Let's figure out what's going on.
The first visit
Plan on about 60 minutes. Most of it is conversation and examination, because I'd rather understand the pattern than treat the first thing that presents itself.
I'll ask what hurts and when, what you've already tried, what you do all day, and what you want back. Then I'll look at how you move — both how the joint moves when I move it and how it moves when you do. Those two disagree more often than you'd think, and the disagreement is usually the most useful thing in the room.
You'll leave with a plain explanation of what I think is happening and what I'd like to do about it. Most people get some treatment that day too, depending on what the exam turns up.
What treatment might involve
Soft tissue work and active release.
Muscle and fascia pull joints out of position and hold them there. Treatment can consist of mostly releasing the soft tissue.
Decompression.
Gentle traction that takes pressure off a disc or a nerve root.
Graston.
Stainless steel instruments worked along the muscle to find scar tissue and restriction. More precise than hands alone, and it tells me things by feel I can’t get any other way.
The Activator.
A small spring-loaded instrument that delivers a specific, low-force impulse into a joint. It’s quiet and it stays well inside the joint’s range, which makes it a good place to start with hypermobile joints or with anyone who’d rather work up to a hands-on (aka manual) adjustment.
Manual adjustment.
The one most people picture. A good tool, used often, once we know what’s driving the problem and you’re comfortable.
Stretching, strengthening, and homework.
A few specific things rather than a long list, because a long list doesn’t get done.
About the popping sound
A loud pop is gas releasing in a joint. It's a satisfying noise and a poor measure of whether an adjustment did anything, which is worth knowing if you've been judging your care by it. Some of my most effective visits are quiet ones.
How often you'd come in
Depends what we find, and I'd rather tell you after the exam than guess. The arc is usually the same: closer together at the start while things are changing, then spacing out as they hold. A higher-frequency stretch typically lasts four to six weeks.
What this costs
Some patients on a basic maintenance plan use 15-minute visits.
Insurance. I do not bill insurance, but I can provide a superbill or itemized bill per visit that patients can submit to their insurance for out-of-network benefits reimbursement.