Should we do something different?

by Dr. Brian S. Seaman, DC, FRCCSS(C), FICC

Neck pain, back pain, headaches, whiplash - all very common conditions - and for many, all too familiar problems which can affect your daily activity level.

There are many types of treatment for these conditions - or what health care professionals refer to as "presenting complaints". Chiropractic care, physiotherapy, massage therapy and pharmacotherapy (medications prescribed by your family physician) are all approaches which are commonly used for these conditions. However, there are an increasing number of the general public who are consulting with chiropractors for these types of problems and others. In fact, the percentage of Nova Scotian's who are utilizing chiropractic care has doubled over the past five years.

There are many reasons for this increased utilization:

  • Chiropractic care is non-invasive.
  • Chiropractic care is drug-free.
  • Chiropractic care is a hands-on approach.
  • Research has shown that chiropractic care is effective and cost-effective for many musculo-skeletal conditions including neck and back pain.

Regardless of which approach you decide to take, there should be an active component to your treatment protocol - in other words, that means exercises!

Obviously some conditions respond better to certain approaches than others. When you consult with your health care professional, you should always have them explain the following:

  • Explain your condition in terms you can understand. For instance, could you repeat it back to your health care professional, or explain it to your spouse, family member or friend?
  • What type of treatment is being recommended? Do you understand this approach that is being recommended?
  • Are there any other approaches that should, or could, be considered? Or used in conjunction with the treatment being recommended.
  • Finally, what is a reasonable time frame to expect your condition to respond to the condition being recommended? This is a very important question as it may have implications with respect to how you wish to approach your health care. Every health care professional should be able to provide you with a reasonable estimation of the amount of time, number of treatments and type of treatment which will be necessary for your particular problem.


Communication with your health care professional is essential. There is no doubt that a lack of clear and understandable explanations, or a breakdown in communication, can lead to difficulties. Never feel 'bad' about asking a question. It is important that you understand what your condition is, and what types of treatment would be most appropriate. Also be cautious as to using descriptors other than what has been used by your health care professional. Unfortunately, there are situations which arise, in which an explanation is not clearly understood, or perhaps an off-the-cuff comment or descriptor, used by your health care professional, 'sticks in your mind'. I have had a number of patients over the years, present to the clinic and describe their condition or injury in a manner which is not reflective of how it occurred, their examination findings or their x-rays.

Types of Treatment

With chiropractic care, the primary approach to treatment is specific chiropractic manipulation techniques (also known as 'adjustments') which are performed manually. In addition, your chiropractor may use modalities (ie. muscle stimulation or ultrasound), as well as recommend 'homework' such as ice therapy, exercise prescription, lifestyle changes, weight reduction, dietary changes and ergonomics (for the workplace); just to name a few.

Your chiropractor will also recommend a plan of management for your treatment with respect to frequency of care as well as duration of care during which time a response to treatment should be evident.

At times, there will be situations in which your chiropractor or another health care professional may recommend what is referred to as a 'therapeutic trial'. A therapeutic trial is a short course of treatment during which time your condition is evaluated as to whether it responds. By 'responding' this does not refer to your problem resolving completely, but rather see if it responds in a favourable or positive manner.

Other Approaches?

There are times when a condition has multiple factors which have to be dealt with. For instance with lower back pain, your condition may be related to structural changes (ie. degenerative disc disease, osteoarthritis or osteoporosis; refer to other articles on the clinic website for more indepth discussion about these), mechanical problems (related to how the joints are moving), and perhaps postural muscle weaknesses or imbalances (this is quite often noticed on examination and for which postural exercise program is prescribed).

Other types of approaches may include a functional assessment by a physiotherapist and designing a work conditioning program. Massage therapy, acupuncture and orthotics (customized arch supports) may also be utilized at times.

Reasonable Time Frame?

As was indicated earlier in this article, your health care professional should be able to provide a reasonable estimation as to the frequency and duration of your treatment. Periodic examinations may be scheduled in order to fully evaluate your progress and determine if additional treatment or follow-up care is clinically indicated.

If your condition is not responding as you had anticipated, be sure to discuss this with your health care professional. It may be that your condition has been developing for a number of months or perhaps even years, in which case it will obviously take longer to respond. Talking with your health care professional about your response to treatment, also allows an opportunity to clear up any misunderstandings which may have developed with respect to your condition as well as discussing if something different should be considered.


Reprinted with permission of
The Seniors' Advocate. P.O. Box 5005, Waverly, Nova Scotia, B2R 1S2

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