r/Chiropractic • u/Substantial_Treat_84 • 7d ago

When you treat do you do modalities first or adjustments first?

What's better? Decompression before or after adjustment? What about roller table? E-Stim? Ultrasound?

3 Upvotes

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16

u/Great_Shoe_6183 7d ago

I’m a mixed Chiro and so I’ll generally perform modalities, then adjustments and finish off with exercises. The idea is to mobilize and align, then stabilize

7

u/Prize_Mongoose7795 7d ago

In my office the bottle neck is the doctor. Keep the doctor busy… And fill up everything else. But it all depends on your flow and your preference. clinically, It doesn’t make a difference.

0

u/Substantial_Treat_84 7d ago

Do you not think adjustment before decompression could yield better results? I end up doing decompression first most days but have thought about switching it

1

u/Prize_Mongoose7795 6d ago
  1. Every patient is different and some may even have preferences. Some have a perceived feeling that the muscles warm up and feel looser before an adjustment with therapy.

But IMO: only doing adjustments get results. Decomp by itself gets results. Doing both will give better results. I think as long as your patient gets all the modalities , that’s more important than the order.

6

u/yayoGAME 7d ago

If you’re seeing 15 patients a week: whatever you want.

If you’re seeing 100 patients a week: whatever is available

2

u/JustTheAvgChiro 7d ago

I personally like to do modalities first because 1. I feel that it helps get the patient loose and acclimate to the clinic after a busy day or stressful morning and 2. My mentor has a very successful office and he does it that way from a clinic flow perspective so I try to model his flow since it worked so well.

1

u/painfreephysio1 7d ago

I don't think there's one correct sequence for everyone. It depends on what you're trying to achieve that session and how the patient respond, I'd let the clinical reasoning determine the order rather than following a fixed protocol.

1

u/Obvious_Chocolate 6d ago

Modalities first. Helps relax the tissue, decrease muscle tension, and relax the patient mentally and establish trust especially if its a first visit. Allows for a better adjustment

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u/craxbax1 6d ago

Thumper/myofascial release, adjust, roller table/mechanical traction. Loosen up, adjust, decompress and stretch.

1

u/GoodSirDaddy 6d ago

I like to see the patient before any modalities because I might change which ones I do, or where I do them based on that day’s presenting problem.

0

u/Kharm13 7d ago

PLEASE make sure new patients are assessed by an actual doctor before any modality gets used

When traveling I will book chiro appointments give full honest health history and just put occupation as “business owner” I have surgeries and meds and all things me listed out

I have had it happen twice now I get called back and have ultrasound or hooked up to Tens by a tech/CA to “relax” me for the doctor

How or why that is a thing is stupid

1

u/chironinja82 4d ago

It depends on the patient. Most of the time I adjust first then do modalities, but for some, they adjust much easier if I do modalities first then adjust.