When it comes to ailments of the musculoskeletal system, chiropractic should be first if not physical therapy, drug second, surgery last. Why is that? In this article, Dr. Sebastian Kverneland DC, will go through what modern chiropractic care entails, how it works, and its benefits. What is chiropractic care?
Chiropractic care is a complementary medical practice that diagnoses and predominately treats ailments in the nerves and musculoskeletal system (muscles, bones, joints, cartilage, and tendons). Chiropractors are experts on the biomechanics, and can easily address unfavorable movement patterns and know how to address them in forms of soft tissue techniques, stretching, exercise, diet, and lifestyle advice. Doctors of Chiropractic cannot prescribe medicine nor do surgery. The treatment is safe and gentle and suitable for all ages.
Historically, chiropractors believed that a misaligned spine (a static concept of bones out of place) could cause disease. They believed that a chiropractic manipulation (cracking) would correct problems and, in turn, cure disease. This has long since failed to convince anyone in the academic arena and has no basis in science. Skeptics and scientists found the “misaligned spine” believed to be deficient in a scientific basis. As a result, chiropractic care lacked legitimacy in the eyes of the scientific community. But modern chiropractors have left behind this belief system.
Many thanks to some chiropractic pioneers, such as Dr. Leanord Faye DC, the Chiropractic theory has evolved and the profession has slowly transitioned to becoming scientifically researched and educated. Chiropractic has gained legitimacy as a complementary medical practice. In many countries, it is now even considered to be part of mainstream medicine. There is a global growing demand and utilization of chiropractic care especially in the area of sports. One example would be the NFL, where thirty-one percent of the teams have a full-time chiropractor officially on staff.
So what does a chiropractor do?
A chiropractor focuses on the clinical biomechanics (the way the body with its muscles and joints move in coordination with each other), identifying the dysfunctional joints (joints not moving in a normal fashion) and how it relates to the whole locomotor system. To assess function and determine if the kinematic system is functioning normally, chiropractors will use techniques including the art of static and motion palpation and the art of observation. All three help recognize the abnormal from normal.
To determine the stage of the pathology and predict with accuracy the treatment schedules needed, a chiropractor will conduct an orthopedic, functional assessment, and a neurological examination. These findings will determine the x-rays and other tests required to make decisions that are in the patient’s best interest.
Joints are motion-units, and most joints are coupled, meaning they have an associated motion occurring consistently with the primary motion. A closed kinematic system can compensate within the system, to perform gross ranges of movement in an abnormal fashion. All biological systems strive to be normal is the law of nature. Activities of daily living can contribute to joint dysfunction. Prolonged poor posture, nutritional neglect, improper exercises, and other unfavorable exposures are all contributors. The degeneration starts with an abnormal movement, the movement becomes increasingly mobile and unstable.
The reason for the restriction of motion can be purely muscular, but as the joint progress, in its pathogenesis, the ligaments will restrict movement, and degenerative changes occur. The spine and the whole locomotor system is set up in such a way that it can naturally adapt to its problems. While walking, if you don’t toe off the big toe, if you don’t dorsiflex at the ankle (raise foot up), if you don’t let the hip swing while walking, if you’re not perfectly balancing the weight, if the piriformis muscle doesn’t level off the pelvis for foot clearance etc. your spine will start to accommodate to these pathomechanics. Motion can be restricted in one direction and exceedingly flexible in another direction. A dysfunctional motion unit in which movement integrity and/or physiological function are altered (contact between joint surfaces remains intact) is what chiropractors refer to as a subluxation (not to be confused with the medical-term for subluxation). The dysfunctional, hypomobile joints (subluxation) of the closed kinematic locomotor system are the joints that a chiropractor will manipulate.
Essentially, a subluxation is evaluated diagnosed and managed through the use of chiropractic procedures based on the best available rational and empirical evidence. Modern chiropractors are comfortable with the western model of pathology and the holistic concepts and practice procedures of Chiropractic. It’s a heuristic model that demands that the practitioner is a lifetime reader and implementer of rational concepts based on the evidence at hand.
The effects of chiropractic care
The effects of spinal manipulation are supported by substantial research – including randomized controlled trials, practice-based, and cost-effectiveness studies.
Manipulation (cracking) or adjusting is the core part of what chiropractors do. It is this procedure that causes the distinct audible gapping of a joint. Manipulations change the dynamic function of joints and not the position of the vertebrae. A Manipulation can be therapeutic or non- therapeutic, depending on the state of the joint being adjusted. Manipulation is based on the S.A.I.D principle; specific adaptation to an imposed demand.
Manipulation of joints is nothing new as “bone setters” has been around for thousands of years in more or less every culture.
Changing the function anywhere in a closed kinematic system can help change the function of all of the components of the system. Manipulation deals with the biomechanical component specifically and the other components indirectly. Soft tissues heal better and differently with motion. Along with stretching, exercise, diet, and lifestyle advice chiropractic care can act both curative and preventative.
It is not uncommon that after manipulating a restricted sacroiliac joint and thereby restoring normal movement to find much less suboccipital muscle tension, enough to relieve headaches. More often than not, the pain is caused by inflammation and the site of the inflammation is not at the restricted joint. The inflammation is often at the level of the adaptation.
Chiropractic remains a great area of study as there are still many unanswered questions. We still don’t have a clear picture of how spinal manipulation works. Luckily, many chiropractors are enthusiastic and dedicated to holistic healing and working to further the scientific and rational development of the profession. As more funding becomes available, future research will aim to fill the gaps in our knowledge, as well as answering questions such as, “Can we better predict which patients are most likely to benefit from chiropractic care?,” “How well do doctors of chiropractic deliver prevention and wellness care?,” “Why do clinicians in private practice experience more dramatic outcomes than found in clinical trials?,” and “In what ways can chiropractic care help pediatric, elderly, and pregnant patients?” Answering these questions through further research will enhance our understanding of contemporary chiropractic practice.
Some physicians are hesitant to refer patients to chiropractors or physical therapists and concerned about the cost of spinal manipulation, especially since many insurance carriers don’t cover it. Visiting a chiropractor may cost more than taking many non-narcotic pain medications, but more invasive interventions can cost a lot of money. Studies have shown that, in general, users of complementary medicine spend less overall for back pain than users of only traditional medicine. Medication and surgery can also lead to harm. Prescription pain medications, like opioids, can lead to huge costs, especially when they’re misused.
Low back pain is the most common cause of disability in American workers. Chiropractic is offered at a lower cost and lower risk and has proven effectiveness. Spinal manipulation — along with other less traditional therapies like heat, meditation, and acupuncture —is as effective as many other more medical therapies, and if not safer. Interventions that focus on the relief of symptoms and allow the body to heal and restore itself to normal are ideal.
When it comes to ailments of the musculoskeletal system, chiropractic care should be on the top of the list of treatment types to consider. Chiropractors are experts on the biomechanics, and can easily address unfavorable movement patterns and know how to address them in forms of soft tissue techniques, stretching, exercise, diet, and lifestyle advice. Modern chiropractic care is well documented to have significant benefits as both preventative and curative care.
Written by: Dr. Tage Sebastian Kverneland DC