Chiropractic @ Small Street

CHIROPRACTIC @ SMALL STREET
 
To those accessing our website:
Millions of Australians have received chiropractic care over the past 100 years. Chiropractic has been a registered health care profession in Australia for over 40 years. Accordingly, as with all registered health care professions, in order to protect the public and ensure the highest quality health care to all Australians, the practice of chiropractic health care is governed by federal legisltation. All registered chiropractors in Australia are required to complete a 5 year undergraduate university health sciences degree.
However, there are still many myths concerning chiropractors and what they do. The reasons for this is myriad, so we thought we would answer a few commonly asked questions about our profession. Please take the time to peruse this information at your leisure and if you have any questions, feel free to email us.
We are aware that our website is actively trolled by anti-chiropractic fundamentalist bigots who are shamefully hiding themselves behind the cover of “science” to attack our profession. Why are they not using science to investigate empirical observations that chiropractic management of certain health disorders are at least as beneficial as other therapies? Why are they not referring to scientific studies that are confirming these conclusions and are leading to the evidence-based evolution of the chiropractic profession? One can only assume these bigoted trolls represent certain “cartels” and are really interested in elimination of all competition within the health care space.
-Paul Noone and Tony Cassis
 
FREQUENTLY ASKED QUESTIONS ABOUT CHIROPRACTIC
At present, two chiropractors practice at Small Street Clinic providing chiropractic services:

Dr Paul Noone

Dr Paul Noone B.App.Sci (chiro), PhD
Registered Chiropractor, Chiropractic Board of Australia
To learn more about Dr. Noone click here
For a full, complete and factual CV on Dr Nooneclick here.
 


Dr. Tony Cassis

Dr Tony Cassis, B.App.Sc (Comp Med-Chiro), M.Clin.Chiro, ICSSP
Registered Chiropractor, Chiropractic Board of Australia
To learn more about Dr. Cassis click here
For a full, complete and factual CV on Dr Cassisclick here.
 
 
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1. What is Chiropractic? Where did it start?
Chiropractic is one of the oldest healing professions in Australia. The first chiropractors commenced practice in the United States in the 1890s and chiropractic was brought to Australia in the early 1900s. In the early years, chiropractor’s used only their hands to administer spinal manipulation (called the spinal “adjustment”) to help their patients.

 

Patients presented for chiropractic care for a range of health reasons, and found relief from many of them. At this time chiropractic (as well as many other professions such as physiotherapy and psychology) was not a registered health care profession as it is now. There was no university training for chiropractors in Australia. If you wanted to become a chiropractor, you needed to undergo a 4-year university-level course. In these early years, chiropractic care was much more simple, with simple explanations about how spinal adjustments were helping patients. But remember, antibiotics had not been invented, painkillers were not refined, and there were no anti-inflammatories available. Advanced information about human health had not been discovered at this time. The term “Evidence-based health care”  had not been coined.

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2. How do today’s 21st Century Australian chiropractors practice?
Since these early times, chiropractic has evolved into a government-registered health care profession in Australia. There are almost 4,000 registered chiropractors in Australia, all of whom have been required to undergo 5 years of university training to become registered health care professionals.
 
The majority of chiropractors embrace modern evidence-based explanations for their diagnoses and treatment plans. The required five years of training plus subsequent registration allows chiropractors to diagnose and treat a range of neuro-musculoskeletal conditions.
These include:
  • Acute and chronic pain conditions
  • Advice and treatment of work, sports and recreational conditions
  • Advice and treatment of spinal, arm, pelvic and leg conditions
Chiropractic treatment modalities have evolved over the past 100 years, as have most health care professions. Chiropractors are leaders in the field of spinal manipulation, and have made it a priority to evolve treatment techniques for their patients that are more gentle and safe. A modern chiropractic treatment table is vastly different to those used 100 years ago. Chiropractors use a variety of treatment tools to treat those patients not suitable for manual spinal manipulation. Chiropractors have an improved understanding of spinal and body biomechanics through research and practice; they understand how ergonomics, exercise, rehabilitation, nutrition and general wellbeing all play important roles in your health.

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3. Are today’s chiropractors University trained?
Yes, Chiropractors in Australia have been University trained since the mid 1970s. Chiropractors are required to undergo 5 years university training before they can become registered with the Australian Health Practitioners Registration Agency (This is the Government agency that registers all health professionals such as medical doctors, dentists, nurses, psychologists etc.) There are four Universities in Australia where accredited undergraduate Chiropractic Health Science degrees are provided. Chiropractors are registered as primary care practitioners in Australia (you do not need a referral from you GP). The 5 year university degree trains registered chiropractors to diagnose and treat many neuro-musculo-skeletal conditions without drugs or surgery, and appropriately refer you to other health professionals if your problem requires assistance outside the scope of practice of your qualified chiropractor.

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4. Do Chiropractors undergo post-graduate training? Are there Chiropractic specialists?
Many chiropractors undergo postgraduate university or university-level research or clinical training.  This means that some chiropractors may have a PhD (as does Paul Noone), or MSc (as does Tony Cassis) indicating they have reached the highest University research standard. Other chiropractors may have accredited professional clinical post-graduate qualifications in areas specific to chiropractic practice including radiology, neurology, paediatrics, orthopedics, sports rehabilitation etc. Even though these chiropractors have studied and passed rigorous examinations in their post-graduate fields, and may achieve specialist recognition in other jurisdictions around the world, at this point in time they are not permitted by AHPRA to call themselves “specialists” in post-graduate fields they have studied.
Hopefully this situation will be addressed over the coming years. The physiotherapy registration board, for example, appears to be ignoring AHPRA regulations, and is actively encouraging those physiotherapists who are using the term “specialist” within their advertising material. As chiropractors eligible for specialist recognition, we feel this move by the Physiotherapy Board is hopeful for our profession.

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5. What happens at my first chiropractic consultation?
Like all trained and registered health care professionals, we will first “take a history” from you. This means we will sit down and let you tell us your story about your condition or pain. As you tell us more about your problem, we will ask you more specific questions, narrowing down the cause, or finding out about other aspects of your life that might be contributing to or causing your condition.
We will then examine you. We might test how well you can bend and move your spine, test the strength of your muscles, do some testing of your reflexes. Chiropractors are well trained to conduct and interpret standard orthopaedic and neurological tests on you. If your chiropractor deems it necessary, you might then be referred for X-rays, CT scans, or MRI. During our initial consultation we are gathering information to determine how best to treat your complaint with our chiropractic treatment methods. However, chiropractors are trained to act as a portal of entry into the health care system. Some patients are surprised to see a chiropractor take blood pressure or pulse rate as well as a general examination of your nervous system or muscles and joints. As part of the Australian health care team, we have a duty of care to assess your general health, and refer to other health care providers if necessary. If you tell your chiropractor you have facial pain, and s/he feels it is a dental problem s/he will refer you to your dentist. If you are complaining of pain behind your eyes, you may need to see your optometrist. Your chiropractor is continually assessing your health, and determining where s/he can serve you best.

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6. What kind of chiropractic treatment will I receive? Are there guidelines that Chiropractors adhere to?
This will really depend on what your chiropractor determines to be your problem. Chiropractors have many ways of treating and managing your health care problem. It is obvious that we would treat a 7 year old differently to treating a 97 year old, yet we treat patients from newborns to very old age. Some patients’ problems are so bad they can hardly walk, others not so bad. Some have been in major car accidents; some have injured their backs just picking up a toothbrush. Everyone is different, everyone has a different problem, and everyone has a different response to our treatment. We will aim to serve you in the manner that best suits you.
So whether you are male or female, a recreational or elite athlete, a recreational or elite IT specialist, surgeon, electrician or gardener, mother, father, child or parent, we feel we may be able to assist you to overcome your pain and health problems.
Evidence-based Best Practice Clinical Guidelines have been available to chiropractors for many years. All chiropractors are encouraged by the chiropractic registration board and the 2 main chiropractic professional associations to use these guidelines where clinically practical. All chiropractors are required by to demonstrate their annual attendance to a minimum of 20 hours CPD (continuing professional development). Various seminars and conferences available to chiropractors present current practice guidelines for a variety of conditions encountered by a chiropractor in his or her practice.

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7. Will it hurt? Is it safe?
In 33 years of treating thousands of patients, I don’t think my chiropractic treatment has hurt many patients. (PN) However, most of the patients I have seen have conditions that are hurting them. The fact that they can’t work, or play sport or play with their children is what “hurts”. You see, it is the problem that hurts, not the treatment. Our aim is to reduce the hurt, get you out of pain, find out what caused it in the first place, and give you advice on how best to avoid that hurt again!
Safety to patients undergoing treatment in our office is our highest concern. There are adverse reactions to every type of health care procedures and medications. It is our responsibility as registered health care practitioners to maximise the benefits of our treatment , and minimise the risks of our treatment. There are many myths regarding the danger of chiropractic care, especially when sensationalist media outlets falsely attribute tragic mishaps to chiropractic care. We need to look at the scientific literature to determine how safe chiropractic care is.
The most recent scientific review of chiropractic neck manipulation and stroke concluded that there was no cause-effect between chiropractic treatment and vertebral artery strokes.
The authors conducted an exhaustive review of all cases reported in the scientific literature that associated chiropractic and artery damage.
Their conclusions were :
“The quality of the published literature on the relationship between chiropractic manipulation and CAD is very low. Our analysis shows a small association between chiropractic neck manipulation and cervical artery dissection. This relationship may be explained by the high risk of bias and confounding in the available studies, and in particular by the known association of neck pain with CAD and with chiropractic manipulation. There is no convincing evidence to support a causal link between chiropractic manipulation and CAD. Belief in a causal link may have significant negative consequences such as numerous episodes of litigation.”
Interestingly, this latest paper adds to a long line of conclusions of scientists investigating this topic.
The most recent reviews have revealed significant bias amongst those making claims that link chiropractic care with the very rare occasion of vertebral artery damage.
More likely is the explanation in this diagram:
copied from Church EW, Sieg EP, Zalatimo O, Hussain NS, Glantz M, Harbaugh RE. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation Cureus. 2016 Feb 16;8(2):

copied from Church EW, Sieg EP, Zalatimo O, Hussain NS, Glantz M, Harbaugh RE. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation Cureus. 2016 Feb 16;8(2):

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8. How long will it take to get better?
In my experience this is the toughest question of all. (PN)
Let’s look at an ideal scenario:
You bent over last week to do your shoe laces up, and you experienced sudden low back pain, and it has been with you a week, and you are no better.
With our treatment, you should be better within 10-14 days IF you tick the following boxes
  • it was the first time you experienced this type of injury or pain,
  • The pain does radiate down your leg
  • Our examination does not reveal any neurological deficit (eg. leg weakness, loss of reflexes)
  • you exercise regularly,
  • you are fit and have good spinal “core” muscle tone,
  • you eat well and are not overweight,
  • X-rays, CT scans and/or MRI reveals that you have no pre-existing degeneration in your spine or joint,
  • you don’t sit all day at your job AND
  • you are prepared to do about 5-10 minutes a day after treatment exercises to improve your recovery rate.
This scenario would most likely represent less than 1% of the cases I have seen in 30 years (PN). So, if you don’t tick all these boxes, it could take 2-8 weeks for you to recover, or even longer. Our patients’ treatment response depends on their health and the state of their bodies at the time of the injury, as well as how quickly they are prepared to change the behaviour and embark on a spinal strengthening exercise routine. Chiropractic treatment contributes largely to your recovery, but you must be prepared to make some changes also!

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9. Why does my doctor say terrible things about chiropractors?
Chiropractic was not popular with the medical profession when it first started in the 1800’s. There are many reasons for this, and you can read all about it yourself on the internet. I must state here and now that in my opinion the chiropractic profession was at many times insular, antagonistic, and set in their ways. However, in the US in the 1920s and 30s, many chiropractors were unjustly jailed for practising chiropractic.
It has taken a long time for the chiropractic profession to trust the medical profession. In the US in the 1970s the medical profession tried again to eradicate the chiropractic profession, resulting in a landmark Anti-Suit case. In my opinion (PN) it appears that in 2016, through a trolling internet group, the medical profession is trying again to eliminate the chiropractic profession in Australia. In my experience (PN) the average GP in Australia wants to help his or her patients the best s/he can. I have received, and continue to receive many referrals from GPs who have recommended my services to their patients.
It appears to me that this is a minority of medical professionals who may be making political and economic moves on my profession. So, your GP may be influenced by this minority. Otherwise, I don’t really know why. PN and TC are trying our best to help you and be a collaborative part of your health care team. We recognise we can’t help you with all your health care conditions, and other health professionals are best suited to help you with those conditions. We just hope that the rest of your health care team feels the same.

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To learn more about Chiropractic in Australia, click here