The idea of seeing a chiropractor may be daunting. It often conjures images of the body being forcefully pulled and twisted and of sounds of bones cracking and popping.

While some chiropractors may apply an abrupt force on the joints, a technique known as High Velocity Low Amplitude (HVLA), many practitioners use gentler methods and combine other treatments to relieve pain.

At Lind Wellness Center in north Salem, chiropractor Peter Lind takes several paths to diagnose and treat patients. He uses computers to measure balance of the nervous system and oxygen concentration on tissues.

The center offers nutrition advice, homeopathy, ionic cleansers to pull free radicals out of the system and low-level lasers to increase ATP production and speed healing by communicating to damaged tissues.

"We take a holistic approach. People with chronic back problems have multiple areas of stress in their lives. We take care of the back problem but we take care of the whole person, too" explained Lind, whose clinic treats anything from hormone imbalances to chronic pain problems.

As far as spine adjustment goes, Lind said "I am totally gentle. I don't really crack or manipulate the spine. I use instruments."

Doctors of osteopathy (D.O.s), like chiropractors, are manual therapists. They diagnose and treat illnesses or injuries using Osteopathic Manipulative Treatment (O.M.T.), a gentle technique of applying resistance, stretches and pressure. Osteopathy can help bring about rapid healing. "Usually within a few visits, the treatment is either going to work or it's not. My favorite thing to do during an appointment is an examination, treat the patient, and see them walk out the door happy," said Mark Scherlie, a D.O. and primary care doctor at West Salem Family Practice.

"A technique I use a lot is counterstrain, where the muscles totally relax and things that are out of position gently go back into place," he said.

Osteopaths hold medical degrees and are comprehensive practitioners. They are licensed to write prescriptions and perform surgeries.

"It is said that we are America's best kept secret, because we don't advertise like chiropractors do. But we don't mean to be secretive," said Scherlie, who was going to receive chiropractic training while he was attending medical school, until he found the alternative of osteopathic medicine. Not all osteopaths do manipulations, so it is better to find out if they do before scheduling an appointment, advised Scherlie.

Another option for those with musculoskeletal problems is physical therapy. Physiotherapists cannot diagnose nor prescribe medications. They typically provide treatment following a physician's or a chiropractor's referral.

After a 2007 Oregon law was passed, people gained the right to access physical therapy directly, which can reduce costs and speed the process. "Ideally, we'd like to see clients as soon as possible after an injury," said Jennifer Hartford, a physical therapist at Willamette Spine Center.

However, not all insurance companies will cover treatment without a referral, so it is better to check with your insurance before walking in, she warned.

Physical therapy has an exercise focus, but practitioners sometimes perform manipulations.

"Different physical therapists have different backgrounds and training, but we tend to do more mobilization," explained Jeff Kundert of PT Northwest. "We work a lot with exercise to strengthen the muscles, and we usually recommend patients to follow through with home exercises," he added.