Being in Branson, its common for me to see a few tourist every week. Occasionally they are under treatment and go on vacation and wish to continue with whatever therapy they are receiving at home, but predominantly while on vacation they have an “incident.” This might be a new injury or an exacerbation of a chronic condition, but it has them in enough pain to take time away from their trip to seek care. We try to accommodate them on the schedule, figure out what is going on with them, provide as much relief as possible and make any referrals necessary. At this point in the game, I actually have a handful of tourist that will seek me out annually when they come to town again. They are generally a very satisfied patient population. Enough to where I get request on “how can I find a good chiropractor in my area?”
This is not a dig on dentist, but dentist are pretty dang similar. Sometimes I’ll say that a dentist is a dentist is a dentist, but boy, can Chiropractor ever vary. Let me help you understand how I go about finding good providers.
There are good and bad apples in every field. Good attorneys, and well, not so good ones. Good mechanics and bad ones. Good teacher and bad and so on. Maybe a defining common thread between any professions good and bad actors is just honesty. However, honesty is a difficult thing to assess from a website. Even google reviews or even personal referrals may not be enough to accurately gauge that. There are a few red flags though that you can ID online or on your first encounter:
Moving on from honesty. Theres plenty more that goes into finding and identifying a top quality chiropractor.
Manipulation (Chiropractic Adjustments) are an awesome tool. Chiropractors vary in whatever techniques they like and use. Personally I use Motion Palpation Institute methods mostly. You could almost break it down to techniques that usually cause a pop (cavitation) and those that don’t. Most use what is call a diversified technique, which is a popping technique that is essentially an amalgam of all the specific techniques out there. In general, someone that is a “Technique Purest” would not be my first recommendation of who to see. The notion that their adjusting technique is the panacea of greatness should be something of a red flag. Its nearly standard that any chiropractor has at least 2 techniques, a popping one, and one that doesn’t. Now I have a lot of non popping techniques that could be considered “manipulation:”
You should be able to scour a potential chiropractors website, or their youtube channel for information on what their non popping techniques are. Maybe the most common is the activator, and I’m happy to use mine when its (rarely) the best choice or when patients have a strong bias towards using it, but seriously, its not that special. There are a lot of low force or non popping techniques out there. Obviously I find the three listed superior, but most chiros have at least one they use.
Honestly, its 2020, if you don’t have at least one soft tissue therapy tool in your belt, I won’t advise patients to see you. We are not bone setters. Chiropractors treat the MUSCULOskelatal system. You need a handful of ways you address soft tissues. Soft Tissue means stuff that’s not bone. It does mean muscle, but also tendons, ligaments, facia, and nerves. Rehab could be included in this, but ill touch on that in a bit. For direct treatment of soft tissues I use the following
There are a ton of options out there. Any chiropractor worth their salt should be paying attention to the soft tissues. If I find a provider that has done some work in nerve mobilizations, I know they know their stuff and would do great work with any of my patients.
If somebody has nothing on their site regarding soft tissue, thats a red flag.
When I search for a good Chiropractor, I look for any of these three first honestly. Im biased that they represent the best of the best. Sorry not sorry.
But any rehab is generally better than no rehab, so as long as you doing something, that provider is helping you to take control of the situation in a positive manor. As opposed to making you dependent upon his/her treatments.
The American Academy of Family physicians does not advise the routine X-Ray of patients with low back pain
In the absence of red flags, they recommend a trial of care, and only begin imaging if there isn’t marked progress. No one gets better from and MRI or X-Ray. Chiropractors that take X-Rays routinely on the first visit should be avoided. Most of the time these are going to find age appropriate findings and serve as scare tactics to sell large treatment plans.
This gets into the highly variable nature of chiropractors. Some of us use some, lets call them “unique” digital tests.
The most common include:
These are both more or less thermal imaging scans that produce a nifty graphic that packages nicely when selling care. Think of them like a car fax report, but not as useful. To me, they are massive red flags. If they were literally of any diagnostic or clinical value, wouldn’t we see other types of providers using them? Lots of fields use X-Rays, MRIs, Diagnostic Ultrasounds. Doctors that specialize in treatment of nerve entrapments use Nerve Conduction Velocity test (which are an absolutely miserable experience to undertake) why wouldn’t they use these “Nerve” Scans. Well, because they are not nerve scans, they are just temperature scans, and worthless.
Even the acupuncture ones that somehow measure the “chi flow” I am just not too sold on any of those.
I don’t think vaccines should even be discussed in a chiropractic office. I don’t think Podiatrist should talk much about shoulder pain. I don’t think Dentist should have strong opinions on foot pain. And I don’t think chiropractors have the slightest bit of cultural authority in discussing vaccination. It’s not our business. It’s not our area of expertise. It exposes an anti medicine, anti science position, that is outside the scope of a chiropractors practice. We should stay in our lanes. This is a significant red flag in my opinion. This should be left to parents, Immunologist, Primary Care Physicians, and Pediatricians.
A good provider, be it a chiropractor or physical therapist, should aim to answer those questions.
In the absence of red flags and needs for imaging promptly, you should leave your chiropractors office (hopefully feeling marginally better at least) with an idea and plan going forwards.
If your chiropractor hits most all of these points, you’ve got a keeper. If not you might wanna shop around. When I shop around for providers in a tourist area I search this:
Then I kinda inspect their website looking for red flags (nerve scan images, vaccine talk), trying to ascertain what sort of things they do and if they are up to the challenge. Especially locally, in St Louis, Columbia and Kansas City I actually know clinics that do stellar work. Believe it or not Missouri has some of the absolute best chiropractors in the world.
Notice I mentioned nothing about insurance. I actually feel that in general, a non-insurance clinic might trend towards being quacky, but that is not a completely accurate sentiment. In some cases the absolute best in the world, are flat out too good to mess with third party payers and I can respect that. It also depends on the affluence of your region. Here in Branson I definitely take third party insurance.
I hope this information helps you in your search. If I can help you find someone in your area don’t hesitate to reach out
Zach Vahldick DC