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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The reason, Emily, is that there is no evidence for any of the ludicrous claims made by practitioners either for their methods or the supposed science that they use to prop it up. Go to a chiropractic with numbness in your feet and be told that you have a “neurological imbalance” and that you need to be “adjusted” on a weekly basis for six weeks at 60 bucks a half hour. But discover, that the numbness was actually an autoimmune disease known as GBS that is lethal, end up hospitalised three days later and being treated with intravenous IgE to save your life.
Are you trying to claim that a chiro would have spotted the early signs of your dad’s heart failure? I doubt that very much, instead they would have “adjusted” him to remedy the supposed subluxations in his spine that were manifest as shoulder pain.
Conventional meds do have side effects as does chiro treatment, look at the stroke incidence in patients who have had neck manipulation.
Your logic is massively flawed given that alt meds are almost always about how the patient “feels” rather than actual clinical tests…
soo…if I understand correctly…some folks think chiropractic is trickery and only treat problems that would otherwise go away on their own? My father had a nagging pain in his left shoulder…it went away on its own. It came back as a massive heart attack requiring a triple bypass. To say that you can gage your health by how you “feel” is ignorant and dangerous. How do you know the injury if internal has gone away? Because you are not in pain? And can we address the many and alarming side effects to pain medication and drug treatment programs? Some people are so content to pop a pill rather than accepting responsibility for their bodies and addressing the real cause of the pain. Drugs only mask the symptoms. NSAIDS have never cured anything! They do however, require you to monitor your liver enzymes and are highly addictive. Sounds healthy! Why is it that a practice (chiropractic)that wants you to allow your body to work at its optimal levels and does not push drugs is deemed as quackery? Pobably for the same reason every other commercial on TV is for a perscription drug? One more point, how many deaths are caused by the “medical” profession? How many from “chiropractic”?
The argument is not about whether anyone questions “conventional” medicine, it’s about the fabricated science on which much of alternative medicine is pinned. There are huge gaps in our understanding of the human body and how it responds to different treatments but that doesn’t mean that we should turn to quackery for solutions. It is for alt practitioners to prove their approaches work beyond a placebo effect not for science to disprove them. There are shared origins of conventional and alternative medical practices. E.g. about 40% of pharmaceuticals have a herbal ancestor, but I’d rather take a purified, active extract to treat a particular condition than chew on boiled willow bark. There are serious issues with many of the claims made by some alt practitioners, particularly in areas of microbial pathogens. Homeopaths have no right to claim that their sugar pills and bottled water can be used to treat malaria and HIV. I realise the discussion here is of chiropractic, but chiropractors if they want credibility should stump up the cash for independent clinical trials to demonstrate true efficacy against placebo, particularly in those areas they claim to be able to treat that are wholly unrelated to alignment of vertebrae.
Every profession includes those people who are passionate about contributing their best for humanity’s sake and also those who just want to make money and at the expense of others. I wish they weren’t in my profession, but that is part of humanity..so you must be a smart consumer of health care just as you would be a smart parent for your child’s safety. No! Your chiropractor shouldn’t teach you that your nerves are pinched like a garden hose! Yes, they should teach you the most current science as it relates to your spine.
Despite the overwhelming research for both medical treatments and chiropractic, medicine is never questioned as whether it is a benefit, but chiropractic is. Why don’t you question going to see your M.D. or Dentist for healthcare prevention and treatment? Is it because it is the “right” thing to do to take care of your health? I may not “save” lives from death as M.D.s do so often, yet the health care I offer allows people to get their life back in also a very important way and that is to “enjoy” their human experience through better spinal structure which minimizes strain on nerve tissue. You don’t have to “believe” in whether chiropractic works or not because the results have been proven. Chiropractic works because treatment based on index medicus research scrutiny proves that it has value whether you choose to “believe” in it or not.
Chiropractic research is published in the National Library of Medicine. I recommend you start at this website. http://www.idealspine.com. Go to the CBP research page. Click on medline lookup for the Drs. Harrison. What you will see is math, physics, engineering, biology, neurology and as it applies to the human spine. An ideal mathematical spinal model was published and over the course of the past 25 years the theorem has been tested in large population studies to establish the “normal ranges” for the sagittal curvature of the spine.
I agree with much of your original posting; however, due to the erroneous teaching of pseudoscience I.e. “garden hose theory” by chiropractors who want the glory of a title without the responsibility of one…we all have cause for concern.
We are policing our own profession because we care. The thoughtfulness of your post was inspiring, and I hope when you need chiropractic care again in the future you will consider looking to treat with the most advanced to date…CBP.
Chiropractic BioPhysics®, or CBP®, is, in short, a higher level of chiropractic. It is a more knowledgeable, comprehensive, systematic, scientific approach to chiropractic, that provides predictable results for patients and will contribute to building a more stable and successful chiropractic practice. Support for this claim includes a considerable amount of data from research, the experience of numerous flourishing CBP® practitioners, and the longevity of the approach. CBP® combines standard chiropractic joint adjustments with mirror image® (opposite position) postural adjustments, mirror image® spinal/postural exercise, and mirror-image® traction to provide more permanent relief and improved health for patients through spine and postural correction.
Well, I have to admit that I used to fall in the camp of skeptics–that is until I had unbearable back and neck pain, and out of desperation went to see a chiropractor. I am so thankful that a particular friend suggested that I go to this particular doctor, because he does not require repeat visits. He only says (to all of his patients) that possibly you might need to come back, especially depending on the severity of the issue and how long the issue had been taking place. It is left up to you, the patient, to decide if you want to/need to come back. This is totally different than others in town (my son and daughter-in-law both went to another before switching who wanted them to be there a couple of times a week, for months on end. To make matters even worse, they felt less relief from that doctor than they do the one we all currently go to, who does not insist on repeat visits!). I guess the moral of the story is: If you get a chiropractor with whom you do not feel relief, and who wants you to be there over and over, switch! It’s the same with a medical doctor, people have to find one who suits their particular needs and personality. If I had gone to one of the less-effective doctors I would have dismissed chiropractic as a hoax, but as it is I am totally pain-free and feeling great! I would whole-heartedly recommend that anyone at least try it!