Manipulation of the joints, especially those of the spine, dates back to ancient times in regions such as China and Greece. Hippocrates (460-375 BC) stated, “Look well to the spine for the cause of disease.” Tuina, traditional massage in China (originating about 2700 BC) and a major source of inspiration for myself to learn chiropractic, is performed by doctors and incorporates skeletal manipulation.
The origins of chiropractic itself date back to 1895 and its founder, DD Palmer, and his son BJ. They were the founder and developer of chiropractic, respectively. Over the years, various others have developed a multitude of methods within the profession, some very different interpretations of chiropractic than one might think. It wasn’t until 1913 that chiropractors were licensed in the first state and, by the 1930’s, chiropractic was viewed as the largest alternative healing profession in the United States.
The overall paradigm in chiropractic is that improperly moving joints, primarily within the spine, create stress on the associated nerves, which therefore can impact all areas of the body that depend on nervous energy flow – input and output. This means the internal organs, muscles, bones, skin, and so forth are potentially affected by less mobile joints due to impaired flow of nervous energy. While chiropractic has gained acceptance within the medical community after many years of challenges and persistence, internal debates are somewhat widespread within the field. I view this as mainly an ego-driven issue, often due to differences on paradigm or which technique system is ‘superior’. Ultimately, ethical patient treatment geared toward active care should be the primary concern.
If there’s one thing I’ve learned about chiropractic, it’s that no two chiropractors will think similarly about the profession. Chiropractic is embodied by the triad of art-science-philosophy, however, every chiropractor varies in emphasis to these three categories. Since the ‘art’ applies to all facets of chiropractic and implies that all chiropractors attempt to, regardless of technique system preference, deliver the most safe and accurate manipulations/mobilizations possible – even if no force is delivered.
As with any skill, from martial arts to sports and beyond, chiropractic techniques require practice to master and are always (hopefully) in some stage of development and/or refinement. Art is ever-present and leaves the divisive spectrum between philosophy/subluxation-focused chiropractors and science/evidence-based chiropractors. The art is what ties everything together, so if you receive care from someone with poor/dangerous technique, regardless of their preferences for philosophy vs science, you may have a non-beneficial outcome – this is one component that can vary widely among all practitioners of chiropractic.
Some chiropractors focus strictly on philosophy, the words of DD and BJ Palmer – the ‘straight’ chiropractors, who believe that vertebral subluxations (not the same as medical subluxations) are the main reason your nervous system/innate intelligence/overall health becomes disrupted. By extension, the chiropractic adjustment is the primary method to correct such problems to allow your nervous energy to flow freely. Chiropractic originally involved some level of religious/moral obligation, so it is no surprise that many hold onto the original beliefs, regardless of what scientific evidence has proven/disproven.
Other chiropractors focus on science and what research has shown yields the best results, which has both positives and negatives. The positives would be based around having reliable outcome measures and reasonable care plans with proven results. The negatives, however, mostly relate to lack of studies conducted in favor of chiropractic. This isn’t a knock against the field, but it is reality since there are no prescription drug companies or similar helping to fund studies. Thankfully it is changing, but there is still plenty of work to be done.
I find myself somewhere in between, as I am on board with the concept that nervous system interference compromises health but I am also interested in what evidence has shown over the years. The fundamentals of chiropractic never seemed to have a solid foundation, as DD Palmer himself changed his stance more than once and BJ became somewhat of a ‘mixer’. Having worked with the RAND Corporation as a data abstractor on a multi-million dollar study about the appropriateness of chiropractic care, I can see why there are problems within the field. Ultimately, I mean no offense to anyone in particular, regardless of perspective – as long as taking care of patients ethically and efficiently is the focus of the chiropractor.