If you’ve ever visited a chiropractor, then you know that they are specialists in health problems associated with the body’s muscular, nervous, and skeletal systems, especially the spine. They diagnose and treat back and neck pain and address injuries and aches felt at the elbows, shoulders, knees, ankles, and feet, among other spots.

So can a doctor of chiropractic be a primary care physician?

Short answer, yes. Not only can chiropractors be primary care physicians, but they usually are primary care physicians. Why? Because you don’t need to see a general practitioner to know when you’re experiencing muscular-related aches and pains. Instead, you can call the chiropractor directly, who becomes the first point of contact for patients.

Now, don’t get the wrong idea. General practitioners are recommended as primary physicians for overall care. They know a lot about the body, especially the relationship between environmental, psychological, and physical health and they are educated diagnosticians. When a generally healthy person checks goes in for a checkup once or twice a year, they usually go to a general practitioner. They get checked in their eyes, ears, and throats. They are measured to see if their heartbeat is steady, their cholesterol is normal, and their blood sugar levels are good, among other pokes and prods.

A general practitioner will refer out to a specialist when something in the body is nagging or feels off, and it’s not a run-of-the-mill flu or an intestinal disorder. And when it comes to muscular pain it’s usually a chiropractor. On occasion, a general practitioner may instead suggest seeing an orthopedist. That’s a different kind of musculoskeletal doctor. Orthopedists address muscular or bone problems associated with breaks or fractures and usually prescribe medication or surgery. But in many acute and chronic musculoskeletal cases, chiropractors are the practitioners who can treat patients with non-pharmaceutical or orthopedic techniques, including manual adjustments, manipulation, decompression, stretching, and other exercises.

What is a doctor of chiropractic?

A doctor of chiropractic goes through a lot of schooling, including regular undergraduate studies with prerequisites that are required for chiropractic. In most cases, doctors of chiropractic must complete a four-year course of study followed by an internship or residency.

All the chiropractors at Capitol Rehab of Arlington are doctors of chiropractic. As undergraduates, Dr. Booker studied psychology with a biology minor. Dr. Beck studied exercise science. Dr. Hatch did a double major in history and biology and was conferred two bachelor’s degrees (showoff). All the doctors’ biology and exercise science credits qualified them for acceptance to chiropractic colleges.

For their chiropractic training, Dr. Booker attended the Cleveland Clinic in Los Angeles; Dr. Beck studied at the Palmer Chiropractic College in Davenport, Iowa; and Dr. Hatch got his doctor of chiropractic from University of Western States in Portland, Ore.

Being a successful doctor means constantly learning new techniques and keeping up with changes in the medical field. That means continuing education and certifications. The doctors are all certified in Active Release Technique (ART), which is one of the most complete and effective treatment techniques for soft-tissue injuries.

They have also picked up specialties along the way that complement their personal interests. Dr. Hatch, for instance, is a certified medical professional with the Titleist Performance Institute. Golfers with acute or chronic pain are referred to him in most cases. Dr. Beck is a runner and has worked with many local running groups as well as long-distance competitive athletes from the region. Dr. Booker focuses on youth athletics and has been a team doctor for high school and club soccer, track, and basketball teams. He has also worked with college and Olympic teams.

What happens when you get a chiropractic adjustment?

Chiropractors use techniques that involve placing their hands on a patient’s body and identifying joints that are under stress. They then manipulate the joints, nerves, and muscles to ensure that the joints can move from their resting positions and back smoothly so that the body can move normally.

Joints are under stress because people are physically active. Physical movement can irritate the spinal nerves coming out of the spinal cord. This results in the feeling of pain or soreness or stiffness. These spinal nerves control other functions besides the musculoskeletal system but in terms of chiropractic, when any part of the musculoskeletal system is irritated, it causes spasms, muscle weakness, and loss of function.

Generally, a joint doesn’t get dislocated from use. Instead, it gets stuck within its normal range of motion and can’t move beyond it. For instance, the elbow can bend up toward the upper arm so the lower and upper arm are parallel. The elbow can also extend the lower arm away from the upper arm so the arm is straight. That’s the normal range of motion for an elbow. But the elbow joint can get stuck anywhere inside that range and when it does, that aggravates the nerve that controls the joint.

When a joint get stuck, a chiropractor “unsticks” it so it can complete its full range of motion. The chiropractic adjustment physically moves the joint off the nerves and trains the body to maintain the correction so that the nerve can heal and do its job and the patient can feel better as a result.

A multitude of causes can trigger the senation of pain. Patients may have a flare-up from an old injury or they may suffer from repetitive stress. Perhaps a new activity, like shoveling snow or a tennis game, caused movement in the joints. Nerve pain can even be caused by diabetes or an autoimmine disorder. Many variables can contribute to joint immobility that requires chiropractic adjustment or treatment.

The chiropractic doctors at Capitol Rehab treat patients of all ages and activity levels. When a new patient comes in or an existing patient returns after a long break between visits, they need a thorough evaluation. This takes longer than a regular treatment so that the doctors can address changes in physical mobility as well as give proper attention to new triggers and reactions to pain. The doctors check patients from top to bottom for limitations in movements and will investigate where the patients’ joints may or may not be moving or whether muscle function is firing normally. They will learn a little bit of a patient’s history of activities to discover any changes in habits or traumatic events like a slip or fall. This information helps direct the doctors to the part of the body where the muscles, joints, and nerves may be under stress.

New patients and those needing a re-evaluation can expect to be in the office for a half hour to an hour’s time meeting directly with the doctor. Existing patients can usually be in and out of the office in about half an hour because the doctors have recently addressed issues that recently occurred.

When a patient comes in for a regular adjustment, the doctors recheck areas they’ve worked on at previous appointments to see how they are behaving and make sure that they are working like they are supposed to. If these joints are not behaving, the doctors address these parts through a series of muscle tests and make chiropractic adjustments. They frequently employ electric stimulation (E-STIM) to loosen areas of particular concern. The electricity helps bring blood flow into the area to make the patient more comfortable and the doctor’s job of moving joints easier. They may also suggest particular exercises to address these areas of concern.

The doctors at Capitol Rehab value their patients’ time and so the treatment process is very precise. Unlike many therapeutic offices, the doctors don’t throw a bunch of modalities at patients like ice, treadmill, bikes, and stretching in order to maximize their billing. They take an active role in each treatment. Each chiropractic adjustment has a specific goal — to increase joint mobilization and improve joint function and to address the neurologic causes of muscular pain. Patients can — and are expected — to do assigned modalities like ice, stretching, and other exercises on their own time.

How often should you see a chiropractor?

Regular chiropractic maintenance prevents the build-up of pain. The frequency of regular maintenance depends on the individual. High-level athletes might come in once a week or once every other week because their bodies are more intensely used. For the average person living their everyday life — someone who probably sits in an office but gets proper rest, hydration, exercise, and monitors their stress and self-mobilization  — coming in for an appointment once every four to eight weeks is usually adequate. For most people, this is the length of time before the body starts to revert out of position.

Unfortunately, the average patient waits too longs for a regular visit while others don’t address their pain until it’s moderate to severe. That’s a mistake!

Because of the advanced techniques used by the doctors at Capitol Rehab of Arlington, patients who come in for chiropractic adjustments feel better fast. But how fast and how much better depends a lot on subjective measures.

Feelings of pain vary from patient to patient. One person’s pain may feel excruciating while another person with the same injury may perceive their pain as moderate. That’s one reason why there are at least 10 different types of pain scales that medical professionals use to evaluate patients.

For patients who feel discomfort but describe their pain level as mild, a 1-3 on a 10-point scale, they may notice the pain but they are able to function almost normally. A series of chiropractic adjustments four-six times over a two-three-week period will probably do the trick.

For patients who are experiencing moderate pain, somewhere in the middle of the scale — a 4-6 out of 10 — pain may curtail some of their activities and interrupt parts of their regular lifestyle. In this range, getting back-to-normal could take eight-12 chiropractic adjustments over a four-week period.

Patients who have reached acute pain — a 7 or higher on a 10-point scale — often find that pain interrupts their routines and enjoyment of regular activities. For patients at this end of the spectrum, 15 visits over a six-week period are recommended to address the causes and repair them. Patients who are in acute pain due to injury may need physical therapy two times a week for 4-8 weeks simultaneously with chiropractic or afterward.

Most people suffering acute or chronic pain feel better before their last visit, which is the goal, but they should not stop the prescribed number of treatments. When patients say they feel good, they sometimes think they don’t need to come back. This too is a mistake.

Getting out of pain is the primary goal but staying out of pain is harder and takes longer. Patients must “brain train” their bodies to prevent them from returning to the same activities or missteps that caused the pain in the first place. Patients must commit to their wellbeing and do their homework, which frequently involves exercise and stretches that alter the patient’s neurology. That doesn’t happen overnight. It’s an ongoing process.