools such as chelation therapy or magnets, or tries to prescribe you “dietary supplements,” it’s time to look elsewhere.

Q: How long will I need to be under treatment?

A: If you haven’t yet undergone a diagnostic workup with a good medical history, the answer should really be, “I don’t know yet.” The chiropractor may give you a general range of treatment length, based on experience with prior patients. But if he tries to lay the groundwork for an extended treatment plan (“Oh, some of my patients need up to 100 visits”), especially without having examined you, find another doctor.

Q: Do you have a diplomate?

A: Diplomates are advanced certification programs for chiropractors in fields such as radiology, neurology, orthopedics and sports medicine. Although they are not required for practice and many excellent chiropractors don’t necessarily have diplomates, if your chiropractor has one, it represents a commitment to advanced training.

Q: Do you have any affiliations with hospitals or other health organizations? What is your relationship with the neurologists and orthopedists in town?

A: Most doctors of chiropractic care don’t necessarily have hospital privileges, but many will have some kind of relationship with either hospital-based practices or private practices in fields that intersect with chiropractic, such as orthopedics, neurology or sports medicine. If the chiropractor you’re interviewing talks positively about collegial relationships with specific medical groups in the area, this is a good sign. Open communication between chiropractors and a patient’s other caregivers is always beneficial.

About the Author

Gina Shaw is the medical writer for The Washington Diplomat.