Straightening Out the Facts on Chiropractic Care

By Amanda Kalaydjian

Although the ideas behind chiropractic care have developed and changed since the days of Daniel Palmer, some of the basic tenets remain central to the practice today. Chiropractors believe that any physical, chemical, or emotional stress to which the body cannot adapt, can result in subluxations. Doctors of Chiropractic use spinal adjustments to correct these subluxations, and restore the function of the spine. The care is natural and intended to promote health by removing any interference in the flow of information throughout the nervous system. Melinda A. Maxwell, D.C., the CEO of Maxwell Chiropractic and Wellness Center, believes that the structural correction "addresses the problem at a deeper level...by getting rid of nerve intervention...and allowing the body to do its own healing and curing."

The approach is whole-body, with the focus of the chiropractor being on what is considered the foundation, the nervous system. Approximately 15-20 million Americans visit chiropractors each year. The conditions treated include back and neck pain, trauma resulting from an accident, headache, asthma and high blood pressure. Chiropractors can be divided into roughly two different factions, and the treatment received depends on the philosophy of that particular chiropractor. A small faction, termed "straights," make up about 15 percent of chiropractors, and they espouse the traditional belief that all illness is caused by spinal subluxations. The more predominant faction, termed "mixers," treat mostly back and musculo-skeletal pain, and often use complementary diet, herbal, or homeopathic treatments as well.

Whatever the method, it appears that there is public support for chiropractic care. A Gallup Poll from 1991 revealed that 90 percent of chiropractic patients felt their treatment was effective. Furthermore, the 1993 Manga Report and the 1992 America Health Policy Report both found that chiropractic users have lower total health care costs, and a reduction in chronic problems and disability. Physicians believe that all patients should first consult a medical doctor, given their superior ability to diagnose disease. Oftentimes patients have either first consulted a medical doctor and find no relief of their symptoms or are using chiropractic care in conjunction with conventional medical care or physical therapy.

Although there was once a time when medical doctors viewed chiropractic care as unscientific, there is now greater support for the field. Melissa Steiner, P.T, states that there is definitely " a place for chiropractic care in the medical field." This greater acceptance could be the result of increasingly technical means by which chiropractors diagnose and treat subluxations, as well as evidence accumulating in support of spinal manipulation. A landmark finding in support of spinal manipulation came in 1994 by the federal Agency for Health Care Policy and Research (AHCPR). Based on their review of more than 4,000 short-term studies on lower back pain, an expert panel concluded that spinal manipulation provides temporary relief from lower back pain. A long term study by T.W. Meade, published in the British Medical Journal Report, concluded that spinal manipulation results in long-term benefits as well. Dr. Eisenberg, the author of a study printed in the New England Journal of Medicine on unconventional treatments,considers spinal manipulation for low back pain an effective method of treatment, although some physicians assert that acute back pain is likely to go away on its own with or without treatment. Although the literature is in support of chiropractic treatment for lower back pain, there is not as much support for the use of spinal manipulation for neck pain. Individual studies published in the Journal for Manipulation and Physiological Therapy are in support of chiropractic care for the treatment of neck pain, but some physicians, such as Dr. Eisenberg, consider it risky. Although more evidence is necessary to assess the role of spinal manipulation for the treatment of certain conditions, it is becoming increasingly obvious that chiropractic care has established a place for itself in the medical profession and perhaps should no longer be considered an alternative.

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