Is Chiropractic Regulated In Thailand?

In 2007 the Thailand Ministry of Public Health approved regulations for Chiropractors to practice legally in Thailand. To practice legally, a Chiropractor must apply for, and pass, the 2 day Chiropractic Examination. To apply for the examination, Chiropractors must have a Doctor of Chiropractic (DC) degree from a Council Of Chiropractic Education (CCE) approved chiropractic college. For more information on this acrediting body please go to www.cce-usa.org/. This website is a valuable source of information for anyone who wants to learn more about Chiropractic and the education of a qualified Chiropractor. All candidates applying for the Thai Chiropractic examination are screened for any prior history of professional misconduct or criminal record.

Upon successful passage of the Chiropractic exam, a permit to practice is issued by the Thailand Ministry of Public Health. Chiropractic is only legal when it is; a) practiced by a Chiropractor who has been issued a current valid permit, and b) is performed in a licensed clinic. All health care in Thailand must be performed in a licensed clinic to be legal. All licensed health care clinics in Thailand must display a sign outside the clinic with the name of the clinic and the clinic license number clearly visible on the sign. The Chiropractor’s permit must be prominently displayed inside the licensed clinic. Licensed clinics undergo inspections on a regular basis to insure they meet the required standards. Our clinic has been licensed since 1999.

All chiropractors with a valid permit to practice must attend continuing education seminars to maintain their permit to practice. Dr. Mark successfully passed the exam the first time it was administered in 2007 and has maintained his permit since that time with regular attendance at the required professional re-licensing seminars.

The Thailand Chiropractic Association has received complaints from people who have been improperly treated by people in Thailand claiming to be Chiropractors who, upon further investigation, were found not to be bona fide Chiropractors at all. Choosing to accept care from a Chiropractor who has met all the legal requirements to practice in Thailand is the best way to assure you are receiving appropriate care from a truly qualified Doctor of Chiropractic.

I Usually Go To The Hospital For My Health Concerns. Why Should I Come To Your Clinic?

In Thailand, it is common for people to seek care at hospitals for virtually all their healthcare needs. This is in contrast to many western countries, where people often seek care at clinics, while only going to hospitals for major health problems.  For a major health problem such as cancer, hospitals are the best choice for care because major health problems require management with very expensive diagnostic and therapeutic equipment, often costing millions of dollars. This is not the case for managing most musculoskeletal conditions. While some of the equipment required to manage musculoskeletal conditions is sophisticated and somewhat expensive, it is not so expensive as to make it beyond the reach of a successful practice such as ours.  Our practice has all the equipment necessary to successfully treat the vast majority of musculoskeletal conditions in a conservative manner. If you need a sophisticated test such as an MRI examination, we can refer you for the exam.

The advantage you get in receiving care from a small clinic such as ours is that you are in a much more intimate environment. This is in contrast to the impersonal feel of many larger health care facilities. We see a relatively low volume of patients as opposed to the high volumes of patients seen in the local hospitals. You are always seen by the same small team of practitioners rather than one therapist on one day and another the next day, as sometimes happens in larger facilities.

How Should I Prepare For My Visit?

This is an important question. Go to the “New Patient Center” section of the website for more details.

Do I Need X-rays To Start Treatment?

In most cases we do not need x-rays or an MRI to start treatment. During the intake process we will screen you for red flags, whose presence would require an x-ray or MRI prior to starting treatment. This is fully in line with international standards on best practices for treating low back pain. If we determine X-Rays are necessary, we would prefer you wait for us to order the X-Rays rather than go get them yourself first, before coming to see us. There are a few reasons why we would prefer to order your X-Rays for you. Firstly, in addition to looking for medical conditions such as fractures and tumors, we also want to make a biomechanical assessment of your spine from the x-rays. To do this we make special measurements on the x-rays that medical doctors do not perform.  When a patient has x-rays prior to coming to see us, on the order of a medical doctor, the x-ray technicians often focus the x-ray beam too narrowly, or they shoot the x-rays lying down, or they put the name tag on a part of the x-ray right where we would like to make a measurement. These mistakes can make the x-rays useless for biomechanical analysis. It is also best to wait until the acute inflammation goes down if possible before ordering the x-rays because the acute inflammation will cause you to stand in a way that is not your normal stance. This is called an antalgic posture. When x-rays are taken when an antalgic posture is present, they do not give us useful biomechanical information. The hospital we refer our patients to for x-rays knows exactly what we want, avoiding this potential pitfall. We also prefer real x-rays rather than a CD-ROM of the x-ray. In an effort to save money, many hospitals today only give their patients a CD-ROM of their x-rays unless the patient insists on real films. If you are going to bring old x-rays, we request you try to get copies of the real x-rays if possible. It is easier for us to make a biomechanical assessment on real x-ray films.

How Long Are The Visits?

For most cases, visits usually last about an hour. The first visit usually runs longer. For difficult cases, the subsequent visits sometimes run longer than an hour as well. There is no additional charge when additional time is required. Those patients who come early are most likely to receive the benefit of additional time. Visits typically incorporate deep tissue trigger point and fascia release-massage, physiotherapy modalities and chiropractic manipulation in one comprehensive service. Sometimes acupuncture is additionally performed by a qualified Traditional Chinese Medicine Doctor on staff. We find we get quicker results by combining these tools into the treatment regimen rather than performing only 1 type of treatment alone.

How Long Will It Take For Me To Get Better?

There are several factors that figure into how long it will take to resolve your problem. Some of these factors include; your age, the length of time the problem has existed,  the existence of chronic diseases such as diabetes and advanced heart disease,  your diet, your exercise habits,  work demands, stress levels at home and at work, sleeping habits, and alcohol and tobacco consumption. It should come as no to surprise to anyone that those who pursue healthy habits and avoid bad habits get better quicker. See the section on Healthy Habits for some advice on how you can help speed your recovery by pursuing healthy habits while avoiding unhealthy ones.  Every effort will be made to assess the influence of these factors with advice given to remedy their effects. See the sections on the specific conditions treated for estimates of how long each type of condition takes on average to get better.

If you have had a similar problem before and it was quickly cured with chiropractic, chances are your recovery will be similar this time.

Generally speaking, the longer you have had your problem, the longer it will take to reverse it. If you have had your problem for more than a month, your body has already undergone some abnormal compensations to adapt to your problem. Muscles have shortened and the nerve receptors in your muscles have recalibrated themselves to accept the shortened muscles as the “new normal” length of the muscles. This makes these shortened muscles resist efforts to stretch them back to their normal pre-injury length. Treatment is required in the form of releasing the muscles to reset the nerve receptors in the muscles to accept lengthening of the muscles, back to their true normal length. The joints have also lost mobility and are already beginning to take on some scar tissue which, if not treated, can cause a long term loss of mobility. The longer you have had your problem, the more extensive these abnormal changes are.

A good treatment session at our clinic can stimulate your body to begin to reverse the abnormal changes that have occurred in your body as described above. While some patients feel better right away, for others it does not happen instantaneously at the time of the visit. In a difficult case it can take 2 to 3 weeks to get the full benefit of even 1 visit to the clinic, especially if you have had a problem for a long time. Patience and persistence pay off!

Can I Cure My Problem More Quickly?

For many chronic conditions, we recommend approximately 6 to 12 visits over 4 to 10 weeks. If you have had your problem for many years, sometimes an even longer period of time is required to successfully treat your condition. Some patients don’t want to wait for a cure. Some patients would like to have all the visits over a week or 2, to more quickly cure their problem.

Some of our patients come from far away from Bangkok and are in the city for a short time. For these patients we would encourage them to come as many times as they can during their brief stay, however, if you live in Bangkok, it is more cost effective to follow the treatment schedule over the prescribed period of time. Healing a chronic condition takes time.  Just as you can’t expect to get bigger stronger muscles by working out every day for only 1 week in a gym, nor go to an orthodontist to have your crooked teeth straightened in 1 week, nor grow a tree from a seed in a couple of weeks, you cannot expect to heal a chronic problem quickly.

The most common reason for patients to fail treatment is when they fail to stick with the treatment long enough for healing to take place. While patients with new problems usually recover rapidly, it is important to understand that most patients with chronic problems don’t feel better immediately in the early stages of treatment. Most patients don’t heal in a straight linear fashion, rather, they typically improve a little and then have a minor setback, followed by a little improvement, then another minor set back. Over time, you can expect more good days than bad days with most problems gradually fading away. Please try to be patient and don’t become discouraged the first time you have a minor setback.

Unfortunately, we now live in a world where most people expect immediate gratification for their needs. While modern technology has been able to provide such gratification in our pursuits of higher work productivity and instant access to entertainment through the internet, it has not provided the same level of success in improving our health. Instead, doctors prescribe ever increasing amounts of medicines in an attempt to satisfy this desire for instant gratification and provide the illusion of health. In reality this approach masks the true source of a patient’s pain and they often continue to get worse.  If you have a chronic condition, we urge you to be patient and persistent. It is also critical that you follow the home instructions we give you and follow healthy habits as well.

Are The Same Procedures Used In Each Visit?

Not necessarily, it depends on the particulars of each case. Some patients have multiple areas of involvement. Some patients are aware that they have multiple areas of involvement because they hurt in multiple areas. Other patients are unaware they have multiple problem areas because the pain originating from the primary problem has an overriding influence on the nervous system diverting attention away from the secondary areas of involvement. If you have multiple areas of involvement, you may need to have all of the problem areas corrected to find lasting relief. For instance, some lower back pain patients have articular dysfunctions in the lower back, the sacroiliac joints, the hip joints, the knee joints, the joints of the foot and ankle and/or the lower thoracic spine. There are even times when articular dysfunctions (chiropractic subluxations) in the upper cervical spine can contribute to lower back pain. Trigger points in muscles in areas other than the lower back can also contribute to lower back pain. For instance, trigger points in the abdominal muscles can refer pain to the lower back.

For patients with neck (cervical spine) pain, it is common to have articular dysfunctions (chiropractic subluxations) in the first rib, shoulder joint and thoracic spine in addition to the cervical spine itself. Trigger points way down in the rib cage can also cause neck pain. Even a short leg can contribute to neck pain.

If you have a complex problem with many areas of involvement, we will spend most of the time on the most immediate problem areas first. If you are fortunate, fixing the immediate area of your pain is enough to make your pain go away. If this is not the case, as the immediate area of concern improves, we often have to shift gears and redirect our attention to other problem areas to totally solve your unique pain syndrome.

Occasionally when treating a patient, the first line of treatment fails to resolve a patient’s problem. This occurs in all branches of healthcare. For instance, when a medical doctor  treats a patient for high blood pressure, they choose the drug they feel is most likely to lower the patient’s blood pressure with the least amount of side effects. Sometimes the first drug tried fails to adequately bring down the blood pressure, or has unexpected side effects. When this happens, the doctor will then prescribe other drugs until they find the best choice for that patient. We use the same type of management strategies for our patients. When seeing a new patient, we choose the techniques and therapies that, based on our experience,  are most likely to work the quickest to resolve a patient’s symptoms. If the treatment does not adequately resolve the problem, or the patient would prefer a different style of treatment, we will change the treatment regimen to accommodate the patient. This is the advantage of having many different types of treatment options in our practice.

If I Simply Wait, Won’t the Problem Gradually Go Away Anyway?

If you are fortunate, the inflammation associated with your problem will eventually recede and your pain levels will improve, however, the underlying imbalances in your muscles and skeleton usually remain. If you choose to wait out your painful condition, in hopes it will go away by itself, you are jeopardizing your future because even a minor musculoskeletal problem left untreated often progresses without the patient knowing it. You may not experience symptoms again until the problem has become much more deeply ingrained in your musculoskeletal system. When this happens, it is much more difficult to untangle the problem. A similar sort of thing can happen with your dental health. It is common for patients to put off fixing a simple cavity in a tooth, which eventually becomes so advanced, a root canal or extraction is required.

The takeaway here is: if you have a musculoskeletal problem you have been put off treating, it is better and cheaper to fix it sooner, rather than later. The biggest mistake most people make in their lives is spending too much time and money on the pursuit of material wealth and not enough on safeguarding their health. The biggest irony is that in the end, people who fall into this trap have to spend much more of their money and time treating advanced health problems which could have been prevented with a little treatment earlier, when the problem started.

Can’t I Simply Exercise More To  Cure My Problem?

This is one of the biggest myths people believe about their musculoskeletal system. It is absolutely true that exercise is essential to maintaining musculoskeletal health.  Exercise also plays an important role in the rehabilitation of a musculoskeletal problem, however, it’s role in rehabilitation is not exclusive. Exercise can not unlock a locked pelvis of vertebrae in your spine nor can it free up key blockages in your fascia. You need the aid of a highly skilled Chiropractor to find exactly what bones are locked up, what muscles have shortened, and what areas of the fascia are thickened. Once found, a great deal of skill is required to normalize these blockages and shortened muscles. The blockages in your bones and fascia can only be treated with a patient in a totally relaxed position. It takes a great deal of exertion and skill on the Chiropractor’s part to release these blockages. It is not possible to do this to yourself. Not even a highly skilled Chiropractor can treat himself.

Do You Treat Children?

Many adult musculoskeletal problems have their origin in childhood. All kids have accidents. They fall off of bicycles, fall out of trees, wrestle with their siblings, and on and on…. Parents often do not witness some of the accidents their children experience. More often than not when you question an adult patient about past injuries, it is common for them to deny any past injuries. People often forget the traumas they sustained during childhood. Some traumatic events occur at such a young age it isn’t possible to remember them. I recall being in a restaurant several years back observing 2 mothers having lunch with their toddlers in high chairs. The women were engrossed in conversation and weren’t paying enough attention to the toddlers. Suddenly, I saw one of the kids lean over in his high chair and before I could say anything, the kid took a head first nose dive onto the floor. He screamed and cried for a couple of minutes and then eventually settled down to the point of whimpering for the rest of the meal. I have little doubt this injury was never addressed as the mother went right back to her conversation with her friend as soon as the child’s suffering was reduced to a whimper. She certainly did not show any urgency to leave and seek care for the child. One event like this can alter the normal development of skeletal alignment if not treated. A fall of this kind usually does not lead to a fracture because of the extreme flexibility of a toddlers bones, however, it will cause an inflammatory reaction with muscle spasms setting in and possibly some scar tissue formation in the injured area. These muscle spasms cause a shortening of the affected muscles which in turn alters the mobility of the adjacent joints, causing them to ultimately become less mobile. If the muscles are not released and the joints gently freed up, the child will begin to grow with an unbalanced skeleton. When someone goes through their development with an unbalanced skeleton, the asymmetries become permanent.

Everyone’s body is like a minefield littered with evidence of previous injuries. We can see the evidence of these previous injuries expressed through chronically shortened muscles which may be abnormally painful to touch and abnormally stiff joints. Some kids already have evidence of this upon examination, particularly if they have a history of a known past injury that was not treated, or the child is known for particularly rough play, such as playing a lot of sports. If you don’t think your child has ever had an injury, click on this link to watch a video of kids taking the kind of spills that happen everyday:


In addition to treating traumatic injuries in children, Chiropractors are also interested in correcting postural problems in children. Poor posture causes painful musculoskeletal conditions, even in children. Many adults are well aware that their desk jobs cause them pain. What most don’t realize is that their children are being exposed to the same postural strains while sitting in classes at school all day. This is a relatively new phenomenon is the history of mankind. Our ancestors did not sit hours a day in classrooms and then go home and study some more. They also didn’t stare down at computer screens or mobile phones. The kids of earlier generations were out helping their families to survive, doing hard work from a relatively young age. When they played, they were much more likely to be playing outdoors in a manner that was more strenuous than todays kids. This lack of adequate activity levels, often contributes to the development of poor posture. Poor posture is often a key contributor to what is often misdiagnosed as “growing pains”. If your child complains of pains or obviously has bad posture, we urge you to bring them in for a checkup.

Do You Treat Seniors?

We treat many seniors in our practice. Pictured above is Mr. James Davison, a long time patient at our clinic. He has been a radio DJ and presenter in Thailand for over 40 years. At 99 years old, he still lives independently and works part time. He likes to go dancing for fun. He finds chiropractic care helps keep him going.

Seniors often come with complaints of lower back pain, fatigue to the legs and neck pain. Chronic knee pain is also one of the most common complaints we treat seniors for. We have specialized gentle techniques to accommodate the needs of seniors.

I Have a Question That is Not Answered Here. Can I Call You To Ask My Question?

As a general rule, Dr. Mark does not answer phone calls from prospective patients during working hours. He is usually working continuously throughout the day, often only stopping for a few minutes to eat lunch. It would be unfair to those paying customers to interrupt their treatment to answer the phone. Dr. Mark’s wife Ning can usually answer most questions posed on the phone as she has been working together with him for a very long time.   Alternatively, you may email Dr. Mark and he will return your email inquiry. This is a much better approach because people do not remember most of what is said in a brief spoken conversation in contrast with reading a detailed, well thought out email response to your question.