People's inherent power to heal is central to chiropractic's philosophy. By making small adjustments to correct spinal misalignments, and remove interference with spinal cord function, chiropractic can improve the body’s ability to heal itself. The brain, spinal cord and nerves control all other organs and tissues of the body. The optimum function of the nervous system lessens the probability of disability and disease.
The holistic approach is a central tenant of the philosophy of chiropractic. It stresses the patient's overall well being and recognizes that many factors affect health. Chiropractic focuses on maintaining optimal health naturally and helping the body resist disease, rather than simply treating the symptoms of disease after the fact. Chiropractors use manipulations, herbs and exercises. They work with medical doctors as needed.
Chiropractors focus on the nervous system (the brain and spinal cord) which manages the body’s resources to ensure homeostasis and health. The brain sends messages through the spinal cord across the body’s network of nerves to deliver information to every cell, organ and system in the body. (Click here for a diagram of the chiropractors view of the nervous system)
Chiropractors believe that when bones of the spine become misaligned, they can interrupt the flow of information and therefore interfere with the normal function of the body. Chiropractors aim to correct misalignments and restore homeostasis
The chiropractor’s primary treatment is the spinal adjustment. A short and painless thrust with the doctor's hands is used to correct vertebral subluxations. The intent of an adjustment is to restore normal motion the flow of nerve impulses.
Visits to chiropractic have grown steadily over the last twenty years . About 16 percent of the public now regularly sees a chiropractor. Studies from the New England Journal of Medicine report that in 1998 Americans visited non-physician health providers on 629 million occasions. The U.S. Department of Labor predicts the continued growth of chiropractic through at least 2008.
Why Chiropractic Is Controversial
Chiropractic has been controversial since its legalization. In the United States there are over 30,000 chiropractors.1 Most insurance companies are required to pay for chiropractic services.
Spinal Manipulative Therapy
An estimated 80% of adults will experience at least one episode of back pain at some time in their life. Manipulative therapy is effective in relieving back pain and speeding one's return to work2,3,4. The laying on of hands, a technique widely employed throughout history by folk and faith healers, enhances suggestibility and the placebo effect5,6. Many people like manipulation because of the direct contact and the immediate relief of pain. Charles DuVall, Sr., D.C., has even reported that manipulation can become addictive7.
Chiropractic is commonly thought to be synonymous with manipulation. In reality, manipulation has been practiced since at least the time of Hippocrates (400 B.C.). Chiropractic began only about 100 years ago. Folk healers ("bonesetters") and early osteopaths used manipulation. Today manipulation is employed by medical specialists (physiatrists, orthopedists, sports medicine practitioners), osteopathic physicians, physical therapists, and athletic trainers, as well as by chiropractors.
A survey of back-pain sufferers revealed that of medical doctors, physiatrists are seen as the most effective at treating back problems.8 Physiatrists offer manipulation. Chiropractors are more accessible than physiatrists, and 85% of people who patronize them do so for neuromusculoskeletal problems.1
Palmer was the father of modern chiropractic. Obsessed with uncovering "the primary cause of disease," Palmer theorized that "95 percent of all disease" was caused by spinal "subluxations" (partial dislocations) and the rest by "luxated bones elsewhere in the body." Palmer speculated that subluxations impinged upon spinal nerves, impeding their function, and that this led to disease.
Chiropractic propagandists have made much of a 1987 court decision that found the members of the American Medical Association, and others, were guilty of illegally colluding against chiropractors.10
Yale University anatomist Edmund Crelin, Ph.D., demonstrated that a disabling spinal injury could produce the impingement that Palmer posited as the basis for chiropractic.11 Differences between the recommendations of individual chiropractors, who each examined the same patient were significant. Even though their treatments recommended were different, they were effective.12,13,14,15,16
Factions in Chiropractic
Only a minority of today's chiropractors adhere to Palmer's "one-cause-one-cure" theory, but most still believe that subluxations exist and play an important role in the cause and treatment of diseases.
Chiropractic practitioners who limit their care to analyzing the spine and correcting subluxations are called "straight" chiropractors. Those who believe in Palmer's theory of "Innate Life Force" are often called "superstraights." The “straight” chiropractors label those who do more than manipulation as "mixers," because they mix other modalities.
The skill of chiropractors varies among individual practitioners. When evaluating a chiropractor's claims, it is useful to ask what diseases are not benefitted by their adjustment and manipulation. Good practitioners will readily admit limitations, and do not offer treatment for non-musculoskeletal problems.
Chiropractic Technique List
There are hundreds of subtypes of chiropractic care practiced under a bewildering variety of names. The following is an incomplete list.
Difference between chiropractic and medical approaches.
Chiropractors teach health maintenance techniques and believe that people should be freed from their dependence on frequent medical treatments. If a chiropractor recommends frequent visits, lifelong care contracts, and dependency, his advice should be questioned. There is nothing conservative, holistic or natural about endless care
A subluxation-free world
Normal x-rays may seem to be a noble goal, but a person without symptoms should not receive extensive treatment just because they have abnormal x-rays.
Scope of chiropractic
Most people think of chiropractic physicians as proficient in treating orthopedic problems, backaches, disc pain, sciatic problems, and whiplash injuries. In these cases it is reasonable to seek chiropractic care first. Other disorders, like hypertension and diabetes, should be managed with the help of a medical doctor.
Chiropractors vary considerably
There are good and bad, honorable and dishonorable, as well as honest and dishonest people in every profession. Be sure to select only the best chiropractors for your care.
Many chiropractors practice rationally
Every profession includes a few who provide poor service. Although in the minority, they can do a great deal of damage to their patients and their profession if they are dishonest or careless.
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4. Moritz U. Evaluation of manipulation and other manual therapy. Criteria for measuring the effect of treatment. Scandinavian Journal of Rehabilitative Medicine 11(4):173-179, 1979.
5. Neher A. The Psychology of Transcendence. Englewood Cliffs, NJ: Prentice-Hall, 1980, pp 49-52, 244
6. Homola S. Bonesetting, Chiropractic, and Cultism. Panama City, FL: Critique Books, 1963, pp 95, 96.
7. DuVall CE Sr. Facts on SMT. in DuVall CE Sr. Chiropractic Claims Manual. Akron, Ohio: Charles E. DuVall Sr, 1984), p. 3.
8. Klein AC, Sobel D. Back Relief. New York: New American Library, 1980, p 402.
9. A. E. Homewood AE. The Neurodynamics of the Vertebral Subluxation. Canada: Chiropractic Publishers, 1973, p. 80.
10. Getzendanner S: Memorandum opinion and order in Wilk et al v. AMA et al. 671 F Supp 1465, U.S. District Court for the Northern District of Illinois, Eastern Division, September 25, 1987.
11. Crelin ES. A scientific test of the chiropractic theory. American Scientist 61:574-580, 1973.
12. Barrett S. The Spine Salesmen. In The Health Robbers, Second Edition. Philadelphia: George F. Stickley Company, 1980, pp. 143-145;
13. Smith RL. I get the treatment. In Smith RL. At Your Own Risk: The Case Against Chiropractic. New York: Simon and Schuster, 1970, pp. 27-37.
15. London WM. Free chiropractic spinal exams, consultations, and literature: An empirical investigation. resented at the Chiropractic Forum, American Public Association Annual Meeting, Chicago, Oct 24, 1989.
16. Brown M. Chiro: How much healing? How much flim-flam? Davenport, IA: Quad-City Times, December 13, 1981.
17. Moran WC et al. Inspection of Chiropractic Services Under Medicare. Chicago: OIG Office of Analysis & Inspections, 1986, pp 9-12.
18. How DCs in the USA practice. Dynamic Chiropractic 6(17):3, 1988.
19. United States Food, Drug, and Cosmetic Act, Section 201.
20. Fickel TE. An analysis of the carcinogenicity of full spine radiography. ACA Journal of Chiropractic 23(5):61-66, 1986.
21. Cherkin DC, MacCornack FA. Patient evaluations of low back pain care from family physicians and chiropractors. Western Journal pf Medicine 150:351-355, 1989.
22. Kane RL and others. Manipulating the patient: a comparison of the effectiveness of physician and chiropractor care. Lancet, June 29, 1974, pp 1333-1336.
23. Kizer KW. The case against colonic irrigation. California Morbidity, Sept. 27, 1985.