Answers to Questions about Chiropractic:
Is Free Screening by Chiropractors Ethical?

Samuel Homola, D.C.

Question.I have been suffering from neck/shoulder tension and stiffness as well as lower back pain/stiffness on and off for the past nine months. I know it has a lot to do with my poor posture and the fact that I sit in front of a computer and answer phones all day, along with my tendency to get stressed out. I also workout daily and lift weights, which sometimes leads to stiffness.

When massage, Advil, and hot/cold compresses failed to relieve my stiffness, I decided to see a chiropractor. Since my insurance doesn't cover chiropractic, the chiropractor's receptionist gave me a certificate for a free screening. They took three x-rays on my first visit, one of my neck, spine, and then a side view. I went back the next week and was shown these x-rays. The doctor explained that my neck had no curve in it and that was why I had soreness at the base of my neck --which made sense to me. My lower back was also in need of adjustments, and he said that adjustments would help ease my stomach indigestion and menstrual cramping. He recommended three treatments a week for six months and offered me a student discount.

I have started the treatments and I must admit that I do feel a bit better for at least a few hours after the adjustments, but after reading through your website I am becoming very concerned. Here are my concerns:

  1. Has damage been done to my body because I had three x-rays?
  2. Is my doctor a quack because he has set me up with a treatment and payment schedule? Because he treats children? Because he gave me three certificates to give out to friends for free screenings? Because he promotes wellness adjustments?
  3. Are these treatments hurting my body more than they are helping? Am I getting long-term damage?
  4. Are these treatments useful for alleviating back and neck pain?

Answer

Appropriate spinal manipulation and physical therapy provided by a good chiropractor can be beneficial in treating mechanical-type neck and back pain and stiffness. Such treatment, properly performed, should not be damaging in any way. The three x-rays you had will not be significantly harmful if you have not had many other x-rays made.

There is no reason to believe that spinal adjustments can ease indigestion or your menstrual cramps. If you feel the treatment eases your off-and-on neck and back symptoms, you should get treatment when you feel you need it. You should not go for treatment three times a week for six months. Stop when you feel okay or if symptoms persist after a weeks weeks of treatment.

Chiropractors who use aggressive practice-building tactics—such as free screening, a long course of treatment with a payment schedule, and discounted "maintenance" care—may not be putting the welfare of their patients first. If you cannot find a chiropractor who does not use a sales pitch, or one who does not suggest that everyone, including children, needs spinal adjustments to stay well, you should pay for treatment as you go—and go only when you feel you need it.

Excessive treatment can do more harm than good. Risk may outweigh benefit when treatment is unnecessary (when there are no symptoms) or when treatment is inappropriate, especially when neck manipulation is done. You should be wary of any doctor who solicits patients with certificates for free screening and then attempts to lock patients into a long-term treatment program, which often involves unnecessary or inappropriate treatment.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on June 23, 2002.