Monthly archives

November 2008

Laser Therapy for Rotator Cuff Injuries

Low intensity laser therapy is a great option for treating rotator cuff problems. The laser therapy system used by your Comox Valley Chiropractor is especially suited to treat the entire joint and provide quick relief. For a quick explanation of rotator cuff impingement and how laser therapy can help, watch the following video.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Chiropractic is Safe and Effective

Myth #4: Chiropractic treatment is dangerous.

A great synopsis of the risks associated with chiropractic treatment was recently published in the Journal of Manipulative and Physiological Therapeutics. While the full text article can be found at the bottom of this post, the summary is as follows:

This synopsis provides an overview of the benign and serious risks associated with chiropractic care for subjects with neck or low-back pain. Most adverse events associated with spinal manipulation are benign and self-limiting. The incidence of severe complications following chiropractic care and manipulation is extremely low. The best evidence suggests that chiropractic care is a useful therapy for subjects with neck or low-back pain for which the risks of serious adverse events should be considered negligible. (J Manipulative Physiol Ther 2008;31:461-464)

This synopsis references a previous study published in Spine which found that the risk of experiencing a stroke following a visit to a chiropractor was equal to the risk of experiencing a stroke following a visit to a family doctor. It led the authors to conclude that “The increased risks of VBA stroke associated with chiropractic and PCP (family doctor) visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.” So, people who are already having a stroke will experience neck pain and headaches, and will logically go and see either their chiropractor or their family doctor. It is not the treatment of either of these practitioners that causes the stroke to happen.

In summary, there are risks of adverse events with chiropractic treatment. These risks are small and self-limiting, and the risks of severe complications are very small. When compared to other common treatments such as taking medication or surgery, chiropractic is a very safe form of treatment for neck and low back pain.

Synopsis of Chiropractic Safety

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

The Evidence Supports Chiropractic Care

Myth #3: There is no evidence to support that chiropractic works.

I don’t even know where to start with this one. The fact is that there is are so many studies done on spinal manipulation that a Medline search would be overwhelming. Instead of going through the many systematic reviews and meta-analyses that exist, I think the evidence is well summed up by an review exploring international low back pain guidelines. The review can be accessed here.

Over the last 10 years, 12 countries have done critical reviews of the scientific literature concerning low back pain. The international consensus is that the balance of the evidence shows that chiropractic spinal manipulation is effective in managing low back pain, and therefore is included in the recommendations. Here is a summary of their findings:

Clinical practice guidelines for the treatment of acute lower back pain

  • Reassurance of the favourable natural history
  • Advice to stay active
  • Discourage bed rest
  • Acetaminophen, p.r.n.
  • Chiropractic spinal manipulative therapy
  • Advice against passive physiotherapy modalities, prolonged bed rest or specific back exercises.

Essentially the investigators found that following these treatment guidelines (including chiropractic spinal manipulation) led to better outcomes than usual medical care. It is important to note that the guidelines don’t recommend chiropractic as a stand alone treatment, but as one component of a continuum of care.

One of the authors of the study then went on to launch the 2-part C.H.I.R.O study (Chiropractic Hospital-Based Interventions Research Outcome study). The first part pitted chiropractic care (along with the above guideline recommendations) versus usual medical care. The people who received chiropractic care showed better functional and quality of life improvements. The results of this study have been presented at Canadian Spine Society Meeting, the International Society for the Study of the Lumbar Spine, and the North American Spine Society and will be published in an upcoming edition of Spine. A summary of the results can be found here.

In the opinion of this Comox Valley Chiropractor, we are so far past establishing that there is evidence supporting chiropractic care. We are now heading in the direction of trying to establish how to best use this tool in the management of patients, or whether certain subsets of patients will respond more favourably. In the past 5 years, Chiropractic Research Chairs have been established at many universities across Canada in order to further chiropractic research.

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Yes Suzy, Chiropractors ARE Doctors!

Myth # 2: Chiropractors aren’t doctors, they have very little education compared to medical doctors.

This is a continuation of my post on the top 4 myths about chiropractic. Before I address the educational qualification of chiropractors, how about a refresher on what makes someone a doctor. In British Columbia, Chiropractic is regulated by our College under the Chiropractic Act.  The Act provides us this designation due to our right to diagnose. This means that we are able to determine a specific cause for a group of signs and symptoms with respect to spine and spine-related disorders. We have enough education and training to be able to come to a diagnosis, and more importantly, to determine when a condition is outside our scope of practice.

As stated by Canadian Memorial Chiropractic College (where I attended), “The chiropractic curriculum encompasses a diverse range of knowledge including anatomy, pathology, biomechanics, chiropractic principles, diagnosis, and adjustive techniques.” The 4-year program focuses on diagnosis and treatment of musculo-skeletal injuries, and includes 4232 hours of instruction in subjects such as Neurodiagnosis in Chiropractic Practice, Differential Diagnosis, Systems Pathology, Clinical Biomechanics and Radiographic Interpretation. The requirements for admission into an accredited chiropractic program include minimum 3 years undergraduate study (as with medicine) but most students have  completed an undergraduate degree. That works out to 8 years of post-secondary education.

Interestingly enough, a 2001 article in the Journal of Bone and Joint Surgery analyzed the curriculum of Canadian medical schools and discovered that on average only 2.26% of class time was devoted to musculo-skeletal injuries. This is surprising considering that in BC, one third of all visits to MDs are for spine and spine related conditions. The article concluded that “There is a marked discrepancy between the musculoskeletal knowledge and skill requirements of a primary care physician and the time devoted to musculoskeletal education in Canadian medical schools.”

So it begs the question – if you have a problem with your back, what kind of doctor do you want to see? In my opinion, the information above speaks for itself.