An Introduction To Chiropractic Care

By Dr. John A. Papa, DC, FCCPOR(C)

Chiropractic is one of the largest primary contact health professions in Canada.  Approximately four and a half million Canadians use the services of a chiropractor each year.  Despite the professions growing popularity, there are still many in the public who don’t exactly know what services a chiropractor performs or what qualifications and training they possess.  This article is the first of a two part series introducing the chiropractic health discipline and the profession’s role in the health care system.

A large majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system (joints, muscles, tendons, nerves and bones).  Chiropractors provide diagnosis, treatment and management of these complaints which may include but are not limited to:  back pain, neck pain, sciatica, whiplash, osteoarthritis, migraine and tension headaches, upper and lower extremity complaints, along with repetitive strain, sport, work and motor vehicle injuries.

Chiropractic practitioners undergo a rigorous course of study similar to that of other health professionals.  Training involves a minimum of three years undergraduate university education, followed by another four years of intensive academic and clinical education at an accredited chiropractic college.  Becoming licensed to practice chiropractic requires all eligible candidates to pass national and provincial examinations before applying to the Licensing Board.  Specialized post-graduate training enables the chiropractors of today to offer their patients additional treatment options.

Chiropractic in Canada is regulated by provincial statute in all provinces (The Chiropractic Act, 1991), created in accordance with the Regulated Health Professions Act (RHPA, 1991).  Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor.  The College of Chiropractors of Ontario, like the colleges in each of the other provinces, is similar to the regulatory bodies for other health professions.  It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.

Chiropractic is well recognized within the health care system.  Chiropractic care is covered by the Workplace Safety and Insurance Board (WSIB) for occupational injuries, by automobile insurance in the event of a motor vehicle accident (MVA) injury, and by many Extended Health Care (EHC) plans.  A medical referral is not necessary to access chiropractic care.  Chiropractic adjustments are just one mode of therapy utilized by chiropractors today (but not with every patient).  Some chiropractors are also trained to employ other forms of physical therapy such as acupuncture, electrotherapy, soft tissue therapy, and rehabilitative exercises.  If your complaint is not something that would respond favorably to chiropractic care, a referral is made to the appropriate health professional.

Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).  Join us next time for the second part of this series on chiropractic where you will learn about the chiropractic experience from a patient’s perspective.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

What Smoking Does To Your Musculoskeletal System

By Dr. John A. Papa, DC, FCCPOR(C)

The musculoskeletal (MSK) system includes the muscles, tendons, joints, and bones of the body.  Cigarettes contain many harmful chemicals, including nicotine and carbon monoxide which negatively affect the physical health and integrity of the MSK system.  Included below is a summary of those affects:

1.  Smoking decreases bone mineral density (BMD) and increases the risk of osteoporosis and future fractures.  Studies have shown that nicotine reduces the blood supply to bones, slows the production of bone forming cells, and decreases the absorption of calcium.  Post-menopausal women who smoke have greater spinal osteoporosis than non-smoking counterparts.  Among men, a consistently lower BMD at all bony sites is observed regardless of when in their life they smoked.  In addition, a relationship between cigarette smoking and low BMD in adolescence and early adulthood has been identified.

2.    Smoking delays healing times for bony fractures and soft tissue injuries such as rotator cuff tears.  Nicotine has been shown to decrease the production of fibroblasts (the main cells responsible for tissue repair).  In addition, the carbon monoxide found in tobacco smoke reduces oxygen levels in the body which is critical for all tissue healing.

3. Smoking contributes to an increase in spinal problems.  The reduced blood circulation found in smokers deprives spinal discs of vital nutrients which can lead to premature degeneration.  Smoking may also provoke disc herniation through coughing.  Studies demonstrate a definite link between smoking and low back pain that increases with the duration and frequency of the smoking.  Exposure to secondhand smoke during childhood may also increase the risk of developing neck and back problems later in life.

4.    Smoking increases pain levels.  Smokers complain more often of MSK pain than non-smokers.  Studies indicate that smoking makes individuals more susceptible to sensing pain at lower thresholds.  In addition, smoking causes general damage to the MSK system through direct chemical irritation, chronic inflammation, and restricting blood and nutrient flow.

5.   Smoking causes stress and de-conditioning in the body.  For optimal functioning, your muscles and joints need a steady supply of oxygen-rich blood.  Smoking not only stiffens your arteries, it also decreases the rate at which oxygen and carbon dioxide are exchanged in the blood.  Other side effects of smoking include fatigue, lung disorders, impaired healing, and chronic pain.  Impaired healing means that injuries affect you for longer than usual, and healing from surgeries or infections can be problematic.  These side effects can lead to inactivity, which causes deconditioning.

Scientific evidence has established links between cigarette smoking and its detrimental impact on the MSK system.  However, it is never too late to try and quit smoking.  Some of the negative health aspects of smoking start to reverse after a smoker quits.  Those looking for help in trying to quit should speak to a medical professional.  Valuable resources can also be found on the Health Canada and Canadian Lung Association websites.  For additional information on health and wellness, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

An Introduction To Chiropractic Care

By Dr. John A. Papa, DC, FCCPOR(C)

 

Chiropractic is one of the largest primary contact health professions in Canada.  Approximately four and a half million Canadians use the services of a chiropractor each year.  Despite the professions growing popularity, there are still many in the public who don’t exactly know what services a chiropractor performs or what qualifications and training they possess.  This article is the first of a two part series introducing the chiropractic health discipline and the profession’s role in the health care system.

 

A large majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system (joints, muscles, tendons, nerves and bones).  Chiropractors provide diagnosis, treatment and management of these complaints which may include but are not limited to:  back pain, neck pain, sciatica, whiplash, osteoarthritis, migraine and tension headaches, upper and lower extremity complaints, along with repetitive strain, sport, work and motor vehicle injuries.

 

Chiropractic practitioners undergo a rigorous course of study similar to that of other health professionals.  Training involves a minimum of three years undergraduate university education, followed by another four years of intensive academic and clinical education at an accredited chiropractic college.  Becoming licensed to practice chiropractic requires all eligible candidates to pass national and provincial examinations before applying to the Licensing Board.  Specialized post-graduate training enables the chiropractors of today to offer their patients additional treatment options.

Chiropractic in Canada is regulated by provincial statute in all provinces (The Chiropractic Act, 1991), created in accordance with the Regulated Health Professions Act (RHPA, 1991).  Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor.  The College of Chiropractors of Ontario, like the colleges in each of the other provinces, is similar to the regulatory bodies for other health professions.  It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.

Chiropractic is well recognized within the health care system.  Chiropractic care is covered by the Workplace Safety and Insurance Board (WSIB) for occupational injuries, by automobile insurance in the event of a motor vehicle accident (MVA) injury, and by many Extended Health Care (EHC) plans.  A medical referral is not necessary to access chiropractic care.  Chiropractic adjustments are just one mode of therapy utilized by chiropractors today (but not with every patient).  Some chiropractors are also trained to employ other forms of physical therapy such as acupuncture, electrotherapy, soft tissue therapy, and rehabilitative exercises.  If your complaint is not something that would respond favorably to chiropractic care, a referral is made to the appropriate health professional.

Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).  Join us next time for the second part of this series on chiropractic where you will learn about the chiropractic experience from a patient’s perspective.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Drink Water For Healthy Living

By Dr. John A. Papa, DC, FCCPOR(C)

 

The average person’s body is composed of approximately 70% water.  The body's water supply is responsible for and involved in nearly every biological process.  Human beings can survive without food for thirty to forty days, but without water, we would not be able to live beyond three to five days!

 

Below are some interesting facts about the role of water in the human body and the health benefits of adequate water intake.

 

1.    Regulation of body functions.  Water is essential for respiration, digestion, nutrient absorption, and elimination of waste products and toxins from the body.  Water is also responsible for healthy circulation, and controlling body temperature through perspiration.

 

2.    Signs of dehydration.  If not enough water is consumed, toxins can build up in the body resulting in many negative side effects.  The consequences of inadequate water intake/dehydration may include:  muscle and joint pain, cramping, headaches, fatigue, digestive problems, inflammation, and poor functioning of many organs.

 

3.    Helpful for weight loss.  Water is a great fluid replacement for high calorie drinks such as alcohol and sodas/carbonated drinks.  Drinking water before meals can also help kickstart metabolism and act as an appetite suppressant.

 

4.    Support for the Musculoskeletal (MSK) system.  Water brings vital nutrients to muscle tissue to support performance and decrease the risks of cramps and strains.  Water also helps to protect our joints by providing lubrication and cushioning.

 

5.    Better productivity at work.  Your brain consists of 90% water.  Therefore, proper hydration helps you think better, be more alert and focused, and feel more energized.

 

6.    Look younger with healthier skin.  Your skin is the largest organ in the body.  Water helps to replenish skin tissues by improving circulation to skin cells, maintaining elasticity, and moisturizing from the inside out.

 

7.    Feel healthier.  Consuming plenty of water can help maintain proper immune functioning, and can prevent or improve symptoms of the common cold, flu, arthritis, kidney stones, constipation, and many other conditions.

 

How much water is enough?  This is not an easy question to answer and can be dependent on many factors.  A general rule of thumb to follow is to consume 0.5-1 litre of water daily for every 50 pounds of body weight.  Special consideration for greater water consumption must be taken into account for those who are engaged in vigorous activity or exercise, and during the warmer months when more water is lost through perspiration.  Additional considerations must be taken into account for those who consume caffeine, alcoholic beverages, and certain medications, as these substances can act as diuretics and actually drain your body of water.

 

Looking at the color of your urine is an easy way to determine whether or not you are consuming enough water.  As long as you are not taking riboflavin (vitamin B2), which fluoresces and turns your urine bright yellow (it is also in most multi-vitamins), then your urine should be a very light-coloured yellow.  If it is a deep yellow then you are likely not drinking enough water.

 

Proper hydration is key for optimal functioning.  For additional information on improving your health, visit our website at www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Nutrients That Support Musculoskeletal Health

By Dr. John A. Papa, DC, FCCPOR(C)

The musculoskeletal (MSK) system includes the muscles, tendons, joints, and bones of the body.  Many nutrients contribute to the healthy functioning and integrity of the MSK system.  Included below is a summary of 5 common nutrients that significantly contribute to MSK health.

 

1.    WATER brings vital nutrients to muscle tissue to support movement and decrease the risk of cramps and strains.  Water also eliminates waste products and toxins from the body and helps to protect our joints by providing lubrication and cushioning.  The consequences of inadequate water intake/dehydration include:  muscle and joint pain, cramping, and fatigue.  A general rule of thumb to follow is to consume 0.5-1 litre of water daily for every 50 pounds of body weight.

 

2.    CALCIUM is best known for building strong bones.  It is also needed for muscular growth and contraction.  A deficiency in calcium status can lead to aching joints, muscle cramps, and osteoporosis.  Foods such as milk, yogurt, and cheese are good sources of calcium but may not be suitable for individuals sensitive to dairy products.  Other healthy foods high in calcium include pinto, navy, red and white kidney beans, sesame seeds, almonds, and dark leafy vegetables.

 

3.    VITAMIN D is essential for helping bones absorb calcium, keeping them strong, and preventing osteoporosis.  Signs of Vitamin D deficiency may include painful muscle spasms, leg cramps, numbness in the extremities, bony malformations, and arthritic pain.  Vitamin D is naturally found in food sources such as cod liver oil, salmon, mackerel, tuna fish, sardines, and egg yolks.  Sensible and safe sun exposure is also an important natural source of Vitamin D.

4.    VITAMIN C plays a vital role in collagen production and tissue repair.  Collagen is the building foundation for many body tissues and is found in all MSK structures.  There is an abundance of Vitamin C in strawberries, citrus fruits, and vegetables including, red peppers, broccoli, spinach, brussel sprouts and cauliflower.

 

5.    GLUCOSAMINE SULPHATE is a normal element of cartilage matrix and joint fluid and provides the body with the building blocks necessary to repair joint damage.  As we age, our bodies slow down the production of glucosamine sulphate.  Published research suggests that glucosamine sulphate is beneficial for arthritic patients, particularly for those individuals with mild to moderate osteoarthritis of the knees.  Some glucosamine sulphate supplements also contain anti-inflammatory herbs that can be combined with other nutrients such as Omega-3 fatty acids to help with arthritic pain.

 

Sensible eating should include nutritional balance with the correct proportion of quality carbohydrates, proteins, healthy fats, and adequate water intake.  Although nutritional supplements can help support MSK health, many nutrients appear to be most effective when consumed in their natural state within whole foods.  For additional information on diet, nutrition, and how you can improve your MSK health, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Keeping a Healthy Spine During Holiday Travels

Canadian Chiropractic Association

With the holiday season nearly upon us, many people are gearing up for travels in the next few weeks to visit loved ones or to take a much needed vacation. While time with family and vacations are relaxing and a great way to regenerate energy and zest, the process of traveling itself can often take a toll on our bodies and MSK system.

 

We want you to travel safe, and keep your spine safe too! Take a look at these helpful tips before you jet off this season:

 

Taking Care of Your Posture When Traveling¹

 

Carrying luggage, and long flights or road trips can place stress on the lower back which may result in back pain or other musculoskeletal (MSK) conditions. The following tips may assist in keeping your back safe from injury while traveling during the holidays and beyond.

1. Supporting your lower back. Supporting the curve in the lower back is important. In some cases, airplane seats are worn out and no longer adequately support the lower back leading to the loss of curvature and additional tension on the structures. To avoid sitting for prolonged periods in an “unnatural” position, place a small rolled-up airline pillow, blanket or a towel or lumbar pillow to fit and support the curve of your lower back. Moreover, you may consider sitting in a slightly reclined position to relieve the stress on your spine.
   
2. Sit Properly. While seated, your knees should be supported and bent at more or less a 90 degree angle. For example, if your seat is too high, consider placing your feet on something that can act as a firm footrest to keep your knees at a right angle.
   
3. Move. Sitting in a static position for extended periods of time can stiffen the back muscles and cause creep in the spine. Movement is key to keeping the spine and MSK system healthy. Get up, stretch and move around every 20 to 30 minutes when possible.
   
4. Use proper lifting technique. Use the entire body to turn when lifting heavy luggage. Pivot with your feet, not your back, so that your whole body moves, rather than only twisting your spine.
   
5. Don’t make luggage or carry-ons too heavy. Manage what you pack to avoid being left with heavy luggage to carry and maneuver. Lifting excessive weight overhead, for example, can cause hyperextension injuries. Decrease your risk of injury by packing light .

If you’re going to be sitting on a long flight or waiting in airports on long layovers, remember to take time to move, stretch and relieve the stress from travel. Choose lightweight suitcases that are easy to wheel and a properly fitted backpack as your carry on. Making smart choices throughout your travels will help you to enjoy your vacation comfortably once you arrive.

 

¹Katherine Teel, “Easy tips from Texas Back Institute to avoid Back Pain while Traveling this Holiday Season,” https://texasback.com/_docs/TBI_Holiday_Travel_Tips_Release.pdf.pdf.

The Chiropractic Patient Experience

By Dr. John A. Papa, DC, FCCPOR(C)

 

In last week’s article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care.  This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice.  Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.

 

Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain.  Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.

 

First, a thorough Medical History is taken which documents an individual's specific complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history.  Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing.  X-rays may also be ordered to help determine the source of pain or dysfunction.  Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care.  If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.

 

For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration.  Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions.  In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.

 

Chiropractors are trained to offer multi-modal physical therapy incorporating the use of different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function.  Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints.  Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion.  Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound).  Acupuncture can be used to promote healing, decrease pain, and control inflammation.  Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.

 

Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints.  Additional chiropractic resources can be found at:  (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

An Introduction To Chiropractic Care

By Dr. John A. Papa, DC, FCCPOR(C)

 

Chiropractic is one of the largest primary contact health professions in Canada.  Approximately four and a half million Canadians use the services of a chiropractor each year.  Despite the professions growing popularity, there are still many in the public who don’t exactly know what services a chiropractor performs or what qualifications and training they possess.  This article is the first of a two part series introducing the chiropractic health discipline and the profession’s role in the health care system.

 

A large majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system (joints, muscles, tendons, nerves and bones).  Chiropractors provide diagnosis, treatment and management of these complaints which may include but are not limited to:  back pain, neck pain, sciatica, whiplash, osteoarthritis, migraine and tension headaches, upper and lower extremity complaints, along with repetitive strain, sport, work and motor vehicle injuries.

 

Chiropractic practitioners undergo a rigorous course of study similar to that of other health professionals.  Training involves a minimum of three years undergraduate university education, followed by another four years of intensive academic and clinical education at an accredited chiropractic college.  Becoming licensed to practice chiropractic requires all eligible candidates to pass national and provincial examinations before applying to the Licensing Board.  Specialized post-graduate training enables the chiropractors of today to offer their patients additional treatment options.

 

Chiropractic in Canada is regulated by provincial statute in all provinces (The Chiropractic Act, 1991), created in accordance with the Regulated Health Professions Act (RHPA, 1991).  Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor.  The College of Chiropractors of Ontario, like the colleges in each of the other provinces, is similar to the regulatory bodies for other health professions.  It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.

 

Chiropractic is well recognized within the health care system.  Chiropractic care is covered by the Workplace Safety and Insurance Board (WSIB) for occupational injuries, by automobile insurance in the event of a motor vehicle accident (MVA) injury, and by many Extended Health Care (EHC) plans.  A medical referral is not necessary to access chiropractic care.  Chiropractic adjustments are just one mode of therapy utilized by chiropractors today (but not with every patient).  Some chiropractors are also trained to employ other forms of physical therapy such as acupuncture, electrotherapy, soft tissue therapy, and rehabilitative exercises.  If your complaint is not something that would respond favorably to chiropractic care, a referral is made to the appropriate health professional.

 

Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).  Join us next time for the second part of this series on chiropractic where you will learn about the chiropractic experience from a patient’s perspective.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

 

Drink Water For Healthy Living

By Dr. John A. Papa, DC, FCCPOR(C)

 

The average person’s body is composed of approximately 70% water.  The body's water supply is responsible for and involved in nearly every biological process.  Human beings can survive without food for thirty to forty days, but without water, we would not be able to live beyond three to five days!

 

Below are some interesting facts about the role of water in the human body and the health benefits of adequate water intake.

1.    Regulation of body functions.  Water is essential for respiration, digestion, nutrient absorption, and elimination of waste products and toxins from the body.  Water is also responsible for healthy circulation, and controlling body temperature through perspiration.

2.    Signs of dehydration.  If not enough water is consumed, toxins can build up in the body resulting in many negative side effects.  The consequences of inadequate water intake/dehydration may include:  muscle and joint pain, cramping, headaches, fatigue, digestive problems, inflammation, and poor functioning of many organs.

3.    Helpful for weight loss.  Water is a great fluid replacement for high calorie drinks such as alcohol and sodas/carbonated drinks.  Drinking water before meals can also help kickstart metabolism and act as an appetite suppressant.

4.    Support for the Musculoskeletal (MSK) system.  Water brings vital nutrients to muscle tissue to support performance and decrease the risks of cramps and strains.  Water also helps to protect our joints by providing lubrication and cushioning.

5.    Better productivity at work.  Your brain consists of 90% water.  Therefore, proper hydration helps you think better, be more alert and focused, and feel more energized.

6.    Look younger with healthier skin.  Your skin is the largest organ in the body.  Water helps to replenish skin tissues by improving circulation to skin cells, maintaining elasticity, and moisturizing from the inside out.

7.    Feel healthier.  Consuming plenty of water can help maintain proper immune functioning, and can prevent or improve symptoms of the common cold, flu, arthritis, kidney stones, constipation, and many other conditions.

How much water is enough?  This is not an easy question to answer and can be dependent on many factors.  A general rule of thumb to follow is to consume 0.5-1 litre of water daily for every 50 pounds of body weight.  Special consideration for greater water consumption must be taken into account for those who are engaged in vigorous activity or exercise, and during the warmer months when more water is lost through perspiration.  Additional considerations must be taken into account for those who consume caffeine, alcoholic beverages, and certain medications, as these substances can act as diuretics and actually drain your body of water.

Looking at the color of your urine is an easy way to determine whether or not you are consuming enough water.  As long as you are not taking riboflavin (vitamin B2), which fluoresces and turns your urine bright yellow (it is also in most multi-vitamins), then your urine should be a very light-coloured yellow.  If it is a deep yellow then you are likely not drinking enough water.

Proper hydration is key for optimal functioning.  For additional information on improving your health, visit our website at www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.