Chiropractic
If this is your first visit to our Chiropractic Clinic we would like to welcome you and thank you for selecting us to care for your spinal health. The clinic in the centre of St Helens always aspires to provide high quality healthcare in a warm, caring and friendly atmosphere.
Chiropractic diagnosis identifies the underlying cause of your pain and endeavours to correct it, thus providing a long-term solution. The body is a very adaptable structure and has a remarkable capacity to compensate for spinal problems. Because of this, pain is often the last symptom to appear. Chiropractors can also uncover underlying spinal dysfunction before it becomes painful and help you to be the best that you can be through chiropractic care.
Whether you are looking for pain relief or would improve your health potential and prevent future problems, chiropractic is a natural, non-invasive, safe and effective way of reaching optimal health.
Our Philosophy
Our aim is to move away from ‘crisis management’ and towards preventative chiropractic care. We believe people should enjoy optimum health – for a lifetime. We also believe that the prevention of disease is less costly and more comfortable and enjoyable for all concerned. We want our patients to learn how to maintain their spinal health, be free from nerve interference and keep the reoccurrence of pain and symptoms to a minimum.
Chiropractors use a natural and drugless approach to health. We help problems in the nerve, joint and muscular systems. Chiropractors look for areas in your spine where the are not functioning as well as they can be, potentially causing nerve irritation and inappropriate muscular tension and inflammation.
The Chiropractic manipulation
The most common type of Chiropractic care is diversified chiropractic which is when chiropractors correct spinal restrictions with gentle, specific manipulations which we call an ‘adjustment’. Sometimes when a spinal joint is adjusted there is a slight ‘click’ or ‘popping’ sound as the joint separates and dissolved gas in the fluid forms a small bubble. The adjustment can relieve irritation around the nerves and helps restore normal spinal movement. There are many different approaches to chiropractic care and each patient is individually assessed as to what approach will be the safest and most effective.
Appointments
We will do everything in our power to run to our appointment times, avoiding unnecessary waiting. However, sometimes unforeseen circumstances may arise. We ask that you are on time for your appointment. If you do not have an appointment, or are late for your appointment, we will attempt to see you as soon as a time is available.
Caring for your spine
Excellent spinal health can be achieved in partnership with us. We ask you to co-operate in keeping your appointments and following instructions for home/work care. We will often recommend an exercise programme tailored to your individual needs. This home exercise plan is an excellent tool for you to maintain core strength and keep your spine healthy.
Maintenance care programme
Depending on your needs and if you wish to, you will be recalled at periodic intervals for a spinal check-up. Our approach and emphasis is on maintenance care. We actively encourage you to think ‘prevention’ rather than ‘crisis care’.
Free screening
We are happy to talk with prospective patients to answer any questions they may have about chiropractic before they decide to begin treatment.
Should you feel unsure if chiropractic can help you we do provide a free screening service. In this telephone appointment you have the chance to discuss your problem with the chiropractor who will then advise whether chiropractic can help you. This appointment is free of charge but no treatment is carried out at this time.
How is chiropractic regulated?
In the UK, chiropractic is regulated by the General Chiropractic Council (GCC) - a statutory body established by The Chiropractors Act 1994. The role of the GCC is to protect the public, set standards for practice and promote the chiropractic profession. Note that the term 'chiropractor' is protected in the UK such that it is a criminal offence to describe yourself as a chiropractor unless you are registered as such with the GCC. The GCC's activities are described in more detail on the GCC's website which you can visit by clicking here.
Chiropractic Training
The GCC sets the standards for chiropractic education in the UK. All UK registered chiropractors must have graduated from a GCC accredited institution, or from an EU/overseas institution that awards an equivalent qualification. Overseas graduates are required to demonstrate their clinical competence under formal test conditions prior to GCC registration.
Follow this link to the GCC's website for further details about the criteria for recognition of degrees in chiropractic.
Graduates who join the College of Chiropractors must undertake a year of 'PRT' postgraduate training as a requirement of Associate Membership. The major Professional Associations also require their new graduate members to undertake the PRT programme. Full Membership and Fellowship of the College of Chiropractors requires the achievement of formal postgraduate qualifications, or equivalent, above and beyond primary chiropractic qualifications.
Evidence for chiropractic care
There is a range of evidence demonstrating that chiropractic care is effective for low back pain. Summaries of some of the most significant evidence, with links to the detailed documents and articles, are provided below. For evidence that chiropractic is effective for other musculoskeletal conditions, please click here.
1. Meade et al (1990) Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment. BMJ 300; 1431-1437
This large UK trial funded by the Medical Research Council (MRC) compared chiropractic and hospital outpatient treatment for managing low back pain of mechanical origin. Outcome: chiropractic treatment was 30% more effective than hospital outpatient management, mainly for patients with chronic or severe back pain
This follow up trial conducted in 1995, again funded by the MRC, confirmed the findings of the earlier report - patients with low back pain treated by chiropractors derive more benefit and long term satisfaction than those treated by hospitals.
3. RCGP (1999) Clinical Guidelines for the Management of Acute Low Back Pain
Evidence:
· Manipulation can provide short-term improvement in pain and activity levels and higher patient satisfaction.
· The risks of manipulation are very low in skilled hands.
Recommendation: Consider manipulative treatment for patients who need additional help with pain relief or who are failing to return to normal activities.
This recent MRC-funded study estimated the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to "best care" in general practice for patients consulting with back pain. All groups improved over time. Exercise improved disability more than "best care" at three months. For manipulation there was an additional improvement at three months and at 12 months. For manipulation followed by exercise there was an additional improvement at three months and at 12 months. No significant differences in outcome occurred between manipulation in NHS premises and in private premises. No serious adverse events occurred.
Spinal manipulation is a cost effective addition to "best care" for back pain in general practice. Manipulation alone probably gives better value for money than manipulation followed by exercise.
Summary of recommendations for treatment of acute non-specific low back pain:
· Give adequate information and reassure the patient
· Do not prescribe bed rest as a treatment
· Advise patients to stay active and continue normal daily activities including work if possible
· Prescribe medication, if necessary for pain relief; preferably to be taken at regular intervals; first choice paracetamol, second choice NSAIDs
· Consider adding a short course of muscle relaxants on its own or added to NSAIDs, if paracetamol or NSAIDs have failed to reduce pain
· Consider (referral for) spinal manipulation for patients who are failing to return to normal activities
· Multidisciplinary treatment programmes in occupational settings may be an option for workers with sub-acute low back pain and sick leave for more than 4 - 8 weeks
Manipulation/mobilisation - Summary of the evidence:
· There is moderate evidence that manipulation is superior to sham manipulation for improving short-term pain and function in chronic low back pain (CLBP)
· There is strong evidence that manipulation and GP care/analgesics are similarly effective in the treatment of CLBP
· There is moderate evidence that spinal manipulation in addition to GP care is more effective than GP care alone in the treatment of CLBP
· There is moderate evidence that spinal manipulation is no less and no more effective than physiotherapy/exercise therapy in the treatment of CLBP
· There is moderate evidence that spinal manipulation is no less and no more effective than back-schools in the treatment of CLBP
Recommendation: Consider a short course of spinal manipulation/mobilisation as a treatment option for CLBP.
Chiropractic intervention and posture training can limit episodes of acute pain. Spinal rehabilitation, which may include components such as education, lifestyle change, weight loss, general fitness and specific low-back training exercises, may be required.
9. Department of Health (2006) Musculoskeletal Services Framework
“Chiropractors provide evidence-based, timely and effective assessment, diagnosis and management of certain musculoskeletal disorders.”
“The Framework describes a system that enables health and social care professionals to provide more easily a high-quality service to patients. A balanced, well-planned system achieves that, and helps professionals to:
· treat patients at the appropriate point in the system (closer to home or work);
· provide patients with better information to manage their condition, reducing avoidable admissions;
· plan/manage patient flows through primary and secondary care, ensuring appropriate and timely referral to specialist care services;
· develop capacity in primary care by offering a wider range of non-surgical alternatives, eg specialist practitioners, physiotherapy, podiatry, nursing, pain management advice, chiropractic, osteopathy etc.”
10. Low back pain: early management of persistent non-specific low back pain
NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health. Its guideline on the acute management of patients with chronic low back pain was published in May 2009.
The evidence-based recommendations include the following:
· Provide people with advice and information to promote self-management of their low back pain.
· Consider offering a course of manual therapy including spinal manipulation of up to 9 sessions over up to 12 weeks
· Consider offering a course of acupuncture needling comprising up to 10 sessions over a period of up to 12 weeks
· Consider offering a structured exercise programme tailored to the individual.
Note added by the College of Chiropractors: All chiropractors are trained to provide spinal manipulation. Chiropractors are also trained to provide suitable exercise advice and many have in-house facilities for supervised exercise. Note that chiropractic is a profession, not a treatment. Chiropractors provide a package of care, which may include spinal manipulation, based on a detailed case history and careful diagnosis.
Links to relevant organisations
National Institute for Clinical Excellence (NICE)
Links to UK chiropractic organisations
Regulatory Body