With the medical lingo and curriculum invading chiropractic colleges around the country, I thought I would take this blog post to clear up some of the confusion.
Personally, I believe that we as chiropractors, upper cervical or full spine, have a right to our own separate and distinct health profession. What we do is remove interference to the nervous system so that the body’s Innate Intelligence has the opportunity to fully express itself.
No one else on earth does what we do. Osteopaths don’t. Naturopaths don’t. Physical Therapists don’t. Physiotherapists don’t. MDs don’t.
If that is the case, why does part of the chiropractic profession, or should I say the politicians/researchers/school faculty want us to give that up?
The reason is simple. They want to be validated and accepted by the medical community. They also want to have control and cut deals to better themselves, not the profession.
Instead of doing research that validates chiropractic’s relationship with the nervous system, our profession’s researchers waste their time on worthless studies such as Spinal Manipulation Reduces Pain & Hyper-Algesia Following Lumbar Intervertebral Foramen Inflammation in the Rat. This study was recently done at the Parker Research Institute. It showed that Activator-assisted Spinal Manipulation Therapy (ASMT) reduces the severity and shortens the duration of pain caused by inflammation… in a rat.
Does anyone reading this blog care about how an Activator reduces pain and inflammation in a rat? If you are speaking to a skeptic about chiropractic, and you have to choose one study to show him/her, which one would you choose: The NUCCA hypertension study which validates the connection between a precise upper cervical adjustment and brain stem function via lowered blood pressure, or a study showing how well a rat with low back pain responds to an Activator? In fact, if you were speaking to a skeptic, would you even mention the rat-Activator study?
With less than 50% of all medical diagnosis being accurate, why would the CCE think chiropractors would be any better? Instead of mandating the school curriculum to cover chiropractic, we all graduate with the ability to be second-rate PTs and DOs, and third rate MDs. Chiropractic takes a back seat to classes used to teach us material to pass National Boards.
We get $150,000 in debt to get a $20,000 a year job starting out, in many cases. My alma mater alone charges approximately $9,000 a trimester now, with the curriculum now changed to a 10-trimester schedule. You do the math.
Medical Term- Treat, treatment
Chiropractic Term- Checking for nervous system interference
We are taught in school that we “treat” patients or administer “treatments.” Chiropractors don’t “treat” anything. In fact, rarely is it ever legal for a chiropractor to “treat” any kind of disease. “Treatment” comes into play when using physiotherapy such as ultrasound or electrical stimulation. Those practices are not chiropractic whatsoever, though many chiropractors use them. They have no real use beyond earning the chiropractors a few more dollars on an insurance claim. Chiropractors check for interference to the nervous system. Period.
Medical Term- Manipulation
Chiropractic Term- Adjustment
Manipulation is a medical term used for mobilizing joints. It is completely non-specific and not very effective in the way of long-term efficacy. This is what people think of when they talk about chiropractors “cracking” and “popping” people. But as the poster below says, “There is a BIG difference” between that and an adjustment.
However, it takes a lot of practice and dedication to be able to give an adjustment. Most chiropractors settle for using manipulations for that simple reason.
Medical Term- Fixation, fixated joint
Chiropractic Term- Vertebral subluxation
Fixations often occur when there is a dysfunction in a joint, such as immobility, ligamentous weakness, etc. I understand this can be a problem, but in school, more stock is given to removing a fixation than removing a subluxation. How does one remove a fixation? By using “manipulation” as the “treatment.”
Chiropractors remove vertebral subluxations. These are misalignments of the vertebrae that result in interference to brain-body communication. These are the reasons for fixated joints. They are effects of the cause. Chiropractors pride themselves on removing the cause. Unless a vertebral subluxation is removed, the cause hasn’t been removed.
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If the chiropractic profession gives up on its language and chooses to adopt medical terms, we will lose our identity and simply become a subset of medicine itself.
Medicine has its place, just not in chiropractic.
{ 18 comments… read them below or add one }
great and organised remarks. thanks for writing it.
A lot of upper cervical doctors put down the chiropractic school’s these days. They speak about how the school’s are not strong in philosophy, or the school’s are heading in the wrong direction. The direction chiropractic school’s are taking is in direct response to the direction the entire profession has chosen to go.
Chiropractors are not thought of as nervous system doctors by the public, they are thought of as back pain doctors. When chiropractic started evolving into the realm of pain relief, I don’t know, but it did go that direction without the help of the schools. Most of the diversified and Gonstead chiropractor’s I know get their patients by aggressively marketing to people with back pain , which is a large chunk of the population. This is how they get people in the door. This is how they make the money. Upper cervical doctors are guilty of this as well. If you want to be a back pain specialist, then you are forced to look at more than just subluxation. To tell someone they are experiencing low back pain ONLY because they have a subluxation is, to me, completely absurd. There are postural imbalances caused by a sedentary lifestyle, there are soft tissue injuries that have not healed properly, there are fixations.
The school’s are trying to get chiropractic accepted by the public who see them as back pain specialists. This is why we use E-stim, Ultrasound, light therapy, and soft tissue work like MRT. There is nothing wrong with schools teaching us how to treat pain, because this is the direction that chiropractics collective consciousness ultimately went. If someone wants to say hey, according to this study, I might be able to lower your blood pressure. Then fine. But I believe most chiro’s will go with the activator study, because back pain is what get’s patient’s in the door.
Eric, I don’t know if you understood my post. The whole point is that chiropractic was not founded on back pain. Many in our profession wanted to take a medical approach to chiropractic, which isn’t chiropractic. That’s why we are thought of as back pain doctors.
I don’t know many chiropractors who would take a back pain study on a rat over the high blood pressure study. That’s fine to want to do all PT stuff and chase pain, but call it what it is: medipractic.
I don’t believe I have a right to tell another doctor how to take care of their patients, and they don’t have the right to tell me how to take care of my patients, but we as a chiropractic profession have a right to our own lexicon and our own standards of care. Diagnosing and treating is the practice of medicine and NOT the practice of chiropractic. If a chiropractor wants to treat pain then he or she should go to medical school and get the training that a medical doctor gets. Our chiropractic colleges have no right to invade the practice of medicine. If a chiropractor does not believe in chiropractic he or she should have some ethics and get out of the profession. By having so many chiropractors in our profession that do not agree with the very basis of chiropractic (subluxation) it weakens the profession. eg:If a Priest does not belive in his church, he should be accountable enough to get out of the Priesthood.
Well said, Dr. Doble.
Brandon, I understood your post and I went off on a tangent because I wanted to get that particular thought out. Upper cervical chiropractors are very down on the education we get. Dr Doble, I have to disagree with you. Nobody said anything about not believing in chiropractic. I said that if you want to aggressively market to patients with back pain, then you should know how to diagnose and treat it. No, you do not need to go to medical school to treat back pain. In fact, MD’s have no idea how to effectively treat back pain. That is why it is up to us to do so. One can believe in subluxations and nervous system interference and also treat back pain. The righting reflex in the upper cervical spine is a perfect example of something we as chiropractors can affect. Once the head is centered over the neck, we can treat soft tissue and correct postural dysfunction, and this has a beneficial effect on pain. If you want to treat subluxations exclusively, then that’s fine. If I want to treat people’s back pain using NUCCA with other pain relief techniques learned in school, then I am performing a much needed service to my community. Because nowhere else is somebody going to get an upper cervical correction, along with soft tissue treatment and rebalancing of the muscles of the body to work the way they were designed to work. They are not going to get it in a PT’s office, an LMT’s office, or an MD’s office. If that’s the definition of a medipractor, then I am proud to be a medipractor. Fighting this natural evolution of the profession is futile. Dr. Doble, I hope you turn away patients that show up to your office with pain because that would be the ethical thing to do.
Natural evolution of the profession? I’m not sure what chiropractic history books you’ve been reading, but it’s anything but natural evolution. It’s all money driven i.e. what will insurance pay for? You are right about the righting reflex, but if you have good skill and your upper cervical technique is good, applying PT will only interfere with the body’s Innate Intelligence to heal. It comes down to a basic fundamental understanding of chiropractic, which includes proper technique and analysis, and does not include PT or chiropractic massage aka soft tissue treatments.
Brandon, every time I post here you come back with something smart. What books have you been reading? If you have good skill, the body will take care of the rest, and PT will only interfere? I hope your not treating back pain with that mindset. That is a dumbed down and over simplified perception of musculoskeletal function. I’m starting to feel like there aren’t a lot of UC docs who were athletes in their younger days. No amount of upper cervical adjusting can release scar tissue that has built up in over used or injured soft tissue. If the patient does not have full range of motion in the muscle, the joint will never function properly, unless you release it. Brandon and Doble I beg you both to turn away patients that come in with shoulder dysfunction, or tennis elbow, or anything else that is not greatly affected by the righting reflex. Maybe you do refer these patients to doctors that have a better understanding about how muscle imbalance works. If you do, then you are doing right.
Eric, I’m not saying those things don’t help people, but that they are physical therapy, not chiropractic. If I have a sports injury that needs immediate attention, I would first go to my upper cervical chiropractor to make sure I was subluxation free, then I would go to someone who specialized in sports injuries.
Sure the joint will never function properly, but I am of the mindset that if you remove the interference, many times, not all, the body will know what to do.
Of all the conditions you just described, I could find a list of upper cervical chiropractors that have had patients with those conditions all clear up by simply removing interference. Upper cervical is not about just moving one bone and calling it a day… it’s a specific form of chiropractic analysis.
And no, I wouldn’t turn those people down simply because I believe I can help them. If I can’t, I will send them to someone who can.
Honestly, you and I are coming from two totally different mindsets. You focus on treating symptoms, I don’t. I’m not going to change your mind, and you’re not going to change mine.
Brandon,
My point is this: If a chiropractor advertises that he/she treats back pain, then, in my opinion that chiropractor should have the ability to diagnose the problem, and treat the tissues and structures involved. When I google orange county back pain, 10 different chiropractors come up that cliam to relieve pain. I hope these chiro’s are not only treating subluxations, because there is so much more involved when treating musculoskeletal issues. In your case Brandon, you wouldn’t use that google keyword in your SEO. I would. If I knew someone in your area that needed upper cervical adjustments because I wanted them to live an overall better, healthier life, I would refer them to you. If I knew an athlete in your area that was having knee pain because of an IT band contracture, I would refer them to a chiropractor that treats symptoms and soft tissue.
Fair enough. Good discussion, though.
Absolutely. I look forward to more thought provoking discussion on this board. I’m a big fan of this site. keep up the good work.
I think you guys cleared the air quite well on that one. Well done. You all made excellent points. It seems that we are at a place in our history (I think we have been here for some time now actually) where some chiros practice a therapeutic version of chiropractic and others practice subluxation-based chiropractic. The problem may well lie in what Eric was bringing up however, that if your practice one version don’t advertise or tell patients that you do the other one. You either practice therapeutic or you don’t. Maybe we should have, as some have suggested, two different degrees one for the therapeutic bunch and one for the subluxation-based group. Just a thought especially since either side is not going to change the other side.
This is the crux of chiropractic. I don’t treat or advertise that I treat anything. I tell people that I correct vertebral subluxation and if they want their pain treated to go somewhere else. Chiropractors have invaded medicine, is this not true Eric? If you want to treat symptoms with therapy that’s fine, but you should not call it chiropractic, that’s all. Call it physical therapy. Look up the definition of physical therapy in the dictionary and you will see that, that is what you are doing. Please let us chiropractors have our own lexicon and standard of practice. I write this to you with respect, because I respect what you do, I know it helps people, and I believe you should have the right to do it, just as I should have the right to correct vertebral subluxations. I believe we can both exist in harmony and as friends and If someone can benefit from your service, then I will send them your way. But please don’t call it chiropractic. Just an opinion and a friendly suggestion.
Is subluxation-based chiropractic actually health care?
The objective straight philosophy of Gold and Strauss says no, that “getting the sick well,” while admirable, was a short-sighted vision of traditional chiropractic philosophy that BJ embraced (at least for most of his career) and since then, they have jettisoned it. They are strictly working from the perspective that subluxations reduce vitality and impede the work of innate intelligence. Therefore there is zero talk of disease, diagnosis, or any symptoms. This is a very coherent and consistent way to approach practicing chiropractic, if you’re willing to completely remove yourself from health care.
That includes not talking about “getting the sick well,” because we don’t know how innate intelligence should manifest itself in the body. And our definition of “well” could be a mistaken perspective of an educated mind. After all, some people do get better, and others don’t.
That’s why Reggie created Spinology, to get objective straight philosophy out of health care completely.
It makes sense then that objective straights practice a form of chiropractic that advocates an adjustment, anywhere in the spine, where they are detected. It is up to the chiropractor to determine when and how. So, for many, that means being adjusted every week of your life, sometimes more than once in day, that’s fine.
While I appreciate the consistency of the objective straight philosophy, I have a hard time accepting the fact that the body is so intelligent that it needs an adjustment every 3 days. I also know how hard it is to correct a UC subluxation, and I don’t believe it’s possible to do it via palpation alone, except on accident.
I do believe that chiropractic belongs in health care, even though our culture’s working definition of health care is flawed.
I also see value to measuring symptomatic response, because it provides a clue as to whether limitations of matter are being overcome. If there are signs it isn’t, I want to know that, because then that’s a good time for medicine to step in. Or another chiropractor. I also see the value in talking to people about their symptoms because that’s why they are seeking my care. They have goals in mind: they want to know if I can meet their goals.
It is my job to shift their thinking to: will my body meet those goals if I have nervous system irritation reduced or eliminated? By the beginning of the care process we have a working agreement: I’m going to do everything I can do within my system of analysis to correct the atlas subluxation complex, and they are going to do everything they can do to help themselves, without interfering with the process. If their symptomatic goals aren’t being met in a certain time frame, and I’ve done what I can, the person is welcome to stay and enjoy the benefits that have accrued so far, or they can find another provider that will handle it differently.
Of course there are people who don’t understand this process, and they sometimes leave when I refuse to adjust them just because they’re hurting.
I believe Dr. Liss has done a good service in pointing out that accepting patients for the care of symptoms while espousing an “objective straight” kind of philosophy, doesn’t make much sense. There are many UC docs who think they are practicing with this kind of philosophy, but they aren’t.
But what about the traditional (upper cervical) philosophy of “getting the sick well.” Is that really a contradiction?
I think it’s a paradox. An interesting thing about paradoxes is that two things can be true at once, without negating the reality of the other. I work to get the sick well, not through treatment, but through the correction of subluxation. That involves the reduction of symptoms, and the talking about symptoms.
So for me the UC adjustment is an intervention, at first. A measurement of a biomechanical problem and an process to correct that problem. As positive survival value accrues in the body, it is no longer an intervention, but a way to support the body’s well-being through the reduction of nervous system interference when it arises.
When someone calls me and asks me if I can help with Trigeminal Neuralgia I cannot in good conscience say: “Yes, I treat that,” nor can I say, “I’m not interested in your symptoms.” Both aren’t true. What I can say is this: “if the Atlas Subluxation Complex is related to what you’re experiencing, then a positive change is possible. We have seen these changes recently in other people in a similar situation.”
There is a tension there that I have to live with. A tension created by a sick culture that I didn’t choose, but I must work within.
Reggie Gold and Strauss went off track with their objective straight chiropractic. It is important to read what BJP wrote, to read it all and to interpret it in the context of which it was written.
Great analogies and there are some awsome ones in the Parker Practice Manual also
Quote from Richard Doble on theatlasoflife: “If a chiropractor wants to treat pain then he or she should go to medical school and get the training that a medical doctor gets.” Quote from Richard Doble’s facebook page: “If you have neck problems or headaches you need to see me.”