Frequently Asked Questions

The Estonian Manual Medicine & Chiropractic Association receives many questions about chiropractic. Below are answers to the most commonly asked questions.

• What conditions do chiropractors treat?
• How do I select a doctor of chiropractic?
• Does chiropractic treatment require a referral from an MD?
• Is chiropractic treatment safe?
• Is chiropractic treatment appropriate for children?
• Are chiropractors allowed to practice in hospitals or use medical outpatient facilities?
• What type of education and training do chiropractors have?
• How is a chiropractic adjustment performed?
• Is chiropractic treatment ongoing?
• Why is there a popping sound when a joint is adjusted?

What conditions do chiropractors treat?
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches

Does chiropractic treatment require a referral from an MD?

No, a patient does not need referral by an MD before visiting a doctor of chiropractic. Chiropractors are first contact physicians, and are so defined in most countries federal regulations. Following a consultation and examination, the doctor of chiropractic will arrive at a diagnosis under chiropractic care, or refer the patient to the appropriate health care provider.

Is chiropractic treatment safe?
Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of neuromusculoskeletal complaints. Although chiropractic has an excellent safety record, no health treatment is completely free of potential adverse effects. Because stringent educational and professional requirements are required for  licensure, the public is assured of academic competence and clinical experience.
The risks associated with chiropractic, however, are very small. Many patients feel immediate relief following chiropractic treatment, but some may experience mild soreness or aching, just as they do after some forms of exercise. Current literature shows that minor discomfort or soreness following spinal manipulation typically fades within 24 hours.

Neck pain and some types of headaches are treated through precise cervical manipulation. Cervical manipulation, often called a neck adjustment, works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasm, which helps relieve pressure and tension.

Neck manipulation is a remarkably safe procedure. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, there is not yet a clear understanding of the connection. The occurrence appears to be very rare—1 in 5.85 million manipulations— based on the clinical reports and scientific studies to date. If you are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms. This will help your doctor of chiropractic offer the safest and most effective treatment, even if it involves referral to another health care provider.

It is important for patients to understand the risks associated with some of the most common treatments for musculoskeletal pain — prescription and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) — as these treatments may carry risks significantly greater than those of chiropractic manipulation. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers like ibuprofen.

Is chiropractic treatment appropriate for children?
Yes, children can benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.

Are chiropractors allowed to practice in hospitals or use medical outpatient facilities?
Chiropractors are being recognized to admit and treat patients in hospitals and to use outpatient clinical facilities (such as labs, x-rays, etc.) for their non-hospitalized patients. Hospital privileges were first granted in 1983 in the United States.

What type of education and training do chiropractors have?
Chiropractors are educated as primary contact health care practitioners, with an emphasis on musculoskeletal diagnosis and treatment. Educational requirements for doctors of chiropractic are among the most stringent of any of the health care professions. The typical applicant at a chiropractic college has already acquired nearly four years of pre-medical undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology and related lab work. Once accepted into an accredited university faculty of chiropractic medicine or chiropractic college, the requirements become even more demanding — four to five academic years of professional study are the standard. Because of the hands-on nature of chiropractic, and the intricate manipulation techniques, a significant portion of time is spent in clinical training.

In total, the chiropractic curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. The course of study is approved by an accrediting agency that is fully recognized.

How is a chiropractic adjustment performed?
Chiropractic joint manipulation is a manual procedure that utilizes the highly refined skills developed during the intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function. Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.

Is chiropractic treatment ongoing?
The hands-on nature of the chiropractic treatment is essentially what requires patients to visit the chiropractor a number of times. To be treated by a chiropractor, a patient needs to be in his or her office. In contrast, a course of treatment from medical doctors often involves a pre-established plan that is conducted at home (i.e. taking a course of antibiotics once a day for a couple of weeks). A chiropractor may provide acute, chronic, and/or preventive care thus making a certain number of visits sometimes necessary. Your doctor of chiropractic medicine should tell you the extent of treatment recommended and how long you can expect it to last.

Why is there a popping sound when a joint is manipulated?
Manipulation of a joint may result in release of a gas bubble between the joints that makes a popping sound – it’s exactly the same as when you “crack” your knuckles. The noise is caused by the change of pressure within the joint that results in gas bubbles being released. There is no pain involved.

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