We've all been there before: trying to choose between a list of potential businesses or professionals with very little of substance to go on. Most of the time we rely on online reviews, glances at web pages, and if we are lucky we may know someone who has been to that business already and can tell you what to expect.
Going to a chiropractor is an important decision, even more so because many people do not know much about chiropractic to start with. What little they do know may very well be wrong. Some consider chiropractors quite poorly and are skeptical of the profession. Some are open to seeing a chiropractor but have no friends or family to steer them to the right person, and have no experience with chiropractic that would make an Internet search easier. It helps when you know the "language" of something because your Google search will be much more fruitful when you use the right terminology. Using broad terms often will net you nothing more than a list of chiropractors who do a lot of advertising and who fill their websites with keywords just to attract visitors via Google.
Choosing a chiropractor is in many ways a very personal decision. With so many types of DC's out there that means that you can probably find one tailored to your needs. This article will outline how to conduct a good search that will show you all the local chiropractors and allow you to tell them apart so that you can make the best choice.
- Are you going to a chiropractor simply for pain relief, or for general health?
You can loosely separate chiropractors into two groups: holistic chiropractors and mechanistic chiropractors. All chiropractors know of this distinction, and in fact the profession has been in a general state of low-level internal conflict along this fault line since it's inception. Some chiropractors know this as a war of "straights vs. mixers". The internal conflict, which actually has many positive benefits, has been ongoing since the start of the profession in 1895. This duality is a strength of the profession: without the holistic character of chiropractic we would be physical therapists who adjust the spine, and without the mechanistic character of chiropractic we would lose sight of the very real benefits to health that chiropractic care provides millions of Americans every year, and the real detrimental effects of spinal joint malfunction (subluxation).
- Do you want long-term care or would you prefer to have your complaint treated and then have your case closed?
Many chiropractors, with varying degrees of scientific evidence to back this up, promote chiropractic as a viable alternative to traditional healthcare. They view chiropractic as a way to foster the health of your nervous system through chiropractic spinal adjustments, which then allows the body to function at a higher level. Chiropractors and patients all over the country will attest to improved health with less illness and injury after they incorporated chiropractic into their lives. Regular adjustments help adults and children cope with everything from allergies to headaches, and people who want to avoid prescription medication often choose chiropractic instead. Hard scientific proof to validate this is difficult to come by due to inherent problems in designing a study capable of testing the "chiropractic lifestyle" and it's effect on general health, but case series' exist and we've likely all met someone who will swear up and down that chiropractic is keeping them out of the doctor's office.
On the flip side of this coin are chiropractors that will work to promote proper joint function at the injured area and then rehabilitate the joint and supporting soft tissue, after which they will release you from care. There is a value in this, just as there is a value in wellness or maintenance care. Releasing a patient after their pain is gone will save the patient money. It will also please the patient's health insurer - not that your insurer's happiness should ever be a factor in making health decisions, but unfortunately they hold power over your health in some very important ways so there is a value in not ending up in anyone's crosshair at your insurer's corporate headquarters. Rather than promote continuing care, a mechanistic chiropractor will work to correct the immediate problem only. Many times back pain may stem from a weak ankle or knee, so your chiropractor may very well focus on a spot that isn't painful, so do not assume the location of your pain is the cause of your pain.
A fundamental difference between holistic and mechanistic chiropractors is that the holistic chiropractor will treat the patient beyond the scientific limitations a more mechanistic chiropractor would self-impose. This actually ties #1 and #2 together. For example, a mechanistic chiropractor may treat low back pain by working to rehabilitate a sacroiliac joint and then release the client when the sacroiliac joint returns to normal, pain-free function. A holistic chiropractor will treat the client until subluxations (spinal misalignments causing nerve irritation) are fully resolved and then broaden their attention to include general subluxation correction in the entire spine in order to promote general wellness. Both approaches have real value. While imposing limits on treatment based on the limits of what peer-reviewed research can substantiate is important, holistic chiropractors acknowledge that progress in science occurs by pushing the limits of understanding and treating patients in ways that current best evidence may not fully support. The periphery of science is where progress is usually made - though it is also where quackery finds refuge.
- Are you injured or are you dysfunctional? In other words, did your pain come on suddenly from an injury or did it set in more slowly due to something you repeatedly do?
Sudden pain usually means an injury occurred. Sometimes it is a car accident, or a fall, or a sports injury. These type of injuries may be what a certain type of chiropractor focuses on or even has certification and increased training in. In cases of these types of injuries you want a chiropractor who can confidently treat sprains and strains, who can differentiate different types of injuries, and who will recognize when an injury is too severe for them and is also diligent enough to see certain warning signs and refer you to other providers when necessary. Many holistic chiropractors, though not all, are prone to viewing the spine in terms of subluxations only and may therefore miss the subtle signs of a more severe injury that requires the expertise of a specially-trained chiropractor, an orthopedist or neurologist. Though not a firm rule, a more mechanistic chiropractor may be a safer bet when a painful injury is involved.
- What professional associations serve the chiropractic profession, and how can this help you find the right DC?
There are two large national organizations that represent chiropractors: the ACA and the ICA. The ACA is the American Chiropractic Association and the ICA is the International Chiropractic Association. The ACA is more mechanistic and the ICA is more holistic. State associations are more varied, so it is difficult to discern much about a chiropractor from looking at his or her state association membership unless you look into the political or philosophical leanings of that organization - a lot of work for finding a chiropractor. To make things simple, know that many ICA chiropractors actually oppose the ACA, and vice versa, so you can glean more from their membership (or non-membership) in national organizations than you can from other things you might find on the website or online listings for a chiropractor. It's important to not read too much into this bit of information, though, and of course to consider that all people are multi-dimensional and may not fit into the dichotomy I am describing. Still, as part of a larger set of information to make a judgement, this can be helpful to consider.
- Should you consider their websites, reviews, and testimonials? And how important are personal referrals?
You may find out soon enough that many chiropractors use one of a handful of companies to make their websites. This means that if you go to ten different chiropractor's websites you may see the same website over and over again with just a different DC's name on it.
This means the content is unoriginal and you likely cannot learn much about the chiropractor from their website. This reduces the value of the website. Chiropractors would be better off by ditching the spinning 3D spines and instead putting actual content on their sites. These sites are loaded with content but very little, if any, of the information on the site is unique to that chiropractor. Even articles with bylines that include that chiropractor's name are probably not articles written by that actual chiropractor. Suspect intellectual laziness and dishonesty when any professional puts his name and credentials on an article he or she did not author. While it is a common practice, that does not mean it is the right way to promote yourself.
Online reviews, such as Yelp! and Yahoo!, are great. Often, though, businesses game the system by making fake reviews. Are all the reviews from the same approximate time? For example, are ten reviews all from March 2012? If so, that is suspicious. If the reviews seem legitimate they may give you some insight into the kind of DC, but if they are suspicious then you should remember the old adage "buyer beware". Quite often a bad review (that is legitimate) will be followed with numerous illegitimate good reviews in order to drown out the bad one. Getting past the illegitimate reviews you may actually be able to get a lot of good information from reading reviews, so don't hesitate to use a search engine to search for "jones family chiropractic reviews" and see what comes up.
Testimonials should be looked at as marketing, but of course they probably are real stories from real patients. The chiropractor is choosing what message you want to hear. If they choose 5 patients who talk about the chiropractor curing their back pain, then this chiropractor wants you to view them as a specialist in back pain. If they talk about kids and allergies, that is what they want you to know they specialize in. In this way, testimonials can be used to get a look at the chiropractor.
Personal referrals are the best source of information since it is typically unfiltered and direct. Ask a friend or family member and you will get an unbiased opinion. The best chiropractors (and the best attorneys, realtors, and even bakers) all get most of their new clients because they treated the clients they already have so well. People are quick to complain about poor service, so when someone has a good thing to say about how they were treated then you should recognize this as worthy of your attention. Think of it like this: that person experimented with a chiropractor so you don't have to. A personal referral from someone you trust is easily the most valuable information you will come across.