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

So who is the W.H.O.?

Well - it is actually 'what' is W.H.O. - the World Health Organization. Not only is it a question but a statement as well.

The World Health Organization (or W.H.O.) is the section of the United Nations which is responsible for health advice and policy. It has over 190 member nations. The policies and documents produced by the WHO have included such issues as osteoporosis (refer to articles on the clinic website; www.halifaxchiropractic.ca) but over the past few years the W.H.O. has released documents not only on traditional medicine (TM) but also on complementary and alternative medicine (CAM):

  • W.H.O. Traditional Medicine Strategy 2002-2005 (2002).
  • Traditional Medicine - Growing Needs and Potential; W.H.O. Policy Perspectives on Medicines (May 2002).
  • Guidelines on Basic Training and Safety in Acupuncture (1999).
  • Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials (2002).

W.H.O. and Chiropractic

In November 2005 the World Health Organization released its first document on chiropractic health care entitled "The WHO Guidelines on Basic Training and Safety in Chiropractic".

The objectives of this document were to:

  • To provide minimum requirements for chiropractic education.
  • To serve as a reference for national authorities in establishing an examination and licensing system for the qualified practice of chiropractic.
  • To promote the safe practice of chiropractic.

In Canada, the requirements for chiropractic education are established by the Council of Chiropractic Education of Canada. The CCEC accredits the chiropractic colleges in Canada which currently includes the Canadian Memorial Chiropractic College in Toronto, Ontario and the Faculty of Chiropractic at the University of Quebec at Trois Rivieres.

The process of accreditation is very extensive and ensures that a top level of education in Canada is provided for chiropractic.

From a licensure perspective, the Canadian Chiropractic Examining Board has been in existence for over 40 years. The CCEB creates and oversees the written and practical examinations for chiropractors wishing to practice in Canada. In other words this organization provides National licensing examinations for all of the provinces. Doctors of Chiropractic also have to sit for a provincial licensing examination which deals with the issues related to the Provincial Act, Regulations pursuant to the Act, and all the laws, policies and procedures which apply to chiropractors wishing to practice in a particular province.

As for the issue of safety, chiropractic care is widely recognized as one of the safest and most effective forms of treatment available for conditions such as neck pain, back pain, headaches and whiplash. It is estimated that over 150,000 Canadians are treated by chiropractors every day. Patients who have seen a chiropractor, frequently express their satisfaction with this health care approach, and the results of their treatment.

As a chiropractor, I am often asked "How safe are neck adjustments?". The risk of stroke or stroke-like symptoms associated with spinal adjustments in the neck, is very rare. Research published in the Canadian Medical Association Journal estimate the risk at one in 5.85 million adjustments (Haldeman et al; CMAJ, 2001). Reports on this subject over the past number of years present a range of estimates based on different research methodologies. However all the published studies to date agree that the risk is extremely low. Overall, a ratio of 1 case per million neck adjustments, is generally recognized as a reasonable estimate.

Many patients are not aware there are many risk factors for stroke including blood clotting problems, smoking, high blood pressure, elevated cholesterol levels, use of birth control pills and heart disease. All of these carry a higher risk of stroke or stroke-like symptoms than spinal manipulation or adjustments when performed by chiropractors. If a patient presents with a history of TIA (often referred to as a "mini-stroke"), stroke (CVA; cerebro-vascular accident) or is on prescribed anti-coagulants (or "blood thinners" such as Heparin or Cumadin) I do not recommend utilizing spinal manipulation or adjustments in the cervical spine (neck area). As you can see, it is very important that you ensure that your chiropractor is aware of any health conditions or problems you may be experiencing.

Independent acknowledgement - Worldwide

Dr. Xiaorui Zhang (Beijing, China) is the leader of the Traditional Medicine Team of WHO. Various organizations worldwide received a draft of the chiropractic education guidelines, in which Dr. Zhang indicated that "Manual therapy is one of the most popular used forms of TM/CAM". She further indicates that "Among manual therapies, chiropractic is among the most popular used and some countries already have university education programs set up. For this reasoning, the basic training guidelines in chiropractic were prepared first amongst other manual therapies".

The recognition worldwide is not new and in fact chiropractic has been recognized as the leader in spinal manipulation for many years. In 1979 the New Zealand Independent Inquiry in Chiropractic stipulated this as well.

And this means?

So what does this mean? With any health care procedures, it is important that the professionals utilizing the techniques, are adequately educated and competent to practise. Consequently, these guidelines, are not only very important to the chiropractic profession and health care in general, but also timely -

"They are important to governments and the public they serve as detailed recommendations and chiropractic education that provide the basis for safe and effective chiropractic services. They are important to the chiropractic profession as an independent endorsement from WHO, the world's foremost authority on health policy.." (Source: The Chiropractic Report, January 2006).

Additional information on the guidelines can be obtained from the World Health Organization's website (www.who.int) or the World Federation of Chiropractic (WFC) (www.wfc.org).

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

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