Chiropractor

Truro

Cornwall

Michael Gillingham

DOCTOR OF CHIROPRACTIC

        Book an appointment:

01872 264040

6 Ferris Town, Truro

TR1 3JG

                  GCC Registered    |    Royal College of Chiropractors’ Member    |    BCA Member

 

Diagnosis, assessment and treatment


Chiropractors are trained to undertake a comprehensive biopsychosocial assessment. This may include:

  1. -Case history of the main complaint as well as past medical history

  2. -Physical examination and evaluation

  3. -Postural evaluation

  4. -Detailed evaluation of musculoskeletal system

  5. -Orthopaedic and neurological tests

  6. -Diagnostic imaging when clinically indicated, in accordance with current legislation and the guidelines of the Royal College of Radiologists


Chiropractors are trained to triage and screen for serious pathology (red flags) as well as psychosocial factors (yellow flags) which may affect outcomes. Patient reported outcome measures (PROMS) are often used to monitor progress. Upon completion of the clinical assessment, a full report of findings will be explained to the patient. Only after consent has been obtained will treatment be initiated.

Treatment


Chiropractors utilise a package of care. Treatment interventions may include manual therapy (spinal manipulation, massage, stretching and mobilisation), supervised rehabilitation or lifestyle advice. Sometimes, electrotherapy, ultrasound and acupuncture may be used.


Patient Management


BCA chiropractors support the treatment they offer with cognitive interventions such as individual advice about the patients lifestyle, work and exercise, in order to help in managing the condition and assisting recovery. Chiropractors incorporate spinal stabilisation programmes and functional rehabilitation exercises to resolve persistent problems and prevent recurrence.


Follow the link to learn more about a chiropractic examination.


What is Chiropractic?


Chiropractic is a primary healthcare profession that specialises in the diagnosis, treatment and management of musculoskeletal conditions that are due to mechanical dysfunction of the joints and muscles, particularly of the neck and back.


The profession is statutorily regulated through the General Chiropractic Council (GCC). It is illegal to practise as a chiropractor without being registered with the GCC.


The British Chiropractic Association (BCA) is the largest and longest-standing association for chiropractors in the UK, requiring international standards of exemplary conduct and a commitment to ongoing professional development.


Referrals to professionals with a statutory regulatory body


The General Medical Council and the Department of Health advise that GP’s may safely refer patients to practitioners, such as chiropractors, who are on a statutory register. (Complementary Medicine, information fro Primary Care Clinicians, DOH June 2000).


Chiropractors are subject to a Code of Practice and Standard of Proficiency and patients may formally complain to the GCC if they are dissatisfied with their care. The GCC sets standards of education, proficiency and conduct.

Conditions suitable for treatment


Conditions suitable for chiropractic treatment include common musculoskeletal disorders such as:

  1. Neck pain due to posterior joint and ligament strain with referred pain or paraesthesia. This might involve nerve root irritation which could be discogenic or related to degenerative spondylosis.

  2. Migraine of cervicogenic origin.

  3. Tension headaches due to dysfunction of the upper cervical spine and muscle spasm.

  4. Thoracic spine pain with involvement of the costo-vertebral joints which might also affect other body systems.

  5. Disc herniation with nerve root involvement, tension signs and even mild neurological deficits.

  6. Low back pain due to facet and sacro-iliac joint irritation, muscle strain, ligament sprains with associated muscle spasm and referred pain which might also affect other body systems.

  7. Nerve root irritation due to lateral spinal canal stenosis with degenerative changes, and even when there are signs of neurogenic claudication.

  8. Shoulder capsulitis and rotator cuff tendinitis, medial/lateral epicondylitis and carpal tunnel syndrome.

  9. Knee ligament sprains and minor meniscal tears.

  10. Ankle injuries.

  11. Dysfunction of the joints of the hands and feet. Peripheral joint problems can present as local problems, but may involve the spine or a neighbouring joint, and so may benefit from treatment of both areas.

Conditions suitable for treatment


Over 90% of back pain is mechanical in origin and can be treated by a chiropractor in a primary care setting with full clinical responsibility for the patient. For persistent back pain of over six week’s duration, NICE recommends a course of up to nine treatments of manual therapy. www.nice.org.uk/CG88


A GP referral note including details of any previous investigations, treatment or imaging findings can be helpful and a report from the chiropractor can be expected.


Chiropractic treatment is safe. Estimates of serious complications from manual therapy range from 1 in 10,000 to 1 in 1,000,000. Chiropractors see patients of all ages and are trained to modify their care to take account of risk factors such as osteoporosis. Children and pregnant women with back or joint pain can be helped with gentle manual therapy, advice or exercise. Chiropractors are trained to select appropriate forms of treatment and will refer when clinically indicated.

Best Available Evidence Based Approach


National Institute for Health and Clinical Excellence

Early Management of Persistent Non-Specific Low Back Pain. May 2009 www.nice.org.uk/CG88


Airaksinen O, Brox JI, Cedrashic C, Hildebrandt J, Klaber-Moffet J, Kovacs, et al.

Chapter 4, European Guidelines for the Management of Chronic Non-Specific Low Back Pain. European Spine Journal 2006, 15 Suppl. 2:S169-S191


Van Tulder M, Becker A, Bekkering T, et al

The COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. European Spine Journal 2006 Mar; 15 Suppl. 2:S169-S191


The Department of Health

Musculoskeletal Services Framework for England and Wales. July 2006


UK BEAM Trial

Back Pain, Exercise and Manipulation Randomised Trial; Effectiveness of Physical Treatments for Back Pain in Primary Care. British Medical Journal Nov 2004;329 1377 (doi 10.1136/bmj.38282.669225.AE)


Haldeman S, Carrol L, Cassidy D, Schubert J, Nygren A

The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders. Executive Summary. Spine 2008 33 S5-S7