An initial chiropractic exam will most often include a history and a physical. The patient should be asked about the current complaint, whether there are chronic health problems, family history of disease, dietary habits, medical care received, and any medications currently being taken. Further, the current complaint should be described in terms of how long it has been a problem, how it has progressed, and whether it is the result of an injury or occurred spontaneously. Details of how an injury occurred should be given. The physical exam should evaluate by observation and palpation whether the painful area has evidence of inflammation or poor alignment. Range of motion may also be assessed. In the spine, either hypomobility (fixation) or hypermobility may be a problem. Laboratory analysis is helpful in some cases to rule out serious infection or other health issues that may require referral for another type of treatment. Many practitioners also insist on x rays during the initial evaluation
When spinal manipulation is employed, it is generally done with the hands, although some practitioners may use an adjusting tool. A classic adjustment involves a high velocity, low amplitude thrust that produces a usually painless popping noise, and improves the range of motion of the joint that was treated. The patient may lie on a specially designed, padded table that helps the practitioner to achieve the proper positions for treatment. Some adjustments involve manipulating the entire spine, or large portions of it, as a unit; others are small movements designed to affect a single joint. Stretching, traction, and slow manipulation are other techniques that can be employed to restore structural integrity and relieve nerve interference.
Judith Turner, Teresa G. Odle, The Gale Group Inc., Gale, Detroit,