The Chiropractic Difference. As a Doctor of Chiropractic, I am often asked how Chiropractic is different from other types of Therapies.
Medical Doctors and other Primary-Health Practitioners:
The course of study of Chiropractic is similar to that of other doctoral-level health care professionals, including medicine, optometry and dentistry and have similar entrance requirements.
While MDs spend more classroom hours studying the subjects of pathology, pharmacology, pediatrics, gynecology, psychology, obstetrics, and geriatrics, Chiropractors spend more classroom hours studying anatomy,
radiology, neurology, orthopedics, physiology, diagnosis and nutrition.
There are differences in the Medical and Chiropractic Models of Care.
Osteopathy:
In Ontario, the practise of manual osteopathy is not currently recognized as a regulated health profession under the Ontario Regulated Health Professions Act, 1991, or any other legislation.
There is no law that defines a scope of practice for osteopathy.
While Chiropractic and Osteopathy originally shared many similarities in their origin, one can use the designation Osteopath after studying anywhere between 6 months and 2 years, depending on whether a diploma or degree is obtained.
Osteopaths focus their treatment on the spine and in particular the Cranial-sacral regions, Visceral normalization and Fascial release using a light, intentional contact. Osteopathy works under the premise that the cranium, as well as all the other tissues and systems of the body, are in constant motion.
Like Chiropractors, Osteopaths are also trained in using gentle joint mobilization techniques. Unlike Chiropractors, Osteopaths rarely using physical therapy modalities and use less manual manipulation in their treatment.
Physiotherapists:
Spinal manipulation requires a high degree of skill to perform safely:
While Chiropractors receive 1300 hours of internship in clinical hours with patients to develop their spinal manipulative skills, Physiotherapists require only 150 hours of mentorship prior to certification.
Spinal manipulation is a controlled act and requires a high degree of skill and knowledge and experience to perform safely.
In Ontario, Schools of Physiotherapy do not train Physiotherapists in the art of spinal manipulation, only in manual therapy.
Recognizing that the research has increasingly demonstrated that Spinal Manipulation is an effective form of treatment for both neck and lower back disorders, they were sure to include it in their scope of practice since 1925.
It is only since September 2007 that a Masters of Clinical Science program in Manipulative Therapy was created at the UWO, whereby a Physiotherapist can learn how to manipulate the spine with any degree of confidence. Only 302 of the 8807 Physiotherapists in Ontario have this special post-graduate training.
The CPO requires that they must be able to prove that they have successfully completed this additional training and are Fellows of the Canadian Academy of Manipulative Physiotherapy (FCAMPT).
As of March 31, 2012, physiotherapists must enter themselves on a roster that the College of Physiotherapists of Ontario keeps, that lists the physiotherapists who are permitted to perform spinal manipulation.
In April 2013, the Journal Canadian Physiotherapy published an article that revealed that Physiotherapists trained in Spinal Manipulation stated that using spinal manipulation led to quicker patient discharge (meaning that patients improved more quickly) and that spinal manipulation does not create any more adverse effects than more gentle spinal mobilization techniques.
Physiotherapists trained in Spinal Manipulation are less confident than Chiropractors in carrying out Spinal Manipulation:
Physiotherapists admit that they have little evidence about serious adverse events following neck manipulation because these events are rare.
Interestingly, Physiotherapists, even with special training, only adjust the upper cervical spine 2.0% of the time and the mid-cervical spine 10.0% even though clinical reasoning may suggest manipulation is the best choice.
They found that more experienced practitioners adjust the neck more often and female practitioners are less likely to do so than their male counterparts.
In deciding the risk vs benefit of this form of treatment, the study stated that the “skills of the physical therapist may be a limitation for the selection of manipulation as a treatment technique” and “it would, therefore, be a responsible decision to not use manipulation”.
Even after their required post-graduate training, most Physiotherapists lack confidence in adjusting the neck and the study suggests that “Referral to a colleague suitably qualified/trained in the desired manipulative technique may be appropriate”.
In other words, Physiotherapists should be referring many of their patients to Doctors of Chiropractic for spinal manipulation.
Chiropractors are specialists in manual manipulation/mobilizations of the spine and other joints. You can trust Dr. Horowitz to provide evidence-informed, safe and effective health care.
For the highest quality of care, contact My Toronto Chiropractor Health Clinic at (647) 349-4909 to book your appointment or ask Dr. Horowitz a question by completing the form below: