Sedation Chiropractics?

[blondy2061h, MSN, RN]

The other day I saw a billboard advertising sedation chiropractics. This immediately struck me as a bad idea. I just don't feel chiropractors have enough medical education to safely manage a sedated patient in a worst case scenario.

I went home to Google this and found it's an increasingly common trend across the country. I also found it's typically done 1-3 times, under conscious sedation, and thankfully, usually in an ambulatory surgery center where there's nursing and anesthesia staff present. That definitely made me feel better. It's usually followed up with continued regular chiropractic care.

I acknowledge that chiropractic care has it's place and can definitely help some people. I had some chronic pain and tried four different chiropractors with only worsening symptoms. I then went to physical therapy and have never felt better. So I admit I have some bias.

I'm still uneasy with the idea of sedation chiropractics. I just am not convinced there's evidence to back this up. I feel like patient response to the session should be monitored to ensure safety and reduce injury risk. If you sedate them, you take that valuable feedback mechanism away. Further, should chiropractic care really be that aggressive that sedation is required?

The billboard I saw advertised this as "pain relief in one hour!" If you were suffering, I definitely see the appeal. But some of this seems like the continued trend toward immediate, but maybe not lasting, fixes.

What are your thoughts on this?

[TheCommuter, BSN, RN]

To remain solvent in this era, chiropractors must be creative businesspeople and entrepreneurs with a special niche market or two. The run-of-the-mill chiropractor who performs simple manipulations and nothing else will go out of business in short order.

Some chiropractors form partnerships with personal injury lawyers and earn virtually all their money through whiplash referrals. Other chiropractors hook up with naturopathic or homeopathic doctors and generate referrals from yuppie clients who are looking to avoid Westernized medicine.

This so-called "sedation chiropractic" seems like yet another niche market that will cater to chronic pain sufferers who wish to order up some sedation with their massage, electrical stimulation and manipulations. I can see good money-making potential in it, but I can also see the potential for danger.

[classicdame, MSN, EdD]

if the procedure is done in a surgical setting, the Chiroprator may not need the training as he/she will not be doing the anesthesia. It could be the facility requires the doc to have ACLS but in reality, the staff would handle everything.

[SierraBravo]

Keep in mind that the first 2 years of chiropratic school are the same as the first 2 years of medical school. Chiropractors are trained to do many things which they likely will never use, such as interpreting EKG's, etc... I swear by my chiropractor, he is amazing. He has been in business for over 20 years and he has a thriving practice. In terms of melding medicine and chiropractic I can't speak intelligently about that because I don't know all of the logistics involved. But if they are practicing with other staff available (such as anesthesia) then I don't see the harm. Additionally, someone who is licensed and trained has to prescribe and administer the conscious sedation. Remember, too, that in order to use conscious sedation the patient must be evaluated by a physician and the patient must be determined to be able to safely maintain their airway. My guess is they are using conscious sedation in order to more easily make an adjustment vs. not being able to due to the patient being tense, anxious, etc...

[mmc51264, BSN, MSN, RN]

I go to a chiropractor, too. Have for years. It takes some digging to find a good one and sometimes I have to take what he says with a grain of salt, but he has helped me tremendously. I also do yoga and PT when I need it. I love holistic approaches to care. Best doctor I had was a naprapath (you can google it), which is a specialty doctor similar to a chiro but the school is in Chicago and it is very hard to find them outside of there (I am now in NC) If I had the money, I would fly up there every month to see him!!!!

I'm not so sure about the sedation chiro. Why would you need it?

[wirehead]

Hi blondy,

This is known as manipulation under anesthesia (MUA), it's very helpful for contractures, or for things such as frozen shoulder or muscles that are in major spasm. Here in NJ, the sedation is NOT done by the Chiropractor, they do this at an outpatient surgical center and there is an anesthesiologist who performs the sedation and monitors the patient. Typically the use versed or propofol, and the patient is out for a very short period of time. I don't know if other states allow Chiropractors to administer sedation, but I highly doubt it unless they have extensive training to do so.