Presentation to ltinsert name of organizationgt ltinsert dategt Presented by ltinsert name of presentergt What is Chiropractic Assessment diagnosis and treatment of neuromusculoskeletal ID: 238194
Download Presentation The PPT/PDF document "Introduction to Chiropractic" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Introduction to Chiropractic
Presentation to:
<insert name of organization>
<insert date>
Presented by:
<insert name of presenter>Slide2
What is Chiropractic?
Assessment, diagnosis and treatment of
neuromusculoskeletal
disorders, primarily through manipulation and other manual therapies
.Treatment & management of conditions resulting from: joint, ligament, tendon, muscle, nerve and spinal disorders; their effect on the body & nervous system.Nutrition, therapeutic exercise, lifestyle & ergonomic counsellingSlide3
Chiropractic Education (CDN)
Two degree-granting, full-time, accredited chiropractic programs:
Ontario:
4 year, full-time program at the Canadian Memorial Chiropractic College following
a minimum of three years of university study.Quebec: 5 year, full-time program at Université de Qu
é
bec a
Trois Riviéres following graduation from CEGEP. Multidisciplinary faculty and training: anatomy, biochemistry, biomechanics, physiology, neurology, radiology, immunology, microbiology, pathology, clinical nutrition and clinical sciences specifically relating to diagnosis.Slide4
Chiropractic Regulation
Chiropractic is a regulated health profession:
Legislated scope of practice in all Provinces/Territories; controlled act of manipulation
Provincial regulatory colleges charged with licensing, continued competence and public protection
Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards (CFCREAB) provides a national forum for the provincial collegesThree
standardized national exams (clinical competency and written cognitive)
plus
licensure exam conducted in province of practice.Slide5
Chiropractic Facts
Canadian practitioners:
7,800
Utilization: 4.5 million Canadians/year
Average patient load/week fulltime DCs (2011 CCRD):
111
Average fee /visit:
$40 to $45Most common conditions treated: musculoskeletal injuries & complaints (87%)Slide6
Health Plan Coverage
Covered by some provincial health care plans.
Widely covered under extended health care plans with majority of plans providing coverage of at least $500 per annum*.
Covered by all Workers Compensation Boards and most automobile insurance plans.
Included in federal programs, e.g. Veterans Affairs, RCMP etc.Slide7
Chiropractic & WCB
All provincial Worker Compensation Boards utilize chiropractic to treat injured workers.
Data consistently illustrates chiropractic’s high effectiveness in getting injured workers back to work.
Other findings with WCB chiropractic patients*:
Reduced time to care - average time to treatment 3 daysReduced chronicity - 11% required care beyond 12 weeks Earlier return to work - median lost time 9 days
*Ont. WSIB 2003 Program of Care Evaluation for Acute Low Back InjuriesSlide8
Scientific Support
Six formal government reviews (worldwide). All concluded that contemporary chiropractic care is safe and effective.
Canadian Institute for Health Research partnerships with The Canadian Chiropractic Association to provide grants for chiropractic research.
Canada Research Chair in Spinal Function awarded to Dr. Greg
Kawchuk, DC.Slide9
Diagnosis
Trained and licensed to perform differential diagnosis:
Clinical history, MSK assessment, posture/
palpatory
examination, radiology if indicatedIs this musculoskeletal (not pathological)?What is the specific functional disorder? Slide10
Chiropractic Treatment Modalities
Manual Care:
Adjustment (90%), mobilization,
myofascial
release techniquesInstrument assisted soft tissueExercise:Instruction and/or supervision (75%)
Rehabilitation
Adjunctive Therapies:
Ultrasound, TENS, IFC, laser etc.Ice, heat, massage etc.Acupuncture Education:
Condition specific: lifestyle
, ergonomics
, nutritionSlide11
Indications for Referral
Back pain/sciatica
Neck pain
HeadacheRepetitive strain injuries
Myofascial
pain syndromes
Conditions of the extremitiesSlide12
Treatment Goals
Acute Care:Relieve pain
Reduce muscle spasm and inflammation
Increase flexibility
Restore function and range of motionReturn to normal activities of daily living as quickly as possibleSlide13
Treatment Goals
cont’d
Rehabilitation
Stabilize
Increase strengthMaintain flexibilityPreventionCorrect habitsErgonomic modificationMinimize recurrencesSlide14
Distribution of Complaints
Duration: 50% < 3
wks
; 25% >12
wks
Onset: 26% significant
trauma
Shekelle et al. Ann Intern Med 1998Slide15
Back Pain
Most common condition treated.
According to the Institute for Work & Health, low back pain affects 85% of the working population and is a leading cause of disability and absence
.*
*Cassidy et al, Spine 1998Slide16
UK Beam Trial (2004)
“…this is the first study…to show convincingly that both manipulation alone and manipulation followed by exercise provide cost-effective additions to best care [for low back pain patients] in general practice.”
BMJ
, Nov. 19, 2004Slide17
Legoretta
et al (2004)
Benefit plan members with chiropractic coverage vs. members without; 4 year study of low back pain related claims.
With chiropractic care:
Reduced utilization of radiographs and MRIReduced hospitalizationsReduced surgeryReduced costs
Legoretta
et al. Arch Int. Med 2004Slide18
Expert Reviews
U.K. Clinical Standards Advisory Group 1994:
recommends manipulation with exercise and physical activity for low back pain.
New Zealand Acute Low Back Pain Guide 1997:
includes manipulation as appropriate treatment for acute low back pain.Slide19
Expert Reviews
cont’dDanish Institute for Higher Technology Assessment 1999:
adjustment is indicated for management of acute, recurrent and chronic low back pain.
Ontario WCB Guidelines for Chronic Pain 2001:
adjustment more effective for chronic low back pain than usual care, bed rest, analgesics or massage.Slide20
Neck Pain
Prevalence:*
Lifetime 65%
Chronic 10%
Cochrane review of spinal manipulative therapy and mobilization for mechanical neck pain: Multi-modal care (SMT/Mobs) plus exercise is more effective than physiotherapy or usual care.*
* Cote et al. Pain, 2004
* Gross et al. Spine,
2004Slide21
Myofascial
ConditionsTension headache with myogenic trigger
Sports injuries
Repetitive strain injuries
Whiplash and whiplash associated disorder injuriesSlide22
Adverse Affects
Short-term muscle soreness or stiffness
Rib fracture
TIA/dissectionSlide23
Risk Rates
Serious adverse events associated with cervical manipulation are rare:
Estimates vary
One to two events per million cervical
adjustmentsThere was an association between chiropractic visits and a similar association observed among patients receiving general practitioner services. This is likely explained by patients with vertebrobasilar artery dissection-related neck pain or headache seeking care before having a stroke.
Meeker WC,
Haldeman
S. Annals of Internal Medicine, 2002Rothwell DM, Bondy SJ, Williams JI. Stroke, 2001Herzog W, Symons BP, Leonard T. Journal of Manipulative and Physiological Therapeutics, 2002 Haldemann et al. Spine 2008Slide24
What to expect when referring
Musculoskeletal physical examination and diagnosis
Radiology – if necessary
Informed consent to treatment
MD communication (initial, update, discharge)
Referral back if no progress, contraindications to care or pathologies
Outcomes-based therapySlide25
Benefits of Collaborative Care
Continuity of care
Timely assessment, treatment and reporting
Network with other providers
Patient satisfaction