Download
1 / 114
E N D
Chiropractic • Chiropractic is one of the most controversial and poorly • defined healthcare professions with recognition and licensure • in the United States. • Chiropractic was started by D. D. Palmer, a magnetic healer • who formulated the vertebral subluxation theory. • Although the definition of chiropractic as a method of • correcting vertebral subluxations to restore and maintain health is questionable.
Chiropractic • The chiropractic profession is still based on the vertebral subluxation theory and has the confusing image of a back specialty capable of treating a broad scope of health problems. • Despite opposition to use of spinal manipulation as a method of treating a broad scope of health problems.
Chiropractic • In 1895, D. D. Palmer, a magnetic healer, announced “Ninety-five percent of all diseases are caused by displaced vertebrae, the remainder by luxations of other joints.” • Palmer claimed he had cured deafness by using his hands to push a displaced fourth thoracic vertebra into alignment.
Chiropractic • Believing that all bodily functions are controlled by the • flow of nerve vibrations from the brain to the spinal cord • and out through openings between the vertebrae. • Palmer claimed that adjusting the vertebrae to remove • interference with this flow of nerve energy would allow the body to heal most diseases.
Chiropractic • In 1897, he opened the Palmer School and Cure in Davenport, • Iowa, offering a 3-week study course. • It was not until Bartlett Joshua Palmer graduated from • his father’s school in 1902 that chiropractic became recognized.
Chiropractic • Promoting the idea that correcting subluxationsin the spine would cure virtually every disease, B. J. Palmer’s slogans and advertising strategies attracted many students to the Palmer School, by then named the PalmerSchool of Chiropractic. • When World War I ended in 1918, many veterans who • could not find employment were attracted by Palmer’s ads • (my father among them). “Do you want to follow manual • labor or a profession?” the ads asked
Chiropractic • “The commonlabor field is crowded. There are many persons who wantto do hard work. Let those who are anxious have it. Youfit yourself for a profession.” • B. J. Palmer took advantage of ignorance and desperation. “Give me a simple mind that thinks along singletracts,”
Chiropractic • “give me 30 days to instruct him, and thatindividual can go • forth on the highways and byways andget more sick people well than the best, most complete, allaround, unlimited medical education of any medical manwho ever lived.” • Today, the chiropractic profession continues to cling to • the vertebral subluxation theory despite a progressive increase in the educational standards of its school.
Chiropractic • cording to the Council on Chiropractic Education, the • minimum requirements for admission to a doctor of chiropractic program are 90 semester hours (3 years) of undergraduate study leading to a bachelor’s degree and a grade point average of at least 2.50. • A few states and colleges require a 4-year bachelor’s degree. • Chiropractic school is a 4-year course with approximately 4800 study hours.
Chiropractic • Scientific consensus does not support the theory that • nerve interference caused by vertebral misalignment or subluxation is a cause of organic disease. • Spinal nerves primarily supply musculoskeletal structures.
Chiropractic • Organ function is governed by the autonomic nervous system in concert with psychic, chemical, hormonal, and circulatory factors. • The sphincter muscles involved in voluntary control of bladder and bowel functions are supplied by spinal nerves and sympathetic fibers that exit well-protected sacral foramina.
Chiropractic • Spinal nerves are commonly compressed by bony spurs • and herniated discs. • Even the most severe compression of a spinal nerve which • cripples the supplied musculoskeletal structures does not cause organic disease
What Is a Chiropractic Subluxation? • An orthopaedic subluxation is a painful partial dislocation. A • chiropractic subluxation is an asymptomatic misalignment or a “vertebral subluxation complex” thought to be a cause of disease. Such a subluxation has never been proven to exist.
What Is a Chiropractic Subluxation? • The illusive and often undetectable chiropractic subluxation, considered to be a factor in the development of visceral disease and back pain, has been defined by as many as 100 different names, such as a manipulable lesion or a neurobiomechanical lesion.
What Is a Chiropractic Subluxation? • Symptoms resulting from vertebral misalignment caused by • degenerative changes, disc thinning, or structural abnormalities sometimes can be relieved temporarily with manipulation. • Such subluxations are not correctable and are not often • significant.
What Is a Chiropractic Subluxation? • In rare cases, binding or locking of overriding vertebral facets • can be dramatically relieved by one manipulation that restores mobility. • In 1995, in a landmark and largely ignored study of the • literature by two chiropractors, • Nansel and Szlazak suggested that there are no appropriately • controlled studies to indicate that dysfunction in structures of the spinal column could cause organic disease.
What Is a Chiropractic Subluxation? • They reported that, “it has now been firmly established that somatic dysfunction is notorious in its ability to create signs and symptoms that can mimic, or simulate (rather than cause), internal organic disease.”
What Is a Chiropractic Subluxation? • However, Rosner, in a report published by the Foundation for Chiropractic Education and Research, contends that these findings are contradicted by studies supporting the concept of subluxation.
What Is a Chiropractic Subluxation? • In July 1996, the Association of Chiropractic Colleges • (ACC), representing 16 North American chiropractic colleges, reached a consensus and stated that “Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.
What Is a Chiropractic Subluxation? • A Subluxation is a complex of functional and/or pathological • articular changes that compromise neural integrity and may influence organ system function and general health.” This theory seems to ignore autonomic cranial and sacral nerves which do not pass through movable articulations.
What Is a Chiropractic Subluxation? • The ACC’s paradigm and its views on subluxation were endorsed by the International Chiropractic Association and the American Chiropractic Association in November 2000 and by the World Federation of Chiropractic in May 2001.
What Is a Chiropractic Subluxation? • The document was included in Appendix A of the 2005 edition of Job Analysis of Chiropractic, published by the National Board of Chiropractic Examiners. • In 1997, the Foundation for Chiropractic Education and Research (FCER) published the monograph by Rosner titled “The Role of Subluxations in Chiropractic.”
What Is a Chiropractic Subluxation? • A subluxation was described as a vertebral subluxation complex that “embraces the holistic nature of the human body, including health, well-being, the doctor/patient relationship, and the changes in nerve, muscle, connective, and vascular tissues which are understood to accompany the kinesiologic aberrations of spinal articulations.”
What Is a Chiropractic Subluxation? • In this monograph, Rosner also stated that “slight misalignments may not be detectable by any of the current technological methods.”
What Is a Chiropractic Subluxation? • It is unreasonable to assume that slight misalignment of a vertebra or an undetectable subluxation complex can cause disease or ill health when those effects do not occur because of gross vertebral displacement or by impingement of a spinal nerve.
What Is a Chiropractic Subluxation? • Many of the immunologic and physiologic effects attributed to the spinal adjustment are temporary, such as production of endorphins, a decrease in prostaglandin levels, and an increase in leukocyte respiration.
What Is a Chiropractic Subluxation? • They have never been shown to be related to the cause and cure of disease. Numerous forms of physical stimulation, such as deep massage, hydrotherapy, or acupuncture, can produce similar biochemical effects.
What Is a Chiropractic Subluxation? • According to a 2003 random survey of 1102 active • North American chiropractors, 88.1% of 687 respondents • thought that the term vertebral subluxation complex • should be retained by the chiropractic profession.
What Is a Chiropractic Subluxation? • The respondents also thought that vertebral subluxation is a • significant contributing factor in 62.1% of visceral ailments. The majority (89.8%) thought that the adjustment should not be limited to musculoskeletal conditions.
What Is a Chiropractic Subluxation? • The respondents also thought that vertebral subluxation is a • significant contributing factor in 62.1% of visceral ailments. The majority (89.8%) thought that the adjustment should not be limited to musculoskeletal conditions.
What Is a Chiropractic Subluxation? • Atleast one chiropractic journal, the Journal of Vertebral • Subluxation Research, is devoted to preserving and promoting the subluxation theory. Articles on spinal adjustments as effective treatments for conditions such as multiple sclerosis, otitis media, and infertility are published inthis journal.
What Is a Chiropractic Subluxation? • Goertz, in an article published by The American Chiropractic Association in 1998, reported that 94% of chiropractic patients were treated for neuromusculoskeletalconditions. Yet, chiropractic colleges, associations, andresearch organizations continue to promote chiropracticas a method of adjusting the spine to improve generalhealth.
What Is a Chiropractic Subluxation? • There is no proof that subluxations cause organic disease, but chiropractic theory and philosophy support different spinal adjustive procedures that allegedly are effective in restoring and maintaining health by removing nerve interference (Fig 1). Samuel Homola, DC (2006)
What Is a Chiropractic Subluxation? • Christensen et al, in a survey analysis published by the National Board of Chiropractic Examiners in 2005, rated 15 adjustive procedures commonly used by chiropractors. Most chiropractors (96.2%) treating disease.
What Is a Chiropractic Subluxation? • The treatment poses a risk of injury to the vertebrobasilar arteries. Although the incidence of stroke caused by neck manipulation may be low, risk outweighs benefit, when the upper cervical spine is routinely manipulated to restore and maintain health
What Is a Chiropractic Subluxation? • Coulter et al reported an incidence of 1.46 vertebrobasilar injuries per 1,000,000 neck manipulations, noting that only 11.1% of reported indications for cervical manipulation could be labeled appropriate.
What Is a Chiropractic Subluxation? • Another estimate placed the number of strokes caused by neck manipulation at 1.3 per 100,000 persons receiving such treatment. • The true incidence of vertebrobasilar injuries caused by neck manipulation is not known since “they are probably unreported in the literature.”
What Is a Chiropractic Subluxation? • The Activator (Activator Methods Int, Phoenix, AZ), aspring-loaded stylus which somechiropractors claim issafer than manual manipulation (Fig 2), is used by 69.9%of chiropractors to tap misaligned vertebrae back intoalignment. Acupuncture was used by 13.6% of surveyrespondents, acupressure or meridian therapy by 58.2%,and homeopathic remedies by 46.4%
What Is a Chiropractic Subluxation? • The 1995 edition of Chiropractic: An Illustrated Historylists 97 techniques used by chiropractors. Applied kinesiology, a nonsensical method of testing muscle strength touse a diversified full spine approach and various techniques.
What Is a Chiropractic Subluxation? • They reported that 25.7% of chiropractors usethe Palmer upper cervical technique; 26% use a Loganbasic technique (a method of adjusting the sacrum); 38%use cranial adjusting; 49.6% use a sacro-occipital technique (a method that requires adjusting the upper cervicalarea and the sacrum);
What Is a Chiropractic Subluxation? • and 61.3% use the Thompson Terminal Point Technique (a method in which leg length ischecked to determine subluxations in the pelvic and cervical regions)
What Is a Chiropractic Subluxation? • More than 15% of chiropractors use the Meric System (a method of adjusting a specific vertebra for a specific illness). Individual practitioners use six techniques in their practices.
What Is a Chiropractic Subluxation? • A few specialize in only one technique, such as the orthogonal atlas specialists who are members of the National Upper Cervical Chiropractic Association (NUCCA).
What Is a Chiropractic Subluxation? • Upper cervical chiropractic is the most dangerous and nonsensical of all the chiropractic techniques as it routinely is applied to the vulnerable atlantooccipital area.
What Is a Chiropractic Subluxation? • Specialists who use this method think that nerve interference caused by misalignment of the atlas causes most ailments, requiring atlas adjustments for preventing and detect the presence of disease, deficiencies, and subluxations, is used by 37.6% of chiropractors.
What Is a Chiropractic Subluxation? • Some chiropractors use thermography or a thermocouple device, such as a nervoscope (Nervoscope, Electronic Development Labs, Inc, Danville, VA) to detect heat thought to be associated with subluxations that cannot be seen radiographically.
What Is a Chiropractic Subluxation? • Such devices do not have any proven value as a method of locating subluxations. Thermography has not been found to be accurate in detecting the presence or absence of nerve root compression
What Is a Chiropractic Subluxation? • Although some chiropractors use appropriate physical • treatment methods along with spinal manipulation, the absence of an evidence-based approach causes a mixing of science and pseudoscience.
What Is a Chiropractic Subluxation? • Some misguided chiropractors are exploited by practice-building entrepreneurs who offer instructions in how to use a subluxation-based approach to attract patients for lifelong care, which endangers the public’s health.
What Is a Chiropractic Subluxation? • The subluxation theory provides a convenient shortcut for chiropractors who may be diagnostically incompetent or who may want a high-volume practice without any associated responsibility.
