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Chiropractic Care

People often have questions about chiropractors and chiropractic. The following answers to frequently asked questions are the opinion of Dr. JD Kato...

1. What is Chiropractic?
2. What are adjustments?
3. Do adjustments hurt?
4. What are the benefits of adjustments?
5. What is the cracking noise during an adjustment?
6. Can chiropractic treatment provide a preventative function?
7. I hear "once you go to the chiropractor you have to go forever." Will I become addicted to being adjusted?
8. Is neck adjustment safe?
9. How are chiropractors different than physiotherapists or sports medicine doctors?
10. Can a chiropractor treat my sore knee or a rotator cuff problem?
11. Do I need a referral from a medical doctor?
12. Is chiropractic care covered by OHIP?

1. What is Chiropractic?

Chiropractic is a health science that focuses on the examination and treatment of disorders of the neuromusculoskeletal system. Although chiropractors treat various injuries of the arms and legs, they are most famously known for their treatment of low back pain, neck pain and headaches because of their emphasis is on the spine.

Chiropractors are trained in many clinical methods to examine and treat the spine, and the associated nerves, joints and muscles. One of these methods that all chiropractors learn is how to examine the joints for restricted motion and then how to adjust these areas.
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2. What are adjustments?

Adjustments, sometimes referred to as "manipulations", are quick, controlled movements usually performed with the chiropractor's hands that help to move the joints. These can be done on the joints in the back and neck as well as other joints in the extremities.
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3. Do adjustments hurt?

No, most patients experience relief of aches and pains with adjustments. However sometimes a patient can experience discomfort. If you do, it is important to discuss this with your chiropractor - there are alternative treatments or even different ways to adjust a joint, which you may find more comfortable.
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4. What are the benefits of adjustments?

Simply put, adjustments show improvements in range of motion, decrease in pain, and relaxation of muscle tension. These changes translate to improved biomechanics, which can help treat and prevent injuries. The most dramatic effect is the relief of pain and tension without the use of medication or surgery. For example the American Pain Society and the American College of Physicians published guidelines in 2007 recommending manipulation (adjustments) as a non-medical treatment for acute and chronic low back pain.
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5. What is the cracking noise during an adjustment?

Often a cracking noise is heard with adjusting, very similar to when someone cracks his or her knuckles. It is just the harmless release of gas pressure inside the joint.
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6. Can chiropractic treatment provide a preventative 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.
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7. I hear "once you go to the chiropractor you have to go forever." Will I become addicted to being adjusted?

No. There are a few points to keep in mind though. Many people do like to be adjusted and are happy to return to their chiropractor because they feel better after being treated. Also if your injury comes from long work hours, weakness in postural muscles, repetitive activities or other causative factors that are not changed after a course of treatment, then obviously the injury may return again which would require further treatment (if the cause of pain is still there and cannot or will not be changed, then the pain can come back). However many find that proper exercises on a regular basis can help to maintain the mobility and/or stability of the joints and therefore lessen the need for frequent treatment.
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8. Is neck adjustment safe?

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 recent scientific study published in February 2008 looked at data from Ontario hospitals over a nine-year period covering over 100 million person-years. The authors of this study found no evidence of excess risk of stroke associated chiropractic care compared to medical doctors ("primary care"), and that the association of stroke with chiropractic may be explained by the fact that people experiencing neck/head pain from a stroke seeking care before the stroke is diagnosed.
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9. How are chiropractors different than physiotherapists or sports medicine doctors?

There is a lot of overlap between different professions including how a patient is examined, and quite often treatment can be similar. Chiropractors are unique in that they are trained and licensed to diagnose, order/assess x-rays, and provide treatment. In my experience sports medicine doctors will examine and diagnose, but usually refer patients for rehabilitation. Physiotherapists are not licensed in Ontario to diagnose, or order x-rays, and they typically do not use manual manipulation as much as chiropractors.
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10. Can a chiropractor treat my sore knee or a rotator cuff problem?

All chiropractors in Canada have been taught how to examine and manage injuries and conditions of the extremities. Treatment can include adjustments of the joints, soft tissue massage, therapeutic modalities (such as ice, heat, ultrasound, etc.), ergonomics, therapeutic exercises, activity modification and supportive devices like orthotics.
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11. Do I need a referral from a medical doctor?

No. You do not have to be referred. Chiropractors are legislated as primary contact health care professionals in every province in Canada. This means that patients may be consulted directly.

However some extended medical insurance companies insist on a medical referral before they approve coverage. If you are unsure of the details of your extended insurance plan, ask your insurance company. (see blog article on questions to ask the insurance company)
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12. Is chiropractic care covered by OHIP?

Currently it is not, however it is covered or partially covered by many private insurance plans. Call your insurance company if you are unsure of your coverage (see blog article). Recently though OHIP has started to cover part of the fee for x-rays taken at a at an independent x-ray facility when it is ordered by a chiropractor.

 

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