How Does Chiropractic Work
What’s the origin of chiropractic?
Spinal manipulation has been used for thousands of years around the world to try and fix health problems. The modern version was developed by Daniel D Palmer in the nineteenth century and called chiropractic from the Greek words for doing and hand (praktikos and cheiro).
Palmer’s first patient was his janitor who had been deaf for seventeen years following a neck injury. Palmer claimed to have ‘clicked’ a joint back into place and the man’s hearing returned. Palmer, however, was jailed for practising medicine without a licence but his son took up the cause and chiropractic began to become popular.
How does chiropractic work?
Chiropractors like many other complementary health practitioners look at the body as a whole when they treat you. A chiropractor considers the body to be like a living machine – if a joint is misaligned or damaged then the smooth running of the machine can be upset causing inflammation, pressure on nerves and subsequent medical problems.
Chiropractors believe stress, poor posture and accidents, including sports injuries and the like can all stop the body machine running smoothly. Almost any aspect of health might be affected by problems in the spine, they believe.
For instance, pressure on nerves connected to the intestines could be the root cause of some digestive disorders. Chiropractic manipulation of the spine at the point where these nerves emerge from the spinal cord through the vertebra could remedy such a disorder. There is no evidence that chiropractic can deal with anything other than back problems, however, an even then scant controlled clinical evidence is available for that.
What happens during a treatment?
Your first session with a chiropractor often involves an assessment of posture, mobility of joints, and usually lifestyle. There are various standard tests such as the Thomas test, which determines mobility in the hip joints, the Yeoman’s test which involves the practitioner flexing your legs one at a time to assess joints for sprain and mobility. The chiropractor might also ask you to bend, raise your legs, test your reflexes, take your blood pressure or even an X-ray to build up a more detailed picture of a problem.
As with osteopathy, chiropractors try to track down restricted or excessive joint movement, especially in the spine because they believe these problems are the cause of inflammation, swelling and pressure that leads to pain and illness.
A chiropractor might use some massage to loosen stiff muscles before focusing on the manipulation techniques. Manipulation usually involves a sharp, precise thrusting movement of a joint to ‘free it up’. There are several standard techniques aimed at making, what chiropractors refer to as, adjustments. However, a new school of thought among progressive chiropractors avoids the forceful thrusting manipulations and instead relies on more gentle and tempered movements and stretches.
For instance, the Toggle Drop involves a swift and precise pressure applied with the hands to specific verterbrae in the spine while you lie face down. The Bunyon adjustment involves the practitioner applying a stretch between vertebra – a traction – to adjust the spine. The various manipulations often causes clicking noises, which can be quite alarming to the patient and may cause a little pain or discomfort at the time but this quickly eases off and the procedure has been shown to be extremely safe. Clicking noises are not caused by bone against bone, they are simply the sound of gases “popping” as they are expelled from where they may be trapped in the membrane surrounding a joint.
Chiropractic will often attempt to provide an effective long-term management of a condition. However, patients are usually locked in to regular return visits for “maintenance” treatments to prevent them regressing. Chiropractors similarly to osteopaths will claim to help you improve your posture, suggest lifestyle changes that might help your overall health and teach you some easy exercises to do at home.
What problems can chiropractic help?
Chiropractors focus primarily on back problems, but there is a long list of other ailments, diseases and disorders that they offer to treat. Evidence for the more outlandish claims is almost wholly lacking. Commentators such as Ernst and Singh have written that such claims are allegedly “bogus”.
Indeed, one chiropractic association has recommended that its members remove reference to any non-evidence based claims from their websites pending a legal case involving Singh and the British Chiropractic Association. Specifically, they suggest that members remove patient information leaflets that practitioners can treat whiplash, colic or other childhood problems, as there is a serious risk practitioners might be prosecuted.
Of course, many have been too tardy to respond to this call to defence and Alex MacLean (yaxu on twitter) has apparently been scraping and archiving all the chiro sites making allegedly spurious claims about their practice.
- Asthma
- Digestive problems
- Disc injuries
- Headache and migraine
- Joint, posture and muscle problems
- Menstrual pains
- Sciatica
- Spine and neck problems
- Sports injuries
- Tinnitus and vertigo
Where’s the evidence?
There have been various clinical trials of chiropractic several of which have been reported by the well-respected British Medical Journal, published by the British Medical Association. The research reports that showed that chiropractic worked better at treating acute back pain than standard treatments offered in a hospital out-patients. Supposed evidence that chiropractic can treat other problems has been debunked.
What do conventional doctors think about chiropractic?
Chiropractic had a poor image among the medical profession for most of the last century, in the 1960s the American Medical Association condemned it as an ‘unscientific cult’ although the AMA lost its legal battle in 1987 and now chiropractors work in hospitals and sports clinics.
In Britain, in 1994 The Chiropractors’ Act gave them official recognition which means that if you use a registered chiropractor you have the security of knowing they are a state-registered health professional, for what that’s worth.
You are almost as likely to be referred to a chiropractor as an osteopath by your GP, but usually only for musculo-skeletal problems. Many doctors still prefer to send patients to an osteopath instead. However, clinics and community health centres often have chiropractors on-site apparently complementing the work of the doctors and nursing staff. One thing that more and more doctors agree on is that the old advice of long periods of lying flat and still or restrained in a medical corset are not the way to treat back problems.
What is a subluxation?
A medical subluxation is an incomplete or partial dislocation of a joint or organ. The World Health Organization (WHO) considers a subluxation to be a “significant structural displacement, and therefore visible on static imaging studies.” In the spine, such a displacement may be caused by a spondylolisthesis.
An orthopedic dislocation of any joint will usually need medical attention to help relocate or reduce the joint. Nursemaid’s elbow is the subluxation of the head of the radius from the annular ligament. Other joints that are prone to subluxations are the shoulders, fingers, kneecaps, and hips affected by hip dysplasia. A spinal subluxation is relatively rare, but can sometimes impinge on spinal nerve roots causing symptoms in the areas served by those roots.
Can chiropractors remedy subluxations?
Chiropractors talk of vertebral subluxations and have their own unique definition of this problem, they say it is relatively common and is apparent as a spinal vertebra having lost its proper juxtaposition, or alignment, with one or both of its neighbours. This apparently interferes with the nervous system. Conventional chiropractic attempts to remedy vertebral subluxations using manipulation techniques. However, even though research is ongoing mainstream medicine and even progressive chiropractors have often rejected the subluxation hypothesis.
When your back suddenly flares up while in America’s Finest City, the best chiropractor in San Diego CA can help make you feel better.
32 Responses to “How Does Chiropractic Work”
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Science is not this “thing”. It’s a process. Of course, there are opportunities for people to fail to carry out the process properly. But, fundamentally, those who recognise that the process can provide an understanding of the nature of reality are more likely to be skeptical of activities that have not been investigated by the process or somehow try to hide behind non-facts and anecdote. More to the point, I’ve personally had successful chiropractic treatment for a back problem, but it never occurred to me to take my kids to a chiropractor for cholic, there’s such a disconnection between some problems and the claims regarding mode of action of chiropractic.
It amazes me that people have so many opinions of chiropractors. I am also amazed that people have such faith in science. I too bought the idea that science was pure, and science explains all. I was taught that in school as well. I see educators indoctrinating my kids as well. The reality is science is bought and sold like any other commodity on the market. How many double blind randomized controlled trials are done on open heart surgery? What is a sham operation? And to say that chiropractors treat things that would just go away on there own? Please! It would serve most people well to know just how frequent the side effects of anti-inflammatories are. It would likely surprise most people. I wish medical doctors and chiropractors could put their turf battles aside and start working hand in hand to the benefit of their patients who in reality stand to benefit from both.
This is one of the many infiltrations of the quackish community that can be readily seen in our everyday lives; most people would assume that because it is so widespread, chiropractic is based on real science. Unfortunately, people are entirely misinformed.
@Sarnia I agree. I certainly wouldn’t claim that my own case represents any kind of trial… But, are you saying that chiropractors are fraudsters?
David – I call bullsh!t on this:
“There is no way to carry out a full-scale clinical trial on a practice that tailors its approach to the individual patient presenting unique symptoms…”
It doesn’t matter if you have had success with a chiropractor – unless there is an objective outcome to measure studies are going to fall victim of self-reporting which is almost always biased.
Pain is so subjective. Chiropractors may simply be curing something that never existed or “curing” something that was going to get better on its own.
I, too, visited a chiropractor and received positive results. Are the results better than a placebo or regression to the mean? Studies suggest they aren’t.
I’m almost certain that the majority of people in the chiropractic profession don’t sustain simply on the tiny area of chiropractic that just MIGHT be as good as other treatments (ie. anti-inflammatories).
Prior to the case with Simon Singh, EVERY Chiropractor in my city that has a website claimed to be able to treat asthma, ear infections, colds and more. Many even practice acupuncture and other “woo-woo” to support themselves. Many have removed the references to asthma, ear infections, bed-wetting but a good number still suggest efficacy as it relates to the relieving of such symptoms/problems.
Finally, if it worked, it wouldn’t be alternative medicine. (Especially not for a hundred years!)