Chiropractic Adjustment

It is a high velocity, low amplitude thrust that is done by hand with the intent of restoring proper movement and function to the joints.

The noise that is heard during an adjustment is called a cavitation. A cavitation occurs when nitrogen gas builds up within a joint and then is released with the adjustment.

Chiropractic adjustments have been extensively researched and are very safe. Side-effects are rare but usually include minor complications such as temporary soreness.

There are many reasons to visit a chiropractor, including: car accidents, work place related injuries, sports injuries, injuries as a result of household chores and even the stress of everyday life can contribute to musculoskeletal injuries.

The most common reason patients seek chiropractic care is the alleviation of back pain, neck pain and headaches. Back pain is one of the most common afflictions affecting Canadians with 30 percent of the population suffering from back pain at any given time, and a life-time prevalence of 80 percent. Back pain is also one of the highest health care cost in the developed world as a result of missed work and school days Low back pain also results in a reduction of quality of life.

• 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
• enhanced athletic performance
• Improve your flexibility and range of motion
• Relieve pregnancy-related back ache
• Correction gait and foot problems

Spinal Manipulative Therapy (SMT) has been shown to have the highest level of efficacy in treating acute low back pain patients (2012 physiotherapy clinical low back pain guidelines).

In addition, the neck pain task force (part of the World Health Organizations Bone and Joint Decade, 2008) showed that SMT and home exercise advice were superior to medication for treating neck pain. In 2012, a collaboration of medical doctors and chiropractors published a report that showed SMT was superior to home exercise advise and that both treatments were superior to medication for treating neck pain.

Chiropractors are legislated as primary contact health professionals in every province in Canada. They are 1 of 5 health care professionals in Ontario that have the rights to use the title Doctor along with its accompanying rights and obligations. The 5 regulated health practitioners are:

(a) College of Chiropractors of Ontario;

(b) College of Optometrists of Ontario;

(c) College of Physicians and Surgeons of Ontario;

(d) College of Psychologists of Ontario; or

(e) Royal College of Dental Surgeons of Ontario.

In order to obtain your doctorate of chiropractic, applicants must complete a minimum of 3 years at university and 4 years at a recognized chiropractic college, with 1 year of clinical internship.

A study by Couter et al, 1998 compared the educational requirements of 3 chiropractic and 3 medical schools in the U.S. The study found that chiropractic students spend more hours in lab and lectures (3790 vs. 2648); whereas, medical doctors had more clinical hours (3 years compared to 1). The study also looked at the amount of hours studying individual subjects and the researchers found that the chiropractic students spent more hours learning anatomy, biomechanics, orthopedics, physiology and radiology.

This question pertains mostly to a chiropractic manipulation. Efficacy and safety of a chiropractic adjustment has been researched ad nauseam and is now widely recognized as one of the safest, drug-free, non-invasive therapies available for treating headaches, neck and back pain. Even though chiropractic manipulations have been extensively researched and shown to be safe. No healthcare treatment is completely free of potential adverse effects, as even over-the-counter medications carry some risk.

The majority of patients experience immediate relief following an adjustment; however, some patients may experience some adverse effects. The most common adverse effects seen in patients following chiropractic treatment, includes: a temporary increase in pain, stiffness or swelling. A smaller percentage of patients may also experience temporary dizziness, local numbness, or radiating pain. It should be pointed out that adverse effects associated with spinal adjustments are typically minor and short lived.

1. Neck Adjustments

Spinal manipulative therapy to the neck is very safe; however, on rare occasions stroke and stroke-like symptoms have been associated with neck adjustments, particularly the top two spinal vertebrae. Nevertheless, researchers investigated the relationship between visits to a chiropractor (all treatments provided, not just neck adjustments) and a family medical doctor. The results of the study showed that the association with chiropractic care and stroke is the same as if the patient had seen their family doctor. Therefore, the researchers concluded that the association with chiropractic care and stroke is more likely due to the fact that patients with neck pain and headaches (some of the symptoms associated with stroke) commonly seek chiropractic care and that the signs and symptoms of a stroke might go unnoticed. Therefore, it is important that the healthcare practitioner is aware of these signs and symptoms and that they conduct a thorough examination to rule out any red flags.

A Canadian study that was published in the medical journal Stroke (2001), concluded the risk of strokes in relation to neck adjustments to be so rare that it is difficult to calculate an accurate risk ratio; however, a generally accepted ratio is one event per million neck adjustments. The risk associated with neck adjustments and stroke is lower than that associated with manly commonly used diagnostic test and prescription drugs

Recent research has investigated the biomechanical association between neck adjustments and stroke to determine what strain, if any, is placed on the vertebral arteries (the artery most commonly associated with stroke due to neck adjustments). The results of the neck pain task force (2008) determined that a neck adjustment places half the strain on the vertebral artery compared to checking your blind spot during driving. It should be noted that both activities were shown to be a fraction of force and movement required to cause a tear of the vertebral artery. In addition to the vertebral artery, a recent article has found that the strain placed on the internal carotid artery during a neck adjustment is also less than a number of everyday activities.

Every patient should be aware of each treatment, medical or complementary, and the potential risk factors that they carry. Patients should know that there are many risk factors for stroke including blood clotting problems, hypertension, smoking, high cholesterol, birth control pills, heart problems and traumas such as blows to head from car accidents, sports injuries or falls. If you wish to know more about the signs and symptoms of stroke or other possible complications please visit the heart and stroke foundation of Canada website at www.heartandstroke.ca

As mentioned in section 5 of this page, chiropractors are legislated as primary healthcare providers in every province in Canada. This legislation dictates that patients are allowed to consult chiropractors directly. Nevertheless, a lot of chiropractors work closely with medical doctors, many of whom refer to chiropractors when they believe a patient can benefit from chiropractic care. Similarly, chiropractors will refer to medical doctors when they deem necessary.

For the majority of patients the answer is no. Most patients seek chiropractic care for resolution of acute or chronic injuries and to receive advice to remain pain-free, so that they can resume their everyday activities. There are some patients who choose to receive chiropractic treatment for wellness care. In addition, office workers, professions with repetitive movements, the elderly and patients with some chronic impairments may wish to receive ongoing care to maintain mobility and normal range of motion.

Chiropractors receive a lot education in anatomy and biomechanics and are very effective in treating or alleviating the cause or symptoms of a number of musculoskeletal conditions, such as:

• Ankle pain (strains/sprain, tarsal tunnel, over pronation, etc.)
• Elbow pain (tennis elbow, golfers elbow, etc.)
• Hand pain (de quervain's tenosynovitis, dupuytren’s disease, trigger finger, etc)
• Hip pain (althetica pubica, tight hip flexors, OA, etc.)
• Knee pain (OA, PFPS, ligamentous sprains, etc.)
• Shoulder pain (rotator cuff injuries, impingement, etc.)
• Wrist/hand pain (Carpal tunnel, TFCC, sprain, etc.)

While chiropractic care has been shown to be beneficial in a number of musculoskeletal injuries, patients should know that chiropractic adjustments cannot cure every ailment and that there are some pathologies where adjustments are contraindicated. Even though chiropractors may be unable to treat the cause of a number of serious conditions, chiropractic care can be beneficial in alleviating a number of the muscle and joint pains that may arise.

Yes. Many athletes from the amateur to the professional levels in all disciplines of sport incorporate chiropractic care as part of their overall health care, fitness and maintenance programs. Chiropractic is often used to improve joint range of motion and muscle conditioning. Both of which can have an effect on an athletic performance. Chiropractic care can also be beneficial in helping athletes to fine-tune their muscles and joints prior to an athletic performance, which may reduce long term wear and tear. Prevention is vital the longevity of an athletic career and chiropractic care can be incorporate with nutrition and exercise to prevent and sometimes shorten, the healing time of some injuries.

Unlike the average consumer, athletes tend to use chiropractic care to improve performance and prevent injuries. In some instances the treatment may be similar; however, in all cases the treatment is individually selected to meet the needs of the patient. In the case of professional and elite athletes, chiropractors tend to work in collaboration with other health care practitioners, including: sports medical doctors, medical doctors, massage therapist and physiotherapist.

No. X-rays can play an important role in formulating a diagnosis and should only be taken when deemed necessary after a chiropractor has completed a thorough history and physical examination. Chiropractors receive hundreds of hours of radiological education in everything from interpretation and diagnosis, to positioning, theory and when to refer a patient for x-rays. Every provincial government in Canada has recognized the training and competence of chiropractors to take and interpret x-rays and have granted them this right.