Your First Chiropractic Visit for Back Pain: What to Expect at Our Ann Arbor Clinic

By Dr. Tim Dehr, DC, CCSP | Performance Health Chiropractic

If you've been dealing with back pain for a while—whether it's from sitting at your desk all day, an old sports injury that never quite healed, or something that just started hurting one morning for no obvious reason—you've probably thought about seeing a chiropractor.

And then you've probably hesitated.

Maybe you're not sure what chiropractors actually do. Maybe you've heard stories about aggressive adjustments or cracking sounds that make you nervous. Maybe you just don't know what to expect, and the uncertainty is enough to keep you living with the pain instead of doing something about it.

I get it. Walking into any new healthcare office for the first time can feel intimidating, especially when you're already uncomfortable and not sure if this is going to help.

So let me walk you through exactly what happens during your first visit at Performance Health Chiropractic in Ann Arbor. No surprises, no pressure, no mysterious procedures you weren't expecting. Just a straightforward explanation of how we figure out what's causing your back pain and what we can do about it.

Please note: This article is for informational purposes only and is not medical advice. If you're experiencing severe or persistent back pain, consult with a healthcare provider to determine the most appropriate treatment for your condition.

Before You Even Get Here

When you call to schedule your first appointment, we'll send you over our electronic forms that ask you some basic questions about your back pain—when it started, what makes it worse, whether you've tried anything that's helped. This isn't an interrogation; it just helps me prepare for your visit and make sure I have enough time blocked out to address your specific situation.

If you have any imaging (X-rays, MRIs) from previous healthcare visits, bring them with you. They can be helpful, but they're not required. A lot of what I need to know, I'll learn by talking with you and examining how your body moves.

Also, wear comfortable clothes. You don't need to change into a gown or anything like that, but avoid restrictive clothing that makes it hard to move or assess your spine. Athletic wear or casual clothes work great.

Step 1: We Talk About What's Actually Going On

Your visit starts with a conversation. Not a rushed five-minute check-in where I'm halfway out the door before you finish talking, but an actual discussion about what's happening with your back.

I'm going to ask you a lot of questions, and they might seem overly detailed, but there's a reason for all of them:

Where exactly does it hurt? Lower back? Upper back? One side more than the other? Does it radiate anywhere—down your leg, into your hip, up into your shoulders?

When did it start? Was there a specific incident (you lifted something heavy, you slept wrong, you were in a car accident), or did it just gradually get worse over time?

What makes it better or worse? Does it hurt more when you sit? When you stand? First thing in the morning? After a long day at work? Does movement make it better or worse?

What have you already tried? Physical therapy, massage, medication, stretching, ignoring it and hoping it goes away (this is surprisingly common)?

What does your daily life look like? Desk job? Physically demanding work? Do you exercise? What do you do for fun? (Yes, this matters—if you're a runner with lower back pain, that's different from a desk worker with lower back pain, even if the pain feels similar.)

I'm also going to ask about your overall health history. Previous injuries, surgeries, chronic conditions, medications—all of it helps me understand the full picture of what's going on with your body.

This part of the visit usually takes 10-15 minutes, and it's probably the most important part. I can't help you if I don't understand what's actually wrong, and a lot of that comes from listening to you describe your experience.

Step 2: Physical Examination—Figuring Out What Your Body Is Doing

After we talk, I'll do a physical examination. This is where I assess how your spine is moving, where you're holding tension, and what biomechanical issues might be contributing to your pain.

Here's what that looks like:

Posture assessment. I'll have you stand normally while I look at your posture from the front, side, and back. Is one shoulder higher than the other? Is your head shifted forward? Is your pelvis tilted? These postural imbalances often contribute to back pain, and they give me clues about what's happening with your spine.

Range of motion testing. I'll ask you to bend forward, backward, and side to side so I can see how your spine is moving. Where does the movement stop? Where does it hurt? Is one direction more restricted than another? This tells me which joints or muscles are tight or dysfunctional.

Palpation (feeling your spine and muscles). I'll use my hands to feel along your spine and the surrounding muscles to identify areas of tension, misalignment, or tenderness. You'll probably notice some spots that are more sensitive than others—that's normal, and it helps me pinpoint problem areas.

Orthopedic and neurological testing. Depending on your symptoms, I might do some specific tests to check nerve function, reflexes, or muscle strength. If you have sciatica or leg pain, for example, I'll do tests to determine whether a nerve is being compressed and where that compression is happening.

Functional movement assessment. Sometimes I'll have you do specific movements—squatting, stepping up, single-leg balance—to see how your body compensates and where the dysfunction shows up. This is particularly helpful if your back pain is related to how you move during daily activities or exercise.

The physical exam usually takes about 15 minutes. Nothing about it should be painful, though some movements or palpation might be uncomfortable if we're hitting a tender spot. If anything hurts, tell me, and we'll adjust.

Step 3: I Explain What I Found and What We Can Do About It

Once I've gathered all the information from talking with you and examining you, I'll explain what I think is going on.

This isn't a quick "your back is out of alignment" brush-off. I'm going to explain in detail what I found, what I think is causing your pain, and why your body is responding the way it is.

For example:

• "Your lower back pain is likely coming from how you're sitting at your desk. Your hip flexors are tight from sitting all day, which is pulling your pelvis forward and increasing the curve in your lower back. That's putting extra stress on your lumbar spine and the muscles around it."
• "You have significant restriction in your mid-back (thoracic spine), which is causing your lower back to compensate and move more than it should. That's why your lower back hurts even though the dysfunction is actually higher up."
• "Your sciatica is being caused by a misalignment in your pelvis that's compressing the sciatic nerve. We need to address the pelvic alignment to relieve the nerve compression."

I'll also be honest about what I can and can't help with. If I think your issue is something that needs imaging or medical evaluation first, I'll tell you that. If I think chiropractic care can help but it's going to take time and consistent treatment, I'll tell you that too.

Research shows that spinal manipulation is effective for certain types of acute and chronic lower back pain, and the American College of Physicians recommends it as a first-line treatment before medication. But it's not a one-size-fits-all solution, and I'll be upfront about what I think will work for your specific situation.

Then we'll talk about the treatment plan. This includes:

How often you should come in. Some people need to come in multiple times a week initially. Others can start with once a week or every other week. It depends on the severity and chronicity of your pain.

What the treatment will involve. Spinal adjustments, I utilize multiple techniques —I'll explain what we're going to do and why.

What you can expect. How long it typically takes to see improvement, what "improvement" looks like (less pain, better mobility, fewer flare-ups), and what you need to do between visits to support the treatment.

This is also when you can ask questions. If you're nervous about adjustments, tell me. If you've had bad experiences with other providers, tell me. If you're skeptical about whether this will work, that's fine—tell me that too. The more I know about your concerns, the better I can tailor the treatment to what you're comfortable with.

Step 4: Your First Treatment (If You're Ready)

A lot of patients receive their first chiropractic adjustment during the initial visit. Some don't—it depends on your specific situation and what you're comfortable with.

If we do an adjustment, here's what to expect:

Positioning. Depending on what we're adjusting, you might be lying face-down on the table, on your side, or seated. I'll position you so that the adjustment is effective and comfortable.

The adjustment itself. I'll use my hands to apply a controlled, precise force to a specific joint in your spine. You might hear a popping or cracking sound—that's just gas being released from the joint (like cracking your knuckles). It's not your bones cracking, and it's not dangerous.

Some adjustments involve that audible "pop." Others don't. Both are effective. The sound doesn't determine whether the adjustment worked.

How it feels. Most people feel immediate relief—a sense of looseness or freedom in the area that was tight. Some people feel a little sore afterward, like you worked out a muscle you haven't used in a while. That soreness usually goes away within 24 hours.

If at any point you're uncomfortable or want me to stop, just say so. This is your treatment, and you're in control.

Alternative approaches. If you're not ready for a traditional adjustment, or if your condition is too acute to adjust right away, we might start with soft tissue work, stretching, or gentle mobilization instead. There are a lot of ways to address back pain, and not all of them involve the traditional "crack."  I also have a low force instrument that feels like a gentle tap that we can use if you're in too much pain or just unsure you're ready for a manual adjustment.

Step 5: What You Need to Do Between Visits

Chiropractic care isn't something that happens to you—it's something you participate in. The adjustments and treatment I provide in the office are important, but what you do between visits matters just as much.

Before you leave, I'll give you guidance on:

Posture and ergonomics. If you sit at a desk all day, we'll talk about how to set up your workspace so you're not putting unnecessary strain on your back. Small changes—monitor height, chair position, how often you stand up—can make a big difference.

Stretches or exercises. I'll usually give you one or two specific things to do at home. Not a 45-minute workout routine (nobody does those consistently), but simple, targeted movements that address your specific dysfunction. If your hip flexors are tight, I'll show you a hip flexor stretch. If your glutes aren't firing properly, I'll give you a simple activation exercise.

Activity modifications. If certain activities are making your back pain worse, we'll talk about how to modify them or avoid them temporarily while your back heals. This might mean taking a break from running, changing how you lift things, or avoiding certain movements that aggravate your pain.

What to expect after your first visit. Some people feel better immediately. Others feel a little sore for a day or two before they start to feel improvement. Both are normal. I'll let you know what to expect based on your specific condition.

How Long Does Treatment Take?

This is one of the most common questions I get, and the honest answer is: it depends.

If you have acute back pain from a specific incident (you threw out your back lifting something), you might feel significantly better after 3-4 visits over a couple of weeks.

If you have chronic back pain that's been building for months or years, it's going to take longer. Dysfunction that took months to develop doesn't resolve in a single visit. You might need consistent treatment over several weeks or months to see lasting improvement.

I'll give you a realistic timeline based on what I find during your exam. And if you're not seeing the improvement we'd expect within that timeline, we'll reassess and figure out what else might be going on.

What If Chiropractic Care Isn't the Right Fit?

Not every back pain case is appropriate for chiropractic care. If I examine you and determine that your issue is something that needs medical imaging, a referral to a specialist, or a different type of treatment, I'll tell you that.

I'd rather refer you to someone who can actually help you than keep treating you when it's not working. That's not good for you, and it's not good for me.

If chiropractic care is appropriate but you're not seeing the results we'd expect, we'll figure out why. Sometimes it's a matter of needing more time. Sometimes there's another underlying issue we need to address. Sometimes the treatment plan needs to be adjusted.

The point is, you're not stuck on a predetermined path. We reassess as we go and make changes based on how you're responding.

Frequently Asked Questions About Your First Visit

Will the adjustment hurt?

No. The adjustment itself shouldn't be painful. You might feel some pressure or a stretching sensation, and you'll likely hear that popping sound, but it shouldn't hurt. If you have acute inflammation or muscle spasm, some positions might be uncomfortable, but I'll adjust my technique accordingly. Some people feel a little sore afterward—similar to post-workout soreness—but that usually resolves within 24 hours.

Do I need X-rays or an MRI before you can treat me?

Not usually. Most back pain doesn't require imaging. I can learn a lot from your history and physical examination. However, if there are red flags during your exam (severe neurological symptoms, recent trauma, suspicion of fracture or infection), I may recommend imaging before we proceed with treatment. If you already have recent imaging from another provider, bring it with you—it can be helpful.

How many visits will I need?

It varies based on your condition. Acute back pain from a recent injury might resolve in 4-6 visits over 2-3 weeks. Chronic back pain that's been present for months or years typically requires more consistent treatment over several weeks to months. I'll give you a realistic estimate during your first visit, and we'll reassess regularly to make sure you're progressing as expected.

What if I'm nervous about the "cracking" sound?

That's completely normal. The popping sound can be surprising if you're not expecting it, but it's just gas being released from the joint—similar to when you crack your knuckles. It doesn't mean anything is breaking or being damaged. If you're uncomfortable with traditional adjustments, I can use other techniques that don't produce that sound. There are many ways to restore proper joint function.

Can I continue seeing my physical therapist or massage therapist while getting chiropractic care?

Absolutely. Chiropractic care often works well alongside other treatments. If you're seeing a physical therapist, massage therapist, or other provider, let me know so we can coordinate care and make sure we're not working against each other. Many of my patients benefit from a combination of chiropractic adjustments, physical therapy exercises, and massage therapy.

What should I do if I feel worse after my first adjustment?

Some soreness after your first adjustment is normal—your body is adapting to the changes. However, if you experience increased pain, new symptoms, or anything that concerns you, call the office right away. We'll figure out what's going on and adjust your treatment plan if needed.

The Bottom Line

Your first chiropractic visit is about figuring out what's going on with your back and creating a plan to address it. It's not about getting you to commit to months of treatment or pushing you into something you're not comfortable with. It's about understanding your pain and giving you options.

If you've been dealing with back pain and you're tired of just managing it with medication or hoping it goes away on its own, we're here to help.

Call (734) 929-4523 to schedule your first visit, or book online. We serve patients throughout Ann Arbor, Ypsilanti, and Washtenaw County.

About Dr. Tim Dehr

Dr. Tim Dehr is a chiropractor and Certified Chiropractic Sports Physician (CCSP) practicing in Ann Arbor, Michigan. A former University of Michigan varsity gymnast and Big Ten Champion, Dr. Dehr has worked with competitive and professional athletes including 3-time Olympian Sam Mikulak and over 50 NFL players. He has provided care to US Olympic athletes preparing for the Tokyo 2021 and Paris 2024 Games. At Performance Health Chiropractic, Dr. Dehr brings this same level of biomechanical expertise to all patients—from weekend warriors to desk workers—focusing on identifying root causes rather than just managing symptoms.

This blog post is for informational purposes only and does not constitute medical advice. If you're experiencing severe or persistent back pain, consult with a healthcare provider to determine the most appropriate treatment for your condition.