Chiropractors are regulated healthcare professionals who treat musculo-skeletal injuries.
Chiropractic was founded in 1895 by an American magnetic healer, Daniel David Palmer, who believed that manipulation of the spine could cure disease. Palmer founded The Palmer School of Chiropractic in Iowa in 1897. During the 20th century, chiropractic practice grew and was developed worldwide. In the UK, it was regulated by law in 1994 with the passage of the Chiropractors Act 1994, and the naming of the General Chiropractic Council (GCC) in 1997. There are presently over 2,200 practising chiropractors in the UK.
Chiropractors diagnose, treat, prevent and rehabilitate musculo-skeletal injuries caused by accident, lack of exercise, poor posture or illness. Their aim is to relieve pain, increase mobility and get patients back to full health and movement. They focus on the alignment of vertebrae as the primary means to relieve pain and tension, as they believe in the importance of the integrity of the spine in ensuring good health.
Chiropractors can treat chronic and acute conditions such as:
- Back, shoulder and neck problems
- Migraine and headaches
- Sports injuries
Some chiropractors work with animals: the McTimoney College of Chiropractic offers an MSc Animal Manipulation. The course is currently unique in the world.
Chiropractors take a holistic approach to their patients’ issues: not only do they look at their physical issues, they also assess mental and social factors. They design treatments aimed at encouraging the body’s natural healing process and don’t use surgery or medication.
The word chiropractic means “done by hand”: chiropractors use a variety of manual techniques and therapeutic exercises. There are several schools of chiropractic manipulative techniques, although most practitioners mix techniques from several schools.
During an initial assessment, the chiropractor asks patients about their medical history and undertakes a physical, neurological and orthopaedic examination. They might order x-rays or an MRI scan before proceeding with treatment.
During treatment, the practitioner aims to improve the joints’ range of motion. They align the spine by manipulating the vertebrae through massage, stretching or “adjusting”. Adjusting means that the practitioner applies pressure to a vertebra, moving the joint out of its usual range of motion and then putting it back into position. This allows the joint to move more freely. It produces a cracking sound that comes from the release of bubbles of gas that have been building up in the fluid of the joint.
After treatment, chiropractors advise patients on lifestyle changes that can improve their health and wellbeing, for example by changing their diet and following exercise routines.
Chiropractors use a different approach to physiotherapists and osteopaths although they share some techniques. Physiotherapy is more concerned with having a direct effect on muscles rather than the joints and bones. Physiotherapists don’t usually use spinal manipulation. Osteopaths use a wider range of techniques and are concerned with the whole body.
Salary in a private practice starts at around £20,000 per year and can rise to £40,000 with experience.
Senior self-employed chiropractors can earn between £50,000 and £70,000 per year.
- Take patient’s medical history
- Assess patient’s medical condition, range of movement and posture
- Order and interpret x-rays if needed
- Devise a treatment plan
- Manipulate the joints of the spine
- Use other hands-on techniques such as massage and stretching and apply treatment with specific equipment such as laser and ultrasound machines
- Advise patients on rehabilitation exercises and lifestyle changes
- Keep confidential records
- Liaise with other healthcare practitioners
- Undertake continuing professional development (CPD)
- Promote the practice
All chiropractors complete a four-year degree course in one of the three educational institutions accredited by the GCC:
- The Welsh Institute of Chiropractic at the University of Glamorgan
- The Anglo-European College of Chiropractic (AECC) in Bournemouth
- The McTimoney College of Chiropractic in Oxfordshire (offers a five-year Integrated Masters in Chiropractic programme)
Graduates of any subject may be considered for entry, provided they have 3 science A-levels or equivalent.
Prior to full registration, chiropractors must undergo a CRB check and satisfy the GCC that they are physically and mentally fit. They also have to spend one year doing supervised clinical practice work. They can then apply to become members of the British Chiropractic Association.
30 hours of annual CPD are required in order to maintain registration with the GCC.
- Mechanical and hands-on skills
- Sensitivity and empathy
- Enjoy working with people
- Excellent communication and interpersonal skills
- Problem-solving skills
- Strong code of ethics
- Confidentiality and discretion
Most chiropractors are self-employed, working on their own or in a private practice. Some chiropractors may work in several practices, so they need to travel within the working day.
In a practice, chiropractors generally work between the hours of 9 and 5. However, some practices receive patients in the evenings and during weekends. If you are on your own, you can work flexibly and from home, choosing the hours to work that suit your needs.
You must have a good ability to cope with the intellectual and physical demands of the training and the profession. You need to maintain a good fitness level to avoid work-related injuries.
A career in chiropractic can be very fulfilling: you will feel rewarded when you have a positive impact on patients’ health and daily life.
Life experience is an important asset: you need a mature personality to undertake this job and listen to patients’ complaints. According to the GCC, 80% of chiropractors in the UK are aged over 30.
With experience, you may wish to set up your own practice.
You can use CPD to develop more specialist skills in the areas of sports injuries, paediatrics, animal manipulation or orthopaedics.
You can also go into academic research.
Hazel Bulger, 29, is a chiropractor and managing director of THE Medical, a chiropractic clinic in Bristol.How long have you been in this particular job?
I became the managing director of THE Medical in July 2010. Prior to this I was working at the clinic just as a chiropractor and practice manager. THE Medical is a private multidisciplinary clinic based in Bristol city centre and Longwell Green. It offers a range of different services including chiropractic, osteopathy, physiotherapy, acupuncture and sports therapy/massage.
What did you do before this job?
Prior to graduating I was obviously a student studying and I had also been away travelling for a year. Previous jobs have included working as a fitness instructor and personal trainer within a health club.
How did you end up doing this job? Was it a childhood dream or was it by accident?
I have had an interest in the human body since I was a child and I love working with people. My first degree was in sports and exercise science but having worked in the fitness industry, I found I wanted a more ‘hands-on’ approach. Then after doing some research I found that being a chiropractor was a perfect job for my knowledge, interests and aspirations.
What do you do in a working typical day?
My week is currently split between managing the clinic and treating patients. On a treating day I generally work long hours to accommodate patients and can treat on average 12-15 patients during the course of the day. This could involve assessments of new patients, review of returning patients and also administrative tasks such as x-ray reports, GP letters and research. On a managing day, my tasks can range from covering reception to recruitment, promotions, bookkeeping and invoicing.
What conditions do you treat? Do you have a specialty?
I treat any condition that has a musculo-skeletal involvement – generally affecting muscle, joint, tendon or ligament. The most common conditions involve the lower back and neck but I also treat plenty of problems with the extremities, knee and shoulder. I have a particular interest in treating sport injuries due to my background and previous degree. Therefore a high proportion of my patients are very active either in gym-based environments or in competitive sport.
How do you find your clients?
The majority of my clients are now referred from previous patients who have told their friends, family and work colleagues. The clinic also advertises online and we run regular promotions in local health clubs and businesses to increase the awareness of the clinic and the services that we provide.
Do you use any special tools or equipment?
I have a chiropractic bench which has movable sections; I use it to aid moving certain body parts. I use blocks as wedges that can be inserted under the pelvis to align the spine. I also have an activator: it is a device producing a small controlled force that can be applied to joints or soft tissue when appropriate. I also use a variety of rehabilitation equipment and ultrasound.
What do you like about the job?
The opportunity to make a difference in patients’ health and wellbeing has to be the most satisfying part of my job. Each day is different with meeting new people who have various ailments and always have a story to tell. I am also very lucky to work in my own clinic so I can have complete control over how I work and the experience that patients have. I have a great team to work with; they are also great fun and always put a smile on my face on a Monday morning.
What do you dislike about the job?
There is no slacking when you are treating patients; they have paid good money for your time and expertise so you always have to be at your best. It does also involve working sometimes from early until late so that you are flexible to be available for your patients.
What advice would you give to someone thinking of doing this job?
Really ask yourself if you are a people person and also are you ‘hands-on’ – do you mind getting up and close with people and getting in their personal space? Then you need to be academically minded for the training and energetic and enthusiastic about treating people and making a difference.
What job(s) do you think you might do after this role?
I would like to think that I will always be a chiropractor but along with this I will develop my role as managing director and expand the clinic. In the future I will also consider returning to education and possibly doing a PhD and lecturing.