Although mixers are the majority group, many of them retain belief in vertebral subluxation as shown in a 2003 survey of 1100 North American chiropractors, which found that 88% wanted to retain the term "vertebral subluxation complex", and that when asked to estimate the percent of disorders of internal organs (such as the heart, the lungs, or the stomach) that subluxation significantly contributes to, the mean response was 62%. A 2008 survey of 6,000 American chiropractors demonstrated that most chiropractors seem to believe that a subluxation-based clinical approach may be of limited utility for addressing visceral disorders, and greatly favored non-subluxation-based clinical approaches for such conditions. The same survey showed that most chiropractors generally believed that the majority of their clinical approach for addressing musculoskeletal/biomechanical disorders such as back pain was based on subluxation. Chiropractors often offer conventional therapies such as physical therapy and lifestyle counseling, and it may for the lay person be difficult to distinguish the unscientific from the scientific.
One of the reasons I wanted to visit the chiropractor was to take a more active role in my overall health and wellness. I specifically chose an integrated clinic, which offered not only chiropractic care, but also physical therapy, massage therapy and nutrition consultation. We discussed the addition of multi-vitamins, fish oil and vitamin D to my wellness plan. One thing I learned through this wellness planning? Everyone’s health journey is different! Since health is personal, your approach should be tailored to your specific needs. My focus on an integrated clinic may not be right for you, but I found value in being educated about all the options available to me.
Chiropractic is well established in the United States, Canada, and Australia. It overlaps with other manual-therapy professions such as osteopathy and physical therapy. Most who seek chiropractic care do so for low back pain. Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues. Many chiropractors describe themselves as primary care providers, but the chiropractic clinical training does not support the requirements to be considered primary care providers, so their role on primary care is limited and disputed. Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "innate intelligence", and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.
No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors. A focus on evidence-based SM research has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks. Two U.S. states (Washington and Arkansas) prohibit physical therapists from performing SM, some states allow them to do it only if they have completed advanced training in SM, and some states allow only chiropractors to perform SM, or only chiropractors and physicians. Bills to further prohibit non-chiropractors from performing SM are regularly introduced into state legislatures and are opposed by physical therapist organizations.
Chiropractors, especially in America, have a reputation for unnecessarily treating patients. In many circumstances the focus seems to be put on economics instead of health care. Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could possibly present a risk to patients. Some chiropractors are concerned by the routine unjustified claims chiropractors have made. A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence, while 28% of chiropractor websites advocate lower back pain care, which has some sound evidence.
Early chiropractors believed that all disease was caused by interruptions in the flow of innate intelligence, a vitalistic nervous energy or life force that represented God's presence in man; chiropractic leaders often invoked religious imagery and moral traditions. D.D. Palmer said he "received chiropractic from the other world". D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science. Early chiropractors also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, among which they included the American Medical Association (AMA).
Paige, N. M., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., Mardian, A. S., Dougherty, P., ... Shekelle, P. G. (2017, April 11). Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. Jama, 317(14), 1451–1460. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2616395
I finally met the chiropractor! We started out by talking a little about the reason for my visit, and what my goals were. Next, he performed a Selective Functional Movement Assessment, which basically helps the chiropractor find the root and cause of any symptoms—they do this by breaking down dysfunctional patterns logically rather than simply finding the obvious source of the pain.