Introduction to Chiropractic
History of chiropractic
Spinal manipulation is not a new concept
Records show manipulation of the spine dating to the time of Hippocrates (father of modern medicine), around 400 BC
Modern chiropractic in North America
In 1895, a man named DD Palmer, reportedly cured a man of deafness by adjusting the spine. After many trials, he then went on to create the first school of chiropractic. Chiropractors were initially persecuted for practicing medicine with out a license, and were frequently jailed.
The primary tenant of chiropractic
In a landmark trial of 1907, chiropractic was demonstrated to be a separate and distinct entity from the practice of medicine. The primary tenant of chiropractic was that structural and biomechanical derangement of the spine affected the nervous system, which in turn affected other aspects of the body. This was a philosophy distinct to chiropractic, though some facets of medicine were similar (ie: osteopathy), and chiropractic won the right to legally practice under the heading of doctor of chiropractic, or DC.
Portal of entry Physicians
Patients do not need a referral to go see a chiropractor. Because of this, chiropractors must be able to determine if a presenting patient has any problems that necessitate a referral to a medical doctor, or another specialist. A chiropractor must have excellent diagnostic skills for this reason.
Most chiropractic schools are now requiring the completion of a premedical undergraduate degree. Chiropractic college studies then take five academic years, for a total of 9 academic years of study.
Chiropractors receive thousands of hours of training in the neuromusculoskeletal system (neuro = nerve, musculo = muscle, skeletal = bone). Courses include Anatomy, functional anatomy, cadaveric dissections and Neuroscience, to name a few.
Training is essentially identical to medical doctors, with advanced emphasis on the musculoskeletal system, and decreased training in the area of drugs.
The increase in critical investigation and supportive research has turned chiropractic into more of a mainstream treatment than ever before. It is well documented as safe and effective treatment for acute low back and neck pain, and whiplash associated disorder due to trauma. (see ref) Many studies are underway to evaluate the effectiveness of chiropractic for other problems that aren’t as well documented in the scientific literature (ie: autism and bedwetting in children, chronic pain, ear aches).
What do we treat?
Chiropractors evaluate the integrety of joint systems throughout the body, and treat joints that are experiencing mechanical dysfunction. Whether the problem be due to nerves, muscle, bone or a combination of the three. For lack of a better term, the combination of muscle, bone and nerve making up a joint has been coined the “subluxation complex”.
SUB: meaning less than total
LUXATION: meaning dislocation
Subluxation = less than total dislocation.
Why do we treat this?
When a bone, or joint system does not move properly (hypomobile), its function is compromised. This leads to several potential problems:
The surrounding structures must then work harder
The muscles around the area work harder, can become fatigued and prone to injury, or create pain.
The surrounding joints must move more to make up for the other’s lack of motion.
This may cause pain and instability of the joint moving too much (hypermobile). This can lead to early degenerative disease of the hypermobile joint.
The hypomobile joint may pinch a nerve
A true pinched nerve is actually relatively uncommon. Signs of a pinched nerve are tingling, numbness and weakness along the area of nerve supply.
Weakness caused by a hypomobile joint can lead to more serious problems
Such as the term “slipped disc”, a body that is functioning incorrectly can be predisposed to things such as a herniated disc, which is more difficult to treat and has the potential to become surgical.
How do we treat this?
Low force, hi velocity adjustments
From the advent of our chiropractic training, we are taught how to differentiate and distinguish these hypomobile segments. We are able to determine the precise joint that isn’t functioning properly and the direction it needs to move to restore function. The adjustment itself is a quick thrust in the direction of the restricted motion. The hi velocity and low force motion is not painful.
Normalize the surrounding joint structures
The adjustment lasts longer if the surrounding tissue is relaxed or restored to normal function as well. This can be done through methods such as Massage, Active Release Technique, Acupuncture, stretching, etc… This prevents the muscles and surrounding tissue from pulling the bones back into an abnormal position as quickly (this will happen to a degree no matter what, which is why chiropractic takes 6-8 treatments minimum, usually).
The rule of thumb is: the longer the problem has been in existence, the longer it will take to treat.
The exception to this is acute traumatic injury, such as whiplash associated disorder. The traumatic tearing caused by these injuries are difficult to treat and may take much longer.