Top Chiropractic and Physiotherapy Questions Asked by Patients (1 of 2)

Whenever we have a new patient come into our clinic for treatment, we usually expect them to have have a lot of questions about everything to do with their treatment, recovery, and what their treatment will actually entail. Some other patients come into our clinic after a really bad experience somewhere else, or have some general concerns about what to expect from their treatment.

Within this two part blog, we will attempt to answer the most common questions we receive at iWellness.ca Rehab & Wellness Clinic to help alleviate some of your concerns and help to answer some of the more general questions you may have about your treatment options and recovery.

Keep in mind, everyone is an individual and your treatment, and recovery will all depend on you and your current health capabilities.

1. How many treatments will I need for my back pain?

For any course of physical therapy, a proper assessment is first required to determine the cause of the back pain. However, for most uncomplicated low back pain conditions, four treatments should typically resolve it. Keep in mind that this is not a guarantee of results as every patient’s case is unique but by the fourth treatment the therapist should know approximately how many additional treatments will be required if the pain has not yet resolved. Regardless, four visits to the chiropractor or physiotherapist is still a small investment for good health!

2. Does treatment by chiropractor or physiotherapist hurt?

Treatment should not be painful and therapists always strive to minimize discomfort. However, performing certain exercises during supervised active rehabilitation can cause sore muscles during or even after the set. Additionally, certain manual therapies (chiropractic adjustments) may be slightly uncomfortable during the procedure but this is also temporary.

3. How does a chiropractic adjustment work?

Joints in the body, in particular the vertebrae of the spine, are held together by ligaments. A chiropractic adjustment typically involves a high velocity, short axis thrust applied to a spinal vertebra. An audible release of gas typically accompanies and is called a joint cavitation. This is caused by the release of gas from the joint fluids, namely oxygen, nitrogen and carbon dioxide which in turn releases the joint pressure

4. If I can just research exercises for low back or neck pain online, why would I need to go for treatment?

A well trained service provider can make a treatment plan suitable for your needs and can modify it as you progress, which can’t be done by doing online searched exercises.

5. Is a neck adjustment dangerous?

No. Serious complications resulting from chiropractic neck adjustment are rare overall. While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, the best evidence suggests that this type of arterial injury can often take place spontaneously or following everyday activities such as turning the head while driving, or even swimming. Many patients experience immediate relief following chiropractic treatment for a stiff neck but some may sometimes experience mild soreness or aching, just as they do after some forms of exercise. As with any treatable condition or tension in the neck, a proper assessment is necessary first to determine the exact cause of the pain and then the Doctor of Chiropractic can suggest the best course of treatment.

6. If I get into a car accident, won’t my insurance go up if I go to therapy?

No. Insurance premiums are determined through other factors and increases in your premium following a collision are associated with the Fault Determination Rules of Ontario. Insurance companies will determine if you are at fault through the applicability of these rules to your accident. Drivers who are considered to be ‘at fault’ by an insurance company will see an increase in their premiums as they are considered to be high risk drivers. Attending therapy for injuries obtained in an accident will not have an impact on your premium.

7. I can ‘pop’ my own back/neck! So why do I need to have an adjustment?

No! ‘Self’ adjustment or manipulation of your own back is never recommended as it creates loose ligaments or ‘ligament laxity’ in your body. Ligamentous tissue holds the joints together and provides both elastic and what is called ‘plastic’ deformability. Joints will ‘snap’ back once stretched but not quite as much, hence the term ‘plastic’ is used. Repeatedly stretching a joint will eventually cause it to become unstable as the looser ligaments will no longer provide adequate support. Paraspinal musculature will also become more tense as they compensate for the loose ligaments and can eventually result in back aches or headaches. Finally, self adjustment cannot be done with any specificity on a particular joint in the spine as it is considered a type of ‘long’ axis spinal mobilization. Long axis spinal mobilization generally involves contacting the top and bottom of the spine and twisting in opposite directions, hoping something happens in the middle but this is unspecific and rarely effective in eliminating a tight joint. In the end, it is always much better to see a chiropractor for adjustments as these complications and joint fixations can be completely avoided through regular chiropractic maintenance treatment.

8. Does ‘cracking’ your own knuckles cause arthritis?

No. Arthritis, otherwise known as degenerative joint disease, is a progressive deterioration of the joint complex through the gradual wearing of the joint/articular cartilage and change of the bones in the joint itself through time. It is the result of how our body ‘ages’ but can also be accelerated following a chronic injury. ‘Cracking’ your knuckles simply releases the gases in the joint fluid as in a regular chiropractic adjustment.

9. What is the difference between chiropractors and physiotherapists?

Chiropractors and physiotherapists are both orthopedic therapy specialists in their own right. The main difference between them is that chiropractors can use spinal manipulation in addition to treat joint or spinal dysfunctions. A physiotherapist may employ mobilizations to move a joint without manipulation. Both professions use the same types of treatment modalities like electrotherapy and laser therapy and are frequently found working side by side in outpatient rehabilitation facilities.

10. How many years of training does it take to become a chiropractor/physiotherapist?

Training for physiotherapists (PT) varies from country to country. Canada being hub of immigrant from various countries, you may find PT trained from 2 years to 6 years at school.

11. What is activator treatment by a chiropractor?

Activator is a type of chiropractic adjustment technique which involves the use of device known as an Activator ‘gun’. This is essentially a ‘t-shaped’ spring loaded device which can be adjusted to various tension levels to produce a force of thrust in a particular direction. This device can then be applied to various areas in the spine to produce specific movement. It is also safe for elderly patients as the force can be adjusted. If you are interested in this form of treatment, check to see if you local chiropractor is trained for use in this technique.

Have any more questions? Don't worry, stay tuned for part two, coming soon.