Chiropractic

Who are Chiropractors?

What is an Adjustment?

When should I see a Chiropractor?

What are some of the benefits of chiropractic care?

Is chiropractic adjustment safe?

Informed consent

Neck adjustment

Does chiropractic care require a referral from an MD?

Can chiropractic care cure other ailments besides back pain?

How many Ontarians use chiropractic?

Are there many athletes who use chiropractic?

Does chiropractic care require X-rays?

How do you find a good Chiropractor?

What is Chiropractic?

What to expect on your first visit

How often do I need to come in?

Why is there a popping sound when a joint is adjusted?

Why would a neck adjustment effect anything other than neck pain?

Who are Chiropractors?

A Doctor of Chiropractic has spent four years at an accredited chiropractic institution, receiving more than 4,200 hours of specialized clinical training.

The chiropractic curriculum at the Canadian Memorial Chiropractic College, in Toronto, includes studies in anatomy, pathology, biomechanics, chiropractic principles, diagnosis and adjustment techniques.

As primary care practitioners, chiropractors can develop and carry out a comprehensive treatment / management plan, recommend therapeutic exercise and other non-invasive therapies, and provide nutritional, dietary and lifestyle counselling.

Chiropractors are one of only five classes of health care professionals in Ontario that are able to use the title Doctor, with its accompanying rights and obligations.

Chiropractic is regulated by provincial statute. Each province has a regulatory college, established by legislation in the same manner and with the same structure and similar regulations as the regulatory bodies for other health care professions.

Regulatory colleges are responsible for protecting the public, setting standards of practice, assuring quality of care is maintained, evaluating and promoting competency and handling disciplinary issues. Ontario's chiropractors are regulated and licensed by the
www.College of Chiropractors of Ontario.on.ca

What is an adjustment? 

An adjustment is a highly skilled and precise movement usually applied by hand to a joint of the body. Adjustment loosens the joint to restore proper movement and optimize function. 

When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about. 

Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor. Your chiropractor is well-trained to determine if your problem will respond to chiropractic care or if you require referral to another health care provider.
  

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Eight out of ten Canadians will experience back pain at some point in their life, and at least one third of people in Ontario will have back pain at any given time. For many people, the pain can keep them away from work, school or even their day-to-day activities. If pain causes interruptions and restrictions in the activities of your daily life then you should consult a health care provider. 

Chiropractors are regulated primary health care professionals, and they are one of only five classes of health care professionals in Ontario that are able to use the title Doctor, with its accompanying rights and obligations. 

Chiropractors are highly educated and extensively trained to assess, diagnosis, treat and prevent conditions disorders of the spine, joints, muscle and nervous systems. These disorders may include back pain, neck pain, headaches, referring pain in your arms and legs, etc.

Many patients seek chiropractic treatment for wellness care. Others, like seniors, who find that treatment helps them to maintain mobility and good range of motion. Pain should never become a way of life, especially when there is qualified help available.

There are many reasons to seek chiropractic care: Work, accidents, sports injuries, household chores, even the stress of daily living can cause painful joint and spinal problems. Even if you do not have painful symptoms, chiropractic care can help you maintain healthy spine and joint function.

Here are some of the most common reasons why more than 4 million Canadians visit a chiropractor each year:

Back pain
Neck pain
Headache 
Whiplash 

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What are some of the benefits of Chiropractic care? 

Chiropractic care can:
Improve movement in your neck, shoulders, back and torso 
Improve your posture
Provide relief from headaches, neck and back pain
Help prevent work-related muscle and joint injuries
Lead to enhanced athletic performance
Improve your flexibility and range of motion
Relieve pregnancy-related back ache
Correction gait and foot problems

 Is Chiropractic adjustment safe?

Chiropractic is widely recognized as one of the safest, drug-free, non-invasive therapies available for the treatment of headache, and neck and back pain. It has an excellent safety record. However, no health treatment is completely free of potential adverse effects. Even common over-the-counter medicines carry a risk.

Most patients experience immediate relief following an adjustment, however, some may experience temporary pain, stiffness or slight swelling. Some patients may also experience temporary dizziness, local numbness, or radiating pain. However, adverse effects associated with spinal adjustment are typically minor and short-lived.

Informed consent

Prior to starting treatment, all health professionals are required by law to obtain informed consent to treatment from their patients. Health care consumers must receive adequate and accurate information to assist them in evaluating their health care choices, and in balancing the relative risks of treatment options with the benefits. The chiropractic profession takes this responsibility seriously and has been a leader in obtaining informed consent.

Ontario's chiropractors are required in their Standards of Practice to obtain written informed consent prior to treating a patient.

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Neck adjustment

Neck adjustment, particularly of the top two vertebrae of the spine, has on rare occasions been associated with stroke and stroke-like symptoms. This risk is considerably lower than those serious adverse events associated with many common health treatments such as long-term use of non-prescription pain relievers or birth control pills. While estimates vary, a range of one to two events per million neck adjustments is the ratio generally accepted by the research community.

An extensive commentary on chiropractic care, published in the February 2002 issue of the Annals of Internal Medicine, which is the journal of the American College of Physicians, reviewed more than 160 reports and studies on chiropractic. It states the following with regard to the safety of neck adjustment: "The apparent rarity of these accidental events has made it difficult to assess the magnitude of the complication risk. No serious complication has been noted in more than 73 controlled clinical trials or in any prospectively evaluated case series to date." 

A Canadian study, published in 2001 in the medical journal Stroke, also concluded that stroke associated with neck adjustment is so rare that it is difficult to calculate an accurate risk ratio.  The study was conducted by the Institute for Clinical Evaluative Sciences (ICES) and the authors have stated: "The evidence to date indicates that the risk associated with chiropractic manipulation of the neck is both small and inaccurately estimated. The estimated level of risk is smaller than that associated with many commonly used diagnostic tests or prescription drugs."

The most recent research into the association between neck adjustment and stroke is biomechanical studies to assess what strain, if any, neck adjustment may place on the vertebral arteries. The preliminary findings of this ongoing work indicate that neck adjustment is done well within the normal range of motion and that neck adjustment is "very unlikely to mechanically disrupt the VA [vertebral artery]."  

There are many risk factors for stroke including blood clotting problems, hypertension, smoking, high cholesterol, birth control pills, heart problems and trauma such as blows to the head from car accidents, sports injuries or falls. Some strokes happen spontaneously with no obvious cause during activities of daily living such as backing up a car. A patient's health history and activities have to be examined very carefully in order to determine the most probable cause of a stroke.

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Does Chiropractic care require a referral from an MD? 

Chiropractors are legislated as primary contact health professionals in every province in Canada. This means that patients can consult them directly. However, chiropractors often work closely with medical doctors, many of whom refer to chiropractors when they believe chiropractic treatment will help alleviate a patient's condition. Similarly, chiropractors frequently refer to medical doctors when necessary.

 Can Chiropractic care cure other ailments besides back pain? 

Chiropractic care cannot "cure" every ailment, but there is some evidence to indicate that adjustments may have a beneficial effect on a variety of conditions. Adjustment may alleviate some of the secondary or referred pain, arising from the response of the musculoskeletal structures to the primary cause.

How many ontarians use Chiropractic? 

Chiropractic is one of the largest primary-contact health care professions in Ontario, with more than 3,100 practicing chiropractors. Approximately 1.2 million Ontarians use the services of a chiropractor each year to help them get back to work, and back to doing the things they love.

Are there many athletes who use Chiropractic? 

Yes. Many amateur and professional athletes use chiropractic treatment as part of their overall health care, fitness and maintenance program. Chiropractic is often used to improve muscle and joint conditioning, which has a direct effect on an athletic performance. Treatment works to improve biomechanical function and enhance overall conditioning, important in situations where there is continuous repetitive movement. Chiropractic care also help athletes fine-tune their muscles and joints for high level performance, and may reduce long term wear and tear. Finally, treatment can be used to prevent, and sometime shorten, the healing time of injuries.

Athletes most often select treatment to improve their performance, where as the average consumer will select chiropractic care to help manage aches and pains. In some cases treatment will be similar, but in all cases a treatment plan will be developed according to the goals and condition of each patient. In the case of professional and elite athletes, chiropractors often work in conjunction with other health care professionals, including medical doctors and/or sports medicine doctors, massage therapists and physiotherapists.

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Does Chiropractic care require x-rays? 

X-rays can play an important role in diagnosis and are taken when a need has been determined after taking a patient case history and conducting a physical examination. Chiropractors receive 360 hours of education in radiology covering a full range of topics from protection to X-ray interpretation and diagnosis. Governments in every province have recognized the training and competence of chiropractors to take and interpret X-rays and have granted them this right.  

How do you find a good chiropractor? 
Word of mouth
Friends, family and co-workers
Referrals from other health care practitioners
The chiropractor locator on the OCA's website 

What is Chiropractic? 

The word "chiropractic" comes from ancient Greek and means "done by hand." 
Adjustment of the joints of the body has been used in health care for many centuries and is at the heart of modern chiropractic care.

Chiropractors are specialists in manual adjustment of the vertebrae of the spine and other joints. Adjustment helps relieve pain and restore normal functioning to the spine, joints and supporting structures of the body - so you can enjoy your everyday activities again as quickly as possible.

Chiropractors are also trained to prescribe therapeutic exercise, provide nutritional counselling, and recommend rehabilitation and injury prevention strategies.    

What to expect on your first visit.

Your chiropractor may be treating your back pain, neck pain, headache, or other aches and pains, but he or she needs a complete picture of your health history and overall current health in order to provide the best possible treatment for you.

Set aside at least 30 minutes for your first visit to the chiropractor. Future visits typically last 15 minutes or less, though the time required will depend upon the type of treatment you require. Here's what you might expect.

On your first visit, your chiropractor may ask about the following:
Personal and family medical history
Major illnesses you have experienced
Surgeries or operations you have had
                                          

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        Medications you are taking

        A description of your present condition

        The steps you have taken to manage your condition

        Your diet and exercise

        Your sleeping habits, daily activities, work routine, stress level, and home life

It is a good idea to wear comfortable clothes and shoes for your visit to the chiropractor. Your chiropractor may ask you to change into a gown to perform some of these tests:

        A check of your blood pressure, pulse and breathing

        A test of your reflexes, strength and sensations

        An analysis of your posture

        An X-ray of your spine

        An analysis of your movement - he/she will observe how you walk, turn, 
bend or lift things, as well as how your body moves in the affected area

        A hands-on evaluation of how well your spine moves, identifying restrictions 
and areas of improper motion

 Tip: 
Bring a copy of any X-rays or radiology reports you have. These assessments give your chiropractor a better picture of your complete health. He or she will make a diagnosis, prescribe a course of treatment, and once the matter of informed consent has been discussed, treatment usually begins. 

If your chiropractor diagnoses a condition more appropriately treated by another health care professional, he or she will make a referral.

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Stages of care:

1. Relief care is provided for relief of immediate pain, restricted mobility and discomfort. Depending on the diagnosis, your age, physical condition, how long you have had the current complaint, and previous injuries, a few or several visits over a relatively short period of time may be necessary.

2. Corrective care treats conditions that are more severe, recurring or that have existed with or without pain for some time. These may require a longer, more complex period of care. Once the severity of your condition has decreased through relief care, corrective care helps to restore normal function to your spine, muscles, supporting tissues and the nerves affected by them.

3. Supportive or maintenance care helps you maintain and preserve the benefits you've achieved from relief and corrective care. Chiropractors are also trained to detect conditions in their early stages, often before you feel pain or reduced mobility. Continuing to work with your chiropractor and having periodic spinal check-ups and treatments, if needed, will keep your spine as healthy as possible. Your chiropractor will work with you to find a maintenance schedule that suits your condition, health care goals, and lifestyle.

Your treatment from the chiropractor, regardless of the stage of care, will often include exercise, diet and other healthy living suggestions to help keep you healthy and strong.

Your chiropractor will discuss a schedule of care, which will depend on your specific circumstances. For some people chiropractic treatment is like a regular tune-up, to help deal with the daily wear and tear of life. For others, it's simply an effective treatment when pain or discomfort strikes.

Take the time to discuss with your chiropractor the treatment plan that's best for you.

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How often do I need to come in?

Your chiropractor will likely recommend between two and five treatments a week to begin, and will assess your progress after 10 to 12 visits or sooner, depending on how quickly you improve. Once you are feeling better, you may wish to discuss the role that maintenance or wellness care can play in maintaining the optimal function and health of your spine.

Why is there a popping sound when a joint is adjusted?
Adjustment of a joint may result in release of a gas bubble between the joints that makes a popping sound; it is exactly the same as when you "crack" your knuckles. It is not painful. It is caused by the change of pressure within the joint resulting in gas bubbles being released.

Why would neck adjustment have an effect on anything other than neck pain?

Pain or discomfort in one area of the body may be linked functionally to discomfort arising from another area. Consequently, addressing dysfunction in one part of the body may relieve symptoms in another part. If you look at a model of the spine, you can see that the spine is one continuous structure. Adjustment at various points along the structure may be needed to help reduce biomechanical stresses on other parts of the spine and to relieve discomfort when it is clinically necessary.

The spine is also the protective channel that surrounds the spinal cord. Apart from special nerves originating from the brain and brain stem, all nerves in the body involved with bodily functions such as sensation and motor control emanate from the spinal cord and travel through openings in the spine between the vertebrae. Spinal nerves carry highly complex information that is important for the proper functioning of the human body. Spinal dysfunction can have an effect on proper functioning of the nervous system causing symptoms in other parts of the body. Adjustment, often in combination with other therapies, may help alleviate symptoms and even address the causative factors.

Reference: Ontario Chiropractic Association