Frequently asked questions

What is Chiropractic?

Chiropractic is an applied health science, philosophy and technique developed over centuries to diagnose and treat the spine and extremities, to remove the physical restrictions that limit healing. Treatment often consists of adjustments or manipulations to the body to improve alignment and motion. Other modes of treatment include heat, cold, traction, massage, stretching, exercise prescription, mobilizations, dietary advice and referrals when needed.



What training do Chiropractors have? Is it a licensed profession?

The length of a chiropractor's training is very similar to the training of a medical doctor. Both need to have gone to university for undergraduate studies. Initially the training is very similar with both groups taking courses in anatomy, biochemistry, physiology, neurology, developmental anatomy, pharmacology and toxicology. The courses differ in some ways in the later years of their training. Medical students take classes on surgery and concentrate further on drugs, while chiropractic students learn more x-ray interpretation, physical diagnosis and treatment. Chiropractic college is 4 years long with about 4000 hours of student/faculty contact. Drs. Leo, Paul and Matthew all went to the prestigious Canadian Memorial Chiropractic College in Toronto, Ontario.

After graduating, chiropractors have to pass a registration exam before qualifying to practice. In Ontario, the registering body is the College of Chiropractors of Ontario. We are all in good standing with the licensing board. Dr. Leo Rosenberg is a past president of the College of Chiropractors of Ontario. In Ontario chiropractors are governed by the Chiropractic act and the Regulated Health Professions act which are both provincial legislation.



What is Spinal Traction, and Spinal Decompression and what is the difference?

Spinal traction is a continuous or intermittent pull/force on the spine in an attempt to cause elongation. When traction is applied the spine's muscles react and pull back, often very unpredictablly. The pain relief with traction is usually incomplete, inconsistent and temporary.

Spinal decompression is an improvement on traction because the computer controlled tables have the ability to vary the pull intensity according to the tension in the patients spine in very small increments. The pull ramps up slowly, holds and releases according to a computer controlled program that is designed to overcome the body's natural reaction to fight the distraction.



What is bad and good posture and how can we help?

Posture is simply the relationship of your different body parts to each other and our relationship to outside factors. Good posture is keeping your body, limbs and head in an optimal position to most efficiently do what we want to do. This ideal position varies by activity and the duration you will be in that position. For most activities the strongest force we are challenged by is gravity. The best posture to fight gravity is when we can balance our bones directly on top of each other and just make small muscular adjustments to keep us balanced. At the Rosenberg Chiropractic Clinic, your posture and movement will be assessed. The most frequent problem is having a pelvis that is tilted forward. This causes an exaggerated sway in the lower back, a hunch in the upper back and carrying you head in a poked forward position. This is a perfect example of the bones not being stacked on top of each other and then you need to firmly contract your muscles to support your body. The most frequent complaint this causes is shoulder muscle tightness and pain.

Once this posture becomes set, it becomes almost impossible to correct it without professional help. The sensation most people describe is the inability to hold their upper body up in proper posture that after staying erect for a few minutes there upper body starts to drop into their old and bad posture again. This can be treated. You acute care starts with a number of treatments designed to improve motion and alignment. Once these tight joints remain mobile, then you graduate to rehabilitation care that consists of exercises to improve posture and continued adjustments to ensure your body relearns proper movement patterns.



What is stress and can Chiropractic help?

Stress is the body's and nervous system's reaction to physical and mental stimulation. It occurs when a stressor is large enough to change the resting state of any cell, organ or system in the body. Problems start to occur when the stressors and resulting stress are severe or chronic. This causes energy depletion and if the stressor is not removed it causes localized cellular or organ death. Good examples of chronic stressors are alcohol killing liver cells in an alcoholic or nicotine and caffeine decreasing blood flow to spinal muscles. Acute stressors are things like a sunburn damaging our skin cells or a car accident. In these examples, if you remove the stressor (alcohol, sun exposure, trauma or caffeine and nicotine) before cell death occurs and do what is necessary to aid healing then the cells can recover or heal.

Not all stress is bad. Exercise is a form of stress. When you push your body during exercise you damage the muscle cells. This makes you weaker. It is after exercise, when you are getting appropriate rest that your body not only repairs the damage, but supercompensates and makes you stronger.

Spinal stresses include poor posture, traumatic injuries, lack of muscular strength, specific misalignments, poor movement patterns, not enough rest, performing activities that the body hasn't adapted to, obesity, scoliosis, poor nutrition, trauma and bad exercise habits. Chiropractors get to know you as a person. We speak to you about your diet, your exercise habits, your work posture and history of injury to determine what needs to be done to help with the healing. We assess your body and see how your body has adapted to stresses improperly. We provide treatment to help the body help decrease the physical manifestations that have accumulated from years of poor healing after multiple stressors.

A Montreal Physician, Dr. Hans Selye, developed much of the modern concept of stress.



Can chiropractic help arthritis?

The two main types of arthritis are degenerative arthritides like osteoarthritis and inflammatory/autoimmune arthritides like rheumatoid arthritis that after the active inflammatory period is over will morph into osteoarthritis.

The most common causes of joint degeneration are too much motion, not enough motion and improper alignment causing unbalanced forces in the joint. I will address these individually.

Too much motion or hypermobility is common after trauma or chronic tightness in adjacent joints. If untreated, the laxity causes arthritis as the joint capsule and ligament calcify and damage to the articular cartilage around the margins of the joint occurs. Misalignment is very common with hypermobility. Very light adjustments to the hypermobile joint may be necessary. Much of the treatment is often aimed at improving the motion of adjacent joints, as this allows the hypermobility to decrease over time because the hypermobile joint isn't being forced to move beyond it's normal range of motion. Exercises are prescribed once the adjacent joints continue to move properly.

Too little motion or hypomobility has many causes. New and old trauma and poor posture are the most common. Misalignment is very common with hypomobilty. The articular cartilage has a poor blood supply. When a joint isn't moving, the fluid inside the joint becomes stagnant and full of waste products. Motion is needed to cause the exchange of old and spent fluid with oxygen and nutrient rich, fresh fluid. Without the fresh fluid the cells in the cartilage can't maintain the cartilage and the cells may become so stressed by the lack of nutrients that the cells may die. The cartilage will gradually get thinner and thinner causing arthritis. Chiropractic manipulation or mobilization with exercise can restore proper motion to these hypomobile joints. The groundbreaking theories that hyper- and hypo- mobility cause arthritis were proven in 1980 by a Toronto orthopedic surgeon, Dr. R Salter.



Is Chiropractic safe? How safe are the alternatives? Comparing the Risks.

Nothing in life is without risk. When choosing health care, one determining factor should be safety.

The most publicized risk of chiropractic manipulation is the risk of a stroke. In 2001 a Canadian Medical Associations journal article by Dr Haldeman and Dr. Carey found that the statistical risk of having a stroke from an adjustment is 1 in 5.85 million. More pessimistic studies estimate the risk of stroke at 1 in 500,000.

One option is drugs. Are they safe? Regarding NSAID's, quoting from a large meta-analysis in the British Medical Journal "little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms." http://www.bmj.com/content/342/bmj.c7086
To quote the American Journal of Gastroenterology "estimates attributable to NSAID's have widely varied from 3,200 to higher than 16,500 deaths per yr in the United States" or 1 in 25, 000 to 1 in 100,000. http://www.nature.com/ajg/journal/v100/n8/full/ajg2005305a.html
And Tylenol (acetaminophen) is quite toxic to the liver. Journal of Pharmacology http://jpet.aspetjournals.org/content/187/1/211.abstract
Opioids like codeine and percocet killed 13,800 people in the USA in 2006 according to the CDC http://www.cdc.gov/nchs/data/databriefs/db22.htm That is about 1 to 25, 000.

Another option is surgery. In rounds that I attended at Sunnybrook Hospital in 1994 an orthopedic surgeon remarked that the death rate for spinal surgery was about 1 in 500.

So, is chiropractic safe? Unfortunately not completely, and it is tragic to the individual and their family in the very rare event that a chiropractor causes a stroke. Is chiropractic safer than the medical alternatives? Yes! I invite you to be skeptical and look at the studies and articles for yourself. Look at the statistics then choose chiropractic - the safest choice.



What is health and wellness and how does chiropractic fit in the picture?

Health is the optimal physical, mental, spiritual and social well-being and not merely the absence of disease. We are adaptive beings and constantly are being challenged by our physical and social environments. We constantly need to be working to keep the negative influences, whether physical or social to a minimum. Just as importantly, we must strive to have as many positive factors in our lives. Neither the positive or the negative are constant. Our needs change. Our lives need to change with the changing demands.

Most of the factors that relate to our level of health are habitual. Exercise, diet, keeping positive people around you, spiritual self-care, and control of one's emotions are all great examples. Go through that list - Ask yourself 'Are my exercise habits as good as they can be? Do I challenge my body? Do I rest appropriately? Is my diet healthy - low fat, caffeine, alcohol, white sugar, processed foods and high in nutrients, real food, minimal preservatives and in the proper quantity for me? Are there too many people around you that drag you down? Can you minimize their effect on you?

The mental aspect is equally habitual. How we react to most situations is a habit. We are on autopilot. Why? We are able to control our feelings and reactions but usually don't. Why don't we try to react in a more positive and appropriate manner, rather than just letting our emotions go? Laziness and that we haven't learned to put things in perspective. Things that upset us don't really matter. When you are getting upset, ask yourself 'Will this matter next year?'. If not ask yourself 'Is this really worth getting upset by?'. Most of the time it isn't.

We can help, too. Another factor in health is spinal health. If you have misalignments and improper movement it causes pain and local irritation. If they are significant enough the spinal nerves can become irritated. When a nerve becomes irritated, the organs that nerve controls won't function well. Skin becomes dry and numb. Muscles become tight and weak. Blood flow becomes restricted as the blood vessels become smaller due to activation of the smooth muscle in the artery or venous walls. In a child, growth may become asymmetrical. Changes in digestion can occur through somato-visceral connections with the autonomic nervous system. An increase of stress related hormones is extremely common in people with nerve irritations.



Do children need Chiropractic care?

Yes. If you think of all of the physical challenges that kids go through, it is amazing that more of them don't have serious problems.

Infants During a normal birth, think of the physical forces that a very weak, little infant has to endure. It is a hard enough event on the woman. The head and neck of the infant lead the way, having to put up with a large amount of compressive force. Arms and the head are grabbed to help drag the infant out of the birth canal. This can cause trauma. How does an infant tell you that they have a sore neck - they cry and cry. The doctors often mis-diagnose the child as having colic. They have a spinal problem that can often be treated with very gentle chiropractic techniques.

About three months later they are straining their developing neck muscles as they learn to support their heads. Parents often carry kids of this age in inappropriate upright carriers without neck support - these infants don't have the bony or muscular strength to support their heads. This can could cause an asymmetry in spinal development. Neurologically the nerves in the baby's neck are developing at this time as the infants are discovering their hands at this time - grasping and manipulating - further spurring neurological development

Starting at about nine months, the lumbar curve is developing along with an increase in development of the lower back and leg nerves. The infant will start standing and progresses to walking. How many hundreds or thousands of times do toddlers fall. It would be shocking if some of these falls didn't cause spinal problems that would benefit from chiropractic treatment.

Sports injuries and falls, poor posture, school chairs, and asymmetrical growth all need to be managed. An old saying is 'As the twig is bent, so grows the tree'. We feel that many, many of the adults that we treat for chronic problems would not need the care we are providing if they had corrective care when they were children. Another chiropractor I know sarcastically says 'Go ahead and leave your children at home, so they can enjoy their problems for the rest of their lives'.



Once someone starts Chiropractic Care do they have to continue?

No, starting to see a chiropractor doesn't mean you have to continue for the rest of your life. What recommendations we make for your care depends on what is wrong with you. We take a thorough history, do a physical examination and possibly take x-rays all to come up with a diagnosis of your problem. We then recommend a plan of management. We rarely make long-term recommendations at this time, as we don't know how you are going to respond to our care. Some people respond quickly, some slowly. Typically we treat frequently during the initial acute care phase of treatment. In the rehabilitation phase treatment is tapered in frequency as the patient improves and as we are able to prescribe appropriate exercises. Despite proper care, some people just don't get fully better and need ongoing supportive care to keep them as well as they can be despite the underlying condition. Some others get fully better but the misalignment and improper motion recurs which necessitates maintenance care.
In most cases a patient is able to safely discontinue care at any time. They may not reach maximum therapeutic improvement by stopping early, but there is almost no danger in stopping at any time. The long-term danger to not continuing while you have poorly functioning joints is that the poor motion and alignment will cause arthritis (see arthritis FAQ for more details).



What are foot orthotics?

Orthotics are a useful and sometimes necessary clinical tool for changing a patients foot biomechanics. Sometimes a foot problem like a fallen arch will cause a twisting in the lower leg that can cause problems all the way into the lower back. Many people have one leg that is just a little short than the other. This can cause a spinal curvature. Treatment might include an orthotic with a small lift under the heel to restore the proper balance. We prescribe orthotics here at the Rosenberg Chiropractic Clinic. We work with several orthotic labs that offer different orthotic materials and purposes for the orthotic.



Do I need a referral to see a Chiropractor?

No referral is needed to see a chiropractor. Chiropractors receive four years of training in diagnosis and are primary care providers. Most of our patients are referred in by a mix of health professionals and patients.



Do Chiropractors work with other health professionals?

Yes. We are more than happy to treat a patient who is also seeing a MD, registered massage therapist, acupuncturist, naturopath, physiotherapist, etc. The exception to this is if the treatments are working at opposite purposes, but this is very rare. We, the chiropractors in the office very commonly share patients with Paul Kirpal, the massage therapist and acupuncturist in the office. We are more than happy to communicate with other professionals to coordinate treatment. A mix of health professionals and patients are the source of most of our referrals.



Is it safe to see a chiropractor if I am pregnant?

Yes. We have treated many pregnant women safely and effectively. Treatment is frequently for back pain and sciatica. Studies have shown that chiropractic treatments decrease the length of labour and these women experience less back labour than women who haven't been adjusted. Of course we have to modify treatment according to a patient's weight and size.



What is the popping sound during an adjustment?

Adjustments do not always produce a sound. Often adjustments do create the "popping" sound. The sound is caused by gas rushing in to fill the partial vacuum created when the joints are slightly separated. This sound is painless and totally harmless.



Can I adjust myself?

Usually not. A chiropractic adjustment is quite specific. The amount of force and direction of thrust is quite specific and varies from patient to patient. The adjustment is focused on the level that is misaligned and moving poorly. When a person twists a body part rapidly, they may get a popping sound and a temporary reflex relaxation but that isn't a specific adjustment. That person is most usually just moving whichever joint is already loosest. This can cause instability and hypermobility.



What is Massage Therapy and how does it work?

Massage therapy, also known as Swedish massage, is the most common form of massage therapy in Canada. Massage therapists use long, smooth strokes, kneading and other movements focused on superficial layers of muscle using massage oil or lotion.

Massage therapy improves circulation by bringing oxygen and other nutrients to body tissues. It relieves muscle tension and pain, increases flexibility and mobility, and helps clear alctic acid and other waste, which reduces pain and stiffness in muscles and joints.



What is Acupuncture and how does it help?

Acupuncture is an ancient form of Chinese medicine involving the insertion of thin, solid acupuncture needles into the skin at specific points on the body to achieve a therapeutic effect. No drugs are injected. The needling of the specific points provide the therapeutic benefit. Acupuncture encourages natural healing, improves mood and energy, reduces or relieves pain and improves function.

Acupuncture points are points of lower electrical resistance that have been mapped centuries ago by the Chinese. Most are along meridians or channels along which the energy or Qi (pronounced 'Chee') flows. These points are stimulated for 15-30 minutes.



What is Moxibuustion and Acupressure?

Moxibustion is the increased stimulation by lightly heating the needle with a little burning peice of Mugwort (Artemisia Vulgaris). Acupressure is the application of pressure to the acupuncture points, using fingers or thumbs.