Chiropractic

Chiropractors diagnose and treat problems affecting the bones, joints and muscles. This is called the musculoskeletal system. It can help with some symptoms of cancer and its treatment.

Summary

• Chiropractors diagnose and treat problems of the musculoskeletal system
• Chiropractic can help to relieve some symptoms of cancer and its treatment
• It is safe to have with a qualified practitioner
• People with some health conditions including some types of cancer are advised not to have chiropractic
• Tell your cancer specialist before you have it and tell the chiropractor you have cancer

What is chiropractic?

Chiropractic is a regulated health care profession.

Chiropractors don't use medicines or surgery. Treatment involves manipulation of the spine and other joints. Manipulation puts the bones and joints back into their natural place. That way they can move properly.

Chiropractors give a wide range of treatments that may include:

• manual therapy - they use their hands to manipulate or move bones, muscles and joints
• prescribed exercises
• self-help advice
• diet and lifestyle
• rehabilitation programmes

Why people with cancer use it

People with cancer see a chiropractor to help control pain, headaches and tension. There is some scientific evidence that chiropractic treatment might help relieve headaches and back pain.

But there is no evidence that it can help prevent, treat or cure cancer. Chiropractors will not claim to be able to cure cancer.

How you have it

Your first visit to the chiropractor will last between 30 to 60 minutes. The chiropractor will take your full medical history. They will ask you some general questions about your lifestyle. They aim to find the exact cause of your symptoms.

They will also want to know about:

• any injuries you have had
• what type of work and other activities you do
• where and how often you have pain
• the type of bed or mattress you have

The chiropractor will ask your permission to do a physical examination. It might also include checking your:

• heart rate
• blood pressure 
• breathing

They might suggest that you have an X-ray or MRI scan of your spine or other affected joints.

Sometimes the chiropractor will ask to speak to your GP. This is to check it's safe for you to have chiropractic treatment.

You can usually stay clothed when having chiropractic treatment. For some treatments, you might need to take off all your clothes except for your underwear. They will give you privacy to change into a gown.

You usually lie on a couch (table) to have the treatment. The chiropractor will use their hands to manipulate your spine or joints.

Sometimes the chiropractor may use a rapid thrust type action. This can cause a popping sound due to the sudden change of pressure in the joint space. This is not dangerous and shouldn’t be painful.

Some chiropractors may also recommend other techniques as part of the treatment. These might be:

• massage
• hot and cold treatment
• physical stretches
• exercises
• needling (acupuncture)
• electrical currents or laser

Tell your chiropractor if you are in any discomfort or want them to stop.

The number of treatments you need depends on the problem you have. You may need treatments:

• once or twice a week
• only once every few weeks

These sessions may be shorter than your first session.

After treatment, your chiropractor may suggest exercises. You can do them at home to help or prevent further problems.

Finding a chiropractor

The chiropractic profession is regulated by law in the UK. The professional regulatory body for chiropractors is the General Chiropractic Council.

All chiropractors must be registered with this organisation. This means that they have to meet the correct set of standards for training. They must also meet standards for professional behaviour and skills. And they must have indemnity insurance.

The General Chiropractic Council can give you a list of the registered chiropractors. Some GP surgeries provide chiropractic care within their service.

Side effects

Spinal manipulation can have some side effects. But these are usually not harmful (benign). Between 23 and 83 out of every 100 people (23-83%) may have benign side effects.

Side effects are usually mild to moderate and pass within 24 hours. These symptoms can include:

• pain in the muscles, bones or joints (musculoskeletal pain)
• stiffness 
• a headache

After treatment to your neck, you may:

• have dizziness
• feel tired 
• feel lightheaded
• have tingling in the arms

You might also hear a clicking or popping noise during treatment. This is normal.

There are concerns about the risk of having a stroke because of manipulation to the neck. The risk of this is very low. Your chiropractor will follow strict guidelines set out by the chiropractic regulatory body. It guides them to avoid specific manipulation techniques if you are at high risk of having a stroke.

Who shouldn’t have chiropractic care

It is important to tell your cancer specialist before you have chiropractic care. Also, let your chiropractor know that you have cancer. Tell them about any treatment that you're having.

You will be able to go ahead with chiropractic care in most cases. But most doctors and chiropractors won't recommend treatment for people who have:

• any type of bone cancer (primary or secondary bone cancer)
• diseases that affect the spinal cord
• diseases of the bone marrow, such as leukaemia and myeloma
• broken bones
• severe bone thinning (osteoporosis)

Your doctor might tell you not to have chiropractic treatment if you are taking:

• some types of steroids
• drugs to help thin your blood (anti coagulants)

There might be other reasons your doctor might not recommend chiropractic treatment. Check with them before going ahead.

Research into chiropractic

Trials have looked at spinal manipulation as a treatment for various conditions. Research studies have found that chiropractic works well for ongoing lower back pain.

The National Institute for Health and Care Excellence (NICE) recommends spinal manipulation as a treatment option for people with ongoing lower back pain. But only as part of a treatment package. The package needs to include exercise with or without psychological therapy.

In 2010 researchers did a review of scientific evidence on manual therapies. They found that spinal manipulation can also help people with:

• migraine
• lower back pain
• neck related headaches
• neck pain
• knee and elbow conditions
• whiplash injury

The review stated that spinal manipulation does not appear to be helpful for:

• asthma
• high blood pressure
• period pain

The studies could not tell whether it helps with:

• fibromyalgia
• pain in the middle area of the back
• premenstrual syndrome
• sciatica
• jaw joint disorders

Studies have shown that people with cancer do seek chiropractic care. This shows a need for chiropractors and patients medical teams to have better communication about a patient's care plan.

It's important to remember that none of these studies were specific for people with cancer.

We need more clinical trials to show how well chiropractic works. And for what other conditions it might be helpful. Trials might also tell us more about possible side effects. Side effects of treatment should not outweigh the potential benefits.

How much it costs

The cost of a private chiropractic session can vary between practitioners. Some GPs can refer you for chiropractic care on the NHS, although this varies from area to area.

Private health insurance might cover chiropractic treatment. You'll need to check your policy.

Questions to ask your therapist

• How many years of training have you had?
• How long have you been practising?
• Have you had training for treating and supporting people with cancer?
• Do you have indemnity insurance? (in case of negligence)

Useful organisations