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What do Chiropractors Treat? Subluxation Headaches Neck Stiffness Shoulder Injuries Tennis and Golfer's Elbow Carpal Tunnel Syndrome and Hand Pain Low Back Pain S.I. Joint Dysfunction Patellar Tracking Syndrome Knee Pain Ankle Sprains Wellness Care On this page we hope to illustrate the benefits of chiropractic with respect to common orthopedic complaints. We have provided references in an effort to demonstrate that conservative techiques are not only effective but have been scientifically explored, if not verified outright. Talk to the Doc Email the Doctor: drkruis at healthy-body.ca Email the Doctor: drtrochta at healthy-body.ca See how our chiropractors are helping kids. Click here to view Kid's Day 2004
		What is Chiropractic and what is a Subluxation? Chiropractic involves the restoration and preservation of health using the body's natural ability to heal and focuses particular attention on the subluxation (a specific term used by chiropractors that differs from the medical definition). A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity in the spine or pelvis and may influence organ system function and a person's general health. A subluxation (or intersegmental dysfunction) is evaluated, diagnosed, and managed through the use of chiropractic procedures based on the best available rational and empirical evidence from research studies, practice guidelines. (1) One of the main reasons that patients visit a chiropractor is failure of conventional therapy to resolve a problem or desire to avoid side effects of conventional drug therapy.(2) Our patients include recreational to elite athletes, pre- and post-orthopedic surgical patients, acute patients, and patients with difficult, neuromusculoskeletal injuries resulting from biomechanical dysfunctions.
		Headaches Headaches are a common occurence in modern life. How common are they? A study by Pryse-Phillips et al. found that 59% of households in Canada have at least one headache sufferer in the household.(3) Of these, 14% were migraineurs and 36% complained of tension-type headaches. They also discovered that 20% of migraineurs took time off work with symptoms that lasted one or more days. How can chiropractic help headache sufferers? A study by Boline et al. reported the results from a randomized clinical control trial which revealed chiropractic spinal manipulation was just as effective as amitriptyline for the treatment of chronic tension-type headaches.(4) Those headache patients assigned to chiropractic manipulation experienced 32% reduction in headache intensity, 42% in headache frequency, and 30% reduction in over-the-counter medication usage. More recently the Evidence Report on Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache released from Duke University and the Foundation of Chiropractic Education and Research (yet to be published), finds that cervical manipulation is indicated as treatment of migraine. Neck Stiffness Neck pain and stiffness have been encountered by a high percentage of today's population at one point or another in everybody's lives, especially if one works in the service industry.(5,6) Often times the pain or stiffness is not severe enough to warrant invasive procedures such as discography or surgery. Chiropractic treatment combined with Active Release Therapy® has demonstrated to be a highly effective modality in combating day-to-day stiffness and exercise related complaints. When therapy is properly instituted and a complete assessment is made Chiropractic is safe and symptoms are reduced.(7) Elbow Complaints Most cases of tennis elbow are in fact caused by occupational stresses, rather than sports such as tennis or racquet ball.(8) It has been documented that prompt conservative care can minimize acute symptoms and prevent recurrence. Often times conservative management is the most effective and results in fewer side effects as more invasive procedures.(9) If you suffer from any lateral epicondylitis symptoms you should speak with our doctor of chiropractic to investigate prompt treatment for you. Shoulder Injuries Although not many people are familiar with chiropractors treating shoulder complaints they do treat a number of complaints arising from shoulders. Success has been seen in cases with post surgical instability in professional athletes and frozen shoulder in a female patient.(10,11) Shoulder impingement syndrome has also been successfully treated and rehabilitated with chiropractic techniques.(12) With a careful work-up and an understanding of your needs, your doctor of chiropractic can institute a therapy that can bring you results.
		Carpal Tunnel Syndrome Carpal tunnel syndrome (CTS) is part of a group of conditions that have an increased incidence consistent with repetitive stress situations and are known collectively as cumulative trauma disorder (CTD). In a study designed to compare the chiropractic treatment of carpal tunnel syndrome (CTS) to conservative medical treatment of CTS, Davis et al. found that chiropractic treatment was just as effective as medical ibuprofen and a wrist support.(13) This is important for people who want to avoid chronic usage of NSAIDs to combat a common complaint among the Canadian workforce.(14) Often times the pain or stiffness is not severe enough to warrant demanding invasive procedures such as endoscopic tunnel release or open surgery.(15,16) Your doctor of chiropractic will help to answer your questions about this frequently encountered workplace complaint.(17) Low Back Pain Based on several scientific studies conducted by Chiropractic and Medical Research Institutions in America, chiropractic care should the firstline treatment option for non-complicated low back pain.(18) It is more cost effective than drug therapy that only has effects on short term pain, with symptoms returning usually within a month.(19) The van Tulder study also notes that NSAIDS (non steroidal anti-inflammatory drugs), are not any more effective than spinal manipulation, produce more side effects and are no more effective when combined with muscle relaxants. What can chiropractors do for back pain? Chiropractors can do a number of adjustive procedures (spinal manipulations which are also known as adjustments), that help to relieve muscle tension and provide increased range of motion in spinal joints.(20) Chiropractors can also recommend targeted spinal stabilization exercises that have been clinically shown to be effective preventative interventions.(21) Active Release Techniques applied to the spinal musculature has been effective in treating the associated tightness. Sacroiliac Joint Dysfunction The sacroiliac joint (SI joint), is synovial/fibrocartilage two joint complex between the pelvic bones and the sacrum. It is the source of pain for many women during or after pregnancy, which may spontaneously resolve within months (but why suffer that long?). For a small percentage of post-partum women, this dysfunction can last years after the delivery.(22) Furthermore, the natural course of this problem is yet unresolved.(23) It has been documented that conservative care in the form of physical therapy can provide relief for a high percentage of patients.(24) Often times conservative management coupled with specific exercises can help men and women balance musculature that may contribute to the SI joint dysfunction.(25) If you suffer from SI joint dysfunction symptoms you should speak with our doctor of chiropractic to obtain a proper joint movement evaluation and diagnosis to institute treatment for you. Patellar Tracking syndrome This syndrome effects thousands of athletes in North America each year. Non-operative treatments including patient education, activity modification, shoe modifications, braces, and taping.(26) Studies have shown that common practices such as taping have not yielded much clinic benefit and should not be used.(27) Patient's therapy is based on biomechanical analysis and chiropractic.(28) If you continue to suffer from knee pain that is not responding please book an appointment with us to discover the benefits you deserve with conservative care and chiropractic. Knee Pain Continuing research by clinical orthopedic specialists has concluded that conservative managment of osteoarthritis will be more effective for patients and should make use of common nonoperative treatments including patient education, activity modification, shoe modifications, braces, and oral dietary supplements.(29) Our chiropractic clinic offers practically all of these services to our patients right now. What's more, research suggests a strong benefit of using glucosamine sulphate for knee osteoarthritis as it is safer for your body than ibuprofen, causes fewer side effects and pain relief lasts longer after terminating therapy.(30) More recent work in Italy finds that glucosamine may actually clinically slow the progress of osteoarthritis. It is also well known that increased weight augments knee pain. Body mass index (BMI), measurement is used to determine if your weight may play a part in the pain. Click here to calculate your BMI. If you find that your knee pain is not being managed effectively please book an appointment with us to discover the benefits you deserve with conservative care and chiropractic.
		Ankle Sprains Chiropractic care is not limited to the spine. Many recent graduates from Chiropractic Colleges are receiving orthopedic training aimed at managing acute joint injuries. One of the most commonly sprained joints in the body is the ankle.(31) In addition to the regular P.R.I.C.E.S. (protect, rest, ice, elevatie, stretch), approach Active Release Techniques are effective in minimizing adhesions that form as the ankle scars and heals. Full proprioceptive training, strengthening and physical therapy is imparative to improve the ability of the ankle joint.(32) Evidence shows that simple bracing for those with chronic instability may not be effective. Passive support characteristics are not an indication of joint protection.(33) If you have questions about your current rehabilitation, don't hesitate to contact our doctors of chiropractic. Wellness Care Chiropractic health care is well positioned to provide healthy patients and recent sufferers of pain with tips on lifestyle and nutrition. It is the only health care modality that is used to treat acute pain as well as maintaining optimum nervous system wellness, in the absence of pain. Many activities of daily living can be made more efficient and less likely to provoke pain in chronic repetitive situations. Active Release Techniques are excellent for improving athletic performance of occasional as well as professional athletes. What's more, it reduces the amount of adhesions between muscles used for repetitive actions, that may lead to entrapment syndromes in the future. Evaluation of diet and meal choices may reveal certain pro-inflammatory foods that predispose people to chronic pain symptoms. Incorporation of certain fatty acids may improve chronic sympotomatology.(34)
		References 1. Position paper #1. Association of Chiropractic Colleges. July 1996. 2. Palinkas LA, Kabongo ML. The use of complementary and alternative medicine by primary care patients. A SURF*NET study. J Fam Pract 2000 Dec;49(12):1121-30 3. Pryse-Phillips W, Findlay H, Tugwell P, Edmeads J, Murray TJ, Nelson RF. A Canadian population survey on the clinical, epidemiologic and societal impact of migraine and tension-type headache. Can J Neurol Sci 1992 Aug;19(3):333-9 4. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. J Manipulative Physiol Ther 1995 Mar-Apr;18(3):148-54 5. Linton SJ, Ryberg M. Do epidemiological results replicate? The prevalence and health-economic consequences of neck and back pain in the general population.. Eur J Pain 2000;4(4):347-54 6. Vasseljen O, Holte KA, Westgaard RH. Shoulder and neck complaints in customer relations: individual risk factors and perceived exposures at work. Ergonomics 2001 Mar 15;44(4):355-72 7. Ernst E. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage 2001 Mar;21(3):238-242 8. Foley AE. Tennis elbow. Am Fam Physician 1993 Aug;48(2):281-288 9. Kamien M. A rational management of tennis elbow. Sports Med 1990 Mar;9(3):173-191 10. Moreau CE, Moreau SR. Chiropractic management of a professional hockey player with recurrent shoulder instability. J Manipulative Physiol Ther 2001 Jul;24(6):425-430 11. Polkinghorn BS. Chiropractic treatment of frozen shoulder syndrome (adhesive capsulitis) utilizing mechanical force, manually assisted short lever adjusting procedures. J Manipulative Physiol Ther 1995 Feb;18(2):105-115 12. Shrode LW. Treating shoulder impingement using the supraspinatus synchronization exercise. J Manipulative Physiol Ther 1994 Jan;17(1):43-53 13. Davis PT, Hulbert JR, Kassak KM, Meyer JJ. Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trail. J Manipulative Physiol Ther 1998 Jun;21(5):317-326 14. Liss GM, Armstrong C, Kusiak RA, Gailitis MM. Use of provincial health insurance plan billing data to estimate carpal tunnel syndrome morbidity and surgery rates. Am J Ind Med 1992;22(3):395-409 15. Bozentka DJ, Osterman AL. Complications of endoscopic carpal tunnel release. Hand Clin 1995 Feb;11(1):91-95 16. Jimenez DF, Gibbs SR, Clapper AT. Endoscopic treatment of carpal tunnel syndrome: a critical review. J Neurosurg 1998 May;88(5):817-826 17. Rossignol M, Patry L, Sacks S. Carpal tunnel syndrome: validation of an interview questionnaire on occupational exposure. Am J Ind Med 1998 Mar;33(3):224-231 18. Bigos S, Bowyer O, Braen G, et al. Acute Low-Back Pain Problems in Adults. Clinical Practice Guideline No. 14, Agency for Health Care Policy and Research Publication 95-0642. Rockville, MD: AHCPR, 1994. 19. van Tulder MW, Scholten RJPM, et al. Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain. Spine 2000 25(19):2501-2513 20. Colloca CJ, Keller TS. Electromyographic reflex responses to mechanical force, manually assisted spinal manipulative therapy. Spine 2001 May 15;26(10):1117-24 21. Linton SJ, van Tulder MW. Preventive interventions for back and neck pain problems: what is the evidence? Spine 2001 Apr 1;26(7):778-87 22. Albert H, Godskesen M, Westergaard J. Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 2001 Jun;80(6):505-10 23. Daum WJ. The sacroiliac joint: an underappreciated pain generator. Am J Orthop 1995 Jun;24(6):475-8 24. Sasso RC, Ahmad RI, Butler JE, Reimers DL. Sacroiliac joint dysfunction: a long-term follow-up study. Orthopedics 2001 May;24(5):457-60 25. Mooney V, Pozos R, Vleeming A, Gulick J, Swenski D. Exercise treatment for sacroiliac pain. Orthopedics 2001 Jan;24(1):29-32 26. Gigante A, Pasquinelli FM, Paladini P, Ulisse S, Greco F. The effects of patellar taping on patellofemoral incongruence. A computed tomography study. Am J Sports Med 2001 Jan-Feb;29(1):88-92 27. D I Clark, N Downing, J Mitchell, L Coulson, E P Syzpryt, M Doherty. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis 2000;59:700-704 ( September ) 28. Meyer JJ, Zachman ZJ, Keating JC Jr, Traina AD. Effectiveness of chiropractic management for patellofemoral pain syndrome's symptomatic control phase: a single subject experiment. J Manipulative Physiol Ther 1990 Nov-Dec;13(9):539-49 29. Buckwalter JA, Stanish WD, Rosier RN, Schenck RC Jr, Dennis DA, Coutts RD. The increasing need for nonoperative treatment of patients with osteoarthritis. Clin Orthop 2001 Apr;(385):36-45 30. Muller-Fassbender H, Bach GL, Haase W, Rovati LC, Setnikar I. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage 1994 Mar;2(1):61-9 31. Childs S. Acute ankle injury. Lippincotts Prim Care Pract 1999 Jul-Aug;3(4):428-37; quiz 438-40 32. Chun DJ, Chow F. Physical therapy rehabilitation of the ankle. Clin Podiatr Med Surg 2002 Apr;19(2):319-34, vii 33. Eils E, Demming C, Kollmeier G, Thorwesten L, Volker K, Rosenbaum D. Comprehensive testing of 10 different ankle braces. Evaluation of passive and rapidly induced stability in subjects with chronic ankle instability. Clin Biomech (Bristol, Avon) 2002 Aug;17(7):526-35 34. Barham JB, Edens MB, Fonteh AN, Johnson MM, Easter L, Chilton FH. Addition of eicosapentaenoic acid to gamma-linolenic acid-supplemented diets prevents serum arachidonic acid accumulation in humans. J Nutr 2000 Aug;130(8):1925-31 Additional References Vernon HT. The effectiveness of chiropractic manipulation in the treatment of headache: an exploration in the literature. J Manipulative Physiol Ther 1995 Nov-Dec;18(9):611-17
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