Chiropractic + Naturopathic Doctor

When the Pain Stops You

By Katerina Paganos   

Features Health Wellness

Like the age-old adage referring to the cobbler’s children walking
barefoot, a chiropractor may focus on the health needs of clients
instead of his or her own. Efforts to build and sustain a practice and
manage other personal issues are likely to impact his or her health and
wellness at some point.

Like the age-old adage referring to the cobbler’s children walking barefoot, a chiropractor may focus on the health needs of clients instead of his or her own. Efforts to build and sustain a practice and manage other personal issues are likely to impact his or her health and wellness at some point. This is particularly the case for chiropractors that either fully or partly own their clinics, and deal with the daily challenges and stressors that come with entrepreneurial territory.


Like all health-care practitioners, mental and physical stresses are two common workplace issues that chiropractors face. Studies show that there is a strong correlation between mental and physical health. Canadians with symptoms of depression report experiencing three times as many chronic physical conditions according to the Canadian Institute for Health Information. Conversely, people suffering chronic physical conditions – like repetitive strain – are identified by the Government of Canada as being twice as likely to experience a mood or anxiety disorder.


Three of the major risk factors and causes of stress are :

  • Infrequent rest breaks,
  • Long work hours, and
  • Increases in work intensity (higher patient load).

While a reasonable amount of stress in one’s life can help motivate and enhance performance, a large amount of stress can be detrimental to one’s overall health. During highly stressful times, it is common for health and well-being to suffer and this can significantly impact one’s ability to cope. The longer these stressors persist, the more severe the consequences.

Practitioners who experience co-existing mental and physical conditions typically suffer lengthier and more severe illnesses and conditions, translating into increased work absences and higher benefits costs. Periods of disability due to stress tend to be much longer than those for other occupational illnesses or injuries.

Another common risk factor facing chiropractors is physical stress caused by highly repetitive tasks that arise from ordinary arm and hand movements, such as bending, straightening, gripping, holding, or reaching. These common movements are not harmful on their own but can become hazardous based on posture, frequent repetition, or the amount of force used. Although each individual action may not be particularly intense, the collective effect of many smaller traumas can result in lasting and painful damage. Examples of chronic musculoskeletal disorders include carpal tunnel syndrome, tendonitis, thoracic outlet syndrome and tension neck syndrome.

While the disorders are preventable, there are rarely outward warning signs. By the time pain appears, it is typically too late to prevent or fully eliminate the condition without treatment and/or rehabilitation and rest. Painful symptoms can lead to improper sleeping patterns, poor eating habits, depression and even substance abuse. As musculoskeletal disorders are reported very late when joint use is severely restricted, prevention and/or early recognition of these disorders is pivotal.

Chiropractors can combat physical and mental stress by creating a proper workplace layout that, among other things, decreases the overall stress of repetitive motion by implementing reasonable rest periods, work hours, and client load.

Another preventive approach includes helpful resources such as Employee Assistance Programs (EAP), which provide assistance in dealing with physical and emotional stress management, strong social networks, and support. EAPs provide confidential, short-term counselling services for those with work or life issues that affect work performance.

EAP counsellors can help improve work conditions by identifying the stressful aspects of work (e.g., excessive workload) or life and designing strategies to reduce or eliminate the identified issues. For example, stress management training is easy to implement and may rapidly reduce stress symptoms such as anxiety and sleep disturbances. The end result of a strategic EAP is the ability to identify and manage stressors in the workplace, encourage the adoption of healthy coping behaviours, and gain access to high-quality health and wellness programs and services.


Should an injury or illness develop, a holistic approach focused on return-to-work strategies is beneficial. Effective disability management programs include a solid understanding of what causes sick leave, the use of appropriate interventions, and respect for the interrelation of physical and mental issues – factors that support recovery. They should also start addressing all the individual’s needs from the first day of disability, not after the paperwork has been completed and approved.

The value of this approach is that it doesn’t leave the person languishing while waiting for support. In traditional disability management, it can take four to five weeks to have a case adjudicated. During that time, the injured or ill individual is left without support. The emerging best practice in disability management is to reach out to the individual right away. This gives the case manager an opportunity to assess co-existing issues and provide the appropriate support. For example, an employee may be on disability leave because of a back injury and simultaneously be suffering from depression. When physical and mental disabilities are identified early and treated in light of each other, recovery from both the physical and mental disability may be more expedient and effective.

According to industry reports, 82 per cent of disability claims involve mental health issues as the primary or secondary cause. Traditional disability management focuses on the physical. Leading-edge and effective disability management programs are able to identify and address mental health issues and provide appropriate treatments and interventions. Without this kind of support, employees may be physically ready to return to work but, without the accompanying mental readiness, the return is often less than successful and may create a more complex problem.

Return to work is a key component to disability management. Presumably, the goal isn’t just to have the DC feeling better, it’s to help them return to the workplace and be productive and engaged there. In a holistic program, case managers work to ensure a successful return to practice. This may include providing guidance and support for addressing colleagues’ concerns or questions in a way that is respectful to the affected employee – in this case, the DC. It also includes assessing job requirements and environment, and working to make certain accommodations if any are deemed necessary.

The most important aspect to a valuable disability management program is that it treats the person, not the disability.


Long Term Disability (LTD) insurance is also essential for chiropractors who do not have the luxury of paid sick leave. In the event of an unforeseen illness or injury, LTD insurance may be the only thing that prevents chiropractors from losing their home, business or other hard-earned acquisitions. Recognizing this important fact, the Canadian Chiropractic Association (CCA) has assisted in designing a flexible and cost-competitive disability insurance benefit for chiropractors.

To learn more about LTD insurance and other programs and services available under the CCA Group Benefits program, visit .

Chiropractors who take a proactive approach to health and wellness today, position themselves strategically to be healthy, happy, productive and financially secure throughout their careers, even in the event of unforeseen illness or injury. •

Kathy Paganos is a senior consultant with Morneau Sobeco’s Group Association practice. She joined the firm in 2008 and is based in Toronto. Kathy assists clients with the management of their group benefits programs. She provides a full suite of services in this area, including strategic consulting, plan reviews, carrier renewal support, and market studies. Kathy is a graduate of the University of Toronto and is currently working towards a designation as a Certified Employee Benefits Specialist.

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