Chiropractic Neurology

acnb_logoWhat is a Chiropractic Neurologist?

Chiropractic Neurologists are highly trained and qualified experts of the brain, spine and nervous system.   As in medicine, the chiropractic profession has specialists who serve their community’s patients, as well as providing expert evaluations and consultation to other physicians and health care practitioners.

Chiropractic neurologists are chiropractors who have continued with advanced post graduate training and testing to be able to provide all the standard chiropractic services and additionally, the specialized services that their advanced training allows.

How is a chiropractic neurologist different than a medical neurologist or a neurosurgeon?

Chiropractic neurologists, medical neurologists and neurosurgeons differ greatly in their methods of treatment.

The medical neurologist will prescribe medications or injections. The neurosurgeon uses surgery to correct a condition. The chiropractic neurologist uses medication free and non-surgical treatment methods.

Many conditions of the brain and nervous system do not respond well to aggressive interventions such as drug therapy or surgery. Additionally, the drug therapies used by medical neurologists, and the surgical interventions of the neurosurgeon often carry increased risks for serious complications or dangerous side effects.

For this reason, chiropractic neurologists fill a unique and significant role in treating brain and nervous system disorders using safe and effective methods producing lasting health benefits.

What conditions do chiropractic neurologists treat?

All the conditions normally seen by chiropractors like pains from injuries caused by lifting, falls, sports injuries, auto accidents, etc plus:

  • Headaches and chronic pain
  • Learning and attention disorders
  • Vertigo
  • Developmental disorders
  • Head injury or stroke
  • Spinal cord and nerve injuries
  • Movement disorders
  • Balance Disorders
  • Dystonia
  • Autism
  • Dyslexia
  • Thyroid Conditions
  • Diabetic Neuropathy

What special diagnostics do chiropractic neurologists use?

In addition to physical examination methods, chiropractic neurologists may use:

  • MRI – magnetic resonance imaging
  • CT – computerized tomography
  • Xray
  • Ultrasound
  • Bloodwork
  • And others as necessary or appropriate.

What treatment methods do chiropractic neurologists use?

Chiropractic neurology treatment methods are safe, effective and can include a wide variety of tools such as:

  • Chiropractic adjustments by hand or by instrument to the spine and/or extremities
  • Eye exercises
  • Balance and coordination activities
  • Cognitive exercises and activities
  • Sensory training that may include light, sound, smell, or touch
  • Physical exercises
  • Breathing exercises
  • Nutritional modification
  • And many others…

What makes a chiropractic neurologist so special?

Because chiropractic neurologists often have great success treating patients for whom all other treatment methods have failed, people often ask, “What makes a chiropractic neurologist so special?”

The distinguishing factor is the paradigm, or approach that a chiropractic neurologist uses toward diagnosis and treatment. In addition to evaluating for pathologies as medical doctors do;  a chiropractic neurologist evaluates for subtle changes in the function of the nervous system.  It is this expertise in detecting subtle changes in function that sets a chiropractic neurologist apart from other specialists.

How does one become a chiropractic neurologist?

As in all medical specialties, one must complete undergraduate work and earn a professional degree before entering into specialty training.  Upon completion of undergraduate training, the chiropractic neurology student must then attend a college of chiropractic. There he must complete a required minimum of 4,200 hours of combined classroom, laboratory, and clinical experience.

After earning the doctorate degree and passing rigorous state and national boards, the student must attend a “program of instruction that is approved by the continuing education committee of the Commission for the Accreditation of Graduate Education in Neurology of a minimum of 300 credit hours”. Dr. Childs attended the prestigious Carrick Institute for Graduate Studies for his post graduate neurology training.

The student must then pass stringent written and oral examinations given by the American Chiropractic Neurology Board before receiving board certification in chiropractic neurology. Chiropractic neurologists are required to maintain their level of expertise by reading current journal articles as well as attending an additional 60 hours of educational training per year.

The American Chiropractic Association recognizes the ACNB as the sole authority in credentialing in Neurology for the Chiropractic Profession.  The ACNB diplomate program in neurology certification is fully accredited by National Organization for Competence Assurance and the National Commission for Certifying Agencies (NOCA/NCCA).In cooperation with the federal government the National Commission for Health Certifying Agencies (NCHCA) which was founded in 1977 in order to develop standards for voluntary certification programs.   In 1989 the NCHCA was expanded to developing certifications for all professions, becoming the National Commission for Certifying Agencies (NCCA), and forming the National Organization for Competency Assurance (NOCA) as a membership association for credentialing bodies. In 2009 the Board moved to change to a new name and became the Institute for Credentialing Excellence.

Dr. Childs’ practice is in Chester County, Pennsylvania.  He serves local medical and chiropractic professionals with his expertise as well as providing patient care for back pain, neck pain, arm & leg pain, carpal tunnel and chronic pain syndromes along with specialty care for learning and behavioral disorders.

Who tests and regulates chiropractic neurologists?

The American Chiropractic Neurology Board provides the testing and credentialing for chiropractic neurologists.  “The Diplomate Program in Neurology Certification” awarded by the American Chiropractic Neurology Board is fully accredited by the National Commission for Certification Agencies (NCCA), the accreditation body of the National Organization of Competency Assurance (NOCA)now under the umbrella of the Institute for Credentialing Excellence. The American Chiropractic Neurology Board is the only specialty certification agency for the Chiropractic Profession that is fully accredited by NCCA. NCCA’s standards exceed the requirements set forth by the American Psychological Association and the U.S. Equal Employment Opportunity Commission. The National Organization for Competency Assurance is the leader in setting Quality Standards for Credentialing Organizations.”1

Why choose a chiropractic neurologist?

Chiropractic Neurologists are highly qualified specialists in the brain and nervous system. They have dedicated many years to study of these systems and are prepared to offer effective treatment options that do not involve the use of medications or surgery.  If you or a loved one has a condition related in any way to the brain or nervous system, chiropractic neurology provides a new avenue of hope for successful treatment.

References:
1. http://www.acnb.org
2. http://www.carrickinstitute.org

To better help our patients understand chiropractic neurology, the following is an interview with Frederick R. Carrick, President of the ACA Council on Neurology.

What exactly is a chiropractic neurologist?
As in medicine and dentistry, we have individual specialists within the chiropractic profession. Through their education, training and board certification, they choose to limit their practice to a certain specialty to assist members of their profession and allopathic physicians in the diagnosis and treatment of a variety of conditions. Within the chiropractic profession, there are specialists in radiology, orthopedics, neurology and physical rehabilitation. Typically, a chiropractic neurologist serves in the same consulting manner as a medical neurologist. The difference is that the therapies or applications of a chiropractic neurologist do not include drugs or surgery. As a result, certain conditions are more customarily seen by a chiropractic neurologist as opposed to a medical neurologist and vice versa.

Specifically, our people see patients with a variety of movement disorders, dystonia, post-stroke rehabilitation, and radiculopathy or nerve entrapment syndromes that are consequences of peripheral or central types of lesions. Chiropractic neurologists can provide therapies and treatments, as well as counsel, when there is a diagnostic dilemma or a question of appropriateness of care regarding an individual lesion or scenario. There are conditions not amenable to the type of treatment we might do. Myesthenia gravis, diabetic neuropathy and forms of epilepsy are some examples. On the other hand, there are many conditions that are not appropriate to pharmaceutical interventions.

What does training consist of?
The training to become a board-certified neurologist in the chiropractic profession is an additional three years after the doctor’s degree, which is conducted under the auspices of an accredited university or college that is recognized by the US Office of Education. During that training, there is a didactic and residency-based/clinically-based training. After completing those requirements, the chiropractor will sit for a board examination in neurology, which is held once per year by our independent examining board. The areas that are examined are specific to the field of neurology and include clinical and diagnostic techniques and knowledge of neurophysiology. The certification examination includes oral and practical portions, as well as a battery of psychometric testing. There are 250 board-certified chiropractic neurologists in the world.

What is the interaction between medical neurologists and chiropractic neurologists?
Generally, chiropractic neurologists serve as consultants to medical doctors, third-party payers, and other chiropractic physicians, especially in the treatment of pain. Many referrals from medical neurologists are to differentiate central from peripheral lesions and to determine whether or not manipulative procedures, specifically, will be safe in certain conditions. A lot of the work is done in consultation, where the chiropractic neurologist will examine a patient and then give direction to the referring doctor regarding the mode of therapy or the appropriateness of therapy.

How are physicians paid for their services?
It depends on whether the consultant or practicing neurologist wishes to participate in a managed care plan. Some of our members are very much involved in managed care plans. The general trend, however, seems to be that many of our specialists are going outside the managed care parameters. But interestingly, our specialists seem to be able to exist quite well outside these parameters and most are very, very busy. Part of the reason for this is that the services they render are non-duplicative. For example, if a medical neurologist sees a patient with dystonia, he or she may recommend a Botox injection or other type of procedure, whereas the chiropractic neurologist might recommend a type of afferent stimulation or a non-pharmaceutical intervention that is not typically used by the medical neurologist (afferent stimulations are environmental stimulations such as manipulation of the neck, back or extremity; and the use of light, heat, water, sound and electricity–things in the physical environment that are noninvasive and nonsurgical in nature).

Isn’t chiropractic treatment typically considered as a last resort?
That is changing. The normal course of things is that patients who seek the service of a chiropractor have largely been around the block a few times and have seen many other types of practitioners.

Doesn’t this put you at a greater risk?
The successes in chiropractic are the ones that have not been successfully treated by other therapies. Chiropractic is the second largest health profession in the world right now. When it comes to liabilities and danger, I think every physician who undertakes the treatment of patients must evoke responsibility of care and appropriateness of service. Certainly the chiropractic neurologist is very realistic about what he or she is doing, the dangers or liabilities of an individual treatment, the responsibility of direction and teaching of the patient, as well as the ethical and moral decisions that one might have to make in concert with the needs of the patient.  As physicians, as part of state licensure, chiropractors have to have malpractice liability coverage. Malpractice statistics are really fairly low in terms of our discipline.  The number of chiropractic claims for negligence is nowhere near that of medical claims.

How do you see your profession evolving?
As greater emphasis is placed on patient outcomes and appropriateness of services, I believe greater opportunities are being created for cooperative relationships between medical neurologists and chiropractic neurologists. Certainly, our training is similar.  There may even be an intertwining of disciplines to some extent in coming years.  Recently, a large percentage of medical doctors have been enrolling in our chiropractic neurology training programs.  We have several physicians–neurologists, orthopedists, and neurosurgeons–who travel from Europe and Asia for the training.  We’re really pleased that it seems that our brand of neurological application is being accepted as complementary to medicine and occupational, physical, therapeutic modalities and that it is in concert with what seems to be the direction of research and intervention for a variety of conditions.