Chiropractic Care: Out With The Old; In With The New

Manual Therapy Oakville, ON May7th 2018


By: Dr. Patti Farrell, BA (Hons), DC

  • ART Provider
  • Medical Acupuncture Provider


What is Chiropractic?

Chiropractic is one of the largest primary care professions in Ontario. The word ‘chiropractic’ comes from the Greek words ‘cheir’ and ‘praktos’, which translates to ‘Done by Hand’.  It is an evidence-based, non-invasive, hands-on health care discipline that focuses on the musculoskeletal system. Chiropractors practice primarily using our hands, providing diagnosis, treatment, and preventative care for disorders related to the spine, pelvis, nervous system, and joints. It is a regulated health profession, and nearly 2.7 million individuals in Ontario rely on chiropractic care every year to help them live a happy, active life.


What is a Chiropractic Adjustment?

A manipulation/adjustment is a low amplitude, high velocity thrust applied to a joint of the spine or extremity that is not moving properly.  The aim of an adjustment is to reduce stiffness in the joints and the surrounding musculature. The ‘crack’ one hears is a release of pressure/gas in the joint as more space is created for movement.


Old vs. New Chiropractic Care



A Typical Chiropractic Visit at Leaps & Bounds 

  1. Thorough patient history
  2. Physical Examination
  3. Provide the patient with a diagnosis or clinical impression for their condition
  4. Discussion of treatment options unique to the patients condition
  5. Informed consent
  6. Treatment (soft tissue therapy, mobilizations, manipulation, acupuncture, modalities, rehabilitation, patient education)
  7. Referral to another practitioner or further imaging if needed 


Debunking Chiropractic Myths 

Chiropractors only treat the spine
  • Chiropractors are musculoskeletal experts trained in assessing, diagnosing, and treating conditions related to the musculoskeletal and nervous system
  • We are well equipped and educated to treat a variety of issues including, but not limited to:
    • Neck pain and back pain
    • Headaches
    • Repetitive sprains/strains
    • Tendinopathies, neuropathies, arthritis
    • Work and sport related injuries
    • Concussions
A medical doctor must refer you to a chiropractor
  • Chiropractors are primary care providers in Canada and a referral is not needed
  • However – depending on one’s benefits provider, there area a few cases where a referral is needed in order to access coverage 
Chiropractic care is dangerous
  • There are less risks and side effects with chiropractic than most medications
  • Most adverse events with chiropractic are mild and transient (m/c is post-treatment soreness)
  • A recent study showed the probability of a serious adverse event to be 1 in 1-250 million manipulations (0.000001%-0.000000004%)
  • A recent systematic review showed the absolute event rate for any adverse event with medium to long-term Opioid use (over 2 weeks) was 78% (7.5% of these were serious adverse events)
  • Studies suggest that chiropractic care is more effective in regards to pain, quality of life, and disability, when compared to NSAIDs for non-specific acute low back pain 
We fix ‘out of place’ vertebrae
  • There is no evidence to suggest that spinal segments can move out of alignment by themselves and that we can push them back with the force of our hands
  • The amount of force necessary to displace vertebral bones is enough to break the spine!
    • Thus, manipulation cannot significantly affect alignment 
“Once I start seeing a chiropractor, I have to go forever”
  • Upon initial examination, the chiropractor will perform a history and physical examination to determine the cause of pain and/or dysfunction
  • A diagnosis and treatment plan will be developed according to the patients needs and goals and current research
  • Many acute issues come in for a few visits and then to obtain relief when needed
  • When appropriate, a maintenance or prevention plan may be recommended depending on a patient’s job demands or lifestyle in order to prevent any injuries from occurring
  • The decision to continue care is always up to the patient! 
Chiropractic manipulation causes stroke
  • There is NO cause and effect relationship between neck manipulation and stroke
  • Neck pain and headache can be early signs and symptoms of a stroke which are reasons you see a medical practitioner in the first place
    • A thorough history and physical are done to help identify any risk factors
    • So in cases that have been reported, the stroke was already in progress and was not detected
  • A 2009 study showed the risk of stroke to be 5/100,000 manipulations (0.00005%)
  • The risk is no greater than if you were to see your medical doctor under the same circumstances 


“Myths about chiropractic” video by Dr. Shawn Thistle

Safety of chiropractic interventions: a systematic review. Gouveia, Liliana Olim; Castanho, Pedro & Ferreira, Joaquim J Spine 2009

Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Cassidy, J David; Boyle, Eleanor; Cote, Pierre; He, Yaohua; Hogg-Johnson, Sheilah; Silver, Frank L & Bondy, Susan J Spine 2008

Chiropractic care and the risk of vertebrobasilar stroke: results of a case-control study in U.S. commercial and Medicare Advantage populations. Kosloff, Thomas M; Elton, David; Tao, Jiang & Bannister, Wade M Chiropractic & manual therapies 2015