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WHAT TO EXPECT
The purpose of your first visit is to determine whether you are in the right place, and whether we can help you. We will talk to you, examine you thoroughly, review any imaging studies, and then give you our honest impression.
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WHAT TO EXPECT
The purpose of your first visit is to determine whether you are in the right place, and whether we can help you. We will talk to you, examine you thoroughly, review any imaging studies, and then give you our honest impression.
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CALL 02 9487 2161
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WHAT SHOULD I EXPECT?
The purpose of your first visit is to determine whether you are in the right place, and whether we can help you. We will talk to you, examine you thoroughly, review any imaging studies, and then give you our honest impression.
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DO I NEED A REFERRAL?
While most patients do come via referral from their general practitioner or specialist, it is certainly not mandatory. However, Spine Partners Wahroonga is always keen to collaborate with your medical team (where appropriate) to ensure that you get the best care possible.
WHAT WILL HAPPEN ON MY FIRST VISIT?
First and foremost we need to understand your medical and health history. Unfortunately many health problems can mimic disorders of the spine and, as such, we will discuss your history in some detail. This will be followed by a comprehensive examination in order to make the most accurate diagnosis.

The initial consultation will usually take between 40 minutes and 1 hour, depending upon the complexity of your case. Whilst a physical examination is very important, your modesty will be preserved at all times and gowns are provided. Please be assured that if we do not think that we can help you, or if our examination reveals any additional concerns, we will refer you appropriately and liaise with your general practitioner on your behalf.
DO I NEED X-RAYS?
Our location allows us to work in close collaboration with a number of excellent diagnostic facilities, including PRP Imaging and SAN Radiology at the Sydney Adventist Hospital. We collaborate with some of the best radiologists in the country.

The cost of plain film X-rays is largely covered by Medicare (Australian residents only), with only a small out-of-pocket expense. MRI scans are not claimable under Medicare (except when referred by a medical specialist), however, PRP Imaging has very competitive rates and can generally accommodate our patients on short notice.
WHAT ARE THE FEES?
Our consultation fees vary depending upon the nature of your visit and the time required. At your initial consultation our priority is to make the right diagnosis, as this then determines the correct treatment. So this visit may take up to an hour and involve significant discussion, a thorough examination, and a review of available medical imaging. You may, or may not, be treated on this first visit - depending upon whether it is safe and appropriate to do so. As such, our fees range from $175 to $275.

The fees for subsequent visits also vary, depending upon their nature.

A standard treatment costs $70, while extended consultations with/without treatment range from $120 to $90.
CAN I CLAIM ON PRIVATE HEALTH INSURANCE OR MEDICARE?
All major private health funds offer cover for chiropractic services - usually on their 'extras' table. However, annual limits do apply and the amount that you are reimbursed will vary. Check with your own fund to find out the exact details in your case.

If you are referred by your general practitioner under the Enhanced Primary Care (EPC) plan then you are able to claim a portion of your fees from Medicare (up to a maximum of 5 visits per year). You will need to talk to your GP about the appropriate referral.

We do not keep accounts, so payment for all consultations is expected on the day. We have electronic health fund rebates and Medicare Easyclaim facilities that allows you to pay for your consultation and claim your rebate immediately. Your funds will then be deposited into your chosen bank account (if you have set this up).
WILL I BE TREATED ON MY FIRST VISIT?
If you are in pain then naturally you'll be keen to start treatment. We understand that. But it is most important that we make an accurate diagnosis first, so that we know exactly what's causing your problem. Our chiropractors are hugely experienced and will do everything they can to help you as quickly as possible.

Sometimes the situation calls for an X-ray, or an MRI scan, or blood tests first - but we'll explain all of this to you and will only order these tests if they are truly necessary. In other cases it is safe and appropriate to begin treatment immediately.
iPad Targeted Content
Android Targeted Content
DO I NEED A REFERRAL?
While most patients do come via referral from their general practitioner or specialist, it is certainly not mandatory. However, Spine Partners Wahroonga is always keen to collaborate with your medical team (where appropriate) to ensure that you get the best care possible.
WHAT WILL HAPPEN ON MY FIRST VISIT?
First and foremost we need to understand your medical and health history. Unfortunately many health problems can mimic disorders of the spine and, as such, we will discuss your history in some detail. This will be followed by a comprehensive examination in order to make the most accurate diagnosis.

The initial consultation will usually take between 40 minutes and 1 hour, depending upon the complexity of your case. Whilst a physical examination is very important, your modesty will be preserved at all times and gowns are provided. Please be assured that if we do not think that we can help you, or if our examination reveals any additional concerns, we will refer you appropriately and liaise with your general practitioner on your behalf.
DO I NEED X-RAYS?
Our location allows us to work in close collaboration with a number of excellent diagnostic facilities, including PRP Imaging and SAN Radiology at the Sydney Adventist Hospital. We collaborate with some of the best radiologists in the country.

The cost of plain film X-rays is largely covered by Medicare (Australian residents only), with only a small out-of-pocket expense. MRI scans are not claimable under Medicare (except when referred by a medical specialist), however, PRP Imaging has very competitive rates and can generally accommodate our patients on short notice.
WHAT ARE THE FEES?
Our consultation fees vary depending upon the nature of your visit and the time required. At your initial consultation our priority is to make the right diagnosis, as this then determines the correct treatment. So this visit may take up to an hour and involve significant discussion, a thorough examination, and a review of available medical imaging. You may, or may not, be treated on this first visit - depending upon whether it is safe and appropriate to do so. As such, our fees range from $175 to $275.

The fees for subsequent visits also vary, depending upon their nature.

A standard treatment costs $70, while extended consultations with/without treatment range from $120 to $90.
CAN I CLAIM ON PRIVATE HEALTH INSURANCE OR MEDICARE?
All major private health funds offer cover for chiropractic services - usually on their 'extras' table. However, annual limits do apply and the amount that you are reimbursed will vary. Check with your own fund to find out the exact details in your case.

If you are referred by your general practitioner under the Enhanced Primary Care (EPC) plan then you are able to claim a portion of your fees from Medicare (up to a maximum of 5 visits per year). You will need to talk to your GP about the appropriate referral.

We do not keep accounts, so payment for all consultations is expected on the day. We have electronic health fund rebates and Medicare Easyclaim facilities that allows you to pay for your consultation and claim your rebate immediately. Your funds will then be deposited into your chosen bank account (if you have set this up).
WILL I BE TREATED ON MY FIRST VISIT?
If you are in pain then naturally you'll be keen to start treatment. We understand that. But it is most important that we make an accurate diagnosis first, so that we know exactly what's causing your problem. Our chiropractors are hugely experienced and will do everything they can to help you as quickly as possible.

Sometimes the situation calls for an X-ray, or an MRI scan, or blood tests first - but we'll explain all of this to you and will only order these tests if they are truly necessary. In other cases it is safe and appropriate to begin treatment immediately.
Blackberry Targeted Content
Desktop and all none targeted content
DO I NEED A REFERRAL?
While most patients do come via referral from their general practitioner or specialist, it is certainly not mandatory. However, Spine Partners Wahroonga is always keen to collaborate with your medical team (where appropriate) to ensure that you get the best care possible.
WHAT WILL HAPPEN ON MY FIRST VISIT?
First and foremost we need to understand your medical and health history. Unfortunately many health problems can mimic disorders of the spine and, as such, we will discuss your history in some detail. This will be followed by a comprehensive examination in order to make the most accurate diagnosis.

The initial consultation will usually take between 40 minutes and 1 hour, depending upon the complexity of your case. Whilst a physical examination is very important, your modesty will be preserved at all times and gowns are provided. Please be assured that if we do not think that we can help you, or if our examination reveals any additional concerns, we will refer you appropriately and liaise with your general practitioner on your behalf.
DO I NEED X-RAYS?
Our location allows us to work in close collaboration with a number of excellent diagnostic facilities, including PRP Imaging and SAN Radiology at the Sydney Adventist Hospital. We collaborate with some of the best radiologists in the country.

The cost of plain film X-rays is largely covered by Medicare (Australian residents only), with only a small out-of-pocket expense. MRI scans are not claimable under Medicare (except when referred by a medical specialist), however, PRP Imaging has very competitive rates and can generally accommodate our patients on short notice.
WHAT ARE THE FEES?
Our consultation fees vary depending upon the nature of your visit and the time required. At your initial consultation our priority is to make the right diagnosis, as this then determines the correct treatment. So this visit may take up to an hour and involve significant discussion, a thorough examination, and a review of available medical imaging. You may, or may not, be treated on this first visit - depending upon whether it is safe and appropriate to do so. As such, our fees range from $175 to $275.

The fees for subsequent visits also vary, depending upon their nature.

A standard treatment costs $70, while extended consultations with/without treatment range from $120 to $90.
CAN I CLAIM ON PRIVATE HEALTH INSURANCE OR MEDICARE?
All major private health funds offer cover for chiropractic services - usually on their 'extras' table. However, annual limits do apply and the amount that you are reimbursed will vary. Check with your own fund to find out the exact details in your case.

If you are referred by your general practitioner under the Enhanced Primary Care (EPC) plan then you are able to claim a portion of your fees from Medicare (up to a maximum of 5 visits per year). You will need to talk to your GP about the appropriate referral.

We do not keep accounts, so payment for all consultations is expected on the day. We have electronic health fund rebates and Medicare Easyclaim facilities that allows you to pay for your consultation and claim your rebate immediately. Your funds will then be deposited into your chosen bank account (if you have set this up).
WILL I BE TREATED ON MY FIRST VISIT?
If you are in pain then naturally you'll be keen to start treatment. We understand that. But it is most important that we make an accurate diagnosis first, so that we know exactly what's causing your problem. Our chiropractors are hugely experienced and will do everything they can to help you as quickly as possible.

Sometimes the situation calls for an X-ray, or an MRI scan, or blood tests first - but we'll explain all of this to you and will only order these tests if they are truly necessary. In other cases it is safe and appropriate to begin treatment immediately.
MDL
Dr Matthew D. Long
CHIROPRACTOR AND PARTNER
BSc (Syd), M.Chiro (Macq)
Matthew Long graduated from Sydney University with a Bachelor of Science prior to undertaking his Masters degree in Chiropractic at Macquarie University (dux). He established the Wahroonga practice in 1992 and has also been involved in chiropractic education since this time, both as a lecturer at Macquarie University and in post-graduate training programs. Matthew has always emphasised a multi-disciplinary approach to patient care and enjoys the highest level of co-operation with his medical peers. He has an active interest in research and is Chief of Research and Cofounder of Clinical Development International (CDI), a continuing education organisation for chiropractors that delivers evidence-based education around the world.
  • Chief of Research of Clinical Development International (CDI) - Professional Continuing Education Organisation for Chiropractors
  • Past lecturer in Neurology and Pre-Clinical Studies at Macquarie University
  • Completed specialised training in neurology, which less than 1% of Australian chiropractors have undertaken
  • Actively involved in mentoring chiropractors in Australia and New Zealand with an emphasis on professional standards of practice and clinical excellence
  • Areas of clinical interest include chronic spinal pain, sciatica and migraine
  • Past Macquarie University Department of Chiropractic Clinical Competency Examiner
  • Regular lecturer and presenter of CDI’s training programs across Australia, New Zealand and Hong Kong
  • Author of the Clinical Clarity Blog, an online educational resource focussing upon diagnosis
  • Past speaker at RACGP Continuing Education Forums
  • Member of the International Association for the Study of Pain
  • Member of Chiropractic Australia
Anthony Nicholson is a partner of the Wahroonga Practice and an adjunct senior lecturer in neurology at Macquarie University. As an experienced and evidence-based diagnostician, Anthony works largely by medical and specialist referral. He completed his undergraduate training at the University of Queensland and his Clinical Masters degree (dux) at Macquarie University. Anthony then went on to complete further specialised training in clinical neurology to become a diplomate of the American Chiropractic Neurology Board, and then in orthopaedics to become a fellow of the Academy of Chiropractic Orthopedists (one of few chiropractors worldwide to be board certified in both disciplines). Anthony plays a key leadership role in the continuing education of other chiropractors. He is the CEO of Clinical Development International (CDI), a continuing education organisation for chiropractors that he cofounded in 2002. Anthony speaks in Australia and internationally on a regular basis and CDI has grown to deliver professional continuing education to chiropractors across Australia, New Zealand, UK and the United States.
  • Adjunct senior lecturer in Neuromusculoskeletal Diagnosis at Macquarie University, Sydney
  • CEO, Clinical Development International (CDI) - Continuing Education Organisation for Chiropractors
  • Diplomate of the American Chiropractic Neurology Board (DACNB)
  • Fellow of the Academy of Chiropractic Orthopedists (FACO)
  • Frequent speaker at international conferences and regular lecturer of CDI’s continuing education programs across Australia, New Zealand and South East Asia
  • With special interests in neuroscience, pain science and spinal diagnosis, Anthony delivers online lectures to a worldwide subscriber base
  • Areas of clinical specialisation include chronic spinal pain, the neurological control of spinal stability, balance disorders (dizziness and vertigo), sciatica and fall prevention
  • Contributor to exam content for speciality board certification examinations conducted by the American Chiropractic Neurology Board
  • Past Macquarie University Department of Chiropractic Clinical Competency Examiner
Dr Anthony D. Nicholson
CHIROPRACTOR AND PARTNER
BSc (Qld), M.Chiro (Macq), DACNB, FACO
Dr Susan J. Carnegie
CHIROPRACTOR
BSc (Hons) (Glam), PG Cert Clin Man Pain (Edin)
Susan Carnegie has a first class Bachelors of Science Honours degree in Chiropractic from University of Glamorgan Wales and received the award for Clinical Excellence. She has extensive clinical experience across both hemispheres, and enjoys a close working relationship with her local medical community. Most recently she has completed a Post-Graduate Certificate in Clinical Management of Pain.
  • Completed the New Zealand Chiropractic Board Exams
  • Practiced in New Zealand and the United Kingdom
  • Areas of clinical interest include scoliosis, sciatica and pregnancy-related neuromusculoskeletal pain (pre and post natal)
  • Currently undertaking the International Chiropractic Sports Science Diploma
  • Has participated in many multidisciplinary seminars including Royal College of Edinburgh Neurology Symposium on headaches, migraines and dizziness
  • Completed a Post-Graduate Certificate in Clinical Management of Pain
  • Member of the Scottish Chiropractic Association
Close
FREQUENTLY ASKED QUESTIONS
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CAN CHIROPRACTIC TREATMENT HELP?
The spine is an intricate and sophisticated structure. So when things go wrong it requires a unique expertise to diagnose the various conditions that might result.

While there are many fanciful claims made about the spine, no single treatment approach is a panacea. However, it is vital that your clinician is up-to-date with current advances in research. While each profession has its unique attributes and tools, we all share data from a common pool of scientific research, and it is this that directs the state-of-the-art treatment approach.

By first making an accurate diagnosis we can be sure that you are in the right place and that we can give you the best care that science supports.
CAN A SPINAL BONE REALLY 'GO OUT OF PLACE'?
One of the great misconceptions about the spine is that your bones can ‘go out of place’. While true dislocations or sub-luxations (partial dislocations) do occur as a result of trauma, these injuries are serious and often require hospitalisation. Unfortunately there is often confusion regarding the term ‘subluxation’, as chiropractors historically used this word to describe the less severe forms of spinal dysfunction seen on a daily basis. As such, the use of the word ‘subluxation’ to describe most common spinal problems is being used less and less.

So what does happen to the spine?

In truth, there are a myriad of possible forms of spinal problem and each should be treated individually. When the spine becomes painful it may be the result of local tissue damage - perhaps to the lining of a spinal joint, or a tear in the wall of an intervertebral disc. Interestingly, such damage doesn’t usually happen as a result of significant trauma. Rather, our patients often tell us that they suddenly felt pain during some innocuous everyday movement - or that their discomfort crept up on them slowly ‘for no reason’. So what’s going on here?

In many cases spinal problems develop slowly over time without any clues to their existence - a bit like tooth decay or heart disease. But the ‘problem’ might not be what you think. The real reason that a spine might spontaneously become painful has more to do with a loss of spinal control than any loss of strength. The human spine is an incredibly complex and flexible structure that requires precision control if you don’t want to injure it. What’s more, the moment-by-moment regulation of joint alignment is all done unconsciously - just like the beating of your heart. And, in the same way that people might develop problems with their heart rate or rhythm (a control problem), you may also suffer control problems in your spine. If this happens, then you may well injure yourself with a simple movement.

Interestingly, spinal manipulation works directly by stimulating the control centres of your spinal cord and nervous system to help them do their job better and allow you to maintain your own alignment better. We then follow this up with exercises to help you amplify the improvements that we make on your behalf.
IS A COURSE OF TREATMENT NECESSARY?
In many cases you will need a course of treatment. Manipulation of the spine is dose-dependent and its effects are cumulative over time. When manipulation is combined with exercises we can achieve a strong and stable spine that will handle the challenges that you throw at it.

As discussed above, having a pain-free and healthy spine is all about control - and much of the control ‘circuitry’ for your spine resides in the balance centres of your brain. Chronic spinal problems have been shown to involve poor balance and coordination of the spinal muscles. So to help you on your path to recovery we’ll need to identify and address any such issue.

To achieve spinal stability and control is not unlike any other discipline. It takes time to develop, and here at Spine Partners Wahroonga we are experienced in putting together the rehabilitation programs that you need. Furthermore, our dedication to Evidence-Based Practice means that we will measure your progress every step of the way.
IS IT POSSIBLE TO BE OVER-TREATED?
While it is very hard to cause injury through manipulative treatment when performed by a highly trained expert, there must always be an appropriate and rational reason for any clinical recommendation. Manipulation of the spine is a powerful tool and very well supported by the scientific community. However, it needs to be performed by an expert, and the amount must be carefully calculated to match the needs of the individual patient. While we admit that science hasn’t yet found all of the answers, using a scientific approach to your care helps us to fine-tune your treatment and closely monitor it to see what’s working, and what’s not.

Most of the patients referred to Spine Partners Wahroonga have chronic or recurrent problems. In fact, the average length of symptoms prior to seeing us is just over 3 years! As such, we are usually faced with a problem that is ‘multi-layered’. While treating the core diagnosis might be straightforward, such as an intervertebral disc protrusion, dealing with the compensatory changes is not so easy.

Most complex spinal conditions involve the following factors:

  • A core diagnosis or injury - such as a disc lesion, joint arthritis or nerve compression
  • An abnormal movement pattern to compensate for the original injury - think of this like the limp that develops when you sprain your ankle, but imagine it never going away
  • A balance or control deficit that keeps you always on the edge of further injury

Successful treatment and future prevention of your condition involves identifying each of these components and then addressing them all effectively. At Spine Partners Wahroonga, this is our passion and our core expertise.
IS IT SAFE?
Your safety is our first concern, but this involves more than just the way in which you may be treated.

Firstly, your safety depends upon the accuracy of your diagnosis. For this reason we will not compromise in our initial investigation of your case. Our clinical examination and access to state-of-the-art radiology services means that we can be sure that you are being treated in the most appropriate fashion.

Secondly, we work in close co-operation with other medical professionals to ensure that you are appropriately referred if your condition requires another speciality or approach.

Finally, spinal manipulation has proven itself to be remarkably safe when used appropriately. The effectiveness and safety of any tool is only as good as the knowledge that underlies its use, and it is this dedication to knowledge that you can rely upon at Spine Partners Wahroonga.
iPad Targeted Content
Android Targeted Content
CAN CHIROPRACTIC TREATMENT HELP?
The spine is an intricate and sophisticated structure. So when things go wrong it requires a unique expertise to diagnose the various conditions that might result.

While there are many fanciful claims made about the spine, no single treatment approach is a panacea. However, it is vital that your clinician is up-to-date with current advances in research. While each profession has its unique attributes and tools, we all share data from a common pool of scientific research, and it is this that directs the state-of-the-art treatment approach.

By first making an accurate diagnosis we can be sure that you are in the right place and that we can give you the best care that science supports.
CAN A SPINAL BONE REALLY 'GO OUT OF PLACE'?
One of the great misconceptions about the spine is that your bones can ‘go out of place’. While true dislocations or sub-luxations (partial dislocations) do occur as a result of trauma, these injuries are serious and often require hospitalisation. Unfortunately there is often confusion regarding the term ‘subluxation’, as chiropractors historically used this word to describe the less severe forms of spinal dysfunction seen on a daily basis. As such, the use of the word ‘subluxation’ to describe most common spinal problems is being used less and less.

So what does happen to the spine?

In truth, there are a myriad of possible forms of spinal problem and each should be treated individually. When the spine becomes painful it may be the result of local tissue damage - perhaps to the lining of a spinal joint, or a tear in the wall of an intervertebral disc. Interestingly, such damage doesn’t usually happen as a result of significant trauma. Rather, our patients often tell us that they suddenly felt pain during some innocuous everyday movement - or that their discomfort crept up on them slowly ‘for no reason’. So what’s going on here?

In many cases spinal problems develop slowly over time without any clues to their existence - a bit like tooth decay or heart disease. But the ‘problem’ might not be what you think. The real reason that a spine might spontaneously become painful has more to do with a loss of spinal control than any loss of strength. The human spine is an incredibly complex and flexible structure that requires precision control if you don’t want to injure it. What’s more, the moment-by-moment regulation of joint alignment is all done unconsciously - just like the beating of your heart. And, in the same way that people might develop problems with their heart rate or rhythm (a control problem), you may also suffer control problems in your spine. If this happens, then you may well injure yourself with a simple movement.

Interestingly, spinal manipulation works directly by stimulating the control centres of your spinal cord and nervous system to help them do their job better and allow you to maintain your own alignment better. We then follow this up with exercises to help you amplify the improvements that we make on your behalf.
IS A COURSE OF TREATMENT NECESSARY?
In many cases you will need a course of treatment. Manipulation of the spine is dose-dependent and its effects are cumulative over time. When manipulation is combined with exercises we can achieve a strong and stable spine that will handle the challenges that you throw at it.

As discussed above, having a pain-free and healthy spine is all about control - and much of the control ‘circuitry’ for your spine resides in the balance centres of your brain. Chronic spinal problems have been shown to involve poor balance and coordination of the spinal muscles. So to help you on your path to recovery we’ll need to identify and address any such issue.

To achieve spinal stability and control is not unlike any other discipline. It takes time to develop, and here at Spine Partners Wahroonga we are experienced in putting together the rehabilitation programs that you need. Furthermore, our dedication to Evidence-Based Practice means that we will measure your progress every step of the way.
IS IT POSSIBLE TO BE OVER-TREATED?
While it is very hard to cause injury through manipulative treatment when performed by a highly trained expert, there must always be an appropriate and rational reason for any clinical recommendation. Manipulation of the spine is a powerful tool and very well supported by the scientific community. However, it needs to be performed by an expert, and the amount must be carefully calculated to match the needs of the individual patient. While we admit that science hasn’t yet found all of the answers, using a scientific approach to your care helps us to fine-tune your treatment and closely monitor it to see what’s working, and what’s not.

Most of the patients referred to Spine Partners Wahroonga have chronic or recurrent problems. In fact, the average length of symptoms prior to seeing us is just over 3 years! As such, we are usually faced with a problem that is ‘multi-layered’. While treating the core diagnosis might be straightforward, such as an intervertebral disc protrusion, dealing with the compensatory changes is not so easy.

Most complex spinal conditions involve the following factors:

  • A core diagnosis or injury - such as a disc lesion, joint arthritis or nerve compression
  • An abnormal movement pattern to compensate for the original injury - think of this like the limp that develops when you sprain your ankle, but imagine it never going away
  • A balance or control deficit that keeps you always on the edge of further injury

Successful treatment and future prevention of your condition involves identifying each of these components and then addressing them all effectively. At Spine Partners Wahroonga, this is our passion and our core expertise.
IS IT SAFE?
Your safety is our first concern, but this involves more than just the way in which you may be treated.

Firstly, your safety depends upon the accuracy of your diagnosis. For this reason we will not compromise in our initial investigation of your case. Our clinical examination and access to state-of-the-art radiology services means that we can be sure that you are being treated in the most appropriate fashion.

Secondly, we work in close co-operation with other medical professionals to ensure that you are appropriately referred if your condition requires another speciality or approach.

Finally, spinal manipulation has proven itself to be remarkably safe when used appropriately. The effectiveness and safety of any tool is only as good as the knowledge that underlies its use, and it is this dedication to knowledge that you can rely upon at Spine Partners Wahroonga.
Blackberry Targeted Content
Desktop and all none targeted content
CAN CHIROPRACTIC TREATMENT HELP?
The spine is an intricate and sophisticated structure. So when things go wrong it requires a unique expertise to diagnose the various conditions that might result.

While there are many fanciful claims made about the spine, no single treatment approach is a panacea. However, it is vital that your clinician is up-to-date with current advances in research. While each profession has its unique attributes and tools, we all share data from a common pool of scientific research, and it is this that directs the state-of-the-art treatment approach.

By first making an accurate diagnosis we can be sure that you are in the right place and that we can give you the best care that science supports.
CAN A SPINAL BONE REALLY 'GO OUT OF PLACE'?
One of the great misconceptions about the spine is that your bones can ‘go out of place’. While true dislocations or sub-luxations (partial dislocations) do occur as a result of trauma, these injuries are serious and often require hospitalisation. Unfortunately there is often confusion regarding the term ‘subluxation’, as chiropractors historically used this word to describe the less severe forms of spinal dysfunction seen on a daily basis. As such, the use of the word ‘subluxation’ to describe most common spinal problems is being used less and less.

So what does happen to the spine?

In truth, there are a myriad of possible forms of spinal problem and each should be treated individually. When the spine becomes painful it may be the result of local tissue damage - perhaps to the lining of a spinal joint, or a tear in the wall of an intervertebral disc. Interestingly, such damage doesn’t usually happen as a result of significant trauma. Rather, our patients often tell us that they suddenly felt pain during some innocuous everyday movement - or that their discomfort crept up on them slowly ‘for no reason’. So what’s going on here?

In many cases spinal problems develop slowly over time without any clues to their existence - a bit like tooth decay or heart disease. But the ‘problem’ might not be what you think. The real reason that a spine might spontaneously become painful has more to do with a loss of spinal control than any loss of strength. The human spine is an incredibly complex and flexible structure that requires precision control if you don’t want to injure it. What’s more, the moment-by-moment regulation of joint alignment is all done unconsciously - just like the beating of your heart. And, in the same way that people might develop problems with their heart rate or rhythm (a control problem), you may also suffer control problems in your spine. If this happens, then you may well injure yourself with a simple movement.

Interestingly, spinal manipulation works directly by stimulating the control centres of your spinal cord and nervous system to help them do their job better and allow you to maintain your own alignment better. We then follow this up with exercises to help you amplify the improvements that we make on your behalf.
IS A COURSE OF TREATMENT NECESSARY?
In many cases you will need a course of treatment. Manipulation of the spine is dose-dependent and its effects are cumulative over time. When manipulation is combined with exercises we can achieve a strong and stable spine that will handle the challenges that you throw at it.

As discussed above, having a pain-free and healthy spine is all about control - and much of the control ‘circuitry’ for your spine resides in the balance centres of your brain. Chronic spinal problems have been shown to involve poor balance and coordination of the spinal muscles. So to help you on your path to recovery we’ll need to identify and address any such issue.

To achieve spinal stability and control is not unlike any other discipline. It takes time to develop, and here at Spine Partners Wahroonga we are experienced in putting together the rehabilitation programs that you need. Furthermore, our dedication to Evidence-Based Practice means that we will measure your progress every step of the way.
IS IT POSSIBLE TO BE OVER-TREATED?
While it is very hard to cause injury through manipulative treatment when performed by a highly trained expert, there must always be an appropriate and rational reason for any clinical recommendation. Manipulation of the spine is a powerful tool and very well supported by the scientific community. However, it needs to be performed by an expert, and the amount must be carefully calculated to match the needs of the individual patient. While we admit that science hasn’t yet found all of the answers, using a scientific approach to your care helps us to fine-tune your treatment and closely monitor it to see what’s working, and what’s not.

Most of the patients referred to Spine Partners Wahroonga have chronic or recurrent problems. In fact, the average length of symptoms prior to seeing us is just over 3 years! As such, we are usually faced with a problem that is ‘multi-layered’. While treating the core diagnosis might be straightforward, such as an intervertebral disc protrusion, dealing with the compensatory changes is not so easy.

Most complex spinal conditions involve the following factors:

  • A core diagnosis or injury - such as a disc lesion, joint arthritis or nerve compression
  • An abnormal movement pattern to compensate for the original injury - think of this like the limp that develops when you sprain your ankle, but imagine it never going away
  • A balance or control deficit that keeps you always on the edge of further injury

Successful treatment and future prevention of your condition involves identifying each of these components and then addressing them all effectively. At Spine Partners Wahroonga, this is our passion and our core expertise.
IS IT SAFE?
Your safety is our first concern, but this involves more than just the way in which you may be treated.

Firstly, your safety depends upon the accuracy of your diagnosis. For this reason we will not compromise in our initial investigation of your case. Our clinical examination and access to state-of-the-art radiology services means that we can be sure that you are being treated in the most appropriate fashion.

Secondly, we work in close co-operation with other medical professionals to ensure that you are appropriately referred if your condition requires another speciality or approach.

Finally, spinal manipulation has proven itself to be remarkably safe when used appropriately. The effectiveness and safety of any tool is only as good as the knowledge that underlies its use, and it is this dedication to knowledge that you can rely upon at Spine Partners Wahroonga.