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Chiropractic 101

Chiropractic 101 – Common Questions and Answers

What is Chiropractic? [top]

Chiropractic is a branch of the healing arts that is concerned with human health and disease. This drugless profession places special emphasis upon the spine and its inter-relationships with the nervous system.

The practice of chiropractic is distinctive due to the emphasis on the reduction (re-alignment) of spinal or pelvic rearrangements (subluxations). This is achieved by specific spinal manipulations (adjustments), the purpose of which is to normalize the relationship of the vertebrae within its “normal” functioning framework. This procedure is administered with much skill and dexterity after a careful examination is made and the area of involvement determined.

Other considerations of health such as exercise, rest, diet, nutrition, food supplements, etc. will be discussed on an individual care basis.

How do I find a chiropractor? [top]

Chiropractors are “primary contact” health care providers, which means you don’t have to be referred to them by a physician or anyone else. You can select your own chiropractor. As with any other professional, referrals from friends and acquaintances are an excellent way to find a good chiropractor. The Yellow Pages can also come in handy to help you find one in your area. There are over 6,000 chiropractors in Canada. Another way is to use the CCA’s own Chiropractic Locator.

What conditions do chiropractors treat? [top]

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.

What happens during a treatment? [top]

During your first visit, the chiropractor will want to know about your health history as well as your current complaint. Your home and work life as well as your level of physical activity may also affect your health, so don’t be surprised to be asked questions about these.

Although chiropractors use their hands for most treatments, they also use other methods such as heat, light, specialized adjusting instruments, ultrasound, electrotherapy, personalized exercise programs, muscle-testing and balancing. Your chiropractor can also give you information and guidance on how you can stay healthy through proper nutrition, exercise and lifestyle changes.

What kind of education and training do chiropractors have? [top]

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.

What results can I expect from treatment? [top]

That depends on your condition. The length of time you have had the problem, your age and the degree of your disability all affect the length of your treatment. Your chiropractic doctor should tell you the extent of treatment recommended, and how long you can expect it to last.

One of the main reasons people choose chiropractic is that they often get quick results. Individual cases vary and chronic conditions obviously need more treatment, but Workers’ Compensation Board studies show, for example, that people with low back pain get back to work much faster with chiropractic care.

You might also consider the benefits of regular chiropractic adjustments even when you feel healthy. Sometimes you won’t know you have a disorder of the neuromusculoskeletal system until it becomes acute and painful. So, just as you see your dentist to have your teeth checked and your optometrist for eye exams, regular visits to your chiropractor can catch related health conditions early, often preventing them from developing into major problems. Remember, your spine is every bit as susceptible to wear and tear as your teeth and your eyes so you should look after it.

How is chiropractic adjustment performed? [top]

Chiropractic adjustment or manipulation is a manual procedure that utilizes the highly refined skills developed during four intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function.

Chiropractic manipulation is a highly controlled procedure that 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.

How many people see chiropractors? [top]

Public surveys 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.

Is chiropractic covered by government health plans? [top]

Chiropractic services are partially covered by the provincial health plans of Manitoba, Saskatchewan and Alberta. 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.

Is chiropractic manipulation a safe procedure? [top]

Chiropractic adjustment or manipulation is a drug-free, non-invasive approach to common musculoskeletal conditions such as headache, and neck and back pain. As such, it is a low risk therapy. Complications arising from adjustment are rare.

Is chiropractic evidence-based? [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. 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 assessing the appropriateness, effectiveness, and/or cost-effectiveness of spinal manipulation or chiropractic manipulation, most notably for low back pain. The Canadian Institutes for Health Research (CIHI) now offers research grants in partnership with the Canadian Chiropractic Association to chiropractors and other scientists for high quality, chiropractic research.

Is chiropractic regulated in Canada? [top]

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 treatment appropriate for children? [top]

Yes, children may benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.

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

Is every patient’s treatment the same? [top]

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 persons unique situation. Like M.D.’s chiropractors follow generally accepted protocols and guidelines.

Is chiropractic treatment ongoing? [top]

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.

Can chiropractic treatment cure colds, earaches and other ailments? [top]

Chiropractic care cannot “cure” these conditions, but there is some evidence to indicate that adjustment 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. For example, research conducted in Denmark resulted in chiropractic treatment being recommended for the relief of infantile colic.1 Similarly, a recent U.S. study concluded that the application of manipulative techniques in children with recurring ear infections can prevent or decrease surgical intervention or antibiotic overuse.

Can chiropractic treatment provide a preventative function? [top]

Clinical experience suggests that individuals with chronic conditions such as degenerative joint disease (osteoarthritis) or recurrent neck pain, back pain or headaches may 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.

What is the difference between physicians and chiropractors? [top]

That’s like asking the difference between a physician and a dentist: they are different professions within the health care spectrum. Both chiropractors and physicians are legally entitled to use the title “doctor”. As the appellation MD means “Doctor of Medicine”, so DC means “Doctor of Chiropractic”.

The role of chiropractic is complementary to other areas of primary health care. Chiropractic is not, for example, a replacement for medical care, but may offer an alternative to medication and surgery in appropriate circumstances.

Recognition by health science that many illnesses of our modern society are lifestyle based has shown us that we, as individuals, can influence our own health and well being. Many people, therefore, welcome chiropractic’s emphasis on healthy lifestyle and patient responsibility, as well as its help in improving the body’s functions and ability to fight off disease.

Do chiropractors refer patients to medical doctors when necessary? [top]

Yes, like medical doctors, chiropractors refer patients to other health 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.

Does chiropractic treatment require a referral from an MD? [top]

No. A patient does not have to be referred. Chiropractors are legislated as primary contact health care professionals in every province in Canada. This means that patients can consult them directly. Similarly, chiropractors frequently refer to medical doctors when necessary.

Do chiropractors take a medical history? [top]

Like MD’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 contraindications and fully investigate risk factors before a diagnosis and treatment recommendation can be reached.

Does chiropractic treatment require x-rays? [top]

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.

Does neck adjustment require stretching and rotating the neck beyond its normal range of motion? [top]

No, it does not, as anyone who has had their neck adjusted will attest. Neck adjustment is done within the normal range of motion and is often performed to improve flexibility and reduce pain. The normal range during treatment is less than what is required to turn your head when backing up a car.

Is neck adjustment safe? [top]

All health treatments have the potential for adverse effects and, on rare occasions, neck adjustment has been associated with stroke and stroke-like symptoms. A Canadian study, published in 2001, concluded that stroke symptoms associated with neck adjustments are so rare that it is difficult to quantify.2 Similarly, a medical review published in 2002 looked at 73 studies of chiropractic care and found no serious complications reported in any of them.3 By way of comparison, neck adjustment is significantly safer than other common treatments for headache, neck and back pain.

Is neck adjustment a forceful action? [top]

No. This has been demonstrated in studies to determine the degree of physical strain applied during adjustment.1 It is skill, not strength, that is needed to conduct a safe, effective adjustment.

Are all neck adjustment techniques equally safe? [top]

Canadian chiropractors are taught a variety of adjustment techniques and there is no evidence to suggest that any one technique is less safe than the others. Chiropractic techniques that are applied appropriately are effective and safe.

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

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 an interconnected 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.

How Long Will I Take To Get Well? [top]

This is a commonly heard question in any chiropractic office. There is really no definite answer to that question.

However, we have treated numerous other cases of a similar nature and will be able to give you an approximate estimate based on our knowledge and many years of clinical experience.

In most instances, your concept of “being well” is one that deserves some serious objective consideration. To a majority of people, “being well” means to be free from obvious symptoms that initially brought you to this office.

We have found that it is not uncommon for people to present themselves to out office after having spent weeks, even months or years in pain while doctoring with drugs and other types of palliative therapies. When this approach proved to be ineffective, they sought chiropractic care as a last resort, usually on the recommendation of a friend.

A typical visit to this office will include an initial case history, physical examination and other standard procedures, a chiropractic examination of the spine and related structures.

This special attention to the neuromuscular aspect of your health ailment, coupled with a sound understanding of the basic concept of structure and function is a necessary ingredient for health maintenance; we will outline a program for you to follow once you are asymptomatic.

Why is there a popping sound when a joint is adjusted? [top]

Adjustment of a joint may result in release of a gas bubble between the joints that makes a popping sound – it’s 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.

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