The top 6 common myths about chiropractic treatment
Originally published April 2018
Many Canadians are curious about the role that chiropractors play in the healthcare system, and what benefit chiropractic care may have to their health. While you can always find a chiropractor in your community to discuss your specific needs, today we’re busting some commonly shared chiropractic myths:
Chiropractors can only treat back pain
Chiropractors are musculoskeletal experts and are trained in assessing, diagnosing, treating and preventing biomechanical disorders that originate from the muscular, skeletal and nervous system. In addition to the evidence that supports chiropractic care in managing musculoskeletal complaints of the spine, there is also evidence that it supports chiropractic management of the extremities, headaches and pain1,2. Chiropractors are also able to provide lifestyle counselling about nutrition, fitness and ergonomic advice, as well as prescribe rehabilitative stretches and exercises, among others that may be useful in managing or preventing a variety of health conditions. The health of your musculoskeletal system doesn’t just start with a healthy spine, you need to be fully aware of your body to maintain a well-rounded healthy lifestyle!
A medical doctor must refer you to a chiropractor
In all provinces in Canada, chiropractors are primary care providers, which means you can access them directly. Due to the extensive training of chiropractors as diagnosticians, chiropractors will perform a comprehensive assessment to help determine a diagnosis or clinical impressions. Depending on the outcome, the chiropractor can discuss a course of care or refer to another healthcare professional, as needed. In January 2024, the Canadian Life and Health Insurance Association (CLHIA), which represents Canada’s life and health insurance companies, issued an industry statement on the requirements of physician referrals. The statement outlines the industry’s standard practice to not require a physician referral for the reimbursement of eligible treatments provided by paramedical providers. In many cases, this should allow for easier access to paramedical services.
Once you see a chiropractor you have to keep going back
This is false. When seeking care from a chiropractor, they will perform an assessment including a history and physical examination to determine the cause of the pain or dysfunction. From these observations, a diagnosis will be provided, and a treatment plan developed in collaboration with the patient – according to their needs and goals. The treatment plan may recommend a number of subsequent visits to see how the patient responds to care and schedule re-evaluations when indicated. Depending on the patient and the condition, the recommended course of care may vary. Ultimately, the decision to continue care is yours. As a patient, if you have questions or concerns about care, you should feel comfortable to ask the chiropractor for more information on the recommendations made and address any concerns. The care plan should be part of a shared decision-making between the patient and practitioner.
Chiropractors are not ‘real’ doctors
Chiropractors are regulated in all 10 Canadian provinces and are designated to use the title “doctor” similar to physicians, optometrists, and dentists after completing the extensive Doctor of Chiropractic degree program. The professions that are recognized to use the “doctor” title have extensive training in their area of expertise that allows them to be diagnosticians – to provide a diagnosis.
There is no evidence to support the effectiveness of chiropractic care
The chiropractic profession and researchers have invested significant resources to build a robust body of evidence studying the impact of manual therapies on musculoskeletal conditions. For example, spinal and joint manipulation has been shown to be effective treatment for acute and chronic musculoskeletal conditions, like back pain. In fact, spinal manipulative therapy (SMT) is recommended as first line intervention for back pain in numerous clinical practice guidelines including the Bone and Joint Decade Task Force,3 the American College of Physicians and American Pain Society4 as well as Britain’s National Institute of Health and Care Excellence.5
Adjustments are painful
In general, adjustments or joint manipulations do not hurt. In fact, many patients report immediate pain relief. Patients may be nervous about the ‘cracking’ or popping sound that may occur during an adjustment. In a 2015 study, Real-Time Visualization of Joint Cavitation’, authors used functional MRI images to identify that the cracking sound experienced is associated with the rapid creation of a gas-filled cavity within the synovial fluid (the liquid substance that lubricates the joints) when the joint is separated6. As and example, think of cracking your knuckles!
A bonus misconception about chiropractic: Chiropractors only perform adjustments.
This is false. In addition to adjustments (also referred to as joint manipulations), chiropractors also provide other manual and hands-on therapies including soft tissue therapy such as instrument assisted soft tissue manipulation (IASTM), acupuncture, customized therapeutic stretches and exercises, nutritional/dietary counselling, patient education, and more. As mentioned earlier, the recommended course of care will depend on the patient and condition.
Asking questions about your health and treatment options is especially important. You are a partner in your care and your participation is critical to helping us provide the best care to meet your goal. If you have any questions beyond this blog about chiropractic treatment, visit a chiropractor in your area.
References
1. McHardy, A., Hoskins, W., Pollard, H., Onley, R., & Windsham, R. (2008). Chiropractic treatment of upper extremity conditions: a systematic review. Journal of manipulative and physiological therapeutics, 31(2), 146-159.
2. Bryans, R., Descarreaux, M., Duranleau, M., Marcoux, H., Potter, B., Reugg, R., White, E., & , (2011). Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of Manipulative and Physiological Therapeutics, 34(5), 274-289.
3. Haldeman, S., Carroll, L., Cassidy, J., Schubert, J., & Nygren, A. (2008). The bone and joint decade 2000–2010 task force on neck pain and its associated disorders: Executive summary. Spine, 33(4S), S5-S7.
4. Chou, E., Qaseem, A., Snow, V., Casey, D., Cross, T., Shekelle, P., & Owens, D. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478-491.
5. National Institute for Health and Clinical Excellence. (2009). Low back pain early management of persistent non-specific low back pain. Londres, Angleterre.
6. Kawchuk, GN., Fryer J., Jaremko JL, Zeng H, Rowe L., Thompson R. (2015). Real-Time Visualization of Joint Cavitation. Plos One, 10(4), e0119470.