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Author/s: Leonard C. Bruno

Definition of Chiropractic

Chiropractic is a therapy that focuses on the relationship of the spinal column to the nervous system and on its effects in maintaining good health.

Purpose of Chiropractic

Chiropractic seeks to properly align the vertebrae of the spine in order to restore the normal functioning of the nervous system and thus allow the body to heal itself.



Patients with known bone diseases, fractures, or bone cancer should not see a chiropractor. Pregnant women with back pain can be treated, but should never allow themselves to be x rayed.

Description of Chiropractic

In little more than a century, chiropractic has gone from a curious cult-medicine status to an internationally recognized alternative treatment. Founded in 1895 by a Canadian-American, Donald David Palmer (1845-1913), chiropractic had its origins in Palmer's cure of a deaf janitor by putting one of his vertebrae back into its normal position. Palmer continued to refine his work and eventually based an entire medical philosophy on the notion that the vertebrae of the spine must be properly aligned in order for people to achieve and maintain health.

Misalignments, or what he called "subluxations," interfere with the normal transmission of nerve impulses from the brain to the body's organs and tissues and can affect health. In contrast to the medication and/or surgery of traditional medicine, chiropractic techniques offered many what they considered a safe and economical alternative. Since Palmer's days, chiropractors have grown into the third largest healthcare profession, after physicians and dentists. By the mid-1990s, they were licensed to practice without supervision or referral from medical doctors in every state, and Americans spent nearly two-and-a-half billion dollars annually on chiropractic care. Also, one in twenty Americans visit a chiropractor each year, and some thirty U.S. hospitals have chiropractors on their staff.

The word chiropractic is derived from the Greek word "cheir" meaning "hand," and "prakticos" meaning "done by" or "skillful use of." Described as the skillful use of hands, chiropractic focuses virtually all its efforts on the physical manipulation of spine and joints. It does not use drugs or surgery, and it does not diagnose diseases or ailments or even claim to treat them specifically. Rather, it believes in the holistic concept that the body possesses its own innate healing capability and that healing occurs from the inside out. Further, when the body is in balance -- and specifically when the vertebrae of the spine are kept in proper alignment -- good health ensues because the body's immune system is working properly. Chiropractic attributes a damaged or inefficient immune system to the impairment of normal nerve transmission caused by spinal misalignment. It is thus the single aim of the chiropractor to regard the spine as the major factor in health and disease and to therefore concentrate all his or her efforts on manipulating the spine back to its normal, healthy position.

Within the framework of chiropractic there are several schools or philosophies that differ according to their methods and goals. Two contrasting schools -- the "mixers" and the "straights" -- differ in the actual methods employed. As the simpler, more traditional school, straight chiropractic relies exclusively on spinal adjustments to correct vertebral misalignments and therefore restore nerve function. Although "straights" account for only about 15% of all chiropractors, hundreds of these traditionalists graduate each year, suggesting they will remain a considerable force for pure chiropractic tradition. The other chiropractic philosophy whose proponents are called "mixers" believe in blending or mixing other available therapeutic methods with traditional chiropractic. Thus, these individuals also use other adjunctive therapies such as massage, applied kinesiology, acupressure, nutritional counseling, and ultrasound among many others, seeking to employ whatever works best. A third branch of chiropractic follows the teaching of John McTimoney (1914-1980). This philosophy says that the entire musculo-skeletal system of the body is as important as the spine, and it therefore treats the joints of the entire body. A McTimoney chiropractor will examine, and work on if necessary, all areas of the body where joints can become misaligned. This technique is an especially gentle form of manipulation and involves only the practitioner's hands. Finally, there are chiropractors who make limited claims for their art, saying that it is most useful for structural problems like back pain. There are also many others whose claims are substantially more ambitious and who dismiss the role of infectious agents in causing disease and say rather that every medical disorder is attributed to spinal misalignment.

A visit to a chiropractor begins very much like one to an orthodox physician. The chiropractor will take the patient's detailed medical history, concentrating on understanding the nature of the complaint. He will then perform a physical examination, again much like an ordinary doctor, taking the pulse and blood pressure, and checking reflexes. He may also order blood and urine tests. The physical exam concentrates primarily on the spine, and he will instruct the patient to perform a number of movements while he is both carefully watching and palpating (probing with pressure) certain areas. This allows the chiropractor to focus on detecting muscle strength or weakness, the range of spinal motion available, incorrect posture, or any structural deformities. Most chiropractors now also x ray the patient's spine if they complain of pain, and these x rays allow them to locate vertebral misalignments. Treatment for a specific problem is always tailored to the individual's age, weight and build, overall condition, and even level of pain tolerance, and it consists of what are called adjustments. These are hands-on treatments in which the chiropractor uses his or her hands to manipulate the patient's spine. Depending on what part of the body is being treated, the patient will be asked to stand, sit, or lie down. Manipulation itself is done quickly, with each adjustment taking only seconds. It is here that the chiropractic technique differs from regular physical therapy and massage, for the practitioner typically performs a special, high-velocity thrust maneuver that places many pounds of force to a part of the spine for only the briefest time. Although this usually does not cause pain, it often results in popping or cracking sounds similar to knuckles being cracked. However, the chiropractor usually explains his actions before performing them, and the patient should know what to expect. For patients who are not comfortable with high-velocity techniques, the indirect thrust may be used. The indirect thrust uses a gentle stretching motion to manipulate the joint over a towel or padded block. Finally, depending upon the nature of the problem being treated, heat or cold may be applied.

Many people visit a chiropractor because of low back pain. In order to check out any chiropractor, prospective patients can call their state's Chiropractic Board of Examiners (found in the telephone book under state government listings) and discover if the chiropractor is licensed to practice in that state, if he or she is current with continuing education requirements, and whether he or she has any sort of record of disciplinary actions. It is also best to call the chiropractor before making an appointment and discuss whether he or she is willing to refer patients to a medical doctor if necessary. The reasons for x rays should be discussed. Most doctors make follow-up recommendations and it is up to the patient to follow these or not. If the patient's condition improves, he or she may not wish to continue future visits. Chiropractic treatment is covered by most health insurance companies, with most insurers feeling that chiropractic care not only cuts treatment costs but actually gets workers back on the job sooner than conventional care. Despite the generally wide acceptance of chiropractic healthcare, there is little solid evidence for its benefits beyond back care. Although there is little research evidence to support the basics of chiropractic philosophy, many people simply do not care as long as they get some relief from their problems. Supporters say that it is only a matter of time until such evidence appears, and in the meantime, patients take fewer drugs, have less surgery, and have fewer hospital stays with chiropractic care. This certainly accounts for much of its broad appeal.

Risks of Chiropractic

Overall, chiropractic has an excellent safety record. However, vigorous manipulation of the spine can do more harm than good if a tumor or a fracture exists. Excessive x rays can also have severe side-effects.



This web site is intended for your own informational purposes only. No person or entity associated with this web site purports to be engaging in the practice of medicine through this medium. The information you receive is not intended as a substitute for the advice of a physician or other health care professional. If you have an illness or medical problem, contact your health care provider.


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