By Dr. Lyle E. Koca, DC, ACP, DPhCS
Koca Chiropractic Clinic | Omaha, Nebraska

At your first chiropractic appointment, you can expect a discussion about your health history, symptoms, personal goals, and a physical examination to determine whether chiropractic care may be appropriate. Depending on your condition, additional testing may be recommended. At Koca Chiropractic in Omaha, our first visit focuses on gathering information, and our second visit typically focuses on explaining findings and discussing your individualized recommendations.

If you’ve never visited a chiropractor before, you probably have questions.

Will I get adjusted on my first visit?

Will I need X-rays?

Does the examination hurt?

How long will the appointment take?

What happens if the chiropractor finds something wrong?

I’ve been in chiropractic practice since 1989, and I understand why people ask these questions.

When you’re uncomfortable, uncertain, or have already tried several approaches, the last thing you need is more confusion.

That’s why our approach at Koca Chiropractic begins with one simple principle:

WE TEST — DON’T GUESS.

Let me walk you through what you can expect when you visit our Omaha chiropractic office.

1. What should I do before my first chiropractic appointment?

Before your first chiropractic visit, complete any requested health forms, gather relevant medical information, and think about what you want to accomplish.

At Koca Chiropractic, you can complete your new patient paperwork before arriving.

This allows us to begin learning about your health history and helps make your appointment more efficient.

We recommend bringing or having available:

A list of your current medications

Information about previous injuries or surgeries

Relevant imaging reports, if available

Details about your current symptoms

Questions you want answered

Insurance or payment information, if applicable

Wear comfortable clothing that allows you to move during the examination.

Most importantly, think about this question:

“What is this problem keeping me from doing?”

Maybe you’re struggling to sleep comfortably.

Maybe you’re having difficulty getting through your workday.

Maybe you want to return to golf, gardening, exercise, or playing with your grandchildren.

Your answer helps us understand what meaningful improvement would look like.

Complete your Koca Chiropractic new patient forms.

2. What happens when I arrive at Koca Chiropractic?

When you arrive, our team welcomes you, reviews the information needed for your visit, and helps you understand what happens next.

We know that visiting a new healthcare office can feel intimidating.

You may not know what questions to ask.

You may be concerned about the examination.

Or perhaps you’ve been dealing with a problem for so long that you’re simply frustrated.

We want your first experience to be organized, welcoming, and understandable.

At Koca Chiropractic, our goal is to treat you as a person—not simply another appointment on the schedule.

You’ll have an opportunity to explain your concerns and ask questions.

We want you to understand what we’re doing and why we’re doing it.

Your first visit should begin with a conversation, not an assumption.

3. Why does Dr. Koca ask about my WHY?

Your WHY is the personal reason you’re seeking help—the activity, experience, or part of your life that your symptoms are affecting.

This is one of the most important parts of our examination process.

You might tell me:

“Doc, my low back hurts.”

That’s important.

But I want to understand something more.

“What is that back pain keeping you from doing?”

Maybe you answer:

“I can’t play golf comfortably anymore.”

Or:

“I can’t sit through my workday without getting up constantly.”

Or:

“I’m worried I won’t be able to keep up with my grandchildren.”

Now I understand more than the location of your symptoms.

I understand why addressing the problem matters to you.

At Koca Chiropractic, we use your personal goals to help guide our discussions and evaluate progress.

Because improvement isn’t only about a pain number.

It’s also about what you can do in your everyday life.

Dr. Koca’s perspective: The symptom tells me where to begin. Your WHY tells me what matters to you.

4. What questions will the chiropractor ask about my health?

Your chiropractor will ask about your symptoms, medical history, previous treatment, medications, daily activities, and possible warning signs.

A thorough history helps determine which examinations are appropriate.

We may ask:

When did the symptoms begin?

Did they start after an injury?

Are they constant or intermittent?

Does the discomfort travel into your arms or legs?

Do you experience numbness, tingling, or weakness?

What makes the symptoms better or worse?

What have you tried already?

How is the problem affecting your daily life?

We also review relevant medical conditions, previous surgeries, and other health information.

Why?

Because two people with similar symptoms may have very different clinical needs.

For example, someone with uncomplicated mechanical low back pain may be a candidate for conservative treatment.

Someone with progressive neurological weakness may need additional medical evaluation.

A good history helps us determine what to examine, what to consider, and when another healthcare professional may be needed.

5. What happens during the chiropractic examination?

A chiropractic examination typically evaluates movement, joint function, neurological findings, and other factors related to your symptoms.

At Koca Chiropractic, our approach is strongly influenced by a Specifc System of Chiropractic focused on the patient…called Patient Centered Chiropractic.

Our examination includes five components.

1. Visualization

We observe posture, movement, and other visible findings that may help guide the examination.

2. Instrumentation

Selected instruments may provide additional measurements.

Our office uses tools such as Titron thermal instrumentation and dual-probe assessment.

These measurements have limitations and do not independently diagnose a spinal condition or prove that an adjustment is necessary.

3. Static palpation

The doctor examines tissues while you’re in a stationary position, looking for findings such as tenderness or changes in tissue characteristics.

4. Motion palpation

We evaluate how spinal and other joints move, considering your symptoms and the overall examination.

5. X-ray analysis when clinically indicated

Imaging may be considered when your history or examination suggests it could help clarify a clinically important question or affect management.

We may also perform orthopedic, neurological, and other appropriate physical examination procedures.

The exact combination depends on your individual presentation.

Our philosophy is not to perform every test on every person. It is to select appropriate tests and interpret them carefully.

That’s what we mean by:

WE TEST — DON’T GUESS.

6. Will I need X-rays at my first chiropractic appointment?

Not everyone needs X-rays before chiropractic care. Imaging should be recommended when there is a clinical reason and the information may affect diagnosis or treatment decisions.

For uncomplicated low back pain without warning signs, major clinical guidelines generally discourage routine imaging.

X-rays may be appropriate in certain situations, such as suspected fracture or other findings that warrant imaging. Some conditions require a different imaging method, such as MRI, or referral for further medical evaluation.

If imaging is recommended, you should understand:

Why it is being considered

What we are looking for

How the results could affect your care

What alternatives may be available

It’s also important to understand that degenerative changes on an X-ray do not always explain someone’s symptoms.

An image is one piece of clinical information—not the entire diagnosis.

7. What are HRV, thermal scans, and posture assessments?

These are tools that measure different aspects of physiology or physical presentation, but they do not independently diagnose the cause of back pain or determine whether a chiropractic adjustment is needed.

At Koca Chiropractic, selected evaluations may include:

Heart Rate Variability (HRV)

HRV measures variation in the timing between heartbeats. It can provide information about aspects of autonomic nervous system regulation, but results are influenced by many factors, including sleep, activity, medications, illness, and stress.

Thermal instrumentation

Surface temperature instruments measure temperature differences or patterns. These findings cannot independently establish nerve interference or identify a vertebra requiring adjustment.

Posture assessment

Posture analysis documents aspects of body positioning. Posture findings must be interpreted carefully because there is not always a direct relationship between posture and pain.

We may use selected measurements as part of a broader examination or to document changes over time.

But we don’t want patients to believe that a single scan can explain every symptom.

Dr. Koca’s perspective: The value of a test depends on what it can reliably tell us—and what we do with that information.

8. Will I receive a chiropractic adjustment on my first visit?

That all depends on what we find on our initial visit with you.

We want to understand your concerns, examine your condition, and determine what the findings mean.

On the second visit, we typically review the information, explain our recommendations, and discuss the next steps.

Treatment may begin after the appropriate evaluation, discussion of risks and alternatives, and informed consent.

The timing can vary depending on the patient’s clinical circumstances.

There is an important distinction between wanting an adjustment and knowing whether a particular adjustment is appropriate.

I don’t want to adjust someone simply because they walked through the door expecting an adjustment. I want to determine what care, if any, makes sense for that person.

9. What happens during Day 2, the report of findings?

During your second visit, we explain the examination findings, discuss whether chiropractic care is appropriate, review your options, and answer questions about the recommended plan and costs.

At Koca Chiropractic, we call this our Report of Findings.

This is where we connect the information gathered during Day 1 with the goals that brought you into our office.

We discuss:

WHAT did we find?

We explain the clinically relevant findings from your examination.

WHAT does it mean?

We discuss how the findings may relate to your symptoms and what remains uncertain.

CAN chiropractic care help?

We explain whether your condition appears appropriate for our services or whether additional evaluation or referral is recommended.

WHAT do we recommend?

If care is appropriate, we discuss the proposed approach, alternatives, expected goals, risks, and limitations.

HOW will we know if you’re improving?

We explain how symptoms, function, and relevant findings can be monitored over time.

We also review the financial arrangements before you decide whether to proceed.

Our goal is for you to understand your options and make an informed decision.

10. How does Koca Chiropractic develop my care plan?

An individualized care plan considers your diagnosis, symptoms, examination findings, personal goals, medical history, treatment preferences, and response to care.

A person with a recent uncomplicated back strain may need a different approach from someone with longstanding symptoms and substantial activity limitations.

That’s why we discuss care in the context of your specific situation.

Depending on the findings, recommendations may involve chiropractic adjustments, appropriate movement and exercise guidance, other conservative approaches, or referral to another professional.

Our office also offers additional services such as SoftWave therapy and spinal decompression for selected patients.

These services have their own indications, limitations, and evidence considerations. They are not automatically recommended simply because a patient has back pain.

As care progresses, we periodically reassess symptoms, function, and meaningful goals.

At Koca Chiropractic, progress examinations often occur around 12 visits or 90 days when appropriate, but clinical circumstances may require earlier review.

We want to be able to explain:

Here’s what is improving.

Here’s what that means.

Here’s why we recommend continuing or changing the plan.

Here’s what comes next.

11. How long does the first chiropractic appointment take?

A first chiropractic appointment commonly takes approximately 30–60 minutes, although the actual time varies with the examination and any additional testing.

Your first visit generally takes longer than a routine follow-up because we need time to understand your history and evaluate your concerns.

At Koca Chiropractic, appointment length depends on your clinical needs and which procedures are indicated.

Our team can explain the expected appointment time when you schedule.

If you have previous imaging reports, medication lists, or relevant health records, having them available may help make the visit more efficient.

Completing your new patient paperwork beforehand can also save time.

12. What if the chiropractor finds something that needs medical attention?

If your symptoms or examination suggest a condition outside the appropriate scope of chiropractic care, your chiropractor should recommend additional medical evaluation or referral.

Not every problem involving the spine is a routine musculoskeletal complaint.

Some symptoms require urgent attention.

Seek emergency medical care for:

New loss of bowel or bladder control with back symptoms

Numbness around the groin or saddle region

Sudden or rapidly progressive muscle weakness

Stroke-like symptoms, including facial drooping, speech difficulty, or sudden one-sided weakness

Severe symptoms following significant trauma

Other warning signs, such as unexplained fever with severe back pain, a history of cancer with new spinal symptoms, or unexplained weight loss, may warrant prompt medical assessment.

Chiropractic care should not delay necessary emergency evaluation.

The most important outcome of an examination is making an appropriate healthcare decision—even when that decision involves referral rather than chiropractic treatment.

What makes your first visit to Koca Chiropractic different?

Our first-visit philosophy is centered on five commitments:

We listen to your WHY. We want to understand the activities and experiences that matter to you.

We examine before recommending. Our Patient-centered approach emphasizes careful assessment and individualized clinical judgment.

We explain our findings. We want you to understand the information that matters to your healthcare decisions.

We discuss your options. You deserve to know the potential benefits, risks, alternatives, and costs before choosing care.

We measure meaningful progress. We want to know whether you’re moving toward your personal goals.

I’ve practiced chiropractic since 1989, and one principle has remained important throughout my career:

The patient deserves an explanation—not just a procedure.

At Koca Chiropractic, that’s what we mean by:

WE TEST — DON’T GUESS.

Frequently asked questions about your first chiropractic visit

Does the first chiropractic appointment hurt?

Most examination procedures are intended to be tolerable, but some movements or tests may reproduce symptoms. Tell your chiropractor immediately if something is painful or uncomfortable so the examination can be modified.

Do I need to wear special clothing?

Usually not. Comfortable clothing that allows you to move is helpful. The office can advise you if anything specific is needed for your examination.

Do I need a referral to see a chiropractor in Omaha?

Many patients can contact a chiropractor directly, but insurance coverage and referral requirements vary by plan. Check your benefits or ask the office before scheduling.

Do I have to get adjusted on the first day?

No. A chiropractic adjustment should only occur when clinically appropriate and after the relevant risks, benefits, and alternatives have been discussed and consent obtained.

Will I have to sign up for a long-term care plan?

You should receive an explanation of any recommended plan, its goals, expected costs, and alternatives. You have the right to ask questions and decide whether to proceed. We call this Patient Centered Chiropractic, our care is based upon your goals.

How much does a first chiropractic appointment cost?

Costs vary depending on the examination, testing, insurance arrangements, and current promotional offers. Contact Koca Chiropractic at 402-496-4570 for current pricing and offer details before scheduling.

Can I bring my spouse or family member?

You can ask our team about bringing a support person. With your permission, having someone present may help you remember questions and understand recommendations.

What happens after my first visit?

At Koca Chiropractic, the usual next step is a second-visit report of findings. We explain relevant examination results, discuss appropriate recommendations, review costs, and answer questions before proceeding.

Ready for your first chiropractic appointment in Omaha?

If you’re considering chiropractic care because of back pain, neck discomfort, stiffness, sciatica, or difficulty moving comfortably, we’d welcome the opportunity to learn about your situation.

Your first visit is an opportunity to ask questions, understand your condition, and find out whether chiropractic care may be appropriate.

You don’t need to have all the answers before calling us.

That’s what the examination is for.

Koca Chiropractic — A Practical Solution for You and Your Family

11420 Blondo Street, Suite 102
Omaha, NE 68164

Phone: 402-496-4570

Visit Koca Chiropractic to request an appointment

Complete your new patient forms

WE TEST — DON’T GUESS.