“I Don’t Believe In Chiropractic”: Chiropractic Is Not The Tooth Fairy

Last week, a patient said to me: “Dr. Brigitte, I have a friend who needs help with his lower back pain, but he won’t come in to see you because he doesn’t believe in chiropractic. I’m so frustrated because I know you could really help him.” This type of comment about “believing” or “not believing” in chiropractic comes up from time to time in conversation in the clinic. I’ve spoken to other chiropractic colleagues of mine, and it seems as though they are experiencing similar scenarios.

First of all, chiropractic is not magic. It is nothing like believing in the tooth fairy, or Santa Clause. It is in fact an applied science that is researched, tested, and revised as we learn more. Similar to other regulated health care professions such as dentistry, physiotherapy, psychology, and medicine to list a few.

Chiropractic by definition is a primary care health profession concerned with the assessment and management of conditions related to the neuromusculoskeletal system of the body. This means, a chiropractor is well equipped to assess and treat a patient with a complaint that is related to nerves, muscles, and joints of the body. If they feel your health issue will be best treated along side other health care professionals, such as a physiotherapist, medical doctor, massage therapist, acupuncturist, mental health counsellor etc., they may also recommend these avenues as well. A chiropractor is also trained to speculate if the origin of pain may not be related to the musculoskeletal system, and will in this scenario recommend the patient visit with their family medical doctor to rule out the potential non-musculoskeletal source of their pain.

Some critics say that the chiropractic profession is not evidence-based. This criticism lacks awareness of current clinical studies. Over the last few years, many studies have been published in the medical literature that demonstrates the effectiveness of chiropractic care. Let’s take lower back pain for example: (1) A study published by the medical journal Spine, showed that chiropractic adjustments are more effective than a drug for easing back pain. This study divided 38 patients into two different groups. Group A received spinal manipulative therapy and a placebo drug, while group B received sham spinal manipulative therapy and the real drug. While both groups improved, patients receiving chiropractic care were significantly better off than patients taking pain medication. They experienced improvements in physical disability, function, and time off work. (2) A 2012 study analyzed the medical spending of over 12,000 adults with spinal conditions. Results indicated that chiropractic care was best at preventing recurring disability in patients with back pain, and as a result also minimized medical spending. (3) Canada’s new guideline for opioid therapy and chronic non-cancer back pain now includes recommendations for first-line therapies provided by a chiropractor. (4) Dysfunction of the sacroiliac joint, located in the pelvis, is a common cause of lower back pain. At times it may even contribute as a cause for sciatica type symptoms, resulting in pain that runs down the leg. A recent study involving 51 adults with sacroiliac joint pain revealed that chiropractic manual therapy was the superior choice for treating sacroiliac joint pain, with a 72% success rate.

I find it entertaining when a family member or friend asks me a question like: “I hurt here, what do you think is causing my pain, and what should I do for it?” What some of them are unaware of, is that in actuality, I am not able to answer this question with confidence, without using quite a lengthy process called the evidence based approachThere are three pillars of evidence informed care:research evidenceclinical expertise, and patient preferences. They are all equally important.

I utilize this approach in clinical practice when it comes to managing a patient’s journey through their health goals. This will involve attaining a holistic health history and asking the patient a lot of questions about and surrounding their musculoskeletal health. Questions like: “Where do you feel your pain? How long have you had it? What have you already tried? What kinds of activities have you had to stop because of your pain? Do you have numbness and tingling? What is your current level of physical activity? How would you rate your average stress level?” etc.  The information gained from our discussion, will dictate our physical exam. This type of an exam usually includes postural analysis, gait analysis, range of motion testing, functional testing, orthopaedic tests, a neurological exam, and using our trained hands to look for joint rigidity and muscle tension.  In certain instances, depending on a history of trauma, age, mechanism of injury, or an ominous presentation, a chiropractor may feel sending the patient for an x-ray is warranted in order to provide more information to the case. Once we have gathered all of the necessary information, it is time to make a diagnosis.

We will then sit down with the patient and provide what is called a report of findings. This will include different treatment options the patient can choose from, with greater emphasis put on treatment options with the most support from current research, best clinical outcomes, and the patients comfort level in mind. Frequency and duration of care is suggested by the chiropractor according to patient’s goals, and what is needed in order to attain the results the patient is seeking. These goals could be anywhere from decreasing a patients level of pain from a stubborn issue, managing shoulder and neck tension from prolonged hours at the office, decrease headache frequency and intensity, optimizing an athletes performance, or something as simple as making it easier to keep up with grandchildren.

To summarize, evidence-based approaches to practice involve combining individual practitioners clinical experience, with the best available external evidence from published research in order to make decisions about what to do in response to presenting problem for a patient. Here at Choice Health Centre, we are proud to use the evidence-based approach to help you attain your health care goals. So please, don’t “believe” in chiropractic, try it and experience it for yourself, the “proof” is in the scientific literature.

To book an appointment with Dr. Brigitte MacPhail, DC or one of our other health care professionals at Choice Health Centre call (902) 404-3668 or book an initial assessment online.

References

  1. Von Heymann, et al. Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparison with diclofenac and placebo. Spine 2013; 38 97): 540-48.
  2. Martins B, et al. The association of complementary and alternative medicine use and health care expenditures for back and neck problems. Medical care 2012; 50 (12); 1029-1036.
  3. Cifuentes M, Willetts J, Wasiak R. Health maintenance care in work-related low back pain and its association with disability recurrence. Journal of occupational and environmental medicine 2011; 53(4); 396-404
  4. Jason Busse, editor. The 2017 Canadian guideline for opioids for chronic non-cancer pain. McMaster University- National pain center.
  5. Visser L, Woudenberg N, et al. Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial. European spine journal 2013 {online}.

© 2019 Choice Health Centre. All Rights Reserved   |   Website designed and developed by Red Ear Media.