Chiropractic

Chiropractic Logo

Chiropractic is from Greek words meaning done by hand. It is grounded in the principle that the body can heal itself when the skeletal system is correctly aligned and the nervous system is functioning properly. To achieve this, the practitioner uses his or her hands or an adjusting tool to perform specific manipulations of the vertebrae. When these bones of the spine are not correctly articulated, resulting in a condition known as subluxation, the theory is that nerve transmission is disrupted and causes pain and illness manifested in the back as well as other areas of the body.

Chiropractic is one of the most popular alternative therapies currently available. Some would say it now qualifies as mainstream treatment as opposed to complementary medicine. Chiropractic treatment is covered by many insurance plans. It has become well-accepted treatment for acute pain and problems of the spine, including lower back pain and whiplash. Applications beyond that scope are not supported by current evidence, although there are ongoing studies into the usefulness of chiropractic for such problems as ear infections, dysmenorrhea, infant colic, migraine headaches, and other conditions.

Description

Origins

Spinal manipulation has a long history in many cultures but Daniel D. Palmer is the founder of modern chiropractic theory, dating back to the 1890s. A grocer and magnetic healer, he applied his knowledge of the nervous system and manual therapies in an unusual situation. One renowned story concerns Harvey Lillard, a janitor in the office where Palmer worked. The man had been deaf for 17 years, ever since he had sustained an injury to his upper spine. Palmer performed an adjustment on a painful vertebra in the region of the injury and Lillard's hearing was reputedly restored. Palmer theorized that all communication from the brain to the rest of the body passes through the spinal canal, and areas that are poorly aligned or under stress can cause physical symptoms both in the spine and in other areas of the body. Thus the body has the innate intelligence to heal itself when unencumbered by spinal irregularities causing nerve interference. After his success with Lillard, other patients began coming to him for care, and responded well to adjustments. This resulted in Palmer's further study of the relationship between an optimally functional spine and normal health.

Palmer founded the first chiropractic college in 1897. His son, B. J. Palmer, continued to develop chiropractic philosophy and practice after his father's death.B. J. and other faculty members were divided over the role of subluxation in disease. B. J. saw it as the cause of all disease. The others disagreed and sought a more rational way of thinking, thus broadening the base of chiropractic education. From 1910–1920, many other chiropractic colleges were established. Other innovators, including John Howard, Carl Cleveland, Earl Home-wood, Joseph Janse, Herbert Lee, and Claude Watkins, also helped to advance the profession.

The theories of the Palmers receive somewhat broader interpretation today. Many chiropractors believe that back pain can be relieved and health restored through chiropractic treatment even in patients who do not have demonstrable subluxations. Scientific development and research of chiropractic is gaining momentum. The twenty-first century will likely see the metaphysical concepts such as innate intelligence give way to more scientific proofs and reform.

Many people besides the Palmers have contributed to the development of chiropractic theory and technique. Some have gone on to create a variety of procedures and related types of therapy that have their roots in chiropractic, including McTimoney-Corley chiropractic, craniosacral manipulation, naprapathy, and applied kinesiology. Osteopathy is another related holistic discipline that utilizes spinal and musculoskeletal manipulation as a part of treatment, but osteopathic training is more similar in scope to that of an M.D.

Initial visit

An initial chiropractic exam will most often include a history and a physical. The patient should be asked about what the current complaint is, whether there are chronic health problems, family history of disease, dietary habits, medical care received, and any medications currently being taken. Further, the current complaint should be described in terms of how long it has been a problem, how it has progressed, and whether it is the result of an injury or occurred spontaneously. Details of how an injury occurred should be given. The physical exam should evaluate by observation and palpation whether the painful area has evidence of inflammation or poor alignment. Range of motion may also be assessed. In the spine, either hypomobility (fixation) or hypermobility may be a problem. Laboratory analysis is helpful in some cases to rule out serious infection or other health issues that may require referral for another type of treatment. Many practitioners also insist on x rays during the initial evaluation

Manipulation

When spinal manipulation is employed, it is generally done with the hands, although some practitioners may use an adjusting tool. A classic adjustment involves a high velocity, low amplitude thrust that produces a usually painless popping noise, and improves the range of motion of the joint that was treated. The patient may lie on a specially designed, padded table that helps the practitioner to achieve the proper positions for treatment. Some adjustments involve manipulating the entire spine, or large portions of it, as a unit; others are small movements designed to affect a single joint. Stretching, traction, and slow manipulation are other techniques that can be employed to restore structural integrity and relieve nerve interference.

Length of treatment

The number of chiropractic treatments required will vary depending on several factors. Generally longer-term treatment is needed for conditions that are chronic, severe, or occur in conjunction with another health problem. Patients who are not in overall good health may also have longer healing times. Some injuries will inherently require more treatments than others in order to get relief. Care is given in three stages. Initially appointments are more frequent with the goal of relieving immediate pain. Next, the patient moves into a rehabilitative stage to continue the healing process and help to prevent a relapse. Finally, the patient may elect periodic maintenance, or wellness treatments, along with lifestyle changes if needed in order to stay in good health.

Follow-up care

Discharge and follow-up therapy are important. If an injury occurred as a result of poor fitness or health, a program of exercise or nutrition should be prescribed. Home therapy may also be recommended, involving such things as anti-inflammatory medication and applications of heat or ice packs. Conscious attention to posture may help some patients avoid sustaining a similar injury in the future, and the chiropractor should be able to discern what poor postural habits require correction. A sedentary lifestyle, particularly with a lot of time spent sitting, is likely to contribute to poor posture and may predispose a person to back pain and injury.

Types of practitioners

Some practitioners use spinal manipulation to the exclusion of all other modalities, and are known as straight chiropractors. Others integrate various types of therapy such as massage, nutritional intervention, or treatment with vitamins, herbs, or homeopathic remedies. They also embrace ideas from other health care traditions. This group is known as mixers. The vast majority of chiropractors, perhaps 85%, fall in this latter category.