D.D. Palmer opened the first chiropractic school two years later, and in the century since, chiropractic professionals have used spinal adjustments to help people prevent and cope with back pain, carpal tunnel, muscle strain, headaches and migraines, and a variety of other physical ailments. Millions of people benefit from the work of Dr. Palmer today.


Palmer hypothesized that vertebral joint misalignments, which he termed vertebral subluxations, interfered with the body's function and its inborn ability to heal itself.[5] D. D. Palmer repudiated his earlier theory that vertebral subluxations caused pinched nerves in the intervertebral spaces in favor of subluxations causing altered nerve vibration, either too tense or too slack, affecting the tone (health) of the end organ.[41] D. D. Palmer, using a vitalistic approach, imbued the term subluxation with a metaphysical and philosophical meaning.[41] He qualified this by noting that knowledge of innate intelligence was not essential to the competent practice of chiropractic.[41] This concept was later expanded upon by his son, B. J. Palmer, and was instrumental in providing the legal basis of differentiating chiropractic from conventional medicine. In 1910, D. D. Palmer theorized that the nervous system controlled health:

A 2012 systematic review suggested that the use of spine manipulation in clinical practice is a cost-effective treatment when used alone or in combination with other treatment approaches.[160] A 2011 systematic review found evidence supporting the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain; the results for acute low back pain were insufficient.[11]


Attached to the back of each vertebral body is an arch of bone that forms a continuous hollow longitudinal space, which runs the whole length of the back. This space, called the spinal canal, is the area through which the spinal cord and nerve bundles pass. The spinal cord is bathed in cerebrospinal fluid (CSF) and surrounded by three protective layers called the meninges (dura, arachnoid and pia mater).

Serious research to test chiropractic theories did not begin until the 1970s, and is continuing to be hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine.[37] By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain.[37] In recent decades chiropractic gained legitimacy and greater acceptance by medical physicians and health plans, and enjoyed a strong political base and sustained demand for services.[21] However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions.[21] The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care.[21]
Stabilization surgery is sometimes—but not always—done at the same time as a decompression surgery. In some forms of decompression surgery, the surgeon may need to remove a large portion of the vertebra or vertebrae. That results in an unstable spine, meaning that it moves in abnormal ways, and that puts you more at risk for serious neurological injury. In that case, the surgeon will restabilize the spine. Commonly, this is done with a fusion and spinal instrumentation, or implantation of an artificial disc.
Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.
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