Chiropractic is the largest CAM health profession in North America and the third largest health-care profession in the United States. Is it for you?
| VICUS.COM (8 April 2000) — As the largest of the alternative/complementary health professions in North America, and the third largest health-care profession in the United States, chiropractic is used by more than 50 million Americans each year (Horstman, 1998). Patients visit their chiropractor primarily for relief from back and neck pain following an injury or accident. Is chiropractic the correct alternative medicine for what ails you? Here are answers to frequently asked questions about this profession, whose roots are in antiquity, but whose principles in today’s practice are only about 100 years old.
Question: What conditions are most responsive to chiropractic manipulation?
Answer: Chiropractic is considered to have efficacy in the treatment of the following conditions (Bratman, 1999):
Q: For which conditions is chiropractic most effective?
A: In clinical practice, chiropractic is a reasonable treatment choice for acute neck and back pain, according to Steven Bratman, M.D., in The Alternative Medicine Rating Guide. The strongest scientific support for chiropractic is in the treatment of acute back pain, chronic neck pain and tension headaches.
Q: How does chiropractic work to treat these conditions?
A: The Arthritis Foundation’s alternative therapies data cites that historically, chiropractic manipulation therapy was thought to work by correcting misalignment (subluxation) of vertebrae in the spine. The “pinched nerve” theory behind chiropractic is that the nervous system, which runs through the spinal column, can have far-reaching effects if it is blocked or injured. Although controversy still swirls about its definition, even among chiropractors, subluxation is thought to cause pain and weaken the body’s defenses. By adjusting the spinal joints to address subluxation, chiropractors believe normal nerve function and health may be able to be restored (Horstman, 1999).
Q: Is this theory supported by scientific evidence?
A: Support for the effectiveness of chiropractic manipulation is based more on clinical response than laboratory experiments. For example, in 1973, Yale anatomy professor Edmund Crelin subjected the spines of six human cadavers to a series of mechanical forces and measured the effects of these forces on the sizes and shapes of the intervertebral foramina. These are the openings through which spinal nerves pass and where, according to chiropractic theory, vertebral subluxation induces pinching of nerves. Crelin found that no force short of that which broke the spine deformed the openings so their walls contacted the nerves (Nelson, 1999).
Despite this, the results of clinical studies suggest that chiropractic manipulation is at least as effective for the treatment of low back pain as most standard therapies. Furthermore, several regulatory agencies in the U.S., Canada and England recommend chiropractic manipulation for neck and back pain.
Q: How does chiropractic differ from osteopathic medicine?
A: Doctors of osteopathy (DOs) were actually the first to make use of manipulation to treat disease. Today, the practice of osteopathic medicine is very similar to that of medical doctors (MDs). However, the techniques started by osteopaths have been adopted by physical and massage therapists, as well as chiropractors. For those osteopaths who continue to make use of manipulation, their focus is on soft tissues and joints outside the spine, while chiropractors focus most of their efforts on the spine. In addition, the manipulation technique is different. Osteopaths concentrate on gentle, large movements (low velocity, high amplitude technique), while chiropractors make use of rapid short movements (high velocity, low amplitude technique; Bratman, 1999).
Q: What kind of training do chiropractors receive?
A: Chiropractors are trained in four-year chiropractic colleges, and are licensed in all 50 states, as well as the District of Columbia and Puerto Rico. Licensed chiropractors have the letters “DC” after their name, which stand for doctor of chiropractic.
Q: How does chiropractic training compare to medical training?
A: There are many similarities between chiropractic and medical education. In the basic and clinical sciences, there are more similarities than differences in terms of studies offered and time allotted to each subject. Chiropractic and allopathic medicine differ most in diagnostic evaluation and clinical practice, which in medical schools far exceeds that provided by chiropractic schools. The therapies that chiropractic and medical students learn are also distinct from each other, and the settings in which students receive clinical training are different and isolated from each other (Coulter et al., 1998).
Q: How can I find a good chiropractor?
A: You can start by consulting a known source for reliable health information, including allopaths (doctors, nurses), other health-care practitioners and reputable online professional directories. Other sources of information about chiropractic and referrals to chiropractic physicians can be obtained by contacting the organizations listed in the table in the related article below.
John Russo, Jr., PharmD, is senior vice president of medical communications at Vicus.com. He is a pharmacist and medical writer with more than 20 years of experience in medical education.
Bratman S. The Alternative Medicine Ratings Guide: An Expert Panel Ranks the Best Treatments for Over 80 Conditions. Rocklin (CA): Prima Health; 1998.
Coulter ID, Adams AH, Coggan P, Wilkes M, Gonyea M. A Comparative Study of Chiropractic and Medical Education. Alternative Therapies in Health and Medicine 1998; 4(5):64-75.
Horstman J. The Arthritis Foundation’s Guide to Alternative Therapies. Atlanta (GA): Arthritis Foundation; 1999.
Nelson CF. Spinal manipulation and chiropractic: Views of a reformist chiropractor. Priorities 1999; 11(2):10-13, 34-35.
The Burton Goldberg Group. Alternative Medicine: The Definitive Guide. Fife (WA): Future Medicine Publishing; 1994.