Frequently asked questions about Chiropractic issues

• What is Chiropractic?
• What is Massage Therapy?
• What is Spinal Manipulation/Mobilization?
• What type of Soft Tissue Therapy will I Receive?
• Low Back Pain
• Neck Pain
• Headaches
• References

What is Chiropractic?

Chiropractic is a non-surgical drug-free approach to healthcare. Chiropractors use their hands to assess, diagnose, and treat various spinal and extremity conditions. Chiropractors focus on the assessment of joints, muscles, and tendons and their influence on the nervous system. Chiropractors, like other medical physicians, take thorough histories, and perform orthopedic testing before differentially diagnosing, estimating prognosis for full recovery, and formulating comprehensive management plans. At Aquarius Chiropractic, educating and recommending specific therapeutic exercise and lifestyle guidance for your benefit is of particular interest to us.

Premium Assistance Medical Service Plans (MSP), Extended Health Plan coverage, the Workers Compensation Board (WCB), Insurance Company of British Columbia (ICBC), and other insurance carriers all include healthcare coverage for chiropractic. Kirkaldy Willis, M.D., world renowned medical orthopedist, joined David Cassidy, D.C., PhD. to do an evaluation of the clinical results of Chiropractic care on 171 chronic medically unresponsive low back sufferers for a period of 7 years. Within 3 weeks, Dr. Cassidy eliminated 87% of the ailments. It is significant to note that a reevaluation of these patients one year later showed that they remained pain free (2)! This suggests that the best route to recovery from low back pain and spine-related problems comes from chiropractors. For you, that means less time off work and to the Workers Compensation Board and employers, this means lower costs of compensation.

What is Massage Therapy?

Massage therapy is a system of pressing and kneading different areas of the body to relieve pain, relax, stimulate, and tone the body. Massage therapy helps relieve tension found in muscles, tendons, and ligaments and also stimulates blood circulation and assists the lymphatic system improving the elimination of waste throughout the body.

What is Spinal Manipulation/Mobilization?

Spinal Manipulation, also known as the "adjustment", is the foundation of chiropractic therapy (16). The adjustment involves a gentle specific movement to the involved restricted joint, and may involve a short, controlled thrust to restore functional pain free range of motion. These restricted joints can be thought of as being "locked up" or not moving properly. An adjustment releases joint restrictions, adding and restoring normal functional motion to the joint, while stimulating positional receptors, which in turn inhibits pain receptors that send noxious stimuli to the brain for processing (14). The adjustment also helps break up fibrous adhesions that form around joints. These would otherwise cause wear and tear, due to increased stress on the joint, and the adjustment promotes the gradual return to more favorable neurological and biomechanical function.

Osteoarthritis may progress more rapidly when potentially exposed to greater wear and tear, as a result of joints that are locked up. Thus, it would behoove one to remove stress from their joints in order to prevent complete degeneration of the cartilage and bony structures.

Spinal manipulative therapy is a very effective way of alleviating joint restrictions and compensatory soft tissue conditions, in addition to halting the progression of osteoarthritis. The choice between gentle mobilizing movements and/or dynamic impulse adjusting, will be addressed accordingly as it relates to each individual. Consult with us if you are hesitant about any spinal manipulative therapy that produces noise.

What type of Soft Tissue Therapy Will I Receive?

A specific soft tissue therapy that engages movement (STT) of your body during treatment may be utilized. This is a revolutionary proven approach used to successfully diagnose and treat cumulative trauma disorders, whether short or long standing. It has been shown that the use of STT commonly provides 50% improvement after the first to third treatment (8) helping to "actively release" the involved area.

...It hurts so good!

Cumulative trauma disorders, also known as repetitive stress injuries or overuse syndromes, are major problems in the workforce, athletic population, musicians, as well as the general population. These syndromes are more commonly known as rotator cuff syndrome, tennis elbow, tendonitis, plantar fascitis, carpal tunnel, and chronic low back pain, to name a few.

A major problem with cumulative trauma disorders is the accumulation of adhesions, formed initially as a protective mechanism serving to limit the motion of the affected tissues to allow the damaged tissue to heal slowly. Unfortunately, the body does not always read its owners manual and the resulting adhesions are often laid down in different directions not following the direction of muscle action, which ultimately causes restrictions in free movement of your tissues. The other problem is that adhesions form sticky abnormal bands of tissue that grow together in an abnormal way. Adhesions develop between joints and stick or attach to muscles, ligaments, tendons, nerves, and blood vessels, resulting in restricted motion and or numbness or tingling if nervous structures are obstructed. As the tense soft tissue structures rub against each other, eventually, an injury occurs, which heals with inflammation and scar tissue formation (8).

Solution
Ultimately, early assessment, diagnosis, and treatment of cumulative trauma disorders from everyday work and/or trauma from sports injuries is ideal; however, long standing adhesions complicated by joint dysfunction etc. can also be addressed. Once these adhesions are released, separated and broken up using STT, the underlying soft tissue will reestablish optimal texture, resilience, and proper function (8), becoming smooth allowing the muscles, ligaments, tendons, nerves, and blood vessels to move freely on each other. The powerful hands-on application of STT utilized to separate and break up these adhesions is an integral treatment strategy to fast relief.

At Aquarius Chiropractic, we personalize your care, formulating effective diagnosis and treatment strategies, beginning with the identification of the underlying causes and contributing factors as they uniquely pertain to you. Patients are treated according to their specific needs, goals and objectives. This may involve treatment at Aquarius Chiropractic alone, or may involve treatment in conjunction with another health professional. STT is a valuable technique for not only novice and professional athletes, but the workforce as well. Take control and actively release your pain, knowing that we are fully committed to providing quality non-surgical drug-free care.

Low Back Pain

Low back pain is a common condition comprising a major health problem worldwide. The lifetime prevalence of low back pain is estimated at 60% to 85% (4) with an estimated cost between $20 and $50 billion dollars each year - in health costs, lost workdays, and decreased production (11). Back pain is inevitable and will eventually affect almost everyone at some point in their lives -- the question is when?

Spinal Manipulative Therapy for the Low Back
The Manga Report overwhelmingly supported the efficacy, safety, scientific validity, and cost-effectiveness of chiropractic for low back pain (10).

Approval is also seen with the Agency for Health Care Policy and Research (AHCPR), an organization strongly in favor of manipulation as the primary delivered care to patients with acute low back pain. Among other things, back pain can be caused potentially by motor vehicle accidents, falls, poor lifting technique, sports injuries, and "overuse" syndromes, such as those with desk work.

Most backs hurt because they are out of shape, not due to damage or disease. Recovery and sustaining relief depends on staying active. The key is to stay positive. Degeneration of the spine is a normal process of aging and is known as the "silver hair" of the spine; however, joint dysfunction (locked up joints) can potentially promote accelerated degenerative progression.

Solution
Back pain, in most cases, can be dealt with successfully, assuming the right procedures are undertaken. For those patients with an objective to get better, bed rest should not be an option (9). This is the old way of thinking and does not embrace the new age of rehabilitative care. Adopting an active care role and determining goals and objectives is essential.

At Aquarius Chiropractic, we personalize your care, formulating effective diagnosis and treatment strategies beginning with the identification of the underlying causes and contributing factors as they uniquely pertain to you. Patients are treated according to their specific needs, goals and objectives. This may involve treatment at Aquarius Chiropractic alone, or may involve treatment in conjunction with another health professional. Take control of your pain, knowing that we are fully committed to providing quality non-surgical drug-free care.

Neck Pain

Neck pain is a common problem that affects approximately 50% to 70% of U.S. residents at least once in their lives (7). A common cause of neck pain can potentially be a result of poor posture, and poor neck muscular endurance, commonly seen with desk jobs. As a result, the corresponding musculature becomes tight and looses circulation, ultimately triggering a cascade of events that leads to internal scar tissue formation. Range of motion loss and discomfort is a common result. Other more obvious causes include whiplash and headaches, among other things.

Is Spinal Manipulative Therapy of Neck Safe?
Chiropractic and the use of spinal manipulative therapy is a safe non-surgical drug-free approach to healthcare for the treatment of musculoskeletal conditions (6). That being said, our healthcare providers will acknowledge any concerns patients may have, and will alter treatment strategies accordingly and/or refer patients when necessary for further evaluation.

Solution
Neck pain, in most cases, can be dealt with successfully, assuming the right procedures are undertaken. Adopting an active care role and determining goals and objectives is essential. It should be noted that spinal manipulative therapy is a tailored skill and thus it is encouraged that an individual goes to a skilled chiropractor who will conduct a safe, effective adjustment, rather than to other professionals who are not adequately trained for this procedure.

At Aquarius Chiropractic, we personalize your care formulating effective diagnosis and treatment strategies beginning with the identification of the underlying causes and contributing factors as they uniquely pertain to you. Patients are treated according to their specific needs, goals and objectives. This may involve treatment at Aquarius Chiropractic alone, or may involve treatment in conjunction with another health professional. Take control of your pain, knowing that we are fully committed to providing quality non-surgical drug-free care.

Headaches

The cost, in terms of work loss and decreased quality of life, is high among those who experience headaches, as their effectiveness and ability to perform at work, home, or school, is diminished (13). Individuals are increasingly turning to alternative therapies for relief. Studies report that one of the most common alternative practitioners sought out for the treatment of headaches was the chiropractor (3).

Headaches vary widely in terms of severity, frequency, and disability, from rare episodes of minor discomfort to daily, incapacitating headaches. Most people that suffer from headaches will have either a tension-type headache or migraine headache.

Tension Headache
Tension headaches, also known as muscle contraction headaches, are by far the most common type of headache, with a 1-year prevalence ranging from 40 to 80% (12). Tension headaches are usually felt as a bilateral aching, pressing or tightness, but can be felt anywhere in the head and can be worsened by emotional stress.

Migraine Headache
Migraine headaches are usually more severe and disabling than tension headaches, and generally occur in attacks that can last from a few hours to a few days. Recent population-based studies estimate that 10 to 12% of adults have experienced a migraine in the previous year, with 2 to 4 times more women affected than men (12). Migraine headaches are usually felt on one side of the head as a throbbing, pulsating pain. Migraines are often accompanied by other symptoms such as nausea, vomiting, and increased sensitivity to light. In some cases, the patient experiences an aura - a period of 20-30 minutes preceding the headache during which the person experiences visual disturbances such as flashes of light or zig zags before the eyes.

A 2003 study by Tuchin and Bonello (14) suggested that chiropractic spinal manipulative therapy appears to have a similar effect to amitriptyline, and a greater effect than neck mobilization, in the improvement of standard migraine outcome measures.

Solution
At Aquarius Chiropractic, we personalize your care formulating effective diagnosis and treatment strategies beginning with the identification of the underlying causes and contributing factors as they uniquely pertain to you. Patients are treated according to their specific needs, goals and objectives. This may involve treatment at Aquarius Chiropractic alone, or may involve treatment in conjunction with another health professional. Take control of your pain, knowing that we are fully committed to providing quality non-surgical drug-free care.

References

1. Bergman TF. The chiropractic spinal examination. pp97. In Ferezy JS (ed): The Chiropractic Neurology Examination. Aspen Publishers, Rockville, MD, 1992.
2. Cassidy D, Willis K, University of Saskatchewan, 1985.
3. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 280:1569-75, 1998.
4. Elders LA, Burdorf A. Prevalence, incidence, and recurrence of low back pain in scaffolders during a 3-year follow-up study. [Journal Article] Spine. 29(6):E101-6, 2004.
5. Giles LG, Muller R. Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. [Clinical Trial. Journal Article. Randomized Controlled Trial] Spine. 28(14):1490-502; discussion 1502-3, 2003.
6. Haldeman S, Carey P, Townsend M, Papadopoulos C. Arterial dissections following cervical manipulation: the chiropractic experience.[see comment]. [Letter] CMAJ Canadian Medical Association Journal. 165(7):905-6, 2001.
7. Hurwitz EL, Morgenstern H, Harber P, Kominski GF, Yu F, & Adams AH. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study. American Journal of Public Health. 92(10): 1634-41, 2002.
8. Leahy MP. Improved treatment for carpal tunnel and related syndromes. Chiropractic Sports Medicine. 9(1):6-9, 1995.
9. Lively MW. Sports medicine approach to low back pain. [Journal Article] Southern Medical Journal. 95(6):642-6, 2002.
10. Manga P, Angus D, Papadopoulos C, et al. The effectiveness and cost-effectiveness of chiropractic management of low back pain. Ontario, Canada: Kenilworth Publishing, 1993.
11. Palmieri NF, & Smoyak S. Chronic low back pain: a study of the effects of manipulation under anesthesia. J of Manipulative and Physiol Ther. 25(8): e8, 2002.
12. Rasmussen BK. Epidemiology of headache. Cephalalgia. 15:45-68, 1995.
13. Schwartz BS, Stewart WF, Simon D, Lipton RB. Epidemiology of tension-type headache. JAMA. 279:381-3, 1998.
14. Tuchin PJ, & Bonello R. The evidence on chiropractic treatment for migraine. Conference Proceedings. World Federation of Chiropractic, 7th Biennial Congress, 2003.
15. van Tulder MW, Furlan AD, and Gagnier JJ. Complementary and alternative therapies for low back pain (Review Article). Best Practice & Research in Clinical Rheumatology. 19(4):639-54, 2005.
16. Vear HJ. Standards of chiropractic practice. J Manipulative Physiol Ther. 8(1):33, 1985.