Wise Cracks

If you grew up in a home like mine, chances are your Mother had a penchant for telling you to “stand up straight” or “hold your shoulders back.” We learn from an early age that there’s something about an erect posture that’s important. . .at least to our Moms. As an adult, I have come to value those parental admonitions even more. At the end of a long and stressful day, slumping shoulders seem to ache more; and my low back is not as forgiving as it once was if I don’t stretch congenitally tight hamstrings both before and after I run these days. Chiropractors have built a profession around the concept that correct spinal alignment is vital to good health maintenance.

The word “chiropractic” comes from two Greek words: cheiromeaning “hand” and praktikos meaning “doing”–literally ‘doing by hand.’ A Canadian, Daniel David Palmer, is credited with the invention of Chiropractic as a defined treatment and profession. He moved to Davenport, Iowa and became a powerful and controversial presence in the community. Founding the Palmer Infirmary and Chiropractic Institute there in 1898 to promote his ideas and to train others, Palmer contended that impeded nerve impulses to any part of the body lead to damaged tissues in that area with resultant medical disorders. The most obvious sites for impediment are where the nerves leave the spinal cord–between the vertebrae. Consequently, Palmer maintained that “in 95% of the cases” disease developed because nervous impulses from the brain to the rest of the body were impeded by spinal “subluxations”–meaning misalignments or maladjustments of the vertebrae that created pinching on the nerves as they leave the spinal cord. These misalignments can be major or minor in degree and can be caused by anything from poor posture, muscle spasm, accidents or sports injuries to birth defects.

In addition to this mechanistic concept of disease, Palmer had a strong holistic bent, believing that we all possess an “Innate Intelligence” similar to chi or life force that maintains our bodies in a state of health. So, subluxations impeded not only the nerve impulses, but the general flow of “Innate Intelligence” as well. In Palmer’s view, restoring healthy flow should restore balance, health, and harmony to the body without the use of drugs or surgery. Certainly, a holistic view of health continues to be espoused by Chiropractors today.

Controversy has followed Chiropractic since its inception. Palmer infuriated a portion of local physicians during his practice (because they lost business as a result of his competition), and he was imprisoned in 1896 at their urging for practicing medicine without a license. Though this professional controversy raged for decades, there is now a clear and accepted distinction between the practice of Medicine and the practice of Chiropractic. Both are defined and licensed professions. In addition, in 1987 a federal judge ruled that the AMA had broken the Sherman Antitrust Act concerning restraint of trade by boycotting chiropractors since the early 1960s. Though this decision did not endorse chiropractic therapy or philosophy, it clearly prevented further boycott of the therapy by organized medicine. Today, studies in both Britain and the United States have supported benefit of chiropractic for select patients.

Orthodox medicine has mixed feelings about chiropractic efficacy. Clearly, low back pain is benefited by the therapy. In this country, several studies have agreed that chiropractic treatment of back problems promotes a quicker return to work. Consensus from Great Britain and others supports this finding. What is controversial are claims from some chiropractors that benefits of manipulations extend to a whole host of diseases–including hypertension, asthma, digestive diseases and childhood hyperactivity. As a result, there truly are two schools of thought within the chiropractic community. When looking for chiropractic therapy, you should decide whether your motivation is primarily to treat spinal or other musculoskeletal problems or whether you desire a more holistic and ‘body energy’-oriented approach to your treatment.

Within the chiropractic community, apparently the practitioners who believe in subluxations can be divided into two groups, commonly known as “straights” or “mixers.” The straights follow Palmer’s thinking that subluxations of the spinal column can either cause or contribute to most disorders. However, they do not claim to be able to diagnose and/or treat diseases–just to detect and cure subluxations. On the other hand, the mixers concede that diseases can have other causes (such as infections), but that the subluxations weaken the body and make it more susceptible to a host of diseases. So, if you’ve felt mixed up trying to keep your concept of chiropractic straight. . .no wonder!

Chiropractic has helped many people lead more active and comfortable lives. After detailed histories, examinations, and often x-rays to assess spinal alignment, the practitioners will design a treatment plan to correct misalignment of the spine, restore full range of motion to joints, correct faulty posture, and to relieve pain caused by over-stimulated nerves. Most chiropractors also provide their patients with general advice on maintaining correct posture and preventive back care. Though ‘adjustments’ (the principle procedures used to manipulate joints during a treatment session) may generate a popping sound as the gases in a joint’s lubricating fluid are moved by the quick thrust, these sounds are harmless and usually painless. And, in the hands of a skillfully trained Chiropractor, they are actually wise cracks that will lead to better alignment and less discomfort. In correcting these imbalances, many patients contend that their general health has been enhanced.

So, understand the history and basis for Chiropractic therapy. If you sense that you might benefit from such treatment, most insurance companies will cover a specified plan of therapy when your diagnosis supports it. And, getting your back in order might improve more than your posture. Who knows, you might just get an attitude adjustment as well!

Stephen L. Hines, M.D.
November 2000