- Case History
Taking the form of a patient centered interview, giving the patient the opportunity to express how the complaint is impacting on them and their everyday lives. This also gives the chiropractor the opportunity to question the patient about the mechanism of injury, location, duration and severity of the complaint, thereby giving the chiropractor a thorough understanding of the patient’s complaint and the possible structures involved.
At this stage the patient will usually change into a gown, allowing the chiropractor access to the area of complaint, while allowing the patient to maintain their dignity. The examination is hands on and usually comprises of physical orthopedic and neurological testing to determine and confirm which structures are involved.
Once all this information has been gathered the chiropractor will then take the time to review the case history and examination findings, determining what the probable cause of the complaint is and the best course action. All this will be presented at the Report of Findings, which will scheduled at the patients soonest convenience.
If there are still questions as to what structures are involved with the complaint the chiropractor may refer the patient to their GP or other health care professional for further investigation.
- Report of findings
Once all the information from the Case History and Examination have been reviewed and considered, the aim of this appointment is to set out a plan of action how to best deal with the patient’s complaint, to achieve the quickest and best results. During this appointment the chiropractor will explain the examination findings, tell the patient exactly what is causing the problem, set out a plan to get the patient better and the probable outcomes of the treatment.
- First treatment
Following on from the Report of Findings, once informed consent has been obtained from the patient, the first steps in getting the patient right will take place. This will usually involve some gentle manipulation, mobilization and soft tissue work.
Lasting up to 15 minutes, these treatments will follow a set routine. The chiropractor will establish, through discussion with the patient if there has been any subjective change. The chiropractor will then do a brief examination to see if there have been any objective changes, followed by the treatment, where the best actions are taken to alleviate the patient’s symptoms. After treatment there will also be a brief discussion as to what the patient can do in their own time to help minimize the effect the complaint is having on their life, this may take the form of advice, stretches or rehabilitative exercises.
These usually take place at significant points within the treatment plan which the chiropractor has laid out, they are aimed at re-assessing, both subjectively and objectively the way the course of treatment has affected the complaint. Subjectively the patient is able to express how they feel treatment is progressing, while the objective examination allows the chiropractor to measure the improvements the patient has made.
The Re-report then gives the opportunity for the chiropractor to map out the next stage of care, its goals and objectives, so the patient knows exactly what they can expect, both in terms of treatment, rehabilitation and outcomes.