Chiropractic Doctors are well qualified to diagnose or recognize all medical conditions. Take a quick look at The National Board of Chiropractic Examiners (NBCE), all Chiropractors must pass to become Doctors. It is divided into four main sections:
- Part I covers six basic science subjects – general anatomy, spinal anatomy, physiology, chemistry, pathology and microbiology.
- Part II covers six clinical subjects – general diagnosis, neuromusculoskeletal diagnosis, diagnostic imaging, principles of chiropractic, chiropractic practice and associated clinical sciences.
- Part III covers case history, physical examination, neuromusculoskeletal examination, roentgenologic examination(radiology), clinical laboratory and special studies examination, diagnosis or clinical impression, chiropractic techniques, supportive techniques and case management.
- Part IV covers x-ray interpretation and diagnosis, chiropractic technique and case management skills.
With the addition to the Physical, Neurological, orthopedic, and Chiropractic examination done to better diagnose the patient. Chiropractors depend also on taking or ordering X-rays, MRI’s, NCV/EMG testing and sometimes CT scan as well to better diagnosis the cause of the patients pain. I will discuses some of these procedure below.
X-rays play a vital role in chiropractic. They allow your chiropractors to view your bones, joints and related soft tissues. These x-rays will help your chiropractor see the curves of your spine and determine which are normal and which are abnormal. They will also be able to see any abnormalities in your joints and the degree of degeneration.
What abnormalities are they looking for? They can see such things as bones that are abnormal from birth, fractures, dislocations, arthritic conditions, infections of the bones or joints and tumors. The detection of any of these will be significant in your treatment plan.
Magnetic Resonance Imaging (MRI)
The next most commonly used diagnostic test in chiropractic is magnetic resonance imaging (MRI). It is a non-invasive test that will help your chiropractor diagnose and treat your spinal problem. MRIs are used to visually assess and diagnose soft tissue damage, disc herniation or bulges as well as any space occupying lesion or disease that maybe also causing the pain or discomfort.
Nerve Conduction Velocity (NCV)
Nerve conduction velocity (NCV) is a test of the speed of electrical signals through a nerve. It is most often used to diagnose nerve damage and plan treatments. Nerves carry messages between the brain and body. Many conditions, such as tissue swelling, injury and disease, can put pressure on a nerve and impair its ability to function.
Patches are placed on the skin over nerves in various places. Each patch is an electrode that gives off a very mild electrical impulse, stimulating the nerve. The activity of the nerve is then recorded and the speed of travel between the electrodes is calculated.
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles. EMG is most often used when people have symptoms of weakness or an examination shows weakened muscle strength.
Your chiropractor will insert a very thin needle into the muscle. This electrode records the electrical activity given off by the muscle. Often during the test, you will be asked to move in certain ways so that the activity can be recorded during normal movements.
For a healthy muscle, the electrode will find very little electrical activity in a muscle at rest and more as the muscle is contracted. If this is not the pattern of your muscles, then your chiropractor can diagnose your condition.
Disorders or conditions that cause abnormal results include lateral sclerosis, axillary nerve dysfunction, carpal tunnel syndrome, radial nerve dysfunction, sciatic nerve dysfunction, nerve compression, nerve root injury and more.
Computed Axial Tomography (CAT) is a more sophisticated type of x-ray. A CAT scan takes multiple images that provide cross-sectional pictures, like slices, of soft tissues and bones. CAT scans can take 10 or more images per second.
A CAT scan is a good choice for all patients who have experienced acute trauma. This is especially true when the cervical spine cannot be seen well using a basic x-ray. It is also a good diagnostic test if the basic x-ray shows some abnormality that cannot be diagnosed.
This test can reveal problems such as:
- Herniated disks
- Ruptured ligaments
- Soft tissue hematoma
(Note the difference between the CAT scan and the typical x-ray shown earlier.)
Myelography is another form of x-ray used by chiropractors. This type of x-ray can actually examine the structures within your spinal column looking for such things as spinal tumors, spinal cord swelling and herniated (slipped) disks.
Myelography involves placing a spinal needle into the spinal canal and injecting a contrast material into the space around the spinal cord and nerve roots. When the dye is injected into this space, the radiologist can see the status of the spinal cord, nerve roots, blood vessels and meninges.
The membranes that surround and cover the spinal cord and nerve roots.
Myelography is most commonly used to detect abnormalities including:
- Degeneration of bones and soft tissue
- Spinal lesions
A myelogram can also help determine if surgery is necessary.
Nuclear Bone Scan
A bone scan identifies new areas of bone growth or breakdown. Your chiropractor can use it to evaluate the damage to your spine, as well as monitor infection or trauma.
A radioactive tracer will be injected into a vein in your arm. The tracer travels through your bloodstream to your bone. A special camera, called a gamma, takes pictures of where the tracer is in the bones.
If the tracer is evenly distributed, then there is no problem. A hot spot is where the tracer shows accumulation in the bone. A hot spot can be caused by a healing fracture, bone cancer, tumor, arthritis, a bone infection or a disease of abnormal bone metabolism. A cold spot is where there is no tracer found in the bone. A cold spot can be caused by certain kinds of cancers or a lack of blood supply to the bone.
A discogram helps to determine if a particular disk is the one generating pain. This test is often used when surgery is being considered.
A contrast dye is injected into the disk and “real time” imaging is used to see the picture. The dye helps the radiologist see the anatomy of the disk. The dye can show tears in the lining of the disk.
When the dye is injected, you may feel the same pains from your original complaint. This is called a positive discogram. This means that the source of the pain has been located. If you have no pain, it is called a negative discogram.
Video fluoroscopy is a motion x-ray study of the bones and joints that captures the spine in motion. These moving images are often superior to the stationary photos provided by other forms of x-ray.
A video fluoroscopy can be used to diagnose:
- Soft tissue lesions
- Ligament instability
- Range of motion issues
- Spinal fusion
- Subjective complaints such as headaches and dizziness
The most prominent structures studied are in the cervical and lumbar spine.
Digital Thermal Paraspinal Imaging
Digital paraspinal thermal imaging measures the infrared heat on the surface of your body. It helps your chiropractor determine how your central nervous system (CNS) is functioning. Since the health of the CNS can determine the health of the body, this examination provides critical information that is vital to your care. This process analyzes the surface temperature along the spine, noting the differences in temperature on opposite sides. When communication between the CNS and the blood vessels is interrupted, it causes your body’s temperature to be imbalanced along the spine.