Chiropractic, also known as chiropractic care, is a world-wide health discipline that seeks to prevent and treat health problems utilizing spinal adjustments in order to correct subluxations. The brain and nervous system control and coordinate all the body’s functions, in part through nerve branches that exit from the spinal cord between the verterbra.
Slight spinal misalignments are said to interfere with the function of the nerve as it exits the verterbral foramina. Chiropractors were the first to infer a causal relationship between nerve interferance or compression at the spine, and subsequent problems in more distant parts or organ systems regulated by the nerve.
Practitioners of chiropractic are called chiropractors. They receive the degree Doctor of Chiropractic, (D.C.) and are commonly called a doctor in the same way that a dentist is called a doctor. The term chiropractic physician is allowed in some states, but this term is not in general use.
This practice has been shown to be effective in treating back and neck pain, headaches, and other symptoms of spine-related conditions.
Chiropractic was founded by Daniel D. Palmer of Davenport, Iowa. In 1895, Palmer was investigating the medical history of Harvey Lillard, a deaf janitor. Lillard informed Palmer that while working in a cramped area seventeen years ago he felt a pop in his back and had been nearly deaf ever since. Upon examination, Palmer found what he described as a lump that was sore to the touch. He concluded that this lump was a misalignment, which was the possible cause of Lillard’s deafness. After correcting this misalignment in the janitor’s spine, Lillard’s hearing was restored. Lillard was reported to note that he could now hear the wheels of the horse drawn carts in the street below. After further investigation, Palmer believed he had discovered that a major source of interference to the nervous system, the vertebral subluxation, interfered with the body’s regulatory mechanism, causing what he termed “dis-ease” as in “loss of ease”.
The term chiropractic originated when Palmer asked a patient to come up with a name from the Greek language to describe his practice. Of the several names submitted to him, Palmer accepted one which combined the words chiros and praktikos (meaning “done by hand”) to describe his adjustment of a vertebrae in the spinal column. Palmer had been a beekeeper, school teacher, grocery store owner, and had an interest in the metaphysical health philosophies of his day such as magnetic healing, osteopathy, and spiritualism.
Palmer imbued the term “subluxation” with a metaphysical and philosophical meaning. He held that certain dislocations of bones interfere with the “innate intelligence”, a kind of spiritual energy or life force dependent upon God that connects the brain to the rest of the body. He claimed that subluxations were interfering with the proper communication of this innate intelligence with the rest of the body, and that by fixing them, 95% of diseases could be treated.
In response, in the mid-1990s the Association of Chiropractic Colleges redefined a subluxation as follows: “A subluxation is a complex of functional and/or structural and or pathological articular changes that compromise neural integrity and may influence organ system and general health.” In 1997 the Foundation for Chiropractic Education and Research defined a subluxation as “a joint problem (whether a problem with the way the joint is functioning, a physical problem with the joint, or a combination of any of these) that affects the function of nerves and therefore affect the body’s organs and general health.”
In recent years a number of chiropractic associations have developed new definitions of “subluxation” that have no connection with Palmer’s ideas, yet also are not the same as medical subluxations.
The use of manipulative therapy — not necessarily chiropractic — enjoys wide acceptance by medical authorities in many nations. It is covered by many health plans such as Medicare in the United States. Although some medical doctors (MDs) and many doctors of osteopathy (DOs) do perform manipulative therapy, more than 90% of the treatment of back pain by manipulative therapy is performed by DCs (Doctors of Chiropractic).
Chiropractic has gained general acceptance in the last forty years as an appropriate treatment for certain back and neck problems. This was partly a result of the prolonged litigation between the powerful American Medical Association and various chiropractors over the legitimacy of the field (see Wilk v. American Medical Association). The AMA is politically opposed to chiropractic as a healing discipline and disputes the concept of a subluxation.
Requirements for credentials
The educational requirements for chiropractors in many Western countries are similar to that of medical doctors. The AmericanCouncil on Chiropractic Education (CCE) is in charge of setting minimum guidelines for chiropractic colleges; however, additional requirements may be needed for a license depending on the jurisdiction where a chiropractor chooses to practice. Many states require a four-year undergraduate degree, although the minimum prerequisite for enrollment in a chiropractic college set forth by the CCE is ninety semester hours. The minimum cumulative grade point average for a student entering a chiropractic college is 2.50. Commonly required classes include communiction or language skills, psychology, social science or humanities, biology, organic and inorganicchemistry, and physics, as well as the common medical classes in anatomy or embryology, physiology, microbiology, diagnosis, neurology, x-ray, orthopedics, obstetrics, and gynecology. Interestingly, while chiropractic students in the United States need less clinical experience (residency) than medical students, they must complete more class hours. However the process of credentialing varies widely by country.
Political schools of chiropractic
Contemporary chiropractic is divided into two basic schools:
- The traditional approach, followed by the faction of the chiropractive movement known as straight chiropractic.
- Mixing chiropractic, which combines contemporary medical techniques with spinal and other joint manipulation. Mixing chiropractic is itself divided into conservative and liberal factions.
Medical risks of spinal manipulation
According to the National Council Against Health Fraud, the conviction held by chiropractic believers that every spine will benefit from an adjustment causes them to manipulate spines inappropriately. Among the concerns about chiropractic manipulation is the widespread use of the explosive “dynamic thrust” which takes the patient by surprise, as opposed to more conservative techniques. This maneuver has a greater potential for inflicting injury.
The practice of greatest concern is the rotary neck movement (sometimes called “Vaster cervical or “rotary break”). This type of manipulation has led to trauma, paralysis, strokes, and death among patents. Even chiropractic’s legal advisors have warned against its use.
The overuse of x-ray by chiropractors poses potential patient harm. Of primary concern is the 24′ x 36′ full spine x-ray. This technique exposes patients to a substantial amount of radiation. Exposing the body trunk to x-rays can have serious long-range consequences and should be avoided. Further, according to NCAHF’s chiropractic advisors, such radiographs have little or no diagnostic value.