Unit 8

Question 1

How is chiropractic care viewed in the west form a medical standpoint?

Answer 1

Chiropractic straddles a fine line between conventional medical practice and CAM. Traditionally, in North America, chiropractors have not had hospital privileges. However, the American Medical Association, the Canadian Medical Association, governments, health-funding agencies, and insurance plans recognize chiropractic therapy and treatment, and therefore include practitioners’ fees in their payment schedules.

Question 2

What type of training is needed for chiropractors?

Answer 2

Chiropractic is regulated and taught through accredited programs and colleges in Canada, the United States, and other countries. Its five-year educational program curriculum covers a broad spectrum of study areas. Provincially, chiropractors are regulated under the Health Professions Act with protection of title for Chiropractor, Doctor of Chiropractic, and the abbreviation D.C.

Question 3

What is the difference between osteopathy and chiropractors?

Answer 3

Chiropractic shares some common ground with osteopathy which also practices manipulation of the spine and other body parts. Osteopathy emphasizes the manipulation of bones and joints to increase blood circulation in order to maintain or restore health. By contrast, chiropractic focuses on spinal vertebrae adjustments to allow uninterrupted neural transmission to all parts of the body.

Question 4

What can chiropractors do in their practice?

Answer 4

In their practice, chiropractors can examine, diagnose, and treat through chiropractic adjustment and other means to maintain and promote health and wellness

Question 5

What can chiropractors use to provide a diagnosis?

Answer 5

They can use X-ray, massage, heat, ultra-sound, and electrotherapy to diagnose, analyse, and treat clients.

Question 6

What can a chiropractor not do?

Answer 6

they cannot prescribe or administer medications or anesthetics, and they cannot perform internal examinations or surgery, or treat infectious diseases.

Question 7

What does chiropractic treatment stress?

Answer 7

Chiropractic treatment stresses the development and refinement of manual therapies and promotes total body health and individual responsibility for health. To this end some chiropractors will also ascribe lifestyle recommendations such as exercise and nutrition.

Question 8

What are the contraindications for chiropractic care?

Answer 8

Contraindicated in areas where the following occur:

malignancies 
bone and joint infections
acute myelopathy and caudal equine syndrome
fractures and dislocations
ligament ruptures
rheumatoid arthritis
juvenile avascular necrosis
os odontoideum

Question 9

Which condition do chiropractors spend most of their time treating?

Does evidence support it’s use?

Answer 9

lower back pain

pain slightly improves in the short term but no studies to accurately show long term positive results for people with lower back pain

Question 10

does chiropractic care provide any value

Answer 10

the evidence is really weak

Question 11

what are the risks of chiropractic alignment?

Answer 11

There are several possible risks associated with chiropractic treatment. For several years there has been controversy regarding the possible risk of stroke that has been linked to chiropractic treatment of the neck. The author of the text chapter argues that, first, the risk is extremely low, and, second, that the problem may, in reality, be that persons experiencing the early stage of a stroke are seeking chiropractic treatment rather than that chiropractic treatment is causing a stroke.

However, Ernst (2010) came to an altogether different conclusion:

. . . . numerous deaths have been associated with chiropractic neck manipulations. There are reasons to suspect that under-reporting is substantial and reliable incidence figures do not exist. The risks of chiropractic neck manipulations by far outweigh their benefits. Healthcare professionals should advise the public accordingly.

Question 12

How can you determine credible information when given contradictory information?

Answer 12

Such contradictory opinions are a perennial problem when assessing CAM therapies. In such situations it is important to ask ourselves the following question: Which of the authors have the most credibility?

Question 13

How do practitioners of chiropractic usually deal with patients who have cancer?

Answer 13

They do not treat patients with cancer

Question 14

For many years the explanation for how chiropractic works was based on the concept that subluxations are due to misaligned vertebrae. These are manipulated back into line. A more modern concept centres on intervertebral motion and segmental dysfunction. Explain what is meant by this modern concept.

Answer 14

Intervertebral motion and segmental dysfunction assumes that the cause of many disorders (the subluxation) is a loss of proper spinal joint mobility. This means that the subluxation always involves an interruption in the normal dynamic relationship between two articulating joint surfaces.

Question 15

What is the origin of chiropractic?

Answer 15

Chiropractic started with a case report in the 1890s of a janitor in the U.S. being cured of his deafness by Daniel David Palmer performing a spinal adjustment. Palmer then developed the concept of subluxation and founded his chiropractic school.

Question 16

From the perspective of chiropractic what is the key difference between how they treat pain and how conventional physicians typically treat pain.

Answer 16

Practitioners of chiropractic often claim that they treat pain by dealing with the true cause of the problem whereas conventional physicians typically treat pain by supressing the symptoms.

Question 17

Which type of treatment do chiropractors not administer?

Answer 17

medications

Question 18

Define “spinal manipulative therapy” (SMT).

Answer 18

SMT consists of adjustments or manipulations of any portion of the spine using the practitioners’ hands or a machine.

Question 19

Which type of disorder is not treated by chiropractors?

Answer 19

skin infections

Question 20

Discuss the nature of chiropractic care

Answer 20

Emphasizes healing without drugs

It’s practitioners are portal of entry providers licensed for diagnosis and treatment and is limited by procedures and not anatomical regions

Almost 90% of patients see chiropractors for neuromuscular complaints

Must go through a four year chiropractor school before licensing

Deal with neck, back and headache pains as the principle source of complaints

A wide range of countries recognize chiropractors by national health authorities

Question 21

What are the two fundamental premises of chiropractors?

Answer 21

that vertebral subluxation (spinal misalignment causing abnormal nerve signalling) is the primary cause of all disease

Chiropractic adjustment (manipulation of the subluxation) is the cure

Question 22

What is the reason for existence of chiropractors?

Answer 22

the detection and correction of spinal subluxations

Question 23

What do chiropractors believe to be the underlying mechanism of action for chiropractic adjustment?

Answer 23

somatoautonomic reflex is the underlying physiological mechanism where signals that are initiated by spinal adjustment are transmitted through autonomic pathways to internal organs

Question 24

How has chiropractic theory developed over the years?

Answer 24

through observational analysis where new treatments are applied on an intuitive basis and noted some were more effective than others. They then theorized why this was

Question 25

What are the seven fundamental principles of natural healing from a chiropractic perspective

Answer 25

1) humans have an innate healing ability
2) assessing this healing is the goal of healing arts
3) addressing the cause of illness should take precedence over suppressing symptoms
4) pharmaceutical suppression can compromise natural healing
5) natural measures should be used first
6) a balanced diet is crucial
7) regular exercise is crucial to proper body function

Question 26

What do the core chiropractic principles reveal about chiropractic practice?

Answer 26

Although most people associate chiropractic care with pain relief, it’s focus is on correction of structural and functional imbalances which may cause pain

Question 27

What is the difference between straight and mixer chiropractors?

Answer 27

Straight see their approach as subluxation based rather than symptom based and confine themselves to analyzing the spine to fix subluxations. reject heat electrical stimulation

Mixers approach chiropractic care from a symptom based approach and aim to treat both cause and symptoms. Embrace modern technologies such as heat and electrical stimulation

Question 28

What is the bone out of place theory?

Answer 28

Assumed adjustments worked by moving misaligned vertebrae back into alignment, relieving pressure on spinal nerve

allows for free flow nerve impulses

yet radiographs rarely show any discernible changes in spinal alignment

Question 29

What is motion theory and segmental dysfunction?

Answer 29

The dominant chiropractic model of this era

contends that loss of proper spinal joint mobility is the key issue of vertebral subluxation complex.

The subluxation always involves more than a single vertebrae and involves an interruption between two articulating joint surfaces

Question 30

Describe the theory of restricted joint motion

Answer 30

termed a fixation

fixation-subluxations are the easiest form of spinal manipulation

Question 31

What are three signs which point to segmental dysfunction

Answer 31

1) point tenderness or altered pain threshold in adjacent paraspinal musculature of spinner process
2) abnormal contraction within adjacent paraspinal musculature
3) loss of normal motion in one or more planes

Question 32

What is segmental facilitation and it’s effects?

Answer 32

A lower threshold for firing in a spinal cord segment caused by afferent bombardment of the dorsal horn due to spinal lesions.

The effects include local pain or visceral organ dysfunction

Question 33

“the central focus for chiropractic practice is the analytical process for determining…”

Answer 33

1) when and where spinal manipulation therapy is appropriate

2) the type of adjustment most appropriate in a given situation

Question 34

Where is chiropractic adjustment contraindicated?

Answer 34

malignancies
bone and joint infections
fracture
rupture
arthritis
juvenile avascular necrosis
unstable os odontoideum

Question 35

What are the types of manual internets used by chiropractors?

Answer 35

high velocity thrust with recoil
low velocity thrust
flexion distraction
adjustment with mechanically assisted drop-piece tables
adjustment with compression wave instruments
various specific light touch techniques

Question 36

Where do chiropractors practice?

Answer 36

in olympics for sports and workplace injuries

in health care settings

Question 37

How are referrals treated among physicians to chiropractors?

Answer 37

they are rare going both ways

Question 38

What is the diagnostic logic of chiropractors?

Answer 38

they seek to evaluate individual symptoms

trained to take histories and perform physical exams

they produce sustainable balance in a persons health

Question 39

What is the criteria for referring a patient to a physician?

Answer 39

mandate timely referral to a physician when out of the chiropractors scope

After 1 month of treatment if they fail they refer