Is Chiropractic Legitimate?

Chiropractic continues to be the largest and most accepted of the alternative health providers. Even with the growing number of chiropractic clinics and centers found in most towns and cities, chiropractors continue to suffer from inaccurate perceptions and misinformation. While the chiropractic adjustment is the staple of the profession, chiropractors are utilize additional therapies and offer complimentary services that make them a competent and valuable resource in todays troubled healthcare environment.  Prejudices against chiropractors are often rooted in either economical concerns or just plain ignorance. Those seeking chiropractic care or attempting to find a chiropractor are often thwarted by opinions or egos that are as baseless as they are inaccurate

The American Chiropractic Association states that "Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health" Most people associate chiropractors with neck and back pain which is understandable but incomplete. Chiropractors are well versed in treating a variety of conditions related to the musculoskeletal system and more importantly are proficient in identifying underlying causes and complicating factors of these conditions. This is obtained through a detailed history that focuses on the person as a whole and not just a symptom and also through specific examinations of both the complaint and of the whole body.

Through analysis of the patients history, present complaints and examination findings, a chiropractor will either recommend additional testing if warranted or design a treatment plan. Much like physical therapy, chiropractic is a physical medicine meaning it requires the body to change and adapt through the course of treatment. Although pain relief may be felt after treatment, the objective of chiropractic treatment is to not only decrease discomfort but to improve function which lessens the likelihood of future complications.

Chiropractic was founded on the concept of the subluxation. In general this is explained that when vertebrae are misaligned, the local nerves are irritated and dysfunction results. A subluxation is not to be confused with a dislocation as the latter is and actual structural issue where a subluxation is a physiological disruption.

Addressing the validity of the subluxation would require a completely new article. Modern chiropractors have varying opinions regarding the cause and correction of subluxations, but few will discount their existence. Even the medical community recognises the " pinched nerve" but the effects of this condition are the source of much debate. A basic understanding of the role and structure of the spine and nervous system is important when attempting to comprehend chiropractic.

A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues — such as bones, cartilage, muscles or tendons. This pressure disrupts the nerve's function, causing pain, tingling, numbness or weakness.

The spinal cord is essentially an extension of the brain although it acts more like a transportation vehicle than a data processing center. Between each vertebrae and out from the base of the skull are nerves exiting and entering the spinal cord. As stated above, these nerves can become compressed or irritated.

Pinched nerve signs and symptoms include:

• Numbness or decreased sensation in the area supplied by the nerve.
• Sharp or burning pain, which may radiate outward. When the pinched nerve comes from the spinal cord, coughing or sneezing may aggravate the pain.
• Tingling, "pins and needles" sensations (paresthesia).
• Muscle weakness or twitching in the affected area.
• Frequent feeling that a foot or hand has "fallen asleep."

Irritation of the nerve may either cause increased, decreased or altered function. This results in dysfunction of either sensory information to the brain, messages from the brain to the tissues or both. The above quotation points to both senses and motor abilities being affected by a pinched nerve "Numbness or decreased sensation, Muscle weakness or twitching "

This would suggest that if a nerve is influenced at the spinal level, multiple areas and functions may be effected.

A pinched nerve occurs when too much pressure (compression) is applied to a nerve by surrounding tissues.
This pressure causes inflammation of the nerve and disrupts the nerve's function. If a nerve is pinched for only a short time, there's typically no permanent damage. Once the pressure is relieved, nerve function returns to normal. However, if the pressure continues, chronic pain and permanent nerve damage can occur.

The above quotes in bold are from the Mayo Clinics website discussion of the pinched nerve. You can read it here : Mayo Clinic

As the Mayo Clinic explained, a pinched or irritated nerve can be caused by a misalignment of the bones ( vertebrae) or shortened muscles. Of course there are other factors such as fractures, tumors, arthritides and more that can cause problems, but these are ruled out before treatment. Once it is determined that there is nerve interference present, chiropractors utilize the adjustment to correct the misalignment as well as possibly other therapies to reduce symptoms and improve the body's ability to communicate.

The belief that be removing the nerve interference many conditions will respond is what is commonly attacked by critics of chiropractic. They often claim that there is a lack of evidence supporting the theory of the subluxation. Interestingly enough this same criticism is rarely applied to other providers.

The American Osteopathic Association proudly states on their website:

Osteopathic manipulative treatment, or OMT, is hands-on care. It involves using the hands to diagnose, treat, and prevent illness or injury. Using OMT, your osteopathic physician (DO) will move your muscles and joints using techniques including stretching, gentle pressure and resistance.

The American Chiropractic Association defines the chiropractic adjustment as:

The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function.

You can clearly see that there is a distinct similarity between the techniques of Doctors of Osteopathy and of the Doctor of Chiropractic employ.

Even given these related definitions, chiropractors are still regarded as quacks because we believe that by moving these joints and muscles and restoring the proper nerve flow that the body is better able to thrive.

Guess who else buys into this silly notion:

OMT is often used to treat muscle pain. But it can also help patients with a number of other health problems such as:

• asthma
• sinus disorder
• carpal tunnel syndrome
• migraines
• menstrual pain

When appropriate, OMT can complement––and even replace––drugs or surgery. In this way, OMT brings an imporatant dimension to standard medical care.

Again the above declaration is from the website of the American Osteopathic Association. It boggle my mind that chiropractors are subjected to insults and disdain for a belief that is held by those in the medical community.

Call it what you want

Whether you call it a subluxation or a pinched nerve, it is apparent that the concept is shared equally by differing providers. What is not shared is the approach to treatment. Doctors of Osteopathy are liscensed to practice medicine while Doctors of Chiropractic and physical therapist are not. A look again at the Mayo Clinics website:

Your doctor will ask about your symptoms and conduct a physical examination.If your doctor suspects a pinched nerve, you may undergo some tests.

The tests listed are a Nerve conduction study,Electromyography and MRI

These tests are often completed at the same time and take about one hour

This reliance on expensive testing is why healthcare is out of control. This trio of tests would cost well over $4000. Diagnostic testing should be used to confirm a diagnosis, not to create one. The history and examination should provide the doctor with much of the information needed and additional testing should only be performed if necessary. To order tests in chunks, which is common, without even interpreting the results of the first, is nothing less than a waste of resources and money.

And after these tests are performed, the Mayo Clinic proposes these treatment options: Physical therapy,Medications,Surgery. It suggests that PT "can teach you exercises that strengthen and stretch the muscles in the affected area in order to relieve pressure on the nerve. He or she may also recommend modifications to activities that aggravate the nerve" while medications "can help relieve pain and alleviate inflammation around the nerve." Surgery is suggested "If the pinched nerve doesn't improve after several weeks to a few months with conservative treatments, surgery to take pressure off the nerve may be necessary." According to the Mayo Clinic, conservative care should be used first, following 4k worth of tests, and if all of that fails surgery should be performed.

The Mayo Clinic recognises the pinched nerve and its potential effects but fails to recognise the benefit of manipulation or mobilization performed by chiropractors and osteopaths. At least it gives some credit to the physical therapists who it explains " may also recommend modifications to activities that aggravate the nerve."

The American Chiropractic Association states "Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling."

The American Osteopathic Association explains that DO's: teach patients how to prevent illness and injury by maintaining a healthy lifestyle.

So if Chiropractors move joints like Osteopaths and recommend exercises as well as other counseling, why are our motives, qualifications and results questioned?

Turf!...It all boils down to everyone fighting for a slice of the health care pie!