What to Expect at Your First Chiropractic Visit

If you have never seen a chiropractor, or have not seen one in years, it is natural to wonder what actually happens at a first visit and how long it takes. A first visit at Integrity Chiropractic in Kirkland is a one-on-one appointment with Dr. Frank Wen, and it is designed to dive deep into your problem or problems before providing treatment.

Rather than simply telling you that our care is comprehensive or personalized, this page explains how the time is actually spent, what goes into the examination, and how treatment decisions are made.

This guide walks through the visit in order: the history, the examination and discussion, and the treatment that usually follows the same day. You will learn about your condition throughout the visit, and there are no packages or contracts required to initiate treatment.

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How Long Does a First Chiropractic Visit Take?

The times below are typical ranges, but your own visit may run a little shorter or longer depending on your condition.

A first visit typically runs somewhere between 90 to 115 minutes, as many patients seen at this clinic present with chronic or complex issues. It can be around 60 to 90 minutes if the condition you present with is relatively straightforward or minor once the doctor sees you.

History and examinations generally last between 30 to 70 minutes. Initial treatment then takes on one of two service levels, one being 25–30 minutes or 50–60 minutes, depending on the complexity of the problem. Follow-up visits are scheduled for 30-minute or 60-minute blocks, again depending on the complexity of the problem and the amount of treatment needed.

Visit structure and fees are listed on the New Patient Information page.

Step 1: Your History

The visit starts with a conversation, not a checklist. Dr. Wen asks about:

How the problem started
How and when it shows up now
Who you have seen for it
What has helped or hasn't helped, and how long the relief lasted
Past injuries and other ongoing health issues
Lifestyle and activities over the years

This gives him the story of the problem to understand its evolution and where opportunities have been missed. If records from earlier imaging or care would help, we will work with you to obtain them.

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Step 2: The Examination

Next comes a detailed, hands-on examination. It looks at multiple regions that could be influencing your problem, as areas away from the primary area of concern can sometimes contribute to your symptoms, and symptoms can overlap between different conditions.

For example, tingling in a hand may involve the arm, shoulder, or neck, and the workup may include examining each of those areas, including a neurological examination, to help drill down into the problem.

You are moved, tested, and observed: how your joints move, how your muscles respond, and how the pieces work together. Dr. Wen will discuss the reason for examining an area and educate you as the examination progresses so you can develop a deeper understanding of your body. He also draws on patterns and clinical experiences from over a decade of practice to help explain what he is finding.

Are X-Rays Needed?

This is a question that is frequently asked by patients seeking chiropractic care.

Dr. Wen follows contemporary, evidence-informed recommendations that generally advise against routine imaging when there is no clinical indication for it. Imaging may be appropriate when the history or examination suggests a condition that needs further investigation, when there are concerning findings, or when symptoms are not responding as expected and imaging may help guide the next steps.

X-rays can be useful in the right circumstances, but unnecessary imaging also exposes patients to radiation and may identify abnormalities that have little relationship to their symptoms.

Postural asymmetries and movement restrictions can often be assessed clinically through observation, range-of-motion testing, and physical examination without requiring an X-ray to guide treatment.

While some traditional chiropractic approaches use spinal alignment measurements from X-rays as the basis for treatment plans, many individuals have minor asymmetries or degenerative changes on imaging without significant pain or functional limitations. There is also insufficient evidence that correcting minor vertebral alignment differences seen on X-rays reliably improves pain or quality of life.

The decision to obtain imaging is therefore based on whether it is likely to provide useful information for your particular condition, rather than being a routine requirement for receiving chiropractic care.

Step 3: Discussing Your Exam and Treatment

As you are learning about your body and condition during the examination, Dr. Wen is building a list of likely culprits and contributors to your problems.

He will recap what he found at the end of the exam and discuss which factors are most likely contributing, which matter less, what he wants to address first, and what the next steps for further investigation may be if you don't see improvement within a reasonable number of visits.

You hear the information in plain words, during the same visit, and have the opportunity to ask anything you want. You will understand the treatment plan before he begins.

If what Dr. Wen finds suggests that a referral is needed, he will advise you and assist with the process.

Step 4: The First Treatment

There are rare occasions when patients present with highly complex issues and the entirety of the appointment time is taken up by the examination. If so, treatment will be initiated at the next visit.

However, for most patients, treatment can begin during the same visit and takes 25–30 or 50–60 minutes, depending on your condition. That is the reason why the first visit reserves a large block of time so that this can happen.

Many patients with more involved conditions require close to an hour of treatment to sufficiently address the different facets of their problem. An hour of treatment often comes together from one or a combination of the following:

Soft tissue work: 25-60 minutes
Joint work, if needed: about 2 to 5 minutes
Exercise/rehab, if needed: 15-30 minutes

These are examples of how treatment time may be used, rather than fixed amounts for every patient.

Those with more minor issues will typically need one or two of the above modalities to a much lesser degree. As your care progresses over time, treatment tends to shift from more hands-on work to more rehab. It is not uncommon for patients toward the tail end of their care to spend almost the entire session doing exercise and rehabilitation to prepare them to return to previously problematic activities.

How Is Treatment at Integrity Chiropractic Different?

Chiropractic care at Integrity Chiropractic incorporates a variety of hands-on techniques and exercise-based rehabilitation approaches within the scope of chiropractic practice. Some of these techniques are also used by physical therapists, massage therapists, and other healthcare professionals, although each profession has its own training, licensing, and scope of practice.

Chiropractic care can look very different depending on the clinic you visit. While many of the techniques used at Integrity Chiropractic are also practiced by chiropractors, physical therapists, massage therapists, and other healthcare professionals, the difference lies in how they are brought together and applied to your particular condition. Rather than relying on a single treatment method, Dr. Wen draws from multiple approaches based on what he finds during the examination, how you respond to treatment, and what you ultimately want to be able to do.

Soft tissue work or manual therapy encompasses a diverse set of muscle and tendon release techniques. One way to think about it is targeted or very focused massage-type work in limited regions of interest.

Dr. Wen was trained in many of these techniques as part of his chiropractic education, which also included massage therapy training. In the course of practice, he has pursued additional training and certifications to broaden his skill set and has developed techniques inspired by his training and experience observing patterns over more than a decade of practice.

Most patients have some idea of what to expect from chiropractic joint work through social media, but joint work can range from light and gentle techniques to more forceful methods associated with joint cracking and popping. Some chiropractors also perform joint work with instruments.

Dr. Wen takes an as-needed approach balanced by patient preferences, which can range from indirect joint work to light hands-on joint mobility work or traditional chiropractic adjustments. There are many patients treated at this clinic without chiropractic adjustments.

Lastly, Dr. Wen has a strong interest in exercise and rehabilitation science, as he has found it to be an important part of helping many patients maintain improvements in pain and function over the long term.

This is partly why he pursued certification as a Certified Chiropractic Sports Practitioner® through the American Chiropractic Board of Sports Physicians, reflecting his commitment to continued learning and dedication in this domain.

Like soft tissue work, he enjoys learning and studying from the sciences of physical therapy and rehabilitation as well as sports and athletic training to increase the effective options available to meet patients where they are.

In the end, no single approach works for every patient, even with similar presentations. There are many practices, systems, or techniques that can become overly rigid in requiring practitioners to adhere to a particular method. This is one reason Dr. Wen invests time in developing skills across multiple domains, so that he can help you efficiently and pragmatically address your problem.

What You Can Expect From Every First Visit

Each first visit rests on the same few commitments:

An in-depth, hands-on examination tailored to your condition, which is the foundation of your care
Your findings explained the same day, before treatment, without requiring a separate appointment to hear them
Imaging or referral recommended and coordinated when clinically indicated
Each visit priced on its own, with no packages and no contracts

Questions Worth Asking Before Choosing a Chiropractor

If you are researching different chiropractic clinics, you may notice that many describe their care as comprehensive, personalized, or focused on finding the root cause of pain. These are worthwhile goals, but the descriptions alone may not tell you much about what actually happens during an appointment.

Chiropractors can practice quite differently from one another, and there is no single approach that works for every patient. Before choosing a clinic, it can be helpful to ask a few practical questions to understand whether its approach fits your needs.

How much time is reserved for the first visit, and what does that time include?

A first visit may include paperwork, a consultation, examination, discussion of findings, and treatment. Understanding how much time is actually reserved for examining your condition and providing treatment can help you know what to expect.

Will I be examined and treated by the same doctor throughout my care?

Some clinics operate with multiple providers or support staff who handle different parts of the appointment. That arrangement may work well for some patients, but it is worth understanding who will be responsible for your examination, treatment, and ongoing decisions about your care.

What happens if my problem involves more than the area where I feel pain?

Pain and other symptoms do not always originate from the location where they are felt. Depending on the condition, a thorough evaluation may need to consider nearby joints, muscles, nerves, or other regions of the body. Ask how the clinic determines what should be examined and treated.

What types of treatment are available beyond chiropractic adjustments?

Adjustments can be useful for certain conditions, but they are not necessarily appropriate or sufficient for every patient. It can be helpful to know whether the clinic also provides soft tissue treatment, exercise, rehabilitation, or other approaches when indicated, and how those treatments are incorporated into a visit.

How will I know whether treatment is working?

Pain relief is important, but it may not tell the whole story. Ask how your progress will be evaluated, whether the treatment plan changes as you improve, and what happens if you are not responding as expected.

Will I be expected to do anything outside of my appointments?

For many musculoskeletal conditions, the work patients do between visits can be an important part of recovery. Understanding whether you will receive exercises, activity recommendations, or other guidance can help you decide how involved you want to be in your care.

Are there any required treatment packages or long-term commitments?

Some clinics offer packages or prepaid treatment plans, while others charge for each appointment individually. Neither arrangement tells you everything about the quality of care, but you should understand the financial commitment, how the proposed number of visits was determined, and whether the plan can be adjusted as your condition changes.

The answers to these questions may reveal more about a clinic's approach than its website alone. A good fit is not necessarily the clinic offering the most treatment or the longest appointments. It is one where the evaluation, treatment options, communication, and expectations are appropriate for your particular condition and goals.

What is Expected of Me For Receiving Care Here?

The patients who tend to enjoy the greatest success are the ones who follow their treatment plan, but most importantly, do the homework that is assigned to them.

Care will not be a passive experience here, as the goal is to help you develop knowledge, skills, and habits that allow you to build on each visit and take care of your body in the future.

Does Integrity Chiropractic Take Insurance?

Integrity Chiropractic does not bill commercial health insurance plans directly. Care here is built around time with you, rather than a list of billable procedures and the administrative requirements that often come with insurance billing.

After reading the above, it should be easier to understand why the clinic operates this way. The goal is to make treatment decisions based on what is clinically appropriate for your condition, with the flexibility to spend more time examining, treating, and progressing your care when needed.

Working outside commercial insurance contracts gives Dr. Wen greater flexibility to structure appointments around the needs of the patient, without having to fit treatment into the reimbursement requirements of a particular insurance plan.

A few things to know:

Fees follow the length of your visit rather than the number of individual procedures performed.
A digital superbill can be provided for you to submit to your insurance plan for possible out-of-network reimbursement. What your plan reimburses depends on your individual benefits, and reimbursement is not guaranteed.
HSA and FSA funds may be used, subject to your account's eligibility rules.
Each visit is priced on its own, with no packages and no contracts, as the treatment plan follows your response to care.
Auto injury cases covered by Personal Injury Protection (PIP) are accepted at Integrity Chiropractic. While PIP coverage has its own rules and limitations, it generally does not impose the same contracted fee schedules as commercial health insurance plans. This allows the clinic to maintain its longer, individualized appointment structure while still working directly with PIP insurance for eligible auto injury cases. Coverage and payment remain subject to the terms and limits of each policy.

How to Prepare

Complete the new patient paperwork electronically before you arrive, so your available time with Dr. Wen is spent on you and not on forms.
Wear loose, comfortable clothing.
Bring your HSA or FSA card if you have one.
If you have relevant imaging reports or medical records readily available, bringing them may be helpful.
Details on fees, claims and what to bring are on the New Patient Information page.