Be ready to provide your medical history, which will be essential for preparing a course of treatment for you. Medical records, such as diagnostic test results, or imaging results, such as X-rays and MRIs, also will provide important information about your condition.
Certain things in your health history are particularly vital to a chiropractor. This information could provide important clues that will allow your chiropractor to properly diagnose your problem. Such clues include whether you have or have had:
Bone disorders, such as osteoporosis
Circulatory problems (poor circulation could be a sign that you have a subluxation, for example)
Dizziness or blurred vision
Heart conditions such as hypertension or high blood pressure
Infections, especially those affecting your spine
Injuries, such as bone fractures, muscle sprains, or disc injuries
Joint disorders such as arthritis
Be prepared to answer such questions as:
Did the onset of your pain immediately follow an injury?
Is there anything you do that improves or worsens the pain?
When and how did your pain start?
Where is the pain centered?
The physical exam
Here's what to expect:
The first order of business is checking your vital signs, reflexes, and blood pressure.
Sometimes measurements will be taken to determine arm and leg length. Next, you will be asked to do a series of simple and easy activities or exercises. These exercises will provide information about your motor skills, balance, and gait, among others. These tests also help determine your range of motion, muscle tone and strength, and integrity of your nervous system. Any abnormalities could provide clues about a condition. You may be asked to:
Bend forward, sideways, or backwards - Misaligned spinal vertebrae can sometimes be detected during this exercise.
Flex and extend your leg - This is a test for signs of sprain and helps determine the integrity of your joints (also called the "Yeoman's Test").
Grip something such as a rubber ball - Your grip strength is vital for showing signs of muscular or nerve damage.
Lie down and raise one leg - This is often referred to as the "Thomas Test," in which the chiropractor gently pushes on your raised leg to check for hip joint mobility.
Stand and raise one leg - This test can sometimes show whether you have sciatica, a nerve disorder in your lower back. Another test may involve pushing on your raised leg to determine whether you have pain, inflammation, or imbalance in the joints between your spinal vertebrae. (This is also called the "Psoas Muscle Test.")
Stand or sit - Posture can sometimes show whether you have misalignments in your spine.
Walk a straight line - This test measures your gait, and helps to determine if you have a normal walking pattern.
Walk in Place - Abnormalities in the way your pelvis and spine coordinate can be seen during this test.
Next, a short physical exam by the chiropractor will involve palpation, or use of the hands, to explore the alignment of your spine and other structures, as well as provide information on any stimuli that may cause pain. Depending on your condition, a series of diagnostic tests may follow. These tests may include MRIs, CT scans, X-rays, blood work, and other laboratory tests.
The chiropractor may also consult with you about making important lifestyle changes, such as exercise, nutrition, and smoking cessation to improve your chances of healing faster or preventing further injury.
Back injuries are sustained in a myriad of ways and some people are more likely to develop back pain and injury than others are. Some people incur back injuries from doing seemingly nothing; a simple twist or turn the wrong way in bed, for example, could cause a vertebra to go out of alignment. Others incur injury at home or on the job, while others sustain back injuries from traumatic events such as a vehicular accident.
Back injuries can be sustained on any number of structures in the spine. Although lower back injuries are the most prevalent, many people have sustained injuries to the thoracic (middle spine) or cervical (neck) portions of their spinal cord. Injuries can occur to the vertebrae, discs, nerves, joints, muscles, and other soft tissues. Once an injury has been incurred, other parts of the body, from the toes to the head, also can be affected.
Nationally, back injuries cost U.S. businesses approximately $30 billion per year, at an estimated average cost per claim of $24,000. If surgery is involved, the cost for claims increases significantly to $40,000 per injury or higher. One recent back injury involving surgery totaled $240,000.
Health care industry workers sustain nearly five times more back injuries than any other type of worker and are among 6 of the top 10 professions at greatest risk for back injury, according to the U.S. Department of Labor.