Chiropractic

With more than 50,000 practitioners, chiropractic is the fourth largest health profession (after doctors, dentists, and nurses) in the United States and may be the most commonly used alternative therapy today. Stemming from the Greek words for "done by hand", chiropractic is a therapeutic system based on the belief that most medical problems are caused by misalignments of the vertebrae and can be corrected by manipulating the spine.

Like osteopathy, chiropractic originated in the Midwest in the late 19th century as a reaction to medical orthodoxy. Daniel Palmer, its founder, was a grocer and self educated healer from lowa. His theory that the spine plays a major role in health was sparked by an encounter with a janitor who had been stooped and deaf for 17 years following a spinal injury. Palmer noticed a misaligned vertebra in the man's spine and manipulated It back into place. Subsequently, the man was able to stand up straight without pain, and his hearing was restored. The story illustrates the two primary benefits that practitioners ascribe to chiropractice: relief of musculoskeletal pain and disability and reestablishment of internal organ function.

Palmer, who later opened the first school of chiropractic, taught that the human body seeks to maintain a state of homeostasis and has an innate ability to heal itself. This "innate intelligence" regulates all body functions through the nervous system. . Because the nerves orginate in the spine, Palmer reasoned that displaced vertebrae could disrupt nerve transmissions, a condition he called subluxation. He taught that eliminating subluxations allowed the body to carry out its job of maintaining equilibrium unimpeded.

Palmer believed that almost every disease ultimately stemmed from subluxation and that spinal manipulation could treat them all an idea that became known as "one cause-one cure:" Although few chiropractors today still adhere to this theory, the core of the chiropractic profession remains the detection and correction of vertebral misalignment.

Recent advances in the understanding of neurophysiology may provide a theoretical basis for visceral organ responses to chiropractic adjustment.

The American medical establishment has recently ceased its former condemnation of chirpractic.This result from a 1991 Supreme Court ruling that the Amercian Medical Association (AMA) had conspired to contain and eliminate the competitive professional of chiropractic an antitrust viloation. The judgment required the AMA to reverse its ban on professional coopertation between chiropractors and medical doctors and to pay a substantial settlement. Much of the financial settlement is being used for chiropractic research.

Benefits And Uses of Chiropractic

Although back pain is the most common reason that people see a chiropractor, any musculoskeletal condition clearly related to spinal or vertebral malfunction is a likely candidate for a chiropractic consultation. Other common problems treated by chiropractors are neck and shoulder pain, headaches, sports injuries, and work-related injuries such as carpal tunnel syndrome.

How the treatment is performed

Spinal manipulative therapy is often delivered manually. Some chiropractors use a special treatment table that can be adjusted to numerous positions. Others may use various devices in order to control more precisely the force and direction of adjustments as well as to administer higher force adjustments if necessary.

Chiropractic emphasizes a holistic approach to the diagnosis and treatment of a specific problem, seeking to understand how, for instance, pain in the knee might actually stem from a lower back dysfunction that isn't currently causing pain in the back itself. Physical examination focuses on possible subluxations, muscle strength, and postural and structural problems to determine whether spinal manipulative therapy is appropriate, and it may include X-rays.

The most common manipulation technique is the high-velocity, low-amplitude thrust (also known as osseous adjustment). It's performed by moving a joint to the end point of its current normal range of motion and then imparting a swift, low-amplitude, specifically directed thrust. This generally painless maneuver moves the joint beyond its current normal range of motion, while keeping within the anatomic limits of its range. Other lowvelocity adjustments are used when this standard adjustment isn't appropriate. In addition, some practitioners combine chiropractic with adjunctive therapies, such as joint mobilization, massage, nutrition therapy, heat or cold application, and ultrasound.

Side Effects of Chiropractic

Chiropractors claim that if performed by a trained professional, spinal manipulation should produce few if any complications. However, those who do not support chiropractic say manipulation of the lower spine can lead to such complications as leg weakness, bladder disturbance, and rectal and genital malfunction. They also note reports of life threatening dissection of an artery during an adjustment.

Clinical considerations

Chiropractic manipulation is contraindicated in patients with conditions that might worsen as the result of a spinal adjustment, such as osteoporosis and advanced degenerative joint disease.

Research summary

Some chiropractors still claim they can cure any disease, from allergies and impotence to heart disease and cancer, with spinal manipulation. However, there is no supporting scientific evidence yet for most claims.