Benefits of Chiropractic Treatment
Chiropractors aim to play key role as part of team primary care – Spring 2011
The recent online edition of the Medical Post published an introductory piece on the chiropractic profession, highlighting various examples of primary health care models that include chiropractic across the province. Favourably, this commentary includes perspectives from chiropractors, patients and physicians.
Markham, Ontario – Local firefighter Nick Patel loves the physical and mental challenges of his work. But after four years on the job, pain took him out of service.
“I had a stabbing pain shooting down my leg,” he says. “The pain was almost unbearable.”
When his condition didn’t improve, Patel’s family physician recommended chiropractic.
As one of only 5 classes of health care professionals in Ontario that are authorized to use the title doctor, chiropractors develop and carry out comprehensive treatment / management plans, recommend therapeutic exercise and other non-invasive therapies, as well as provide nutritional, dietary and lifestyle counseling. In Canada, each province has a chiropractic regulatory college, responsible for regulating the profession in the public.
Patel’s chiropractor diagnosed his problem as piriformis syndrome, a problem that occurs when the sciatic nerve is compressed or irritated by tension of a small muscle located in the buttock.
“He gave me a set of stretched and broke down what my muscle imbalance was,” says Patel, who also visited a registered massage therapist during his course of treatment.
“During my treatment and with the stretched, I noticed quite an improvement. He told me that if I felt better after two or three weeks, I didn’t have to come back. I still keep up with the stretched. I also do quite a bit of physical activity, but since when I’ve done other work and I’ve had no ill effects.”
Chiropractors use a combination of treatments, all of which are based on the specific needs of individual patients like Patel. For many conditions, such as lower back and other spinal pain, chiropractic care is frequently the primary method of treatment. One area where chiropractors have long been recognized for their expertise is sports rehabilitation and the treatment of high performance athletes. At the Vancouver 2010 winter Olympics, for instance, not only were chiropractor’s on staff for many of the sports teams, but several were included in International Olympic Committee Core and Host medial teams, where they joined MDs, registered massage therapists, physiotherapists and other sports and rehabilitation specialists.
During the games, chiropractor Dr. Mohsen, Kazemi worked in the clinic on Cypress Mountain, the site of many of the games’ alpine event. An athlete himself, he is a sixth-degree black belt in tae kwon do and has traveled widely with the Canadian tae kwon do team, including to Beijing in 2008 – Dr. Kazemi is a fellow of the Royal College of Chiropractic Sports Sciences.
“High-performance athletes are very attuned to their bodies. They have to be,” says Dr. Kazemi, adding that he hopes increased chiropractic collaboration at the Olympics and elsewhere will help to foster greater understanding of the education, skills and expertise chiropractors can bring to the table.
While it’s not much of a stretch to see the value of chiropractic care for high-performance athletes, chiropractic care may also be used to provide symptomatic relief for patients with chronic conditions. One example of this can be found at Toronto’s St. Michael’s Hospital, where a partnership was formed with the Canadian Memorial Chiropractic College (CMCC) to provide chiropractic care to the hospital’s inner-city patient population, including patients of the facility’s Positive Care Clinic for HIV/AIDS.
What began as a pilot project has now become a permanent program, thanks to the positive results: For patients, clinical outcome demonstrated important differences in quality of life, including pain reduction, improvement in function and perceived well-being. As well, physician respondents to the physician satisfaction questionnaire unanimously supported the continuation of the program.
“I do think that having chiropractors as part of our team has been a tremendous resource in terms of improving the access for our patient’s, in getting them care for their mechanical musculoskeletal issues,” says Dr. Judith Peranson, a family physician with St. Michael’s Hospital’s Department of Family and Community Medicine.
“Patient satisfaction is huge. People are getting a lot of relief. Often, given the socioeconomic vulnerability of much of the community we serve, these are patients who wouldn’t be able to access this kind of care elsewhere.”
Providing relief for the patients isn’t the only benefit of chiropractic collaboration at the hospital, Dr. Peranson, notes. It also improves the centre’s efficiency in several ways.
“Chiropractors are regulated health professionals who are going to practice due diligence in ruling out any serious underlying problems and make note of any red flags. Having the confidence that they’re going to call me if the patient’s condition changed is comforting for both me as the treating physician, and for the patient. I also trust that my chiropractor colleagues are assessing whether or not diagnostic imaging is indicated, which allows for more efficient use of physician time and judicious use of imaging resources.
Dr. Deborah Kopansky-Giles, Chiropractic Program Coordinator with the Department of Family and Community Medicine at St. Michael’s Hospital, and a Professor in the Divisions of Clinical Education and Research at CMCC, agrees.
The St. Michaels’ program clearly demonstrate the value of chiropractic in an integrated environment and how important it is to train future chiropractors in a multidisciplinary approach,” says Dr. Kopansky-Giles.
For its part, CMCC, which is housed in a state-of-the-art facility in the city’s north end and is one of two accredited chiropractic educational institutions in Canada, has established itself as a global leader in chiropractic education and research. It’s a reputation that begins with a rigorous curriculum – students are required to receive more than 4,200 hours of specialized clinical training, with extensive studies in subjects including anatomy, pathology, biomechanics, laboratory diagnostic imaging and advanced imaging, chiropractic principles, diagnosis and adjustment techniques that are investing heavily in research.
“Supporting this research is a key priority of the Ontario Chiropractic Association,: says OCA President Dr. David Brunarski, who is himself a respected researcher and recently became the first practicing chiropractor to be elected to the esteemed Canadian Spine Society.
“We’re very proud to help support the work of our many clinician researcher. It’s their work that helps ensure our patients can continue to reply on evident-informed care of the highest quality,” he says, crediting the Canadian Chiropractic Research Foundation (CCRF) for establishing Chiropractic Research Chairs at Canadian universities including the University of Toronto, McMaster University, Universite du Quebec a Trois Rivieres, University of Manitoba, University of Alberta. As well, chiropractics researchers are being recognized for their important work in the fields of disc biology, spine mechanics and neurophysiology and orthopaedics, to name just a few.
Put simply, there is a large and growing body of evidence that clearly demonstrates the effectiveness, and cost effectiveness, of chiropractic care in the management of MSK disorders. One recent Ontario study, for instance, evaluated a family health team and the impact of access to chiropractors for patients with acute or chronic back pain. For those patients who had collaborative care between a physician and chiropractor: 52% received fewer prescription medications; use of narcotic medication was reduced by 57%; and the median number of physician visits decreased from 2.5 to 1.
Considering that MSK disorders rank second only to cardiovascular disease as a major cause of chronic health problems and long-term disability, costing Ontario more than $1.2 billion and accounting for more than a quarter of the total number of physician visits in the province, the further integration and utilization of chiropractic care in Ontario primary care seems highly likely.
For all the efforts behind the scenes, patients - almost 2 million of them in Ontario alone – continue to rely on chiropractic care for their back pain, neck pain and other common musculoskeletal condition because chiropractic works, letting them get back to work, and to doing the things they love.
Firefighter Nick Patel experienced this first-hand.
“When I was in pain, I had to take a full month off work. My chiropractor was a part of a team of health care professionals who helped me get better,” he says.
“Now I’m back to full duty. My job is incredibly important to me. It’s where I want to be.”
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