Chiropractic Care During COVID-19

The role of chiropractic care in this pandemic

Chiropractor Dr. Amy Brown treating frontline nurse during COVID-19.
Chiropractor Dr. Amy Brown treats one of many frontline nurses during the COVID-19 pandemic, as explained in our Better Health in Any Space feature.

This is my first blog post since joining the Ontario Chiropractic Association (OCA) as CEO. I’m proud to lead an organization that represents 80 per cent of chiropractors in Ontario. This is an outstanding profession of regulated health care professionals, who are respected and valued by their patients.

This appreciation is even more evident as we continue to navigate the challenges of a global pandemic.

Pre-COVID-19, patients value their chiropractors

Long before COVID-19, we commissioned an Environics study on Attitudes of Ontarians Toward Chiropractors in June 2019. We learned that 26 per cent of Ontarians received chiropractic care, up from 20 per cent in 2016 – across regions, age, gender, education and income levels.

This study also told us Ontarians see chiropractors as trusted, competent and ethical health care professionals. In fact, more than seven in ten patients rated their chiropractic care experience as good or great.

COVID-19 has reinforced these findings, demonstrating the multi-pronged value of chiropractic care, while prompting the evolution of virtual care delivery.

Supporting frontline essential workers during COVID-19

During this pandemic, frontline health care and other essential workers have emerged as the heroes. At the best of times, spine, muscle and joint (musculoskeletal) injuries have been cited as the leading category of occupational injuries among health care workers.1 And sprains and strains account for 44 per cent of all lost-time claims across occupations in Ontario.2

The demand for essential workers to sustain COVID-19 efforts imposed longer shifts, increased stress and made redeployment to unfamiliar sites a frequent reality. Those extra pressures increased the risk of injury among frontline workers and the need for spine, muscle, joint and related nervous system (neuromusculoskeletal) care to help treat or avoid them.

Many of our members, such as Dr. Amy Brown, a chiropractor who practises at Coronation Chiropractic, Massage & Physiotherapy in Cambridge, experienced a spike in nurses seeking chiropractic care during the pandemic. Fortunately, chiropractic care was approved to deliver essential services for emergency, acute and urgent care during Ontario’s first lockdown period and could meet this increased need.

And chiropractors continue to provide care to help those on the frontline – from truck drivers to bakery workers – to keep working during the pandemic.

More than a year into COVID-19, it’s been a gruelling marathon for frontline workers. And Ontario chiropractors continue to treat essential workers’ neuromusculoskeletal issues and support the province’s COVID-19 efforts. They also continue to treat Ontarians working from home, who never thought their sofa or dining table would serve as their office for months on end.

Alleviating Stress on Emergency Departments

While hospital emergency departments (EDs) strain to care for patients with COVID-19, the system needs other options for people with back pain.

Data tells us that in a given year, more than 400,000 patients visited EDs in Ontario with musculoskeletal disorders, including arthritis, bone and spine conditions, among others.3 But as many as 97 per cent of emergency patients with back pain are not admitted and are sent home.4

Chiropractors are experts in assessing, diagnosing and treating many of these types of musculoskeletal conditions in the community. They also provide the type of care recommended as first and second-line approaches for low back pain.5

In delivering this direct benefit to patients during the pandemic, chiropractors continue to help reduce unnecessary visits to hospital EDs that are urgently needed for patients suffering from COVID-19.

Growth of Virtual Care Delivery

During this pandemic, patients continue to seek treatments for chronic care. So, with guidance from our regulator, the College of Chiropractors of Ontario (CCO), many chiropractors began offering virtual care.

Patients responded favourably to this treatment option. It enabled those with ongoing needs to continue their care plan, while minimizing the risk of spreading or contracting COVID-19.

Fortunately, insurance providers also adapted and included virtual care in extended health care benefit plans. Four out of five patients rely on their employer’s plans for chiropractic care.

To help our members safely deliver permitted services during the initial 2020 shutdown and beyond, we provided them with the ongoing information and resources they required. We also formed a return to practice working group and collaborated to provide them with a toolkit to support their safe return to patient care.

Recently, we were honoured to receive an Ovation Award of Excellence for COVID-19 Response & Recovery Management and Communications from the International Association of Business Communicators’ Toronto chapter, recognizing this work.

Some of my colleagues in other health care fields asked: “How can chiropractors deliver care without hands-on, manual therapy?”

The answer is that chiropractors develop a comprehensive treatment plan. Hands-on therapy, such as manipulation of vertebrae or other joints, is one type of treatment provided. Chiropractic care also includes customized, therapeutic exercises, patient education and self-management strategies, such as positions of relief.

Ongoing Value of Virtual Care

Even with most clinics open, virtual care continues to prove advantageous to many patients, such as those with compromised immune systems or other health concerns. It’s also valuable for those who have mobility issues or transportation challenges that may be worse during the pandemic.

Chiropractors are also combining virtual and in-person care to provide patient-centred solutions. Medical history, discussing patient expectations, education and coaching are completed virtually while in-person visits for treatments foster optimal patient experience and outcomes.

The Future of Chiropractic Care in the post-pandemic world

In my next post, I’ll talk about another crisis affecting Ontarians before, during and after COVID-19 – the opioid crisis and our strategy to help address it.

I look forward to our collective future in Ontario during and long after this pandemic.

1. Ngan, K., Drebit, S., Siow, S., Yu, S., Keen, D., and Alamgir, H., (2010). Risks and causes of musculoskeletal injuries among health care workers. Occupational Medicine. Volume 60 (Issue, 5). 389 – 394.

2. WSIB (2019), Schedule 1 – By the Numbers, 2019 WSIB Statistical Report. Common Characteristics of allowed lost time claims in 2019 (infographic).

3. MacKay C., Canizares M., Davis A.M., Badley E.M. (2010) Health care utilization for musculoskeletal disorders. Arthritis Care & Research. 62(2). 163-169.

4. CIHI (2017-2018) NACRS Emergency Department Visits and Length of Stay.

5. Foster, N.E., Anema, J.R., Cherkin, D., Chou, R., Cohen, S.P., Gross, D.P., et al. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 391(10137). 2368–2383.