Category: About Chiropractic

What is Chiropractic

by admin

Chiropractic today is one of the largest primary-contact health care professions in Canada with over 5,000 practicing chiropractors. Approximately four and a half million Canadians use the services of a chiropractor each year.1

Chiropractic is a regulated health profession recognized by statute in all Canadian provinces and American states. The benefits of chiropractic care are well recognized by other health practitioners. In a 1995 survey, 44 per cent of Ontario and Alberta physicians indicated that they refer patients for chiropractic treatment.2

Drug-free, non-invasive health care

Chiropractic manipulation is a drug-free, non-invasive manual procedure which utilizes the highly-refined skills developed during four intensive years of chiropractic education. Chiropractors assess disorders related to the spine, nervous system, and joints of the extremities and provide diagnosis, treatment and prevention of those disorders.

The primary goal of chiropractic manipulation, also referred to as adjustment, is to treat areas of decreased movement in the joints of the spine which can create a reaction in surrounding tissues (ligaments, muscles and nerves) resulting in pain, dysfunction and muscular spasm. Chiropractors are also trained to prescribe therapeutic exercise and other non-invasive therapies including dietary counselling.

Manipulation is a highly controlled procedure which rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.

The vast majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system, most often for conditions affecting the spine.3

Scientific study of spinal manipulation has clearly demonstrated that chiropractic treatment improves function and is effective for common conditions such as headache, neck, and back pain.4 Between 86 and 96 per cent of all visits to chiropractors are for these or similar conditions.5

Primary & complementary care

In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. Where other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects of discomfort associated with the condition.

Chiropractic care may also be palliative, providing symptomatic relief to patients with chronic conditions. By treating the musculoskeletal elements of such disorders, chiropractic treatment improves the general well-being of the patient. In this regard, Canada’s chiropractors frequently provide complementary care as one element of a patient’s overall treatment program.

For example, the Canadian Memorial Chiropractic College is a leader in working with other health care providers to offer complementary care to HIV-positive patients at St. Michael’s Hospital, Wellesley Central Site in Toronto, to dually-challenged children and adults at the Muki Baum Clinics, and to patients at St. John’s Rehabilitation Hospital.

Working with other health professionals

Governments and legislative bodies across Canada and around the world have conducted extensive reviews of the chiropractic profession and have consistently recommended that chiropractic services be included in the mainstream health care system.6

Regulation & standards

In Ontario, chiropractic has been governed by statute since 1925. Currently it is regulated by the Chiropractic Act (1991) which is administered by the College of Chiropractors of Ontario created in accordance with the Regulated Health Professions Act (RHPA)(1991).

Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor. The College of Chiropractors of Ontario is established by legislation in the same manner, and with the same structure and similar regulations, as the regulatory bodies for other health professions. It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.

May, 2000

 

  1. Use of Alternative Health Care Practitioners by Canadians, Miller W, Canadian Journal of Public Health, 88(3):154-58, 1997.
  2. Alternative Medicine and General Practitioners: Opinions and Behaviours, Vernoef MJ, Sutherland LR, Canadian Family Physician, 41:1005-1011, 1995.
  3. Chiropractors: Do They Help?, Kelner M, Hall O, Coulter I, Toronto, Fitzhenry & Whiteside, 1980. Demographic and Clinical Characteristics of Chiropractic Patients: A five year study of patients treated at the Canadian Memorial Chiropractic College, Waalen DP, White TP, Waalen JK, Journal of the Canadian Chiropractic Association, 38(2):75-82, 1994. Canadian Chiropractic Resources Databank: A Profile of Canadian Chiropractors, Kopansky-Giles D, Papadopoulos C, Journal of the Canadian Chiropractic Association, 41(3): 155-191, 1997.
  4. See appendix of research references.
  5. Chiropractors: Do They Help?, Kelner M, Hall O, Coulter I, Toronto, Fitzhenry & Whiteside, 1980. Demographic and Clinical Characteristics of Chiropractic Patients: A five year study of patients treated at the Canadian Memorial Chiropractic College, Waalen DP, White TP, Waalen JK, Journal of the Canadian Chiropractic Association, 38(2):75-82, 1994. Canadian Chiropractic Resources Databank: A Profile of Canadian Chiropractors, Kopansky-Giles D, Papadopoulos C, Journal of the Canadian Chiropractic Association, 41(3): 155-191, 1997.
  6. The Effectiveness and Cost-effectiveness of Chiropractic Management of Low-Back Pain, Manga P, Angus D, Papadopoulos C, Swan W. Commissioned by the OCA. Funded by the Ontario Ministry of Health, 1993.Chiropractic Services Review, An Internal Review, Wells et al. Commissioned by the Ontario Ministry of Health, 1994.

About Chiropractic FAQ

by admin

Content

  • Does chiropractic treatment require a referral from an MD?
  • How is chiropractic manipulation performed?
  • Can chiropractic treatment cure colds, earaches and other ailments?
  • Is chiropractic manipulation a safe procedure?
  • Is chiropractic treatment appropriate for children?
  • Does chiropractic treatment require x-rays?
  • Can chiropractic treatment provide a preventative function?

 

Does chiropractic treatment require a referral from an MD?

No. A patient does not have to be referred. 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 MDs, 44 per cent of whom refer their patients to chiropractors when they believe chiropractic treatment will help alleviate a patient’s condition.1

How is chiropractic manipulation performed?

Chiropractic manipulation is a manual procedure which utilizes the highly-refined skills developed during four intensive years of chiropractic education. The chiropractor uses his/her hands to manipulate the spine in order to restore or enhance spinal functioning.

Manipulation is a highly controlled procedure which rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.

Can chiropractic treatment cure colds, earaches and other ailments?

Chiropractic care cannot “cure” these conditions, but there is evidence to indicate that spinal manipulation may have a beneficial effect on a variety of conditions. More research is needed in these areas before definitive benefits can be claimed.

It is important to distinguish between primary treatment and treatment of secondary symptoms. For example, if a patient has an aching ear that is related to the musculoskeletal structures around the ear, and which is not the result of a bacterial infection, then chiropractic treatment may alleviate the pain. This would be considered primary treatment.

If there is ear pain caused by a bacterial infection, then chiropractic care is not the primary treatment, but may help alleviate some of the secondary – or referred – pain arising from the musculoskeletal reaction to the ear infection. This would be considered secondary treatment where chiropractic plays a complementary role in the treatment of a condition.

So, chiropractic care cannot cure a cold or an ear infection, but it may reduce the pain response. Similarly, chiropractic care can be of benefit in relieving musculoskeletal symptoms that are present with other chronic diseases such as cancer or AIDS.

Is chiropractic manipulation a safe procedure?

Chiropractic treatment is a drug-free, non-invasive approach to common musculoskeletal conditions such as neck and back pain. As such, it is a very low risk therapy. In extremely rare situations – between one or two out of one million treatments – there is a possibility that manipulation of the upper neck may contribute to a stroke.

Is chiropractic treatment appropriate for children?

There are many reasons why a child might benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from participating in sports which can cause back pain and discomfort. Chiropractic care is always adapted to the individual patient. It is highly skilled and, in the case of children, is very gentle.

While there is a wealth of clinical evidence that musculoskeletal treatment of infants has many positive effects, well-controlled studies are required to verify some of the benefits that are commonly seen in practice.

Most recently, a research report published in the Journal of Manipulative and Physiological Therapeutics concluded that “spinal manipulation is effective in relieving infantile colic.”2 The study was a randomized, controlled clinical trial with a blinded observer and compared the effect of chiropractic therapy with a commonly prescribed medication used to relieve colic.

A study of chiropractic as complementary therapy for children receiving asthma medication, concluded that spinal manipulation did not provide additional benefits.3 This study which was published in the New England Journal of Medicine in October 1998, is another example of how research continues to inform chiropractic treatment.

Does chiropractic treatment require x-rays?

Guidelines have been developed by the chiropractic profession with regard to the use of X-rays as a diagnostic tool. X-rays provide vital information to help determine a diagnosis but they are not required in every case. In fact, at CMCC from 1997 to 1998 fewer than 20 per cent of chiropractic patients received X-rays, and only 6 percent of patients under the age of 16 required an X-ray.

Use of X-ray as a diagnostic tool by chiropractors, and all other health professionals, is governed in Ontario by guidelines as set out by the Healing Arts Radiation Protection Commission (HARP). X-rays can play an important role in diagnosis but are only taken when a need has been determined by a careful case history and 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 perform X-rays and have granted them this right.

Can chiropractic treatment provide a preventative function?

Clinical experience suggests that individuals with chronic conditions such as osteoarthritis or recurrent neck pain, back pain or headaches experience less frequent and less severe symptoms when under regular chiropractic care. This also applies to individuals in highly stressful situations and those who experience repetitive physical and postural strain from their daily activities.

Whether ongoing chiropractic treatment can prevent back pain from occurring in the first place or prevent a previous condition from re-occurring requires further study.

May, 2000

 

1. Alternative Medicine and General Practitioners: Opinions and Behaviours, Vernoef MJ, Sutherland LR, Canadian Family Physician, 41:1005-11, 1995.

2. The Short-Term Effect of Spinal Manipulation in the Treatment of Infantile Colic, Wiberg JMM et al, Journal of Manipulative and Physiological Therapeutics, Vol. 22, No. 8, October 1999.

3. A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma, Balon J et al, The New England Journal of Medicine, Vol. 339, No. 15, October 1998.

Commonly Held Views About Chiropractic

by admin

Content

  • What kind of education and training do chiropractors have?
  • Is chiropractic regulated in Canada?
  • Is chiropractic covered by government health plans?
  • How many people see chiropractors?
  • What conditions do chiropractors treat?
  • Why do chiropractors take X-rays?
  • Is chiropractic really scientific?
  • Isn’t there a risk of stroke associated with neck manipulation?
  • Why do chiropractors treat children?
  • Do chiropractors refer patients to medical doctors when necessary?
  • Do medical doctors refer patients to chiropractors?
  • Do chiropractors take a medical history?
  • Once you go to a chiropractor, don’t they make you keep going for the rest of your life?
  • Is every patient’s treatment the same?
  • Even if I want to refer to a chiropractor, can patients afford it?
  • How can I find a suitable chiropractor for my patient if I want to make a referral?

What kind of education and training do chiropractors have?

Chiropractors are educated as primary contact health care practitioners, with an emphasis on neuromusculoskeletal diagnosis and treatment. Preparation for the practice of chiropractic is concentrated on three areas: basic training in the biological and health sciences, specialized training in the chiropractic discipline, and extensive clinical training. Becoming a chiropractor in Canada requires a minimum of 6 years of post-secondary education including no less than 4500 hours of classroom and clinical instruction at an institution approved by the Council on Chiropractic Education Canada.

Is chiropractic regulated in Canada?

Like medicine and dentistry, chiropractic is a self-regulating profession, and each provincial chiropractic regulatory body has the authority to grant a license to practice chiropractic. There are Chiropractic Acts in all 10 provinces and the Yukon Territory which establish a self-regulatory process which includes extensive testing for licensure. In all provinces, licensure requirements include a minimum of two years pre-professional university studies, graduation from an accredited chiropractic institution (4 or 5 years), and passing national and provincial board examinations.

Is chiropractic covered by government health plans?

Chiropractic services are partially covered by the provincial health plans of Ontario, Manitoba, Saskatchewan, Alberta and British Columbia. Most federal government departments (such as the RCMP and Veteran’s Affairs) also cover chiropractic services. All worker’s compensation boards and most employer and other third party insurance plans cover chiropractic services as well, thereby making it affordable health care by most Canadians.

How many people see chiropractors?

Public surveys and published studies are finding that the proportion of Canadians that are consulting chiropractors is rising every year. Statistics Canada data found that over 11 percent (3 million) Canadians consulted a chiropractor in 1996. The figures today are closer to 15 percent, or over 4 million Canadians annually. There are approximately 35 million office visits to chiropractors each year.

What conditions do chiropractors treat?

Chiropractors are experts trained in the neuromusculoskeletal system . They diagnose and treat disorders of the spine and other body joints by adjusting the spinal column or through other corrective manipulation. Chiropractors provide conservative management of neuromusculoskeletal disorders including, but not limited to, back, neck and head pain (over 90 percent of conditions treated). They also advise patients on corrective exercises, lifestyle and nutrition.

Why do chiropractors take X-rays?

Chiropractors are trained in physical diagnosis including the use of X-rays. The science of radiology is a major component of chiropractic education, and chiropractors are licensed in each province, through chiropractic legislation, to take and interpret X-rays for their patients. An important reason for the use of X-rays is to detect contra-indications for spinal manipulation.

Is chiropractic really scientific? [Top]

Chiropractic is a healing discipline firmly grounded in science. Few other health care interventions have been assessed as extensively as chiropractic manipulation, both in terms of safety and effectiveness. Furthermore, few other health care professions have been as thoroughly researched as chiropractic. There have been at least six formal government inquiries into chiropractic worldwide over the last 25 years and all have concluded that contemporary chiropractic care is safe, effective, cost-effective and have recommended public funding for chiropractic services. In addition, there have been countless scientific clinical studies (randomized controlled trials included) assessing the appropriateness, effectiveness, and/or cost-effectiveness of spinal manipulation or chiropractic manipulation, most notably for low back pain. The Medical Research Council of Canada now offers research grants in partnership with the Canadian Chiropractic Association to chiropractors and other scientists for high quality, chiropractic research.

Isn’t there a risk of stroke associated with neck manipulation?

The risk of stroke from neck manipulation is extremely remote, and probably not greater than the risk from natural neck movements such as tilting your head into a sink for hair washing, or turning your head to back up when driving. Medical literature estimates the risk of having a stroke that may be related to chiropractic treatments to be anywhere from 1 in 400,000 to 1 in several million. In fact, the risk of serious complications or even death attributed to the use of NSAIDs is much greater for neck pain than the slight risk of injury from chiropractic manipulation. Chiropractors are well trained to recognize risk factors in patients, and treatments are not performed when there is a risk identified.

Why do chiropractors treat children?

Chiropractic treatment is based on the basic biological and physiological sciences which apply equally to children as they do to the adults. Chiropractic treatment is as beneficial to children as it is to adults, and children should be seen by chiropractors when appropriate. The scientific literature is now demonstrating that low back pain is a very prevalent condition amongst school children. For example a 1992 study in the American Journal of Public Health found that the prevalence of low back pain in adolescents up to age 15 is over 36 percent, and thus concluding that LBP in adolescents is a serious public health problem.1 As well, children can benefit by periodic spinal examinations where the chiropractor will look for clues to possible postural weaknesses that may predispose children to later problems related to their spine and skeleton.

Do chiropractors refer patients to medical doctors when necessary?

Yes, like medical doctors, chiropractors refer patients to other professionals when they feel it is appropriate. Chiropractors are well trained to recognize risk factors as well as individual disease patterns and will not hesitate to make a referral when it is in the best interest of the patient’s health.

Do medical doctors refer patients to chiropractors?

Absolutely. Recent studies have shown that the majority of medical doctors in Canada refer patients to chiropractors for musculoskeletal conditions. For example, a 1995 study in the Canadian Family Physician found that almost 60 percent of Canadian family physicians perceived chiropractic as useful or very useful and that over 83 percent referred patients to chiropractors. 2

Do chiropractors take a medical history?

Like M.D.’s, the chiropractor will take a detailed health history during the first visit, prior to initial treatment. This will include details on lifestyle and risk factors to give the chiropractor a full picture of the patient’s health in order to determine the best treatment. As well, a detailed health history is important to rule out any contra-indications and fully investigate risk factors before a diagnosis and treatment recommendation can be reached.

Once you go to a chiropractor, don’t they make you keep going for the rest of your life?

The hands-on nature of the chiropractic treatment is essentially what sends patients back to the chiropractor a number of times. To be treated by a chiropractor a patient needs to be in his or her office. In contrast, a course of treatment from medical doctors often involves a pre-established plan that is conducted at home (ie. taking a course of antibiotics once a day for a couple of weeks). A chiropractor may provide acute, preventative and/or maintenance care thus making a certain number of visits sometimes necessary. The average number of annual visits per patient is eight.

Is every patient’s treatment the same?

The treatment a patient receives is related to the specific condition diagnosed by the chiropractor, and will vary from person to person depending on each person’s unique situation. Like M.D.’s chiropractors follow generally accepted protocols and guidelines.

Even if I want to refer to a chiropractor, can patients afford it?

Chiropractic services are partially covered by the health plans of five provinces, all worker’s compensation boards, most federal departments and a majority of private insurer plans. Most employees have chiropractic coverage under their work insurance plan as well. Therefore, cost of care should not be an impediment to referring your patients to a chiropractor.

How can I find a suitable chiropractor for my patient if I want to make a referral?

As with any other health care professional, patients usually seek the services of a specific chiropractor through the referral of friends and acquaintances. Some family physicians are now working with chiropractors in a group practice setting or referring patients to one. Therefore, your medical colleagues could provide you with a name of a local chiropractor. Don’t hesitate to visit the chiropractors in your building or down the street from your practice. The Canadian Chiropractic Association (CCA) has a chiropractor locator service on its web site, for finding chiropractors through the first three digits of the postal code. Only chiropractors who are CCA members and therefore must have malpractice insurance coverage are on this site.

References

1. Olsen et al. The Epidemiology of Low Back Pain in an Adolescent Population. American Journal of Public Health. 1992; 82(4): 606-608.
2. Verhoef, M.J., Sutherland. L.R. Alternative Medicine and General Practitioners; Opinions and Behaviour. Canadian Family Physician 1995; 41: 1005-1011.