Chiropractic is one of the largest primary-contact health professions in Canada with over 6,000 practicing chiropractors. Approximately four and a half million Canadians use the services of a chiropractor each year (1).

Chiropractic is a regulated health profession recognized by statute in all Canadian provinces and American states. The benefits of chiropractic have been well studied, and well recognized by other health professions. Medical referrals to chiropractors are common for treatment of musculoskeletal condition (2).

Chiropractors are trained to assess, diagnosis, and treat patients for disorders related to the spine, pelvis, nervous system, and extremities. Chiropractors practice a drug-free, manual treatment approach, utilizing a variety of techniques and modalities. This may include spinal manipulative therapy, soft tissue therapy, deep myofascial release, therapeutic modalities such as ultrasound, TENS, and interferential current. Further, the inclusion of therapeutic exercises prescription, nutritional/dietary, ergonomic, and lifestyle counseling are common components in a comprehensive treatment/management plan.

Many people associate chiropractic with spinal manipulation (or “chiropractic adjustment”). Spinal manipulative therapy is a carefully controlled, precise procedure that utilizes the highly-refined skills developed through four years of intensive chiropractic education. Primary goals of adjustments include improving areas of decreased movement in the joints and supporting tissues, particularly of the spine, and decreasing muscle tightness or spasm through restoration of normal mechanics and improved functioning of the spine, extremities and supporting soft tissue structures (3,4,5).

Spinal manipulation, as performed by trained professionals, can cause immediate or delayed relief of symptoms and correction of underlying biomechanical conditions. Rarely an adjustment can cause discomfort, such as mild short term achiness.

Chiropractic procedures are adapted to meet the specific demands of each patient. For example, an elderly patient with osteoporosis is certainly treated differently than a healthy 20-year old male, who is treated differently than a pregnant woman.

The vast majority of patients who seek chiropractic health care do so for musculoskeletal complaints, particularly of the spine – low back pain, neck pain, and headaches. Extensive scientific research has demonstrated, with clarity, the effectiveness of chiropractic treatment for these conditions (6,7,8,9). Legislative bodies across Canada, as well as governments around the world have also conducted extensive reviews of the chiropractic profession and have consistently recommended chiropractic services (10, 11, 12, 13, 14, 15, 16, 17, 18)

References:

1. Miller W. Use of Alternative Health Care Practitioners by Canadians. Canadian Journal of Public Health 1997; 88(3):154-58.
2. Verhoef MJ, Sutherland LR. Altenative Medicine and General Practitioners: Opinions and Behaviours. Canadian Family Physician 1995; 41:1005-1011.
3. 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.
4. Hoving JL, Koes BW et al. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. Annals Int Med 2002; 136:713-722.
5. Mior SA. Manipulation and mobilization in the treatment of chronic pain. Clin J Pain 2001; 17(4 Suppl):S70-6.
6. Aker PD, Gross AR et al. Conservative management of mechanical neck pain: systematic overview and metaanalysis. BMJ 1996; 313:1291-96.
7. Hurwitz EL, Aker PD et al. Manipulation and mobilization of the cervical spine: a systematic review of the literature. Spine 1996; 21:1746-60.
8. 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.
9. Spitzer WO, Skovron ML et al. Scientific Monograph of the Quebec Task Force on Whiplash-associated Disorder: Redefining Whiplash and its Management. Spine 1995; 20:8S.
10. 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.
11. 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.
12. Wells T et al. Chiropractic Services Review, An Internal Review. Commissioned by the Ontario Ministry of Health, 1994.
13. Epidemiology Review: The Epidemiology and cost of back pain. Clinical Standards Advisory Group. 1994 HMSO.
14. 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.
15. Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M, (1999). Low Back Pain Evidence Review London: Royal College of General Practitioners.
16. Danish Institute for Health Technology Assessment: Low-Back Pain. Frequency, Management and Danish Health Technology Assessment 1999; 1(1).
17. 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.
18. 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.