Chiropractic + Naturopathic Doctor

Asking the Right Questions

By Chris Oswald   

Features Clinical Patient Care

Being “critical of everything” was what we prided ourselves on when we
were at the Canadian Memorial Chiropractic College (CMCC) – or
whichever chiropractic school we attended. We were always demanding
that every clinician offer proof of anything that they taught us.

Being “critical of everything” was what we prided ourselves on when we were at the Canadian Memorial Chiropractic College (CMCC) – or whichever chiropractic school we attended. We were always demanding that every clinician offer proof of anything that they taught us.


What happened?


I graduated in 1988 from CMCC. The only difference between me and many of my classmates was that I was a second-generation chiropractor. By rights, I should have been the one saying things like “I was adjusted my whole life and it just works.” But, enjoying a good challenge, I still asked questions all day long. My mandate was “proven and predictable” and then I would accept it, only practising that method or that technique if it could be proven or supported.

After 16 years in practice I became frustrated with almost every product that we chiropractors were selling in our offices to our patients. These products were less than authentic. Furthermore, we were not doing our research when it came to these products. Where were these products made, and, of what materials? Why were some of them breaking down? Our patients were bringing them back to us, unsatisfied, asking for their money back on everything from pillows to back supports and seat cushions to chairs.

Many of these products had been designed by groups who were very interested in marketing; in our clinic, we finally discovered that only one of the products we were selling had been scientifically tested. It seemed we had left school and stopped evaluating things, assuming that these products, if they are being sold, must have been tested and proven effective, safe and durable.


Research the products you will sell
Did any of us ever think about requesting clinical or ergonomic lab testing as being mandatory before selling these products in our clinical settings? Did anyone lay their patients on a certain pillow, check for proper alignment and even palpate the neck muscles and joints to see if they were relaxed or under duress? It is our job as practitioners to sell our patients the healthiest most effective solutions to their problems. Research the products you are selling to find out if they have been scientifically and clinically tested.

We as chiropractors are spinal specialists. Our practice methods are ergonomic by nature. We provide specific adjustments for every patient we see, so why aren’t we as a profession mandating that only specific scientifically tested products can be supported, recommended, or endorsed by us or our associations? Just as specific proven stretches and exercises need to be given to everyone to ensure that they do the best they can while under our care, so we need to avoid offering fad products just to please the patients as many of these are not tried, tested or true to their claims.

For instance, authenticity issues are found in all ergonomic products from back supports and chairs to mattresses and pillows. Even the topical analgesic gels and creams we use daily on our patients have been found to include ingredients that are poor for our health. With my sights set on improving everything we chiropractors use or prescribe from day to day, I was driven to then study the topical pain reliever industry as well as the ergonomic industry.

Two types of products offered by Chiropractors
With respect to topicals, if you do an international literature search you will quickly learn which compounds have been proven to be absorbable and which have been found to provide relief of pain from osteoarthritis and improve mobility and reduce inflammation.

If you study the ingredients of many of the national brands available to professionals and to the public, you realize very quickly that most gels or ointments include wax or petroleum bases that prevent the absorption of any of the “good” ingredients. Much like the beauty industry, I have learned that the topical pain relief industry loves to use parabens as stabilizers or emulsifiers, and many additionally include colouring agents.

Did we ever think to look up what these things do to, or in, the human body? I have found that these ingredients are deemed potentially harmful, “bioaccumulative in human tissue,” “skin irritants” or “found in many types of cancers.” Some have been referred to in a recent scientific document as “endocrine altering in humans,” and some have even been called carcinogenic. As natural practitioners, we should be abreast of this research and know better than to offer products that contain potentially dangerous elements.

The European Union is now banning the use of parabens in certain products. Why is North America so far behind? We asked ourselves, who would allow this to happen? Who polices this industry? No one! It is up to groups, dedicated and responsible professionals like us, to do our homework and not just accept what we see on the shelves or in pamphlets or e-mails that we receive in our clinics.

It is strongly suggested that as natural health-care providers we think more about the skin, its thousands of pores per square inch and how they can absorb anything we apply topically. Why not give your patient something that doesn’t just mask the pain by irritating the skin?
With respect to topicals, look for products that truly penetrate the epidermis and release the actin-myosin cross bridges to allow normal circulation to move into the muscle, a process which seems to push inflammatory exudates out. The effect can often be profound and long lasting.

Did you know that there are very few, if any, independent random, double blind, clinically controlled studies in the topical pain reliever industry? True. The same can be said for the ergonomic industry.

When considering ergonomic products, make sure that they are adjustable. Everyone is different and needs different support. Try the product yourselves. We are very conscientious clinicians and if we don’t like it ourselves, it is highly likely that our patients won’t either.

To conclude, it is our responsibility to be accountable for everything that we recommend to our patients.  It is our duty to be accountable to the general public by only recommending scientifically proven products that will enhance quality of life.

Elements to consider when choosing products for your patients:

Topical pain relief:

  • no wax or petroleum
  • no parabens and no colouring agents
  • independent study or research
  • safety studies
  • NPN #s and NDC #s (FDA)
  • clinical studies


  • pressure mapping for comfort at a university ergonomic lab
  • clinical or pilot studies for effectiveness
  • a trough that is large enough to allow the head to rest flat
  • double contour to offer more fittings
  • risers to allow more support
  • heat sealed foam to prevent dust-mites
  • North American-made generally means less toxic chemical formulations
  • all memory foam is not the same
  • quality assurance tests by a major retailer


  • studies at the university level
  • adjustable lumbar (both depth and height)
  • steel versus plastic bases
  • height adjustable and pivoting arms
  • adjustable seat height with waterfall and memory foam, not mesh


  • continuous coils versus pocket coil, foam, air or waterbeds
  • side supports to minimize deformation and provide more sleeping
  • surface
  • high-quality memory foam toppers on coil seem to outperform synthetic toppers
  • all-natural cottons and wools provide for better toppers as well 


  • custom, custom, custom
  • evaluate the gadgets that many orthotics companies provide
  • non-weight-bearing far superior to weight-bearing molds
  • hands-on  is preferred versus computerized molding

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