How long will the appointment be?
We allow 45 minutes for all first chiropractic visits. This includes 30 minutes for a consultation and examination and 15 minutes for treatment. If you are not a candidate for treatment, require onward referral or imaging, we carry out the consultation and examination only and do not charge for treatment. The decision to progress to treatment is yours to make having had a full discussion of your diagnosis, our proposed treatment and any risks or benefits of treatment.
What should I wear?
On arriving to the clinic, we will provide you with a gown to wear and we will show you to a changing room. We ask that you remove your outer layers, shoes and socks, but keep your underwear on. Should you feel more comfortable you could bring a pair of shorts. We ask patients to change down as it helps us to be able to see the spine and joints to assess for bruising and swelling, heat and rashes as well as muscle bulk or wasting. These are key diagnostic features.
What is involved in the consultation?
During the consultation we will be asking you the following things:
- Details about your current condition eg. pain location, type of pain, areas of tension, reduced mobility, activities affected, duration of symptoms, any referred pain, nerve symptoms.
- Details about your past medical history; previous accidents or injuries, fractures, car accidents, sports injuries, previous medical conditions. This helps our diagnosis of your current condition as well as informing which treatment techniques will be suitable for you and your likely response to treatment including prognosis.
- Current medications: some medications affect which treatments we will be able to offer you. Different medications also affect your current symptoms which will be relevant to our diagnosis
- Family medical history; some conditions have a genetic link.
- General health: many conditions have the same symptoms, we are always on the look-out for conditions that may appear to be back or joint related but aren’t, in which case we can refer you to your GP, the relevant consultant or for imaging to get more information before making a diagnosis.
What is involved in the examination?
During the examination we may assess your gait, movement patterns, nerves by assessing your strength, sensation and reflexes in the arms and legs, the range of motion in different joints, we can also test joints and ligaments. We are always checking for heat, rashes, swelling and bruising.
Do we carry out imaging?
We do not routinely image all of our patients, our decision to image is based on your medical history, mechanism of injury, the impact of imaging on our treatment plan among other factors.
- X-ray imaging is used to see bony structures, and the space between joints.
- MRIs can show soft tissue structures, like muscle, ligaments, tendons as well as inflammation.
- Ultrasound can show muscle, ligaments and tendons as well as blood flow.
We can refer to imaging companies who provide us with copies of the images and reports.
How do we design a treatment plan?
We take into account your general health, our diagnosis, the length of time a problem has been going on, your preferences with regards to treatment techniques, our goals for treatment, and your lifestyle/patterns of movement. You have the option to go away and think about whether you wish to start a course of treatment after the Consultation and Examination. We allow enough time to carry out treatment should you wish us to do so, after we have discussed what we have found and together agreed on an action plan.
Will it hurt?
Depending on how much pain you are in when you come to see us it may be uncomfortable for you to move around for us to examine you. Generally speaking, an examination does not cause any more pain than you may already be in.
How many treatments will I need?
We very rarely will only treat someone once, unless they are in the area only for a very short time and need help to ‘tide them over’ until they can get home.
All of our treatment plans usually involve a course of treatment over several months to get you back to peak health.
When we decide how many treatments will be necessary, we are looking at certain key factors:
- The more severe the problem (this may mean high pain levels or severely limited mobility) the higher the number of treatment sessions.
- The longer the problem has been going on for the longer the treatment plan eg. A 20 year problem will likely take longer to treat than a condition which has only started recently.
- The complexity of the problem; if lots of different areas are going wrong it takes more time to manage, so more treatment sessions.
- Your general health picture, if someone is generally fit and healthy, they recover quicker than someone who has additional health needs. The quicker recovery time requires fewer treatment sessions.
- The nature of the structures injured eg muscles heal faster than tendons as they have better blood supply therefore a muscular injury would require fewer treatment sessions than a tendon injury.
- Your goals with treatment; are we preparing you for a marathon, Iron Man or more intense physical exertion? or are we helping you to be able to bend to put your socks and shoes on? The more complex the goal, the more treatment sessions required.
- If you have a long-term recurring problem, we may discuss with you supportive management, where we keep symptoms to a minimum by having sessions regularly to maintain your quality of life even if your condition doesn’t go away completely.
To make maximum change in the shortest possible time frame we could initially see you twice a week for treatment before reducing the frequency of the sessions as you move through recovery.
Everyone has individual health needs and we design individual treatment plans to reflect that so it is impossible to say exactly how many sessions any one person would need without assessing them.
What do we include in our treatment plan?
We do hands on treatment to improve mobility, muscle control and tension, and nerve tension. We also give advice to minimise the impact of the key reasons you developed the condition in the first place as well as exercises to help you build and maintain strength and movement in the affected areas.