Definition 

Chiropractic is defined as a licensed profession that focuses on the abilities of the body to heal itself. This healthcare profession involves the use of manual therapy, particularly spinal manipulation. Chiropractic also involves the use of nutritional counseling and exercise to treat different medical conditions. Chiropractors tend to administer the treatment in a manner similar to the practitioners of conventional medicine. Manual therapy includes manipulation of joints by applying pressure and stretching the affected area. Chiropractors administer a quick, yet gentle thrust to the involved spine region in order to improve the motion and function of the joint. Chiropractors also cater to other areas of the body along with the spine. [1]

Uses

Chiropractic techniques are employed for the treatment and management of the following conditions. [2]

1. Spinal manipulation is beneficial for the treatment of acute, chronic, and subacute lower back pain. Exercise and massage therapy are also useful for the management of chronic lower back pain.
2. Chiropractic techniques are also effective for the treatment of neck pain. When spinal manipulation is combined with exercise and massage therapy, it is also beneficial for the treatment of acute whiplash. Spinal manipulation is effective for improving chronic neck pain and cervicogenic headache. 
3. Thoracic spinal manipulation is important for the treatment of mild back pain. This is also effective for the associated neck pain. 
4. Chiropractic techniques are effective for the treatment and management of migraine, cervicogenic headaches, and tension-type headaches. 
5. Alongside spinal manipulation, chiropractic techniques prove to be beneficial for the treatment of extremity conditions. These conditions include plantar fasciitis, shoulder girdle pain, patellofemoral pain syndrome, adhesive capsulitis, hip and knee osteoarthritis, and lateral epicondylitis. Studies demonstrate the effectiveness of chiropractic techniques for relieving shoulder pain, carpal tunnel syndrome, rotator cuff pain, and ankle sprains. The treatment has favorable outcomes for hallux limitus, hallux abductor valgus, and Morton’s neuroma.
6. Spinal manipulation has positive outcomes for non-musculoskeletal conditions such as cervicogenic dizziness. Chiropractic techniques may also be beneficial for the treatment and management of pneumonia, nocturnal enuresis, stage 1 hypertension, otitis media, and pre-menstrual syndrome. 

Qualification Required To Become a Chiropractor

For becoming a chiropractor and initiating clinical practice, one must follow the steps mentioned below and acquire the degrees quoted in the following content. [1]

1. One shall complete undergraduate education which is approximately three years long, before advancing to a professional training program. 
2. After obtaining an undergraduate degree, one must enroll in a Doctor of Chiropractic (D.C.) professional program which is approximately 4 years long. The curriculum includes anatomy, physiology, and other basic sciences as well as supervised clinical experience that involves diagnostic skills, spinal assessment, and spinal adjustment techniques. 
3. After earning the D.C. degree, one must clear the exam conducted by the National Board of Chiropractic Examiners in order to acquire the state license. In several states, chiropractors are also required to clear the exam regarding state-specific laws. The chiropractors are also required to attend continuing education classes even after obtaining their license.  
4. After obtaining the D.C. degree, some chiropractors also complete postgraduate education in orthopedics, pediatrics, and other specialized fields. 
5. The Council on Chiropractic Education offers accreditation to the institutions offering D.C. professional programs. 
6. Chiropractors may also use drug therapy, exercises, patient education, and massage therapy for the treatment of different musculoskeletal and non-musculoskeletal conditions.  

Chiropractor Theory

The biopsychosocial model of chiropractic care interlinks the sociological, biological, and psychological factors. The biological factors include chemical and physical alteration of the human body; psychological factors include the mental health and personal development of an individual. The sociological factors include socioeconomics, interpersonal relationships, and social support dynamics. The biopsychosocial model demonstrates significance in the chiropractic treatment and management of spine pain. The psychosocial factors contributing to the onset of spine pain include depression, post-traumatic stress disorders, anxiety, maladaptive beliefs, fear-avoidance beliefs, and unsupportive interpersonal relationships. 

Guideline recommendations for acute, chronic, and subacute lower back pain include the use of spinal manipulation, stress reduction, exercise, yoga, multidisciplinary rehabilitation, tai chi, and cognitive behavioral therapy. [3] 

Chiropractor Subspecialties

The subspecialties of chiropractic care are as follows. [4]

1. Chiropractor Acupuncture 

Chiropractors specialized in acupuncture treatment may use needles to stimulate acupuncture points in certain locations. Chiropractors obtain acupuncture certification from the American Board of Chiropractic Acupuncture (DABCA) by clearing the DABCA exam. 

2. Forensic Chiropractic 

Forensic chiropractic certification is obtained from the American Board of Forensic Professionals (DABFP) and requires a clinical experience of approximately 300 hours. Forensic chiropractors may evaluate the health of the patients and may provide medical information working under the legal system. 

3. Internal Medicine and Family Chiropractic 

Internal medicine and family chiropractors obtain certification from the American Chiropractic Associated – Council on Diagnosis and Internal Medicine (ACA-CDID). With a diplomate status, these chiropractors can use techniques including acupuncture, dietetics, exercise, pharmacologic consulting, botanical, and homeopathic medicine. 

4. Neurologic Chiropractor 

Neurologic chiropractors are responsible for the examination of the association between the neurologic systems and musculoskeletal and sensory systems of the body. The diplomate status in this subspecialty is offered by the American Chiropractic Neurology Board (ACNB) and it requires a clinical experience of approximately 300 hours in functional neurology. 

5. Neuromusculoskeletal Medicine Chiropractors 

Previously termed chiropractic orthopedists, these chiropractors treat and manage neuromusculoskeletal conditions. The certification is obtained from the International Academy of Neuromusculoskeletal Medicine (DIANM) and requires a clinical experience of 300 hours.   

Chiropractor Treatment 

Important guidelines for chiropractic treatment and management of chronic pain conditions are as follows. [5]

1. Chiropractors shall emphasize the biopsychosocial model of treatment.
2. The chiropractor shall prioritize non-pharmacological therapies and self-management over pharmacological therapies. 
3. While passive intervention plays an important role in the initial stages of chiropractic management, active intervention shall be emphasized. These include self-care strategies and exercises.
4. The chiropractor shall recognize the neurophysiological nature of the pain – nociceptive, central sensitization, and neuropathic. 
5. Chiropractors shall classify the magnitude of risk and treat the patients accordingly. For patients at relatively low risk, a less intensive approach shall be opted and vice versa. 

Conclusion 

Chiropractors employ spinal manipulation and other therapeutic techniques for the treatment of musculoskeletal and non-musculoskeletal disorders. The chiropractors shall obtain both undergraduate and D.C. degrees followed by clearing the state licensure exam. 

References 

1. https://www.nccih.nih.gov/health/chiropractic-in-depth 
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/ 
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461754/ 
4. https://www.healthcaredegree.com/faq/types-of-chiropractors 
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578188/