Chiropractic: A Summary of Concerns (original) (raw)
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Chiropractic Care: Concerns & Cautions Spinal Manipulation and Subluxation Nonsense
While chiropractors do a good job treating mechanical-type back pain, there are good reasons to be skeptical about chiropractic manipulation based on correction of "vertebral subluxations." There is evidence to indicate that spinal manipulation can be helpful in treating some types of back pain, but chiropractic care is based upon an unproven and implausible subluxation theory suggesting that many organic ailments can be treated by adjusting vertebral subluxations. A grain of truth mixed with subluxation nonsense makes it difficult for most of us to distinguish between appropriate and inappropriate use of manipulation by chiropractors.
Spinal Manipulation, Chiropractic, and Subluxation Theory
Science-Based Medicine, 2023
While generic spinal manipulation can be helpful in treating mechanical-type back pain, there are good reasons to be skeptical about chiropractic manipulation based on subluxation theory which dictates that health can be restored and maintained by adjusting vertebral subluxations. A grain of truth mixed with subluxation theory makes it difficult for many of us to distinguish between appropriate and inappropriate use of manipulation by chiropractors.
The basis for spinal manipulation: Chiropractic perspective of indications and theory
It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments.
The study is to describe the current evidence for the effectiveness of chiropractic spinal manipulation in comparison to the conservative intervention on Low Back Pain (LBP). The PubMed database was searched for randomised clinical trials of spinal manipulation and low back pain. Criteria for inclusion was subjects with low back pain treated with chiropractic spinal manipulation. Studies were excluded when participants were under the age of 18; conditions that were considered to be outside the discipline of manual therapy including systemic disease or malignancy, osteoporosis, pathological causes of LBP, LBP with radiculopathy; and contraindications to spinal manipulation. Data extraction included study design, number of participants, gestational age, spinal region, number of manipulations, manipulation technique details, profession of manipulator, active exercise reporting (Yes vs. No), type, and number of active exercises. Chiropractic care seems to be more effective than conservative intervention for LBP in reducing pain, increasing range of motion in lumbar spine, improving disability status, and enhancing general health. Furthermore, integrative care for LBP could be considered to improvise in the future treatment plan. The review of comparing different treatment approaches for LBP is still lacking and future research is needed to consider including a control group in order to provide accurate and persuasive outcomes.
The Chiropractic Vertebral Subluxation Part 1: Introduction
Journal of Chiropractic Humanities, 2018
Objective: The objective of this article is to present a rationale for the need of a history of chiropractic vertebral subluxation (CVS) theory based on primary sources. Discussion: There is a dichotomy in the chiropractic profession around subluxation terminology, which has many facets. The literature around this topic spans social, economic, cultural, and scientific questions. By developing a rationale for a historical perspective of CVS theory, including the tracking of the historical development of ideas throughout the profession, a foundation for future discourse may emerge. Conclusions: By using primary sources, ideas in chiropractic on the development of CVS theory are proposed. This introduction presents a basis for the need of a history of CVS theory and suggests how this work may be used to further philosophical dialogs in chiropractic. (
Chiropractic spinal manipulation: what does the ‘best’ evidence show?
Focus on Alternative and Complementary Therapies, 2012
Background The evidence of effectiveness of chiropractic is controversial. Objectives To summarise all Cochrane reviews of chiropractic spinal manipulation. Methods The Cochrane database was searched for all Cochrane reviews of chiropractic manipulation. Cochrane reviews with the terms 'chiropractic', 'manipulation' or 'manual therapy' in the title, abstract or keywords were considered. Protocols of reviews were excluded, as were studies that did not focus specifically on chiropractic spinal manipulation. Data extraction was performed by the author according to predefined criteria. Results Five Cochrane reviews were eligible for inclusion. Due to clinical and statistical heterogeneity, a meta-analysis was not possible and the findings of the reviews were discussed narratively. The five reviews related to the following conditions: low back pain, asthma, dysmenorrhoea and neck pain. Each review included between three and 39 primary studies. Cautiously positive conclusions emerged for low back pain and neck pain. For the two non-spinal conditions, the conclusions were negative. Conclusions Cochrane reviews, generally considered to be the most reliable evidence, provide limited evidence that chiropractic may be effective for low back and neck pain, but failed to support the use of chiropractic for non-spinal conditions.
Chiropractic and Spinal Manipulation Red Flags: A Comprehensive Review
Science-Based Medicine, 2017
Many people visit chiropractors' offices seeking relief from back pain. Appropriate use of spinal manipulation provided by a chiropractor can be helpful in treating mechanical-type back pain, but there are good reasons to avoid chiropractic manipulation based on correction of " vertebral subluxations, " and there are red flags to look for before undergoing any kind of manipulative treatment for neck or back pain.
Journal of Chiropractic Humanities, 2018
Objective: The purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) between the years 1966 and 1980, with an emphasis on consensus models and terminology. Discussion: The consensus models on CVS during this time were an outgrowth of previous model building, research, and practice methods. The first consensus models were developed by the radiology diplomates of the American Chiropractic Board of Radiology. Later work was used to develop Medicare standards. Research and theory were influenced by the 1975 National Institutes of Health conference on spinal manipulation in 1975 and the workshops that followed that meeting. A new historical consciousness about the CVS, developed at the National Institutes of Health conference, which was a turning point for the profession in the use of terminology and the focus on functional pathophysiology associated with CVS. The historical view of CVS developed by Watkins, Haldeman, and Janse led to new integrative and historical developments in the profession. Conclusion: Theories during this period included consensus efforts as well as new distinctions about CVS theory and terminology.
The Yoke of chiropractic: Vertebral Subluxation Doctrine
Science-Based Medicine, 2019
The mysterious, asymptomatic chiropractic "vertebral subluxation complex" alleged to be a cause of disease has never been proven to exist. A real orthopedic vertebral subluxation, which can be identified by imaging and by physical signs, has never been demonstrated to be a cause of organic disease. Chiropractic subluxation theory has been perpetuated largely by misinformation, fear, and a powerful placebo effect, produced, in part, by insignificant cavitation (popping) that occurs during manipulation of normal joints.
Journal of Chiropractic Humanities, 2018
Objective: The purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) during 1996 and 1997. The literature during this period offered critical and integrative models emphasized by a need for research into operational and functional definitions. Discussion: Several integrative approaches emerged, from Rome's 296 synonyms to Bergman's Pain/Tenderness, Asymmetry/Alignment, Range of Motion Abnormality, Tissue Tone, Texture, Temperature Abnormality, and Special Tests (PARTS) analysis adopted by the profession in the United States. Other noteworthy contributions included Ruch's Atlas of Common Subluxations, Epstein's introduction of network spinal analysis, and Kent's review of CVS models. Boone's introduction of the Journal of Vertebral Subluxation Research was accompanied by his 3-part model with Dobson. These years also included the paradigm statement of the Association of Chiropractic Colleges, which was adopted by the American Chiropractic Association, International Chiropractors Association, and World Federation of Chiropractic. Two other papers included Nelson's critique of the CVS paradigm and Keating's 1996 "Hunt for the Subluxation." Conclusion: The CVS reached a new stage of complexity and critique and offered new directions for research, integration, and development.