What Really Happens During Spinal Therapy? Step-by-Step Breakdown

If you have never been to a chiropractor, or you are specifically dealing with a disc issue, it helps to know what an actual visit looks like before you book one. Here is the walkthrough, step by step.

Step 1: Intake and history

Your first visit starts with a conversation: when the pain started, what makes it better or worse, and any imaging or prior treatment you have already had. If you have recent MRI or X-ray results, bring them, though they are not required to get started.

Step 2: Hands-on evaluation

Dr. Esposito checks range of motion, posture, and specific orthopedic tests to identify which spinal segment and which structures are involved. This is what determines whether a disc issue, a joint restriction, or muscular tension is driving your symptoms.

Step 3: The Cox Flexion-Distraction session

For disc-related pain, treatment often uses the Cox Flexion-Distraction Technique: a specialized table gently flexes and distracts the spine with only 2 to 5 pounds of pressure, aimed at taking pressure off the disc and nerve rather than a forceful adjustment. See Spinal Disc Disorders for more detail on how this technique works.

Step 4: Home care and next steps

Most visits end with specific guidance: which movements to avoid for now, which to start doing, and when to come back. Many patients also receive a printable exercise handout, like the ones on our Exercises page, to reinforce what happens in the office.

Step 5: Progress checks

As treatment continues, Dr. Esposito tracks progress against your initial evaluation, and against imaging where available, to confirm the plan is working rather than just hoping it is. If it is not, the plan changes.