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New Study Supports Spinal Manipulation Therapy

New Study Supports Spinal Manipulation Therapy

A new study published in the Journal of the American Medical Association (JAMA) shows the latest evidence that spinal manipulative therapy (SMT) is effective at reducing acute low back pain and improving day to day function.

By Dr. Ron Green, DC

This extensive JAMA review (analyzed 26 studies involving more than 1,700 patients with lower back pain) provide the needed evidence to support what patients and practitioners are seeing in practice.

This review adds to a growing body of recent research supporting the use of spinal manipulative therapy (SMT) as a first-line treatment for acute low back pain. Further, studies such as this will help increase support for further integration of chiropractic into collaborative health care teams which will allow for a more comprehensive evaluation and effective treatment.

Spinal manipulation, which is typically done by chiropractors, involves applying measured manual pressure to move joints in the spine. Patients undergoing spinal manipulation experienced a decline in their pain comparable with relief from NSAIDs, over-the-counter non-steroidal anti-inflammatory medication, such as ibuprofen, but without the side effects!

Medications can cause an upset stomach and a rise in blood pressure. If patients are prescribed stronger medication, such as opioids, they risk long-term use and even addiction.

The new back pain treatment guidelines, as per the American College of Physicians, recommend first using non-invasive, non-drug treatments, including chiropractic, acupuncture, and massage, before resorting to drug therapies.

Take control of your pain and find a good team of professionals to resolve your aches and pains!

Note: It is this author’s opinion that the results from this study will be repeated with other studies on SMT’s effect on pain in the rest of the spine and peripheral joints.

Dr. Ron Green is a chiropractor with over 25 years experience and success helping people achieve good results. The chiropractic treatments are covered by most employee benefits.  For more information please give us a call at 416-929-6958 or submit your online appointment request.

Chiropractic Care for Sports Injuries

Chiropractic Care for Sports Injuries

Whether you’re a seasoned athlete or a weekend warrior, participating in sports is good for your body and mind.

Physical activities provide an opportunity to socialize, exercise and have fun. But occasionally the demands of sports can lead to an injury. Even if you’re in great shape, overuse, impacts, and strains can lead to damage.

Treatment for a sports injury may vary depending on the type and severity of the injury. Immobilization, physical therapy, and surgery can be part of a treatment plan. In some cases, chiropractic care can also help treat sports injuries.

What Does Chiropractic Care Involve?

Chiropractic care is based on the philosophy that the body can often heal itself if it is in proper alignment. Wear and tear, along with trauma can cause the spine to become misaligned. The misalignment can lead to a variety of problems including making you more susceptible to further injuries.

A large part of chiropractic care involves adjusting or realigning the spinal column, which can reduce pressure on the nerve. When a nerve is pinched, it cannot carry messages from the brain to the body or the body back to the brain as efficiently. Inefficient nerve impulses can cause problems with the muscles, joints, and bones.

Common Sports Injuries and Why They Occur

Common sports injuries include sprains, strains, and dislocations. Sore back muscles and knee injuries are also very common. A variety of factors can contribute to injuries. For example, during certain sports, such as hockey, football, and basketball, contact with other players often occurs. Trauma or force to the body can cause an injury.

Force or trauma does not only occur during contact with another player. Twisting or turning the joints wrong way can also lead to a sprained ankle, back injury or dislocation. In another example, repetitive movements during sports can develop wear and tear on a joint. For instance, sports, such as tennis or baseball may involve the same motions repeatedly which may cause tendinitis.

RELATED: Athletic Injuries and Recovery with Massage

How Chiropractic Care Can Help

Chiropractic care for sports injuries involves spinal adjustments, which are intended to reduce pressure on the nerve and allow the body to coordinate the healing process. After an adjustment, the flow of nerve impulses improves, the pressure is released in the joints, which may decrease muscle tightness and promote healing.

During treatment, a chiropractor takes a medical history, performs an exam and may use x-rays to determine the injury. In many instances, force is applied in a specific way to adjust spinal structures to relieve pressure and realign the spine.

The exact technique used to adjust the spine may vary based on the injury and body part affected. The chiropractor may place you in a few different positions to perform the adjustment. Chiropractors may also use stretches or tools to decrease pressure in the joints gently. Some treatments also incorporate methods, such as heat, electrical stimulation, and ice.

Chiropractic care is not only helping to treat injuries, but it may also prevent future problems. Keeping the spine in proper alignment helps the body work more efficiently. Also, if there is less tension in the body, it may also prevent future injuries.

Choosing a Chiropractor for Sports Injury Treatment

Chiropractors are trained healthcare professionals who have a doctorate in chiropractic. They must also become licensed in the state they wish to practice. Any licensed chiropractor should be qualified to develop a treatment program for an injury related to sports. But some chiropractors also specialize in sports injuries and neuromuscular rehabilitation.

When visiting a chiropractor, it is essential to discuss all your symptoms. Sometimes an injury in one part of the body also causes pain in another area. Understanding all your symptoms, allows a chiropractor to consider various options to develop a comprehensive treatment plan.

Prevention of Sports Injuries

It may not be possible to prevent all sports injuries. But there are things you can do to decrease your chances of getting hurt, such as the following:

  • Wear proper gear: Always use the appropriate protective equipment and gear for the sport you’re participating in. Gear may include helmets, pads or shin guards depending on the sport. Also, be sure to wear the correct shoes for the sport. Proper footwear and well-fitted gear can often protect you from injury.
  • Use correct form: Whether it is tackling incorrectly in football or using poor form sliding in baseball, using incorrect techniques can quickly cause injuries. Always use proper form and adhere to the guidelines of play.
  • Warm-up: Exercising when muscles are tight can quickly lead to an injury. Before participating in a sport, do some light exercise to warm-up muscles. A combination of light cardio and dynamic stretching can loosen up the muscles and prepare the body.
  • Strengthen muscles: Having strong muscles may help decrease sports injuries. Performing conditioning exercises, especially for the sport you participate in is one of the best ways to keep your body strong and avoid hurting yourself.
  • Don’t ignore pain: Pain in the body is often a signal that something is wrong. Ignoring an injury can lead to complications and longer recovery time. If you sustain an injury, don’t hesitate seeking an evaluation and treatment from a medical
10 Strategies for managing Arthritis (OA)

10 Strategies for managing Arthritis (OA)

by Dr. Sandeep Kalirah, BSc, DC

 Those who suffer from arthritis know how difficult the colder months can be.  With dreaded winter just around the corner, here are some strategies to help cope with your aches and pains.

What is Osteoarthritis?

Osteoarthritis is the main cause of disability in individuals over age 55.  A debilitating condition that affects the joints, arthritis is a degenerative process that results in severe pain.

Lining each of the bones within a joint is a flexible tissue known as cartilage.  Cartilage acts as a shock absorber for all the stresses that occur within the joints.  Cartilage loses its elasticity with age and repetitive movement – this means that cartilage starts to wear-away.  As a result, the bones that lie underneath the cartilage start to rub against each other.  Swelling, bumps, and bony-spurs develop, and joints lose flexibility.

Patients who experience osteoarthritis often feel pain during repetitive use of the joint, or after a period of inactivity.  Therefore, it is important to manage arthritis accordingly.

Strategies for Managing Osteoarthritis

1. Find support and accept help. There are plenty of interventions aimed to alleviate arthritic pain. Talk to a medical doctor, a chiropractor and/or a physiotherapist to see if there is anything you can do to alleviate your pain, improve your flexibility and stabilize your arthritic joints.

2. Don’t give up on any activities you enjoy. A medical professional can help you make ergonomic modifications and recommend tools or braces to help you cope. Also, take frequent breaks if needed.

3. Avoid keeping your joints in the same position for prolonged periods of time. Move your joints and practice good posture!

4.” Motion is lotion!” Exercise helps to keep your joints lubricated. Try activities like swimming and biking, and avoid activities such as prolonged running/jogging. With that said, do not eliminate your weight-bearing activities completely.

5. Lose weight. Losing 10 pounds is equivalent to reducing the stress of your knees by 40 pounds.

6. Keep a health journal. This may help point out things that aggravate or alleviate symptoms.

7. Quit smoking. Smoking may increase the risk of osteoporosis and post-surgical recovery. Quitting not only reduces your risk for many other diseases but also helps ease joint pain.

8. Increase consumption of omega-3 rich foods. Omega-3’s are known for their anti-inflammatory effects and will help alleviate pain.

9. Make sure you get enough sleep! With every movement we make, we create stress on our muscles, nerves, and joints. Our bodies have the innate ability to repair themselves while we sleep.  To ensure the body has enough time to recover from the stresses from the day before, aim for 8-10 hours of sleep per night.

10. During the winter months keep your arthritic joints bundled up, especially the hands and feet. Also, trap your body heat by wearing plenty of loose layers.

Side Note: Degenerative Disc Disease

A common concern that often alarms my patients is the term Degenerative Disc Disease (DDD). On many X-Rays of the spine, DDD is surely a finding.

As human beings, we all have some level of degenerative changes in our joints.  We are constantly using them!  Therefore, in most cases, DDD is just a fancy (and scary) term for arthritis of the spine.

Depending on the severity, DDD may cause and/or correlate with disc bulges/herniations and/or spinal stenosis (narrowing of the canal where the spinal cord passes through).  In order to determine the severity, DDD is usually classified as mild, moderate or severe.  Moderate and severe DDD is where we maybe a little more concerned, but MRI imaging, in addition to clinical findings, are the Gold Standard for diagnosing disc bulge/herniations and/or spinal stenosis.  As health care practitioners, we commonly rely on symptoms, to determine the complexity of your DDD.

Bottom Line: A finding of Degenerative Disc Disease on an X-Ray is not a cause for concern in the absence of unrelenting pain or disability.

Dr. Sandeep Kalirah has been providing Chiropractic care at Pacific Wellness that is tailored towards individual needs.  The chiropractic treatments are covered by most employee benefits.  You are invited to meet Dr. Sandeep Kalirah for a 15 min complementary consultation to find out if you are a match for chiropractic care.  For more information please give us a call at 416-929-6958.

What is Plantar Fasciitis?

What is Plantar Fasciitis?

By Dr. Sandeep Kalirah, BSc, DC

Plantar Fasciitis is the most common cause of heel pain or pain at the bottom of the foot.  It is estimated that 11-15% of foot complaints seen by a medical professional, may be attributed to plantar fasciitis.

Characterized by tight, aching or burning pain at the arch and/or heel of the foot, Plantar Fasciitis is a debilitating condition that alters the way people walk.  This is due to inflammation and tightening of the tissue at the bottom of the foot, known as the Plantar Fascia.  Sufferers usually report that the first few steps in the morning are often the most painful, whereas moderate activity helps to alleviate pain.  However, if a patient goes for a long walk or is constantly standing, pain is aggravated and/or unrelenting.

Plantar Fasciitis often contributes to other conditions such as knee pain, hip pain, and low back pain.  It is considered a self-limiting condition, meaning that in 80-90% of cases, it resolves on its own within 10 to 12 months.  In the meantime, treatments such as custom insoles, physical therapies, and self-management exercises, may help to alleviate the pain and suffering that goes along with this condition. 

How To Manage Plantar Fasciitis

I often recommend 8 strategies for the treatment of Plantar Fasciitis.

Ice Bottle Technique

Take a plastic bottle and fill it up halfway.  Freeze it.  With a thin towel or sheet placed on top, roll the bottle of ice back and forth with the foot, reaching all the way from the heel of the foot, to the toes.  Keep rolling the bottle for approximately 10-15 minutes.  Repeat this activity as often as possible, or at least, three (3) times per day.

Tennis Ball Technique

Similar to the ice-bottle, use a tennis ball to roll under the foot.  Roll the ball from the heel, all the way to the toes.  Perform this exercise for 10 minutes, three (3) times daily.

 Napkin Technique

Have a seat on a chair and scatter napkins across the floor, all within feet reach.  While seated, attempt to pick-up and pass-aside, each napkin, using the toes.

A-B-C’s and 1-2-3’s

Similar to the napkin technique, this exercise is performed seated.  Attempt to draw out the alphabet with your foot.  Draw letters A-B-C, all the way to Z.  When done, attempt to draw numbers 1 through 10.

Resistance Band Stretch

With a resistance band (or towel if you do not have access), hold both ends as you wrap around the ball of the foot, with the knee straight. Pull-on the band to bring the foot upwards and towards your body.  You should feel a stretch at the bottom of the foot.  Hold the stretch for 10 seconds, repeat 5 times.

Custom Orthotics

If you are experiencing Plantar Fasciitis, it is always a good idea to talk to a licensed health professional, such as a Chiropodist, Chiropractor or Physiotherapist.  These licensed professionals will assess the curves of your foot and footwear and make appropriate recommendations.  These professionals may also fit you for orthotics, which may help cushion, and subsequently eliminate painful areas of the foot.

Nocturnal Splints

Due to the forces of gravity, when we lie on our backs or stomachs, our feet naturally point downwards.  Wearing a device that keeps the ankle neutral during sleep, may help prevent contractures (tightening) of the plantar fascia and the surrounding calf muscles.

Soft-Tissue Therapy

Chiropodists, Chiropractors, and/or Physiotherapists utilize various techniques and instruments that help loosen up and heal the plantar fascia.  They may apply pressures and stretches to these areas or use tools to loosen them up.  Electro-modalities such as Laser or Shockwave Therapy also have promising research evidence as treatment approaches.  To help manage your pain, consultation a licensed health care professional to see what is right for you.

Sleep Better: Pillow & Mattress Considerations

Sleep Better: Pillow & Mattress Considerations

By Dr. Sandeep Kalirah, BSc, DC

Pillow Recommendations

One of the most common questions I get in my Chiropractic office is, “What type of pillow should I be using?”  Well, whenever a patient asks me about a pillow, the only suggestion I ever make is the water pillow.  The reason I recommend the water pillow so much is because it is a custom pillow.  This means that it does not follow a “one size fits all” recipe; you decide how firm or how soft the pillow should be, based on your own comfort and needs.

Each pillow comes with a spout that allows you to fill water into the pillow.  The more water you fill into the pillow, the firmer the pillow becomes; the less water, the softer.  Then, when you lie down on top, the water moves instantly, evenly distributing to surround the weight and contours of your head and neck.

The pillows are made out of durable material, so you don’t have to worry about getting wet.  They are also completely sanitary; you don’t have to worry about changing the water.

Of course, it will take a few uncomfortable nights to decide just how much water is right for you.  But after experimenting with the water levels, I am sure each patient can achieve the perfect pillow for their needs!

I am familiar with three companies that manufacture and distribute water pillows:

1)      Mediflow/Chiroflow

2)      Obusforme

3)      EmbraceAir

You may purchase these pillows from most rehabilitation/chiropractic/physiotherapy clinics, and in some cases, your insurance may be willing to reimburse you for the costs associated; please check with your insurance provider for more information.

Mattress Considerations

When selecting a mattress, I’d like for my patients to consider two principles:

  1. Comfort
  2. Support


When selecting a mattress, it is always a good idea to practice 10 Minute Test Drive.  10 Minute Test Drive is similar to test driving a car; “Drive before you buy.”  Lie down on the mattress for approximately 10 minutes.  If you feel comfortable and don’t toss and turn too much, this mattress may be the perfect bed for you.


When you lie down on your side or back, you should feel your spine remains straight. If at any point you feel you’re sinking into the bed or that the bed is caving in around you, this mattress is not the appropriate bed.

Types of Mattresses:

Generally speaking, there are four main types of mattresses:

  1. Firm
  2. Plush
  3. Memory Foam
  4. Pillow Top

1. Firm
Firm mattresses have flat-tops with no extra padding or layers on top.  Traditionally, firm to medium-firm mattresses has always been recommended for the relief of lower back pain.  However, because firm beds are generally supportive, I recommend my patients always “Test Drive” to make sure they are also comfortable.  Finding a good balance of support and comfort is vital when selecting a firm mattress.
2. Plush
Plush mattresses are among the softest beds on the market; however, the extra foam layering above the coils provides a lot of comforts but very little support. Therefore, I generally do not recommend plush beds and ask my patients to stay away from them.  Over time, patients with plush beds do usually develop spinal pain.
3. Memory Foam
A neat fact about Memory Foam is that it was created by NASA for the space program.  It never did “take-off” but lucky for us, it ended up in mattresses instead.  Made from polyurethane, memory foam mattresses are firm in cool temperatures and soft in warm temperatures.  This is what allows the mattress to mold to the contours of a warm body, providing support.  Keep in mind, it does take approximately 10-15 minutes for the mattress to completely respond to the body’s heat.  If you toss and turn at night, this may pose a challenge when it comes to comfort.  Memory foam is also available as foam overlays or toppers, to place over a pre-existing mattress.
4. Pillow Top
Pillow top mattresses are probably the most common mattress out there, and one that I commonly recommend for comfort.  These mattresses have an extra layer of padding attached to the top, to provide additional comfort.  Support varies for a pillow-top mattress, therefore, like a firm mattress, it is very important to “Test Drive” and make sure your spine does not sink into the mattress.

Dr. Sandeep is accepting new patients at the Pacific Wellness on Mondays, Wednesdays, and Fridays. She offers 15 min. complementary consultations (Exams and Adjustments not included). Please call us at 416-929-6958 to take advantage of this exclusive offer.

Chiropractic Care and the Role of the Nervous System

Chiropractic Care and the Role of the Nervous System

By Dr. Andrew Adamski, BSc, D.C.

According to many research studies, Chiropractic has proven to be one of the most effective treatments for back pain, neck pain, other musculoskeletal ailments, and many types of headaches. Because chiropractic removes subluxations – “blocks in the spine to the normal flow of information,  energy, and intelligence from the brain to the rest of the body” – it can help resolve a number of conditions that you might not associate with the spine or nerves. Once you understand the workings of the spine and nervous system, the effect of subluxations on the overall health becomes all too clear.

The spine is one of the most complex organs in the body, consisting of nearly a hundred intricate joints connected by a vast array of ligaments, tendons, cartilage and six layers of muscles all surrounding and protecting over a trillion nerve pathways that connect the brain to the rest of the body.

The spine is a unique structure within the human skeleton in that it is designed to have enormous mobility, flexibility, and strength. Chiropractors believe that misalignments in the cervical spine have a great impact on the communication from the brain to the rest of the body. Others ascribe to the view that sacroiliac and lumbar spines are the most important because they form the structural foundation of the spine. Regardless all chiropractors believe that it is important for the bones of the spine to maintain proper alignment and function. This ensures uninterrupted communication of life and nerve energy throughout the body.

Subluxations occur frequently and may or may not have obvious causes or symptoms. Think back over your own history of bumps, bruises and less obvious injuries. That fall you took out of the treehouse when you were nine. Maybe you had headaches since that time and never associated the two occurrences?  The sore neck you have when you leave work? The hours you spend with the phone cradled between your ear and shoulder may be pulling your neck out of alignment.

Studies have found that there is some sort of spinal imbalance in 80 percent of twenty-something olds and 95 percent of forty-five-year-olds.

If left untreated subluxations can cause the muscles, bones, and nerves to degenerate. This appears in many different forms such as muscle weakness, degeneration and nerve interference that can cause numbness and lack of function.

Unless you are getting regular chiropractic care you may find yourself with less vitality, greater discomfort, and less mobility and other health concerns.

Note: There is a wide variety of chiropractic techniques. Each chiropractor offers his/her unique sets of skills and specialized techniques based on their background and theoretical beliefs. There are also two major groups that split the chiropractors based on their practice philosophy. One is “old school” subluxation-based chiropractors and another one is “new school” evidence-based chiropractors. The presented chiropractic information on this page is provided for general educational purposes only. It does not necessarily reflect our chiropractor’s view and the way he/she practices chiropractic.