Can chiropractic treatment provide a preventive function?
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.
Does chiropractic treatment require X-rays?
Yes, in some cases 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.
Is chiropractic treatment appropriate for children?
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 chiropractic adjustment a safe procedure?
Chiropractic adjustment or manipulation is a drug-free, non-invasive approach to common musculoskeletal conditions such as headache, neck and back pain. As such, it is a low risk therapy. Complications arising from adjustment are rare.
How is chiropractic adjustment performed?
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.
Does chiropractic treatment require a referral from a medical doctor?
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 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 to solve, control or complement medical therapy for a number of common conditions or manage and relieve pain resulting from injury.
Can chiropractic treatment cure colds, earaches and other ailments?
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. 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.
Why is there a popping sound when a joint is adjusted?
All joints in the body, including those in the spine, are surrounded by a fibrous joint capsule - a balloon of sorts that helps hold the bones together and contain the fluid within each joint. During an adjustment, the joint surfaces are gapped, and this often results in a cracking or popping sound. This sound occurs when gases dissolved in the joint fluid are released due to the negative pressure created during this gapping (like a gas bubble, basically). This is very simlar to what would happen if you pulled on your finger or cracked your knuckles. The sound itself does not always occur during an adjustment, and is not necessary to indicate a successful treatment.
Why would neck adjustments 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 spine 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. Adjusting or manipulating the spine, in combination with other therapies, may help alleviate symptoms in many body regions.
Does adjusting require stretching and rotating the neck beyond its normal range of motion?
No, this is a common myth. Neck adjusting is a skilled procedure performed within the normal range of motion of the neck. By using a combination of available motions (flexion and rotation primarily), the joints of the neck can be gapped and adjusted safely without putting any anatomical structure in its end range of tolerance. In fact, the normal range during an adjustment is less than what is required to turn your head when backing up a car.
Are neck adjustments forceful actions?
No, they are not. However, in order to adjust the joints in your neck, a small amount of force is required. This force has been demonstrated to be well below the maximum forces that neck structures can sustain, particularly the vertebral artery. It is skill and precision, not strength and force, that are required to conduct a safe, effective adjustment. Chiropractic education in Canada is an intensive four-year program following three years of university undergraduate studies. By the time they graduate, Canadian chiropractors are among the most skilled in the world.
Is a neck adjustment safe?
No health treatment is completely free of potential adverse effects and, on rare occasions, neck adjustment has been associated with stroke and stroke-like symptoms. The most current evidence - synthesized from a multinational, multidisciplinary research collaboration that was published in the highly regarded medical journal Spine
, suggests that stroke symptoms associated with neck adjustments are so rare the actual risk is difficult to quantify. The most common side effect reported after neck manipulation is mild, temporary stiffness or pain. This normally resolves within a day or so after treatment. Rest assured that your chiropractor at SHAPE will discuss this in more detail with you and ensure you are comfortable before commencing treatment.
If I have neck pain, do I have to get my neck adjusted?
Absolutely not. In fact, not all cases of neck pain require manipulation. That decision is completely yours and your treatment options will be discussed in detail with you before proceeding. At SHAPE our clinicians have a variety of treatment options to assist you including hands-on manual therapy, muscle/fascia treatments, acupuncture and corrective and rehabilitative exercise techniques.
- Bialosky JE at al. The relationship of the audible pop to hypoalgesia associated with high-velocity, low-amplitude thrust manipulation: A secondary analysis of an experimental study in pain free participants. Journal of Manipulative & Physiological Therapeutics 2010; 33: 117-124.
- Herzog W, Symons BP, Leonard T. Internal forces sustained by the vertebral artery during spinal manipulative therapy. Journal of Manipulative Physiologics and Therapeutics 2002; 25(8): 504-10.
- Multiple authors. The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine 2008; 33(4S): entire issue.
- Vernoef MJ, Sutherland LR. Alternative Medicine and General Practitioners: Opinions and Behaviours. Canadian Family Physician. 1995, 41:1005-11.
- Wiber JMM et al. The Short-Term Effect of Spinal Manipulation in the Treatment of Infantile Colic. Journal of Manipulative and Physiological Therapeutics. October 1999, Vol. 22, No. 8.
- Mills MV et al. The Use of Osteopathic Manipulative Treatment as Adjuvant Therapy in Children with Recurrent Acute Otitis Media. Archives of Pediatrics and Adolescent Medicine, September 2003, Vol. 157.