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Getting Started With Chiropractic Care

Answers to Your Most Common Questions

Welcome to Precision Spinal Care

If you suffer from spinal pain, you are not alone: back pain is the number one cause of debility worldwide. One of the top priorities for many people with back pain is finding an expert to help give relief.

Many people struggle to find something that works: back pain is the leading reason for doctor’s office visits among people with musculoskeletal problems, and is the second most common reason overall to see a doctor. Back pain has also significantly contributed to the opioid crisis.

Fortunately, better treatment options are available. At Precision Spinal Care, my goal is to help you permanently improve your pain and spinal health, healing your spinal problems instead of simply masking the symptoms with drugs.

I’ve written this guide to help you better understand the options that are available to you in order to relieve your back and neck pain. Chiropractic medicine is a science, not a mystery. As a patient, you should leave every appointment knowing the full details of where you are in your course of care. This guide is the first step in your journey to resolve your pain.

Dr. David PackerAbout the Author

My name is Dr. David Packer, and I am a specialist in mechanical spine pain and trauma. I have owned and operated Precision Spinal Care since 2002. In my practice, I focus on NUCCA chiropractic, a safe and painless technique to relieve upper cervical spine problems.

As a board-certified NUCCA doctor, I have extensive training and certifications across multiple fields of spinal care, including:

  • MRI Spine Interpretation
  • Spinal Biomechanical Engineering
  • Orthopedic Testing
  • Stroke Evaluation Protocols
  • Spinal Trauma and Pathology
  • Impairment Rating
  • Interventional Pain Management
  • Orthopedic Surgery – Extremity
  • Orthopedic Surgery – Spine
  • Neurosurgery
  • Neuroradiology
  • MRI Technology
  • Emergency Department
  • Internal Medicine/Primary Care
  • Crash Dynamics
  • Accident Reconstruction
  • Medical – Legal Documentation
  • Trauma Injury – Triage and Treatment Protocols
  • Neuro-diagnostic Testing

I am a fellow in spinal biomechanics and trauma recognized through SUNY Buffalo Jacobs School of Medicine. Additionally, I serve on the Chesapeake Regional Hospital Foundation Board of Directors.

I am committed to helping other doctors improve their chiropractic care. To this end, I teach at NUCCA conferences and at Life University in Atlanta, Georgia, training both doctors and students in NUCCA care. I also serve on the NUCCA Board of Directors as the co-chair of the Education Committee.


  1. How do I choose the right doctor or treatment for my spine-related pain?
  2. 7 key features of how chiropractic helps people
  3. Does insurance cover chiropractic care and what will it cost me?
  4. How long will it take for me to see results?
  5. The next step in your chiropractic care journey

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1. How do I choose the right doctor or treatment for my spine related pain?

Many different types of doctors — ranging from primary care providers to chiropractors to surgeons — can help treat back pain. However, each type of doctor will generally work best at treating specific types of back pain.

For example, an orthopedic surgeon would be a good option for spinal stenosis, which may require surgical intervention. In contrast, a chiropractor would be an excellent choice for spinal imbalance, which can be treated noninvasively.

Your medical team, including your chiropractor, can help to triage you to the appropriate doctor to help address your pain.

Patient Care Triage

How do I choose the best doctor for my neck or back pain?

The first step in choosing a doctor for your neck or back pain is to have a thorough evaluation of the underlying problem that is causing your pain. It is important to not only treat the pain when it comes to your spine, but to treat the causative issue so that the pain does not recur or worsen.

By having your doctor perform a full evaluation of the root cause of your pain, you can choose the most appropriate doctor to help you heal. If you suffer from mechanical spine pain, which is due to ligament problems in the spine, chiropractic can help.

Should I see a chiropractor for lower back pain?

A chiropractor can help you with lower back pain that is due to biomechanical problems, including issues with your ligaments. At your initial intake visit, your chiropractor will determine the root cause of your back pain. If your pain is not due to a biomechanical issue that can be treated with chiropractic, your chiropractor will likely refer you to the most appropriate doctor to serve your needs.

Should I have spinal surgery?

Every person and health problem is unique. For this reason, it is impossible to say if a person should have spinal surgery without a thorough medical evaluation. Surgery is usually not the first treatment choice for spinal pain, and is usually reserved for after other conservative methods have failed to treat spinal problems.

That said, some symptoms are more likely to be successfully treated with spinal surgery than others. These include loss of bladder and bowel control, neurological deficits, sharp radiating pain, and tumors.

Treatment options for chronic spine related pain

The best treatment options for your chronic spine pain depend on the underlying cause of your pain. By working with your doctor to understand the root cause of your spinal issues, you will be in the best position to choose the right treatment option for you.

Some treatment options, like chiropractic, work well for spine pain related to ligament problems. Other options, like physical therapy, work to help you improve flexibility and strength. Further options, like surgery, may be more appropriate for spine pain from anatomical problems.

Is chiropractic right for me?

Although chiropractic can help many people, your medical needs are unique. For this reason, your chiropractor will perform a robust physical exam to determine if chiropractic is right for you.

During your initial chiropractic visit, your chiropractor will analyze your pain. Besides a physical exam, this assessment may involve reviewing your medical records and spinal imaging.

The results of this first exam will determine how Precision Spinal Care can help with your spinal pain. From there, a plan can be developed about the type and duration of chiropractic treatment that is best for you.

Chiropractic versus physical therapy

Chiropractic and physical therapy each play a role in treating back pain. However, they are not interchangeable treatment strategies.

Generally, physical therapy is an excellent option to increase muscle tone, build strength and flexibility, and address non-spine joints. Meanwhile, chiropractic is the gold standard for treating mechanical pain, by mobilizing joints and improving the health of spinal ligaments.

When to avoid chiropractic care

Although chiropractic care is safe and effective for many people, it is not for everyone. People who should avoid chiropractic include those with anatomical spine pain like spinal tumors, fractures and herniated discs. The risk of chiropractic can outweigh the benefits in those cases.

At your first visit, you should discuss your medical history with your chiropractor. Your chiropractor will then be able to let you know if there are any concerns about chiropractic care.

2. 7 key features of how chiropractic helps people

At Precision Spinal Care, I focus on providing you with the best spinal care possible that is backed by medical evidence. Prioritizing your spinal recovery and pain management is my top priority.

What is mechanical spine pain?

Mechanical spine pain is due to ligament problems in the spine. When ligaments are damaged, they often do not heal normally on their own. This leaves them stiffer, weaker, and more sensitive to pain. The joint can then become unstable, which can lead to permanent damage within 6 months.

How Precision Spinal Care helps with pain

At Precision Spinal Care, I help your pain by addressing the root cause of your pain. Spinal pain is a symptom of an underlying spinal condition. Some of these conditions are due to underlying biomechanical problems with which chiropractic can help, like:

  • Decreased range of motion
  • Excessive range of motion
  • Inactivity
  • Repetitive movements
  • Trauma
  • Degenerative disc disease

By figuring out and fixing the cause of your pain, both your pain and the underlying issue can improve. This leads to a long-term benefit in both your health and quality of life.

How does chiropractic work?

Chiropractic medicine works by fixing the biomechanical problems that cause spinal pain. During a chiropractic adjustment, the chiropractor moves your spinal vertebrae into a more stable position. In turn, your spinal health is improved. In addition, the pain sensors in your spine are less likely to become irritated and painful when they are correctly aligned.

For this reason, chiropractic can treat both your spinal health as well as your pain.

Is chiropractic safe?

For the vast majority of patients, chiropractic is considered to be safe and effective. Generally, the only people in which chiropractic is a poor choice are those with anatomical spine problems like fractures. Further, the effectiveness of chiropractic care is backed by science and has been thoroughly studied.

What is NUCCA?

NUCCA is an abbreviation for the National Upper Cervical Chiropractic Association. In NUCCA, diagnosis and treatment are based on X-Ray analysis as well as orthopedic and biomechanical measurements. By analyzing your test results, your NUCCA chiropractor can identify your unique misalignment pattern and gently correct it, improving both your spine health and overall pain.

NUCCA v. traditional chiropractic

Whereas traditional chiropractic is often associated with a twisting motion and popping sound in the back, NUCCA is very different. NUCCA treatments focus on the upper cervical area of the spine, in the neck. In NUCCA, adjustments are gentle, and you will feel only a light pressure on the neck while the chiropractor is working.

When deciding between traditional chiropractic and NUCCA, things to consider include if you would prefer a traditional twist and pop approach to target your symptoms, or if you prefer a lighter, more global approach that treats the underlying cause of discomfort.

How does NUCCA chiropractic work?

NUCCA works by correcting spinal misalignment in your neck. X-ray views of the head and neck are used to make mathematical measurements about your misalignment, guiding your chiropractor’s care.

By analyzing these X-rays, your doctor can identify your specific upper cervical misalignment. By pinpointing the misalignment, there is less need for repeated corrections as your body heals itself.

3. Does insurance cover chiropractic care, and what will it cost me?

It is common to be concerned about the possible costs of chiropractic care. Fortunately, many strategies are available to pay for care. Medical insurance may cover your chiropractic treatments, in addition to other programs like flexible spending accounts, discount medical plans, payment plans, and personal injury liens.

Does my insurance cover the cost of chiropractic care

Many insurance plans cover the cost of chiropractic care. Further, many plans allow you to book an appointment with the chiropractor directly on your own, without a referral from your primary care provider. However, even if your insurance covers chiropractic care in general, you should check to make sure that the services you select are covered. Questions to ask include:

  • If the chiropractor is in-network or out-of-network: If your chiropractor has negotiated a rate with your insurance company and has agreed to accept the terms of your insurance coverage as payment, they are considered an in-network provider. In-network providers may have more favorable costs and coverage compared to out-of-network providers.
  • What your deductible is: A deductible is the yearly amount you pay out-of-pocket for in-network or out-of-network services. You may need to pay a certain amount of money towards your deductible before your insurance coverage will pay for your care.
  • What your copay is: A co-pay is the portion you pay each time you visit your healthcare provider or the amount you pay for each prescription. Many insurance plans will require you to have a copay for each doctor’s visit.
  • If the services you need are covered: Even if your chiropractor is covered by your insurance plan, you should check to make sure that the specific therapies you need are covered.

How much does chiropractic care cost?

The cost of chiropractic care can vary depending on the services performed. For example, at Precision Spinal Care, initial exams are $20 and spinal x-rays are $50. Your initial exam consists of your initial workup and consultation with Dr. Packer.

If your insurance plan covers the cost of chiropractic treatment, you should check with your plan to see if you need to pay a copay for your chiropractor.

If your insurance does not cover chiropractic care, other payment options are available.

What payment options are available if I don’t have insurance?

Although many insurance plans cover chiropractic care, not all do. If yourinsurance does not cover chiropractic services, there are other options to pay for treatment. Most chiropractors do not want to turn away patients seeking care, so their offices may be able to work with you in terms of finding payment options. A variety of options may be available, such as:

  • Health Savings Account (HSAs): These accounts allow you to use pre-tax money to pay for medical expenses like chiropractic care.
  • Flexible Spending Accounts (FSAs): These pre-tax medical savings accounts can also be used to pay for chiropractic treatment.
  • Care Credit: This is a special credit card for medical treatment. A doctor’s office can help you sign up for this plan.
  • Denefits: This is a payment plan that divides your expenses into monthly bills and covers chiropractic treatment.
  • Discount Medical Plans: Discount medical plans are special, low-cost health plans that can dramatically lower your treatment cost. At Precision Spinal Care, we use a discount medical plan called Chiro Health USA.
  • Paying out of pocket: Paying directly out of pocket is an option when it comes to funding medical care including chiropractic treatment.

Personal injury lien

If you have been injured in an event like an automobile accident and have filed a personal injury suit, the money from that suit can be used to pay for your chiropractic care. A personal injury lien, or medical lien, can be filed by your chiropractor to be directly reimbursed for your care from the personal injury suit. If the chiropractor accepts a personal injury lien instead of direct payment, you will not have out of pocket expenses. Precision Spinal Care accepts personal injury liens.

4. How long will it take for me to see results?

How long it will take for you to see results from your chiropractic sessions depends on multiple factors. This includes both the nature and severity of your spinal problem. For example, a person with a herniated spinal disc from degenerative disc disease will have a different spinal problem and course of therapy than a person suffering whiplash from a car accident.

You will likely not receive a treatment on your first visit to a chiropractor. However, you should receive a full evaluation, including a physical exam, review of your medical records, and imaging like X-Rays if appropriate.

After this evaluation, your chiropractor can help set your expectations about how long it may take you to notice improvement in your condition, as well as what goals of care you should expect.

Should I continue chiropractic care?

Determining whether to continue chiropractic care comes down to whether your condition is stable or improving with continued care. You can achieve this by:

  • Setting a baseline for your condition: It is important to identify your condition’s starting point before you began chiropractic care. For some people, this may include subjective metrics like pain, flexibility, or ability to perform activities of daily living. For others, this may be objective data like spine imaging results or orthopedic exams.
  • Making sure your chiropractor reevaluates your condition regularly: Generally, you will get a reevaluation within 30 days of starting treatment to see how well you are responding. Your chiropractor should discuss the results with you to determine how your treatment is progressing.
  • Discussing treatment expectations with your chiropractor: Making sure that both you and your chiropractor are on the same page when it comes to your goals of care is key. Your chiropractor will be able to tell you how much improvement to expect from chiropractic, and how long you should need to continue therapy.
  • Making recommended lifestyle changes: Often, your chiropractor will often recommend lifestyle changes and treatments for you to do at home. These can include exercises as well as dietary changes. Make sure you have carried out the recommended changes to give chiropractic a full chance to work.

Should I get a second opinion about chiropractic care?

Because many treatment options exist for chronic spine-related pain, your choices can seem overwhelming. Seeking the expertise of credentialed spine-care specialists — including your chiropractor — is important.

The most important factor in whether to seek a second opinion is your comfort level with your care. Ideally, you should have as much information as possible about your condition and know exactly what your treatment options are.

Questions to ask if you are considering getting a second opinion about chiropractic care include:

  • Has the chiropractor performed a thorough examination and performed appropriate tests like X-Rays or an MRI? Proper examination and diagnosis is vital to figuring out the cause of your back pain so it can be treated. Reevaluation and treatment modification should occur on a regular basis during your treatment, generally within the first 30 days.
  • Has the chiropractor explained your test results? Before treatment begins, it is important that you have an understanding of what the test results indicate, and what they mean for your long-term spine health.
  • Has the chiropractor explained the treatment plan to you? It is important that your doctor sets expectations for your care including what improvement to expect, and in what timeframe.
  • Has your doctor suggested alternative treatments or providers? Many factors contribute to spine health. Your chiropractor may recommend therapies ranging from routine medical care like physical therapy to evidence-based alternative medicine to help you achieve your goals.

5. The Next Step in Your Chiropractic Care Journey

As with any medical situation, you need to feel comfortable with your doctor and fully understand the path to recovery you are on.

With any form of treatment you choose, have an open and honest discussion with your doctor about your medical history and any concerns you have about your treatment. When in doubt, ask questions.

You deserve to be informed about your own diagnosis and treatment.

At Precision Spinal Care I am happy to help you determine the best way to address your specific needs. If I can help, I will. If I determine it is best for you to see a different specialist, I will help you find a doctor who can address your needs.

To learn the cause of your pain and the best way to treat you, make an appointment with me and let’s get started.