Chiropractic Care
What is Chiropractic?
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 care practitioners. In a 1995 survey, 44% of Ontario and Alberta physicians indicated that they refer patients for chiropractic treatment2.
A natural, non-invasive approach to health care:
Chiropractors practice a drug-free, manual approach to health care that includes patient assessment, diagnosis, and treatment. In particular, chiropractors assess patients for disorders related to the spine, pelvis, extremity joints, and their effect on the nervous system. As a result of taking a physical assessment and patient history, chiropractors are able to provide a differential diagnosis for the patient’s presenting condition(s) and develop a comprehensive treatment/management plan.
Chiropractors are also trained to recommend therapeutic exercise, to utilize other non-invasive therapies, as well as to provide nutritional, dietary, and lifestyle counselling 3-6.
The chiropractic adjustment is a common form of treatment utilized by chiropractors in clinical practice. Also known as spinal manipulative therapy, adjustment is a non-invasive, manual procedure that utilizes the highly refined skills developed through four years of intensive graduate-level chiropractic education. The adjustment is a carefully controlled procedure delivered by a skilled practitioner to dysfunctional spinal or extremity joints. The primary goal is to decrease pain 7,9, improve areas of reduced movement in the joints and supporting tissues 7,9,10,11, and to decrease muscle tightness or spasm 7,11,12 through the restoration of normal mechanics and improved functioning of the spine, extremities, and supporting soft tissue structures 10,11,13. The adjustment rarely causes discomfort, however, as it is a manually applied therapy, patients can experience mild soreness or aching following treatment which usually resolves within 12 to 48 hours.
The chiropractor adapts the procedure to meet the specific needs of each patient. For example, the technique is modified when treating children, pregnant women, and older patients. Patients typically note positive changes in their symptoms immediately following treatment. The vast majority of patients who seek chiropractic health care do so for complaints of the musculoskeletal system. Treatment is often sought for conditions affecting the spine such as low back pain, neck pain, and headaches 3,4,14, and research studies have demonstrated that chiropractic treatment is effective for these conditions 7,8,11,13. Legislative bodies across Canada, as well as researchers and governments around the world have conducted extensive reviews of the chiropractic profession and have consistently endorsed chiropractic services 3, 15-23.
Regulation & standards:
Chiropractic is regulated by provincial statute in all provinces. 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. 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. The regulatory colleges are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance, and maintenance of competency.
References
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2) Verhoef MJ, Sutherland LR. Alternative Medicine and General Practitioners: Opinions and
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3) Kelner M, Hall O, Coulter I. Chiropractors: Do They Help?, Toronto, Fitzhenry & Whiteside,
1980.
4) Waalen DP, White TP, Waalen JK. Demographic and Clinical Characteristics of Chiropractic
Patients: A five year study of patients treated at the Canadian Memorial Chiropractic College.
Journal of the Canadian Chiropractic Association 1994; 38(2):75-82, 1994.
5) Kopansky-Giles D, Papadopoulos C. Canadian Chiropractic Resources Databank: A Profile of
Canadian Chiropractors. Journal of the Canadian Chiropractic Association 1997; 41(3): 155-191.
6) Chiropractic in the United States: Training, Practice and Research, U.S. Department of Health
and Human Services, AHCPR Research Report, Dec. 1997.
7) Bronfort G, Evans R et al. A randomized clinical trial of exercise and spinal manipulation for
patients with chronic neck pain. Spine 2001; 26(7):788-800.
8) Aker PD, Gross AR et al. Conservative management of mechanical neck pain: systematic
overview and meta-analysis. BMJ 1996; 313:1291-96.
9) Spitzer WO, Skovron ML et al. Scientific Monograph of the Quebec Task Force on Whiplashassociated
Disorder: Redefining Whiplash and its Management. Spine 1995; 20:8S.
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practitioner for patients with neck pain. Annals Int Med 2002; 136:713-722.
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review of the literature. Spine 1996; 21:1746-60.
13) Bronfort G, Assendelft WJ, Evans R et al. Efficacy of spinal manipulation for chronic
headache: a systematic review. J Manipulative Physiol Ther 2001; 24(7):457-66.
14) Coulter ID, Hurwitz EL, Adams AH et al. Patients using chiropractors in North America:
who are they, and why are they in chiropractic care? Spine 2002; 27(3):291-6.
15) Manga P, Angus D, Papadopoulos C, Swan W. The Effectiveness and Cost-effectiveness of
Chiropractic Management of Low-Back Pain, Commissioned by the OCA. Funded by the
Ontario Ministry of Health, 1993.
16) Wells T et al. Chiropractic Services Review, An Internal Review. Commissioned by the
Ontario Ministry of Health, 1994.
17) Epidemiology Review: The Epidemiology and cost of back pain. Clinical Standards
Advisory Group. 1994 HMSO.
18) Back Pain. Report of a CSAG Committee on Back Pain. 1994 HMSO.
19) New Zealand Acute Low Back Pain Guide. New Zealand Guidelines Group, 1997.
20) Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M, (1999). Low Back Pain Evidence
Review London: Royal College of General Practitioners.
21) Danish Institute for Health Technology Assessment: Low-Back Pain. Frequency,
Management and Danish Health Technology Assessment 1999; 1(1).
22) Koes BW, Assendelft WJJ, van der Heijden GJMG et al. Spinal manipulation and
moblisation for back and neck pain: a blinded review. BMJ 1991a; 363:1298-1303.
23) Assendelft WJJ, Koes BW, van der Heijden GJMG et al. The effectiveness of chiropractic
for treatment of low back pain: an update and attempt at statistical pooling. J Manipulative
Physiol Ther 1996a; 19:499-507.
Source: www.chiropractic.on.ca