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Chiropractic medicine is a form of treatment that uses manipulative therapy to correct chiropractic subluxation , which many chiropractors theorize as the cause of most disease. Manipulative therapy has been shown to have some efficacy in treating back and neck pain, headache, and other symptoms of spinal-related conditions, the application of chiropractic medicine as a cure or outside of this specific area is not yet fully accepted by the medical community. Chiropractic is an example of alternative medicine.
| Chiropractic Medicine | |
| This article is part of the branches of CAM series. | |
| CAM Classifications | |
| NCCAM: | Manipulative Methods |
| Modality: | Professionalized |
| Culture: | Western |
The use of manipulative therapy - not necessarily chiropractic - for some purposes enjoys wide acceptance by medical authorities in many nations. It is covered by many health plans such as Medicare in the United States. Although some medical doctors (MDs) and many doctors of osteopathy (DOs) do perform manipulative therapy, more than 90% of the treatment of back pain by manipulative therapy is performed by DCs (Doctors of Chiropractic). [1]
A survey released in May 2004 by the National Center for Complementary and Alternative Medicine focused on who used complementary and alternative medicine (CAM), what was used, and why it was used in the United States by adults age 18 years and over during 2002. According to this survey, Chiropractic was the 4th most commonly used CAM therapy (7.5%) in the United States during 2002 ([2] table 1 on page 8) when all use of prayer was excluded. Consistent with previous studies, this study found that the majority of individuals (i.e., 54.9%) used CAM in conjunction with conventional medicine ( page 6). "The fact that only 14.8% of adults sought care from a licensed or certified CAM practitioner suggests that most individuals who use CAM self-prescribe and/or self-medicate" (page 6).
Chiropractic medicine is generally rejected as being based on pseudoscience by most scientists and medical doctors. Classical chiropractic theory denies otherwise accepted medical facts about the origin of diseases, and instead holds that the correction of subluxation can cure or treat most disease. Although manipulative therapy has been shown to have some efficacy in treating back pain, headache, and other symptoms of spinal-related conditions, few rigorous studies have supported the efficacy of chiropractic medicine outside of this specific area. Many people colloquially use the term chiropractic to refer to manipulative therapy of the spine, even by non-DCs.
On September 18, 1895, in Davenport, Iowa, Daniel D. Palmer, inquired about the history of a deaf janitor, named Harvey Lillard. Lillard informed Palmer that while working in a cramp area 17 years ago he felt a pop in his back and had been nearly deaf ever since. Upon examination Daniel D. Palmer found what he described as a lump that was sore to the touch. He concluded that it was possible this lump was a misalignment, that was later to be called a subluxation, was the cause of Harvey Lillards deafness. After correcting this misalignment in the janitor's spine his hearing was restored. Harvey was reported to have noted that he could now hear the wheels of the horse drawn carts in the street below. Danial D. Palmer began further investigation into the phenomena and believed to have discovered that a major source of interference to the nervous system, the vertebral subluxation, interfered with the body's regulatory mechanism, causing what he termed dis-ease or loss of ease
The term chiropractic literally means "done by hand" and originated when chiropractic's founder Daniel D. Palmer asked a patient, Reverend Samuel H. Weed, a Methodist minister and a Greek scholar, to come up with a name from the Greek language to describe his practice. Of the several names submitted to him, Daniel D. Palmer accepted one which combined the words 'chiros' and 'praktikos' (meaning 'done by hand') to describe his adjustment of a vertebra in the spinal column. Palmer had been a bee keeper, school teacher, grocery store owner, and had an interest in the metaphysicalMetaphysics is a branch of philosophy, and related to the natural sciences, like physics, psychology and the biology of the brain; and also to mysticism, religion, and other spiritual subjects. It is notoriously difficult to define, but for purposes of br health philosophies of his day such as magnetic healing, osteopathy, and spiritualismSpiritualism is a religion in which contact with the spirits of the dead through a medium is central. Spiritualism in its modern incarnation started in the mid-nineteenth century in the United States and essentially grew out of Christianity. It is still p. He imbued the term "subluxation" with a metaphysical and philosophical meaning, holding that subluxations somehow interfered with the body's "innate intelligence", or life force.
Chiropractic medicine has gained general acceptance in the last 20 years as appropriate treatment for back and neck problems. Until 1983Events January January 1 Beat Raaflaub became Basel Boys Choir's new conductor January 1 the ARPANET officially changes to use the Internet Protocol, creating the Internet. January 1 compulsory wearing of seat belts becomes law in the UK. January 2 The mu the American Medical Association made it unethical for M.D.'s to refer patients to chiropractors. In September of 1987, the chiropractic profession achieved a victory when Judge Susan Getzendanner found the AMA and others guilty of an illegal conspiracy against the chiropractic profession (Wilke vs AMA), ordering a permeate injunction against the AMA and forcing them to print the courts findings in the Journal of the American Medical Association. The decision was upheld in the U.S. Court of Appeals in 1990 and again by the U.S. Supreme Court later that same year. The current ethical rules of the American Medical Association now permit M.D.'s to refer patients to D.C.'s for such manipulative therapy if the M.D. believes it is in the best interests of the patients.
The educational requirements for chiropractors are similar to that of medical doctors. The Council on Chiropractic Education (CCE) has set minimum guidelines for chiropractic colleges, However additional requirements may be need for a license depending on the state or government a chiropractor chooses to practice in. Many states require a 4 year undergraduate degree, although the minimum for enrollment set forth by the CCE is 90 semester hours as a prerequisite for attending a chiropractic college.The minimum accumulative GPA for a student entering a chiropractic college is 2.50.
48 of the 90 required semester hours much be completed with the courses as follows:
Curriculum for chiropractic college is very intensive and requires slightly more class time than medical school, requiring 2,419 total hours compared to 2,047 a medical student spends in class.
Minimum Required Class Room Hours Chiropractic College / Medical College
Chiropractic students require less clinical experience at approximately 1405 hours where their medical counter parts require roughly 5227 hours during their residency.
Contemporary chiropractic is divided into two basic schools: The traditional approach is that followed by the faction of the chiropractive movement known as straight chiropractic [3]. The other school known as mixing chiropractic, combines contemporary medical techniques with spinal and other joint manipulation. Mixing chiropractic is itself divided into conservative and liberal factions. [4]
The term straight chiropractic is used to more strictly associate with adherents of Daniel D. Palmer's chiropractic theory, and of those chiropractic schools who believe that subluxations are the cause of most or all diseases. Outside of treatment (not cure) of a limited set of symptoms associated with the spine, there is no medical evidence supporting the efficacy of straight chiropractic, and some techniques in the past have not been safe. Doctors who have submitted research backing up the medical benefits of spinal manipulation have found their claims incorrectly applied to the entire field of chiropractic manipulation, including straight chiropractic.
Also note the reformer movement discussed below, The National Association for Chiropractic Medicine (NACM).
According to the National Council Against Health Fraud, the conviction held by chiropractic believers that every spine will benefit from an adjustment causes them to manipulate spines inappropriately. Among the concerns about chiropractic manipulation is the widespread use of the explosive "dynamic thrust" which takes the patient by surprise, as opposed to more conservative techniques. This maneuver has a greater potential for inflicting injury.
The practice of greatest concern is the rotary neck movement (sometimes called Vaster cervical or "rotary break"). This type of manipulation has led to trauma, paralysis, strokes, and death among patients. Even chiropractic's legal advisors have warned against its use. Although study results have varied, the actual risk of stroke is typically calculated to be one in 2 to 5 million adjustments. A recent study published in the Canadian Medical Association Journal puts the risk at 'one in 5.85 million adjustments'.
The overuse of x-ray by chiropractors poses potential patient harm. Of primary concern is the 24' x 36' full spine x-ray. This technique exposes patients to a substantial amount of radiation. Exposing the body trunk to x-rays can have serious long-term consequences and should be avoided. Further, according to NCAHF's chiropractic advisors, such radiographs have little or no diagnostic value.
Some doctors who have submitted research backing up the medical benefits of limited forms of spinal manipulation have found their claims incorrectly applied to the entire field of chiropractic manipulation. Perhaps the most well-known case of this occurred in response to The RAND report on The Appropriateness of Spinal Manipulation for Lower-Back Pain. This study was a meta-analysis of 22 controlled experiments; the conclusion was that certain forms of spinal manipulation were successful in treating certain types of lower-back pain. Many chiropractors seized upon these results as proof that chiropractic theory was sound and that chiropractic medicine had reliable results; in fact, the authors of the report had said no such thing. Misuse of this report reached such an extent that the RAND report authors were forced to issue a public statement. In 1993 Dr. Paul Shekelle rebuked the chiropractic industry for making false claims about RAND's research:
Sixty-two clinical neurologists from across Canada, all certified members of the Royal College of Physicians and Surgeons, have issued a warning to the Canadian public and provincial governments about the dangers of neck manipulation.[5]
Mainstream medical doctors and scientists reject the claims of most chiropractic associations and schools as pseudoscience; many refer to their claims as fraud. Moreover, a chiropractor from the Canadian Memorial Chiropractic College, in Toronto, and two professors at Los Angeles College of Chiropractic have also come to this position; they hold that all chiropractic organizations engage in and promote "quackery."
York University at one point attempted to affiliate with a chiropractic school. The scientists and medical doctors at this school rebelled against the plan, and created their own website explaining why this would be a bad idea. They enlisted the help of Nobel prize winning scientists to explain to the school's administration, and public at large, why chiropractice is unscientific.
There are many investigations and lawsuits underway in Canada for false advertising, deceptive practices and claims, injuries and deaths.
A small percent of chiropractors have rejected the metaphysical beliefs of mainstream chiropractors. They view the beliefs of mainstream chiropractic medicine as metaphysical and religious, and having no scientific validity, and as a profession which may be dangerous. In contrast, they hold that there are scientifically defensible uses of spinal manipulation for medical benefits. According to their website:
Chiropractic books, like other medical books, are reviewed by Doody Review Services . This review can be accessed by selecting Barnes & Noble after clicking on the ISBN for the book.
A chiropractor has assembled a bibliography on amazon.com.
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