Reviews of research studies within the chiropractic community have been used to generate practice guidelines outlining standards that specify which chiropractic treatments are "legitimate" (i.e. supported by evidence) and conceivably reimbursable under managed care health payment systems.[70] Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims.[2][52][43][85][86] Chiropractic remains at a crossroads, and that in order to progress it would need to embrace science; the promotion by some for it to be a cure-all was both "misguided and irrational".[87] A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice, which may have resulted from a lack of research education and skills.[88]

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^ Jump up to: a b Palmer DD (1910). The Chiropractor's Adjuster: Text-book of the Science, Art and Philosophy of Chiropractic for Students and Practitioners. Portland, OR: Portland Printing House Co. OCLC 17205743. A subluxated vertebra ... is the cause of 95 percent of all diseases ... The other five percent is caused by displaced joints other than those of the vertebral column.
Chiropractors often argue that this education is as good as or better than medical physicians', but most chiropractic training is confined to classrooms with much time spent learning theory, adjustment, and marketing.[65] The fourth year of chiropractic education persistently showed the highest stress levels.[188] Every student, irrespective of year, experienced different ranges of stress when studying.[188] The chiropractic leaders and colleges have had internal struggles.[189] Rather than cooperation, there has been infighting between different factions.[189] A number of actions were posturing due to the confidential nature of the chiropractic colleges in an attempt to enroll students.[189][clarification needed]
Jump up ^ Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André (2016). "Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies". PLoS One. 11 (8): e0160037. Bibcode:2016PLoSO..1160037B. doi:10.1371/journal.pone.0160037. ISSN 1932-6203. PMC 4972425. PMID 27487116.
Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age,[147] but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions.[146][148] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS.[149] There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke.[15] While the biomechanical evidence is not sufficient to support the statement that CMT causes cervical artery dissection (CD), clinical reports suggest that mechanical forces have a part in a substantial number of CDs and the majority of population controlled studies found an association between CMT and VAS in young people.[150] It is strongly recommended that practitioners consider the plausibility of CD as a symptom, and people can be informed of the association between CD and CMT before administrating manipulation of the cervical spine.[150] There is controversy regarding the degree of risk of stroke from cervical manipulation.[15] Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven.[17] However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable[17] or definite.[16] There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation.[151] The incidence of internal carotid artery dissection following cervical spine manipulation is unknown.[152] The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke.[153] The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension.[154] Cervical intradural disc herniation is very rare following spinal manipulation therapy.[155]
One of the most common questions that people ask is around the safety of chiropractic care. So, how safe is it? According to the American Chiropractic Association, “Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of back pain, neck pain, joint pain of the arms or legs, headaches, and other neuromusculoskeletal complaints.” While chiropractic is considered a safe complementary therapy, there can be some potential side effects, like soreness following a spinal manipulation.
"Physiologists divide nerve-fibers, which form the nerves, into two classes, afferent and efferent. Impressions are made on the peripheral afferent fiber-endings; these create sensations that are transmitted to the center of the nervous system. Efferent nerve-fibers carry impulses out from the center to their endings. Most of these go to muscles and are therefore called motor impulses; some are secretory and enter glands; a portion are inhibitory, their function being to restrain secretion. Thus, nerves carry impulses outward and sensations inward. The activity of these nerves, or rather their fibers, may become excited or allayed by impingement, the result being a modification of functionality – too much or not enough action – which is disease."[42]
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The next step in the process was an X-ray. Having an X-ray done of your spine can help the chiropractor determine your treatment plan and can aid in the adjustment. That said, not all chiropractors will recommend an X-ray at your appointment. It turns out some chiropractors say that X-rays should be part of routine chiropractic care, while others argue X-rays aren't necessary for every patient. When researching potential chiropractors, feel free to ask if they recommend X-rays for all patients and how the X-rays can benefit your treatment plan.
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