Kyle Bieber, DC is a graduate of Palmer College of Chiropractic and has a practice in Reading, PA. Some of the information used in writing this interview was accessed from the website of the American Chiropractic Association, www. amerchiro.org

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Questions

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Evelyn Corsini:

What education and skills do chiropractors bring to the treatment of patients with pain?

Kyle Bieber, DC: Chiropractic focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Pain is the #1 reason patients initially visit a chiropractor, most commonly for neuromusculoskeletal complaints including back pain, neck pain, pain in the joints of arms and legs, and headaches. Pain is a symptom - a signal that something is wrong with the body - and the goal of the chiropractor is to find and address the underlying cause of the pain. The chiropractic approach is holistic, incorporating the factors of exercise, diet, rest, and heredity. Chiropractors have a drug-free, hands-on approach to health care.

There are more than 60,000 licensed chiropractors in the United States and 16 colleges of chiropractic. Chiropractors must pass national boards and be state licensed. Their education is similar to that of an M.D., requiring a total of 9 years of education, 4 years for a bachelor’s degree and 5 years of chiropractic education studying anatomy, biochemistry, pathophysiology, microbiology, and neurology. Education is focused heavily on neuromusculoskeletal diagnosis and diagnostic imaging, as well as chiropractic technique. The last year includes an internship in a student clinic, followed by an internship in a clinic where patients from outside of the school are seen. Some practitioners go on to externships with licensed, practicing D.C.’s.

EC: How do chiropractors assess and treat pain?

KB: Chiropractors start with a thorough diagnostic assessment, including a history and physical examination. I focus on factors that could have caused injury to the body (such as work history, sports history, sleep patterns) as well as how pain effects the patient’s life and what remedies they have tried in the past that have not resolved the problem. I use static and motion palpation, postural analysis, and sometimes imaging tests and laboratory tests. I am looking for a physical misalignment in the spine which stresses the nervous system. This is called a subluxation, and most people have them to some degree.

During the first patient visit, after the assessment, I will discuss whether I think I can help the patient. At the second visit I will provide education on maintaining optimal health, and I will give the patient their first “adjustment”. An adjustment uses a highly specific, controlled force to influence individual spinal segments and paraspinal tissues, thus correcting the subluxation. There are about 100 different techniques to do this, most requiring just the use of my hands.

During the third visit I will evaluate the response to the first adjustment, making sure the techniques I used were comfortable, and I will describe the difference between symptom relief care (shorter term) and corrective care, which includes teaching the patient how not to stress the spine in the future. Most people choose corrective care in my office.

EC: Do chiropractors treat both acute and chronic pain?

KB: Both chronic and acute pain respond well to chiropractic care, but remember that pain is a signal that something is wrong with the body, and we are looking to correct the underlying cause of the pain, not simply cover up or “treat” it. Treating pain would be like pointing the fire extinguisher at the smoke alarm instead of the fire.

EC: How does chiropractic interface with other health care professions?

KB: A patient can continue to work with other health care providers and can continue to receive medication from them. There is referral in my practice back and forth to medical doctors, orthopedists, neurologists and physical therapists. The patient may be receiving mental health services or using other techniques they feel are helpful. I want my patients to be educated about how they can achieve and maintain optimal health.

EC: What research is being done in the chiropractic profession and what do you see as future treatment trends?

KB: Most of the research being done currently is on the efficacy of chiropractic for the treatment of neck and back pain. Currently chiropractors only receive Medicare reimbursement for neck and spinal adjustments, but I have read that there is a pilot study looking at the effect of expanding this treatment to the extremities, i.e., shoulders, elbows, wrists, feet, and knees. Most other insurance companies already reimburse chiropractors for these services.

In my own practice, I am interested in general health maintenance and teaching patients how to take good care of their health. Patients with allergies, asthma, menstrual problems, digestive problems and many more conditions have responded well to my care. As health care consumers become more educated and empowered to make choices about health care, they are interested in finding care providers who will spend time with them, listen to them, and treat them as a whole person. Since these are skills that chiropractors have, I imagine the profession will thrive.