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  • Writer's pictureDr David Hopper

Using HRV in Chiropractic

As a Chiropractor, I see the many individual issues my patients face daily and the general overall response is the need to alleviate their pain. However, pain is rarely the main problem, it is simply just a symptom. In order to alleviate the pain in the long run it is best to try and get down to the causing issue, rather than treating the symptom for a quick fix.

For example is a patient's knee pain from fallen arches or misalignment in the hips? What is causing those structural issues, is it menstrual or GI issues? Maybe the fallen arches are from excessive weight, so does diet need to be reviewed?

The most common pain symptom I see in my patients is in the shoulder and neck, however stress is often the issue here. Stressors can be anything, even posture is a stressor. In fact there are 3 T’s that can bring on stress to the body - Traumas, Toxins & Thoughts.

This is all related to your Autonomic Nervous System (ANS), and the best way to measure your ANS is through Heart Rate Variability (HRV), which helps take the conversation away from pain and focus on the larger issues.

Here’s how I have been using HRV monitoring in practice.

I have found I can use HRV with my patients in 2 ways.

The first approach is to have my patients come in to take their HRV reading before their session, and then to take it again after the session, for 3 minutes each time. I see immediate change from the effects of the session and see huge improvements due to stimulating vagal activity.

I know there is a general fear of HRV potentially declining after a session, which is not what providers, or patients, may want to see. However it’s worth taking into consideration that you may simply be regulating the patient's ANS. This is why it is so important to establish a HRV baseline, and have that level of communication with your patient.

The second approach is to have my patients go home with a HRV device and take it every morning, again for 3 minutes, so that we can establish that true baseline. I recommend that my patients take their reading each morning because whether you have a positive, negative or normal day, you’re depleted by the evening, and that's your ANS needing rest! Therefore, a morning reading is the most consistent and most true.

Connecting with patients

I have had great feedback from my patients since implementing HRV monitoring as they can then see how a treatment plan is affecting their body. They can see the ups and downs, and we can discuss and connect at a much deeper level, which opens the door to helping more than the immediate pain issue. I get their whole life perspective, not just the symptom. Which makes the session more than an adjustment.

The webdash for practitioners is a great addition to my services and patients love the immediate response to their reading, from taking it in the waiting room to discussing their results at the start of their session, as it uploads immediately.

Everyday I login and see where every patient is and how they’re doing. I’ve also set up alerts so that if anyone has two down HRV days, I can reach out for help.

HRV trending down is an opportunity to catch when a patient is likely to get ill, or injured (if you make mistakes in the gym for example) as you have much less ventral vagal to pull from. In an ideal world your body, and it’s ANS, is needing to rest. However I understand my patients sometimes can’t cancel the big meeting that day, or they still parent children. Sometimes you simply need to show up to life, but show up the best you can be. So what can you do as a practitioner?

I advise my patients to quickly delete everything that doesn’t have to be done that day and try to turn up the good (meditation, slow paced workout, walk someplace happy to them). You need to fulfil and charge the nervous system rather than doing depleting things.

Patients can also test new things: dietary programme, exercise plan, sleep or cutting out alcohol and we can monitor their HRV trends alongside these tests.

Since implementing Optimal HRV monitoring I have found that I’m providing better services and I’m quantifying the effects of those services, adding value to all of my patients, no matter what symptom they entered the practice with.

Get in touch

As always, if you want to know more about how Optimal HRV can help you or your organization provide better care or services to your clients or employees, please let us know at

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