Chiropractic Examination

In many regards, a chiropractic examination is very similar to standard examination procedures administered by all health care providers. With that said, how chiropractors examine the structure and function of the spine and then determine specific chiropractic treatments separates chiropractic care from other disciplines.

See What to Expect at the First Chiropractic Consultation

Chiropractic Exam of Lower Back Pain

An initial chiropractic exam for back pain will typically have three parts: a consultation, case history, and physical examination. Laboratory analysis and X-ray examination may be performed.

1. Consultation. The patient meets with the chiropractor and provides a brief synopsis of his or her lower back pain, such as:
   • Duration and frequency of symptoms
   • Description of the symptoms (e.g. burning, throbbing)
   • Areas of pain
   • What makes the pain feel better (e.g. sitting, stretching)
   • What makes the pain feel worse (e.g. standing, lifting).

2. Case history. The chiropractor identifies the area(s) of complaint and the nature of the back pain by asking questions and learning more about different areas of the patient's history, including:
   • Family history
   • Dietary habits
   • Past history of other treatments (chiropractic, osteopathic, medical and other)
   • Occupational history
   • Psychosocial history
   • Other areas to probe, often based on responses to above questions.

3. Physical examination. A chiropractor may utilize a variety of methods to determine the spinal segments that require chiropractic treatments, including but not limited to static and motion palpation techniques determining spinal segments that are hypo mobile (restricted in their movement) or fixated. Depending on the results of the above examination, a chiropractor may use additional diagnostic tests, such as:
   • X-ray to locate subluxations (the altered position of the vertebra)
   • A device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation.

Many chiropractors utilize a holistic, biomechanical concept of treating the bipedal structure in its entirety, in an attempt to balance the structure from the feet upward.

See Getting an Accurate Back Pain Diagnosis

Chiropractors are typically trained in multiple methods of assessing lower back pain, including:

• Evaluation and management services.¹Globe G, Morris C, Whalen W, et al., "Chiropractic Management of Low Back Disorders: Report from a Consensus Process," Journal of Manipulative and Physiological Therapeutics November/December 2008: 651-658. Chiropractors are trained in examining the joints, bones, muscles and tendons of the spine, head, extremities and other areas of the body with the purpose of noting any misalignment, tenderness, asymmetry, defects or other problems.
• Neurologic and other common physical examination procedures.¹Globe G, Morris C, Whalen W, et al., "Chiropractic Management of Low Back Disorders: Report from a Consensus Process," Journal of Manipulative and Physiological Therapeutics November/December 2008: 651-658. Chiropractors are trained to perform a variety of neurologic tests (nerve root compression/tension, motor strength, coordination, deep tendon and pathological reflexes, etc.) and are skilled in performing orthopedic, cardiovascular and many other common examinations.

• Specialized assessment.¹Globe G, Morris C, Whalen W, et al., "Chiropractic Management of Low Back Disorders: Report from a Consensus Process," Journal of Manipulative and Physiological Therapeutics November/December 2008: 651-658. Chiropractors are trained to assess range of motion, stability, muscle strength, muscle tone and other assessments with the lower back.
• Common diagnostic studies.¹Globe G, Morris C, Whalen W, et al., "Chiropractic Management of Low Back Disorders: Report from a Consensus Process," Journal of Manipulative and Physiological Therapeutics November/December 2008: 651-658. Chiropractors are trained in use of diagnostic studies and tools such as radiography (X-rays), laboratory diagnostics and neurodiagnostics.

The next page provides an overview of how the lower back examination generally results in a classification in one of three categories.