The main aim of this section is to give the Maltese population answers and explanations about chiropractic care and its role within the Health System.
Chiropractic Care is a primary health profession and as such should be available to every citizen who requires it.
In Malta, chiropractic is covered under the ‘umbrella’ of Complementary Professions; in most of the western world, with the only exception of Greece, (recent Law proposal is undergoing parliamentary discussion in Italy and Spain) chiropractic is regarded as an independent Primary Health Care system whose precise definition is that of diagnosing and managing musculosketal conditions such as:
low back pain
neck and shoulders pain
muscles and tendons sprain & strain
Below are the most common questions asked by patients and answered by the professionals:
What is the goal of chiropractic and how does it differ from other therapies?
The main goal of chiropractic is to find the cause of your disability/discomfort and treat it by hands; no use of medical drugs or invasive methods such as surgery.
How do they do it?
Like MD’s, the chiropractor will take a detailed medical and health history during the first visit, prior to initial treatment, i.e. details of injury, previous medical conditions, details on lifestyle and risk factors. Your home and work life as well as your level of physical activity may also affect your health, so don’t be surprised to be asked questions about these. A safe practitioner needs to rule out any contraindications and fully investigate risk factors before a diagnosis and treatment recommendation can be reached.
Will I have to get naked to be examined?
It is not usual for a chiropractor to examine intimate areas; you will normally be referred to your GP if your chiropractor feels you would benefit from this. However, you will be asked to remove your clothes for a detailed examination. Gowns are available for you to wear.
What are the risks?
Being drug-free non-invasive therapy, chiropractic has far fewer risks than many other treatments and serious side effects are extremely uncommon. Complications are extremely rare. Ask more about associated risks to you registered chiropractor.
Will I need x-rays?
X-rays provide vital information but they are not required in every case. An experienced chiropractor will evaluate the necessity to take x-rays only if not contraindicated and to further help to reach a diagnosis. Chiropractors receive 360 hours of education in radiology according to the International standard requirements under the provision of the regulations described within the Ionising Radiation (Medical Exposure) Regulations 2000 and the (Amendment) Regulations 2006. Radiology competence is gained by covering a full range of topics, from protection to X-ray interpretation and diagnosis.
Will I need to visit a chiropractor all my life?
Most definitely not. Once your complaint has been brought under control it is more likely that you need rehabilitation therapy, often consisting of physical exercise. However, regular checkups may possibly avoid further deteriorating of your health and the likelihood of chronic pain. Similarly to a course of treatment from medical doctors often involving a per-established plan that is conducted at home (i.e. taking a course of antibiotics once a day for a couple of weeks), a chiropractor may provide acute, preventative and/or maintenance care thus making a certain number of visits (most commonly, no more than 4-6) sometimes necessary.
How do I find a chiropractor?
It is not possible, yet, to find a detailed list of chiropractic practitioners, satisfactorily registered in Malta, at the Council for the Professions Complementary to Medicine’s web site.
However, as “primary contact” health care providers, you don’t have to be referred to them by a physician or anyone else. You can search within your local business directories or yellow pages; referrals from friends and acquaintances are an excellent way to find a good chiropractor.
Will a chiropractor give me specific advice?
Yes. Usually you will be taught specific exercises to help you with your condition. They also advise patients on lifestyle and nutrition.
What kind of education and training do chiropractors have?
Chiropractors are educated as primary contact health care practitioners, with an emphasis on neuromusculoskeletal diagnosis and treatment. Preparation for the practice of chiropractic is concentrated on three areas: basic training in the biological and health sciences, specialized training in the chiropractic science and philosophy and extensive clinical training. Becoming a chiropractor requires a minimum of 5 years of post-secondary education including no less than 4500 hours of classroom and clinical instruction at an institution approved by the International Chiropractic Council of Education (ICCE).
What results can I expect from treatment?
That depends on many factors, such as: your condition, how long you have had it for, age, location and previous medical conditions. Your chiropractic doctor should tell you the extent of treatment recommended, and how long you can expect it to last. Cases varies: chronic conditions need more treatments, but studies done by various governments show, for example, that people with low back pain get back to work much faster with chiropractic care.
The biggest problem in all health related profession is that patients visit their doctor after they are in pain or a condition has developed. The solution to that would be prevention. A visit to a chiropractor can help keeping your spinal joints and back muscle subtle or, perhaps, catch an early condition which could result in great disability and pain.
Remember, your spine is as susceptible to wear and tear as your teeth and your eyes so you should look after it.
How is chiropractic adjustment performed?
Chiropractic adjustment, or manipulation, is a manual procedure that utilizes the highly refined skills developed during five intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint functioning.
Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment, i.e. increased range of motion, less stiffness, reduction of pain.
Is chiropractic covered by Government Health Plans? Or the National Health System?
Currently, chiropractic is not part of any governmental health plans, nor is it within hospitals in Malta. However, some private insurance groups welcome chiropractic care within their contract. Check with your personal insurance if they cover chiropractic expenses.
Is chiropractic really scientific?
Chiropractic is a healing discipline firmly grounded on science. Few other health care interventions have been assessed as extensively as chiropractic manipulation, both in terms of safety and effectiveness. There have been at least six formal government inquiries (Canada, U.S.A., New Zealand) into chiropractic worldwide over the last 25 years and all have concluded that contemporary chiropractic care is safe, effective and cost-effective and have recommended public funding for chiropractic services. In addition, there have been countless scientific clinical studies assessing the appropriateness, effectiveness, and/or cost-effectiveness of spinal chiropractic manipulation, most notably for low back pain.
Is chiropractic regulated in Malta?
Chiropractic is legislated in Malta but it is not independently regulated, yet. As mentioned earlier, chiropractic in Malta is covered under the register of Complementary Therapies. With the recent formation of a Maltese Chiropractic Association, MCA, there are plans to assist the CPCM with the aim to obtain a law proposal to be deposited to the government.
Do chiropractors treat children?
Yes. Chiropractic care is always adapted to the individual patient and a treatment is as beneficial to children as it is to adults; children should be seen by chiropractors when appropriate and in a preventive way. The scientific literature is now demonstrating that low back pain is a very prevalent condition amongst school children. Children subject to carry heavy school back-pack put their spinal column under a lot of stress and therefore the child is at risk of postural dysfunction, pain and possible structural deformities. (A 1992 study in the American Journal of Public Health found that the prevalence of low back pain, LBP, in adolescents up to age 15 is over 36 percent, and thus concluding that LBP in adolescents is a serious public health problem). Chiropractic treatment in the case of children is very gentle.
Can chiropractic treatment cure colds, infections, earaches and other ailments?
NO. Chiropractic care cannot “cure” these conditions. At present, there is no enough evidence to indicate that chiropractic can help such conditions, although some stipulate that chiropractic care may have a beneficial effect on a variety of conditions.
What is the Difference Between Physicians and Chiropractors?
That’s like asking the difference between a physician and a dentist: they are different professions within the health care spectrum. Both, chiropractors and physicians, are academically trained professionals with thousands of hours of class attendance and more than a thousand hours including clinical experience. As the appellation MD means “Doctor of Medicine”, so DC means “Doctor of Chiropractic”.
Doctors of chiropractic are obliged to abide by strict and ethical standards, such as Scope of Good Practice, set by National and International Governmental bodies.
The role of chiropractic may be considered complementary, or substitute, to other areas of primary health care. Chiropractic is not a replacement for medical care, but may offer a valid alternative to medication and surgery in appropriate circumstances.
It has been recognised by health professional and scientists that many illnesses of our modern society are lifestyle based. Many people, therefore, welcome chiropractic’s emphasis on healthy lifestyle and patient responsibility, as well as its help in improving the body’s functions.
Do chiropractors refer patients to medical doctors when necessary?
Yes, like medical doctors, chiropractors refer patients to other health professionals when they feel it is appropriate. Chiropractors are well trained to recognize risk factors as well as individual disease patterns and will not hesitate to make a referral when it is in the best interest of the patient’s health.
How safe is neck manipulation?
No health treatment is completely free of potential adverse effects and, on rare occasions, neck adjustment has been associated with stroke and stroke-like symptoms. A Canadian study, published in 2001, concluded that stroke symptoms associated with neck adjustments are so rare that it is difficult to quantify. Similarly, a medical review published in 2002 looked at 73 studies of chiropractic care and found no serious complications reported in any of them. By way of comparison, neck adjustment is significantly safer than other common treatments for headache, neck and back pain.
Why is there a popping sound when a joint is manipulated?
Manipulation of a joint may result in release of air bubble/s within the joint cavity (best known to other health professionals as well as engineers as “cavitation”) which leads to a “popping” sound – it is similar to the sound you hear when playing with bubble wraps. It is not painful.
Why can’t I just take some painkillers?
Painkillers may, sometime, reduce the amount of pain you experience but do not resolve the cause of the problem. In other words, they hide an important message being sent to your brain. Would you ignore the fire alarm when it goes off? When you have pain DO NOT ignore it. Get checked.