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Chiropractic diagnoses and treats mechanical disorders of the joints, muscles and ligaments of the body by manual adjustment. Laboratory tests and x rays are sometimes used as an aid to diagnosis. Chiropractic is based on the premise that dysfunction of the spine, pelvis and extremity articulations may disturb associated nerve function. This in turn may lead to specific types of pain syndromes, and in some cases, ill health. If a patient is deemed suitable for chiropractic care, treatment will consist mostly of specific manipulation adjustments. An emerging treatment (especially for back and neck pain) is 'active rehabilitation', based around fitness and endurance regimens which are tailored to the patient's abilities. This approach is also used by osteopaths.

Which conditions or patients might benefit?

These conditions may also be treated by other manipulative techniques, e.g. osteopathy.

Acute low back pain

Clinical guidelines for the management of acute low back pain have been produced by the Royal College of General Practitioners.' These guidelines have been constructed by a multi?professional group and subjected to extensive professional review. They recommend considering the use of manipulative treatment (i.e. chiropractic, osteopathy, and manipulative physiotherapy) for patients with simple backache who need additional help with pain relief or who are failing to return to normal activities. Manipulation provides better short term improvement in pain and activity levels and higher patient satisfaction than the treatments to which it has been compared.

Neck pain

The role of manipulation for neck pain has received considerably less attention than for back pain. A systematic review has been conducted on manipulation for neck pain" and concluded: -mobilisation is probably of at least short term benefit for patients with acute neck pain -manipulation is probably slightly more effective than mobilisation or physical therapy for some patients with subacute or chronic neck pain -all three treatments are probably superior to usual medical care.

Other conditions

There is some evidence of the effectiveness of manipulative treatment in other conditions including: -low back pain associated with dysmenorrhea" -headaches.

Qualifications

UK trained chiropractors have a BSc (Hons) degree. This is a four year degree course which can lead to a Postgraduate Diploma in chiropractic after the fifth year. Chiropractors are trained to a high standard in the use of manipulative treatment, and other supportive measures, as well as in diagnosis for the exclusion of underlying disease -including the use of radiology.

The General Chiropractic Council (GCC) was established by the Chiropractors Act 1994. The GCC is the statutory body that is responsible for protecting patients by regulating the practice of chiropractic in the UK as well as setting standards of education, practice and conduct for chiropractors. The statutory register opened on 15 June 1999 and will close on 14 June 2001. After that time it will be a criminal offence for anyone in the UK to claim to be a chiropractor if they are not registered with the GCC.

Finding a therapist

. The requirement for all chiropractors to be registered does not apply until 15 June 2001. If a chiropractor is not yet registered it does not mean they cannot safely see patients. The register is updated on a regular basis and details are available in a variety of ways. The Chiropractic Registration Information Service at the GCC is able to give advice. Further information is available from: General Chiropractic Council 344-354 Gray's Inn Road London WC1X 8BP Tel: 0845 601 1796 (local rates apply) e-mail: enquiries@gcc-uk.org

website: www.gcc-uk.org