Chiropractic Care

Chiropractic care across MedRehab Group

Chiropractic at MedRehab Group is the joint-focused part of a rehabilitation clinic, not a stand-alone practice. Our chiropractors are Doctors of Chiropractic registered with the College of Chiropractors of Ontario, and they work in the same rooms, on the same patients and from the same notes as our physiotherapists and massage therapists. That matters more than it sounds. If the assessment shows your back pain is a muscle problem rather than a joint problem, you are walked down the hall rather than sold more of the same.

All twelve of our clinics offer chiropractic, from Hamilton in the west to Pickering in the east and Newmarket in the north; the list is at the bottom of this page. You do not need a referral, most extended health plans cover it, and treatment usually starts at the first visit.

Chiropractor or physiotherapist: which should I see?

This is the question we are asked most, and the honest answer is that for many problems either will help and the difference is emphasis. Chiropractic concentrates on how joints move, particularly the spine, and uses hands-on techniques to restore that movement. Physiotherapy diagnoses the injury more broadly and rebuilds strength, control and endurance around it through exercise, alongside hands-on treatment.

A rough guide. If your main complaint is a stiff, locked or painful joint, a neck that will not turn, a low back that has seized, a mid-back that aches between the shoulder blades, chiropractic is a good first call. If your problem is weakness, instability, a post-surgical recovery, a sports injury with a return-to-play goal, or anything that needs a graded exercise program, start with physiotherapy. If you are not sure, book either one: both assess before they treat, and both refer sideways within the clinic when the other would serve you better. Many patients use the two together, chiropractic to free the joint and physiotherapy to keep it that way.

What is a chiropractic adjustment?

An adjustment, or spinal manipulation, is a short, quick, controlled movement applied by hand to a joint that is not moving well, most often in the spine. The aim is to restore movement and reduce pain. It sometimes produces a click, which is gas releasing from the fluid inside the joint, not bone moving on bone, and a silent adjustment can work just as well as a loud one. It is one technique among several, it is used only after assessment and with your consent, and your chiropractor will not use it on everyone.

What chiropractic treatment actually involves

People picture the adjustment. That is one tool. A treatment at our clinics typically draws on several approaches, chosen after assessment:

• Spinal and joint manipulation. A short, fast, precisely aimed movement to a joint that is not moving well. The click is gas releasing from the joint fluid, not bone moving on bone, and it is not the measure of whether the treatment worked.
• Mobilisation. Slower, gentler repeated movement of a joint through its range. Often used instead of manipulation for older adults, after injury, in pregnancy, or simply when a patient prefers it.
• Soft tissue treatment. Work on the muscles and connective tissue around the joint, because a joint rarely stiffens on its own.
• Exercise and advice. What to do between visits so the change holds. This is where most of the long-term result comes from.
• Acupuncture or dry needling where the chiropractor is trained in it and it suits the problem.

You stay clothed for treatment. Wear something you can move in.

Conditions chiropractic helps with

The strongest evidence for chiropractic care is for problems of the spine and the joints around it. The Canadian Chiropractic Guideline Initiative, which reviews the research and publishes practice guidelines for the profession, recommends spinal manipulation and mobilisation as part of conservative care for low back pain, and multimodal care that includes manipulation for uncomplicated neck pain. At our clinics that translates to:

• Low back pain, acute and long-standing, including episodes that flare after lifting, sitting or a bad night
• Neck pain and stiffness, including the desk-and-phone variety
• Headaches that start in the neck, and tension-type headaches, where the guidelines support manipulation and mobilisation for short-term relief of frequency and intensity
• Sciatica and other nerve-related pain from the spine, once serious causes have been ruled out
• Mid-back and rib pain, including the pain between the shoulder blades that comes with rounded posture
• Whiplash and other injuries after a car accident
• Work injuries under WSIB
• Hip, shoulder and other joint problems where the mechanics of the joint are part of the story
• Pregnancy-related back and pelvic pain, with positioning and techniques adapted for it

What chiropractic does, and what it does not

We would rather tell you this now than have you find out after six visits. Chiropractic is good at restoring movement to stiff joints, reducing spinal pain, and helping people get back to normal activity faster. It is not a cure for everything, and a chiropractor who says otherwise is not one we would employ.

Some claims you may have seen elsewhere, and our position on them. Chiropractic does not boost the immune system, lower blood pressure, treat asthma or allergies, or improve conditions that have nothing to do with the joints and muscles. A 2021 international review of the research on spinal manipulation for non-musculoskeletal conditions found no evidence that it works for them, and that is the standard we hold to. Nor is chiropractic a treatment you should need forever. Maintenance visits have a place for some people with recurring problems, but the plan should have a goal and an end, and you should be doing more for yourself as you go, not less.

Some problems need someone else first. Sudden severe pain after trauma, pain with fever or unexplained weight loss, numbness in the groin or loss of bladder or bowel control, weakness that is getting worse, or a history of severe osteoporosis, cancer or inflammatory arthritis affecting the spine: these are screened for at every assessment, and if they appear your chiropractor will send you to your doctor or the emergency department rather than treat. Serious complications from chiropractic treatment are rare, and that screening is the main reason why.

What happens at your first appointment

The first visit is longer, usually forty-five minutes to an hour, and most of it is assessment. Your chiropractor takes your history, asks what you cannot do that you want to do again, and examines you: posture, how your spine and the joints around it move, muscle strength and tension, nerve tests where relevant, and the screening questions above. If imaging would change the plan, they will say so; most spinal pain does not need an X-ray, and we do not send people for them routinely.

You will leave with a working diagnosis in plain language, a plan with a rough number of visits and a point at which you both check whether it is working, and something to do at home. Treatment usually starts the same day, and you consent to each technique before it is used. If you would rather not be manipulated, say so, and your chiropractor will work with mobilisation and soft tissue instead.

Who provides it

Every chiropractor at MedRehab Group holds a Doctor of Chiropractic degree from an accredited program, has passed the national and provincial examinations, and is registered with the College of Chiropractors of Ontario, which sets and enforces the profession’s standards of practice. You can confirm any registration on the College’s public register.

Our chiropractors include Dr. Daniella Astorino, Dr. Farah Ashhadi-Somehsaraei, Dr. Annamaria De Fina, Dr. Alvin De Leon, Dr. Steve Cho and Dr. Jamaal Coke. Each clinic page lists who practises there. Because they work alongside physiotherapists and massage therapists, a referral between the three is a conversation in the corridor rather than a new intake.

Cost, insurance and direct billing

Chiropractic is not covered by OHIP. Ontario removed it from the provincial plan in December 2004, so unless you are claiming through a car accident or a workplace injury, treatment is paid privately or through insurance. The good news is that chiropractic is one of the most commonly covered services on extended health plans through work, usually to an annual dollar limit, and we bill most major insurers directly so you pay only what your plan does not cover. Chiropractic is exempt from HST, so there is no tax on your receipt.

After a car accident, chiropractic is covered through the accident benefits on your auto policy regardless of fault. Your chiropractor submits a treatment plan to the insurer, and most soft-tissue injuries fall under a guideline with a defined treatment budget; we handle the forms. For a workplace injury, once your WSIB claim is allowed, treatment is delivered under a WSIB program of care at no cost to you for approved treatment. Bring your claim number either way.

Questions we are asked most

Related services

Chiropractic sits alongside physiotherapy, which rebuilds strength and control around the joint, and massage therapy, which treats the muscles that tighten around a stiff spine. At five clinics osteopathy offers a gentler whole-body alternative. Most people with a spinal problem use at least two of the three at some point, and at our clinics that is one conversation, not three.