Red Flags When Choosing a Chiropractor in Sioux Falls | Back Specialists

Choosing a chiropractor is a meaningful healthcare decision. You're trusting someone with your spine — arguably the most important structural system in your body — and you deserve to walk into that relationship with your eyes open.

I've been practicing chiropractic in Sioux Falls for nearly 50 years. I've seen the profession at its best and, through the patients who eventually found their way to our clinic after difficult experiences elsewhere, I've heard plenty about what can go wrong. This post isn't about tearing down other providers. It's about giving you the information you need to make a confident, informed choice — whether you ultimately choose Back Specialists or someone else.

Here are the most important red flags to watch for, and in each case, I'll tell you directly how we handle that issue at Back Specialists.

Red Flag #1 — They Adjust You Before Examining You

A chiropractor who puts you on the table and begins adjusting you on your very first visit — before taking a thorough health history, asking about your symptoms, performing a physical examination, or reviewing any imaging — is skipping the most important step in safe, effective care.

Your spine is not a generic structure. You may have a history of surgery, a previous fracture, an underlying condition like osteoporosis, or nerve involvement that needs to be identified before any force is applied. A provider who adjusts first and asks questions later is not practicing safely. They're practicing efficiently — at your expense.

How Back Specialists handles this

Every new patient at Back Specialists begins with a comprehensive consultation and physical examination. Dr. Bruce Jon Hagen reviews your full health history, discusses your current symptoms, and identifies any conditions that might affect your care before recommending anything. Digital X-rays are taken when clinically indicated. Nothing happens to your spine before we understand what we're working with.

Red Flag #2 — They Use the Same Technique on Everyone

Every patient is different. A 28-year-old athlete with a lumbar strain is not the same as a 72-year-old with osteoporosis and degenerative disc disease. A patient recovering from cervical fusion surgery is not the same as a healthy adult with simple neck stiffness. If your chiropractor approaches every patient with the same high-velocity, manual thrust adjustment regardless of age, health history, or condition, that is not individualized care. It is a production line.

Aggressive, one-size-fits-all adjustments are not just ineffective for certain patients. For patients with brittle bones, post-surgical spines, or acute nerve compression, they can be genuinely harmful.

How Back Specialists handles this

At Back Specialists, we practice exclusively with the Activator Method — a gentle, instrument-assisted technique that uses a small, spring-loaded device to deliver precise, low-force impulses to specific joints. The Activator fires faster than the muscles can react, which means joints move into proper alignment without any guarding, resistance, or soft tissue stress.

But the technique is only half the answer. The Activator Method includes a systematic assessment protocol — a leg-length analysis and neurological testing procedure performed at every visit — that identifies exactly which joints need correction. We are never guessing, and we are never applying force to areas that don't need it. Every adjustment is targeted, measured, and appropriate to your specific anatomy and condition on that specific day.

This approach is safe and appropriate for virtually every patient we see — from infants to patients in their 90s, from athletes to individuals recovering from spinal surgery, from healthy adults to those with osteoporosis, arthritis, or herniated discs.

Red Flag #3 — They Make Miracle Claims or Overstate What Chiropractic Can Do

Chiropractic care is exceptionally effective for a defined and well-researched range of conditions — primarily musculoskeletal complaints involving the spine, nerves, muscles, and joints. It is not a cure for cancer. It does not treat diabetes. It does not reverse autoimmune disease. Any chiropractor who claims spinal adjustments can resolve conditions outside the musculoskeletal system is either misguided or deliberately misleading you.

The same concern applies to vaguer claims — promises of "optimal wellness," "total body healing," or dramatic cures delivered through a philosophy that blames every health problem on spinal misalignment. These claims are not supported by evidence, and providers who lean heavily on this framing are prioritizing belief systems over patient safety.

How Back Specialists handles this

Dr. Hagen has practiced evidence-based chiropractic for nearly 50 years. We treat low back pain, neck pain, headaches, sciatica, herniated discs, auto accident injuries, work injuries, and related musculoskeletal conditions. We are very good at what we do. We do not claim to do things we cannot.

If you come to us with a condition outside our scope, we will tell you — directly and honestly — and help you find the right provider for your situation.

Red Flag #4 — They Pressure You Into Long-Term Contracts on Day One

One of the most common complaints about chiropractic practices involves being pressured into signing a multi-month, prepaid care plan on the very first visit — before you've had a single adjustment, before you've had any chance to evaluate the care, and before anyone could possibly know how your body will respond.

Legitimate chiropractic care should be tailored to your response. Most patients with acute, uncomplicated conditions see meaningful improvement within a few weeks. A provider who insists you must commit to six months of care on day one — especially using fear-based language about what will happen if you don't — is prioritizing revenue over your wellbeing.

Be equally cautious of high-pressure sales tactics around upsells: supplements, vitamins, orthotic inserts, and other products aggressively promoted at your first visit. Some of these things may have legitimate value in certain situations. Pushing them on every new patient on the first appointment is a sales strategy, not a clinical one.

How Back Specialists handles this

We do not use contracts. We do not require prepayment for bundles of visits. We do not pressure patients into committing to a plan before they've experienced care.

At your first visit, Dr. Hagen will examine your spine and give you an honest estimate of what your condition is likely to require. That estimate is based on clinical findings — not a sales template. You are always free to ask questions, adjust your schedule, or discontinue care. Nobody will guilt-trip you or give you a sales pitch. As we've said on our best chiropractor page: we'll tell you what we find, what we recommend, and why — and then respect whatever you decide.

Red Flag #5 — They Use Fear Tactics to Keep You Coming Back

A specific form of sales pressure worth calling out separately is the use of fear to retain patients. This typically involves a dramatic reading of your X-rays — using normal age-related changes as evidence of impending catastrophe — followed by a warning that you absolutely must continue care or face serious consequences.

"Your spine is degenerating dangerously." "If you stop now, you'll be in a wheelchair within five years." These are not clinical assessments. They are manipulation — using your fear of pain and disability to keep you paying for visits you may not need.

Normal spinal degeneration is a part of aging that shows up on virtually every adult's X-rays. A finding on an image does not automatically translate to a clinical problem requiring aggressive, long-term treatment. Ethical providers explain what they find in context, with appropriate nuance, and without weaponizing it against you.

How Back Specialists handles this

Dr. Hagen has been taking and interpreting spinal X-rays for nearly 50 years, with over 1,700 hours of post-graduate training in X-ray interpretation and diagnosis. When imaging is warranted, we use it as a diagnostic tool to better understand your spine and plan your care — not as a prop in a sales presentation.

If you have findings that are clinically relevant, we will explain them clearly and in plain language. If you have findings that are incidental and not driving your symptoms, we will tell you that too. Honesty about what your imaging actually means is a baseline expectation at Back Specialists, not a differentiator.

Red Flag #6 — They Won't Refer Out When Necessary

A chiropractor who believes they can treat every patient for every problem is not a chiropractor you can fully trust. Chiropractic care is highly effective within its scope. But that scope has limits — and ethical providers know them and respect them.

If you have symptoms that suggest a fracture, infection, neurological emergency, or serious systemic disease, you need a medical referral — not a spinal adjustment. If your condition isn't improving after a reasonable course of care, you deserve an honest conversation about alternatives — not a recommendation to simply continue the same treatment indefinitely.

A provider who discourages second opinions, dismisses your primary care physician, or becomes defensive when you ask about other options is placing their ego or their revenue above your health.

How Back Specialists handles this

One of the things Dr. Hagen is most direct about is knowing the limits of chiropractic care. If you come to us with something outside our scope — whether that's a condition requiring surgery, a red flag symptom suggesting a serious underlying cause, or a case where chiropractic simply isn't the right tool — we will tell you directly and help you find the appropriate resource.

We work collaboratively with primary care physicians, orthopedic surgeons, neurologists, and personal injury attorneys in Sioux Falls. We view those relationships as part of providing complete, responsible care — not as threats to our patient base. If you want a second opinion, we will support you in getting one. We are confident in what we do and have nothing to hide.

Red Flag #7 — The Technique Is Painful or Aggressive Without Clear Justification

Some post-adjustment soreness — similar to the muscle soreness after exercise — is normal for some patients, particularly after the first few visits. That is different from a chiropractic adjustment that is actively painful during the procedure, leaves you bruised, or applies aggressive force to areas of your spine that are not symptomatic.

Chiropractic should not hurt. A provider who dismisses pain during treatment with "no pain, no gain" or insists that forceful manipulation is necessary when you are clearly not tolerating it is not adapting to your response. That is dangerous for any patient, and particularly so for patients who are post-surgical, have osteoporosis, or are dealing with acute nerve compression.

How Back Specialists handles this

The Activator Method is inherently gentle. There is no thrusting, twisting, or high-velocity force involved. The instrument delivers its impulse faster than the nervous system can register it as threatening, which means there is no pain response, no muscle guarding, and no post-treatment soreness in the vast majority of cases.

For patients who have had painful experiences with chiropractic care elsewhere — and we see many of them — the Activator Method is often described as revelatory. The adjustment is brief, precise, and comfortable. If at any point during your care you experience unexpected discomfort, Dr. Hagen will stop, reassess, and adjust the approach accordingly. No patient is ever pushed through pain at Back Specialists.

Red Flag #8 — Their Credentials Are Thin or Unclear

A chiropractic license is the baseline. It tells you the provider completed an accredited program and passed the required board examinations. It does not tell you how much additional training they've done, what specialty areas they've focused on, or how long they've been in practice.

When evaluating a chiropractor, look beyond the degree. Ask about post-graduate certifications, specialty training, years of experience, and whether they have any advanced credentials in the technique they use. A provider who can't or won't answer these questions clearly is not a provider who has invested seriously in their ongoing education.

How Back Specialists handles this

Dr. Hagen's credentials are extensive and verifiable. He holds Advanced Proficiency Rated status in the Activator Method — the highest credential available through Activator Methods International — and is one of only 5 chiropractors in the entire Sioux

Empire to have achieved it. His post-graduate training includes:

• Over 1,700 hours of X-ray interpretation and spinal diagnosis

• Graduate of the Whiplash Masters' Program — Spine Research Institute of San Diego

• Advanced certification in cervical trauma and whiplash-related disorders

• AMA Impairment Rating — 4th, 5th, and 6th Editions

• Extensive continuing education in personal injury, accident reconstruction, and acute patient management

• South Dakota Chiropractor of the Year — 2009

• Former President, South Dakota Chiropractor's Association

His son and practice partner, Dr. Sean C. Hagen, also holds Advanced Proficiency Rated status — making Back Specialists the only father-son Advanced Proficiency Rated Activator team in the region.

You can read the full credential profile on Dr. Hagen's bio page. We don't hide this information. We lead with it.

Red Flag #9 — They're Unclear About Costs and Insurance

Healthcare financial conversations should never feel like a shell game. You deserve to know what care will cost before it happens, whether your insurance will cover it, and exactly what you're committing to financially before your first treatment begins. A clinic that is evasive about fees, makes vague promises about insurance coverage that turn out to be inaccurate, or presents confusing billing after the fact is not operating with your interests in mind.

How Back Specialists handles this

We accept most major insurance plans and are in-network providers for Avera, Sanford, Blue Cross Blue Shield, DakotaCare, Wellmark, and Medicare Part B. We also accept auto accident insurance and workers' compensation. For patients who are uninsured or underinsured, we participate in ChiroHealth USA.

We will verify your benefits before your first visit so there are no surprises. If you're navigating an auto accident claim, we understand the process thoroughly and will help you through it from the first appointment. Transparency about what care costs and what your insurance covers is not exceptional at Back Specialists. It's standard.

Red Flag #10 — Something Just Feels Off

This one is harder to quantify but worth taking seriously. If the office environment feels chaotic or impersonal, if the provider seems rushed or dismissive, if you leave appointments more confused than when you arrived, if your questions are deflected rather than answered — trust your instincts.

A good healthcare relationship is built on communication, respect, and trust. You should feel heard at every visit. You should understand what is happening to your spine and why. You should feel like a patient, not a number on a schedule.

How Back Specialists handles this

Dr. Hagen has been building patient relationships in Sioux Falls for nearly 50 years. Many of the patients he sees today are the adult children and grandchildren of patients he treated decades ago. That kind of generational trust is not built by rushing people through appointments or avoiding hard conversations. It's built by listening carefully, explaining clearly, and delivering consistent results over a very long time.

If you ever have a question at Back Specialists — about your diagnosis, your treatment plan, your imaging, your insurance, or anything else — you will get a direct, honest answer. That is not a promise we make lightly. It's how we have practiced since 1977.

The Bottom Line on Choosing a Chiropractor in Sioux Falls

Most chiropractors in Sioux Falls are ethical, competent providers who genuinely want to help their patients. The red flags in this post represent behaviors that fall short of that standard — and knowing what to look for puts you in a much stronger position as a healthcare consumer.

The right chiropractor for you is one who listens before they treat, explains before they adjust, is honest about what chiropractic can and cannot do, charges fairly and transparently, and has the credentials and experience to back up their approach.

If that describes what you're looking for — and you're open to gentle, instrument-assisted chiropractic care with no twisting, cracking, or high-force manipulation — we'd like the opportunity to show you what Back Specialists is about.

Call or text 605-361-1700. Same-week appointments are available.

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