Functional Spinal Health – Defending Wellness Care and Defining What Constitutes Worthwhile Research For the Future
For the first 40 years or so of chiropractic it was not uncommon to treat people with infectious diseases, as chiropractic was seen as a cure for disease.
Even as late as the 1960’s in the USA there where chiropractic asylums and people where treated for schizophrenia and ‘insanity’.
Unfortunately very few records have been kept, and many of today’s chiropractors seem ignorant of this past. I myself am thankful for the psychologist who came over from the USA to lecture us on this subject when I was at college.
Nowadays, there is an ever-increasing polarisation of views within the chiropractic profession itself about what we can and can’t do. We should learn from the mistakes of medicine and do the opposite, not copy them in the hope they’ll like us more!
On the one-hand we have young chiropractors who believe that all chiropractic is good for is pain relief, and on the other a group of chiropractors who seem to only want patients on long term care programs for ‘wellness’ and ignore symptoms.
Both of these I know are an over-simplification, and I know that many, like myself, are in the middle. I am not in the business of selling large treatment plans to every Tom, Dick and Sally that comes in through the door, but I also believe that this is not necessarily wrong, that there is something in it, but we do have to prove it.
The problem is, many of today’s chiropractors in power (in the UK that is) and the regulating body – the GCC, may not themselves realise just what evidence there already is, and why we should be driving our research away from proving we can cure headaches, to studies that show we prolong, preserve and maintain healthy physiology.
Luckily, there are a number of well researched theories which have been put forward as to exactly how chiropractic can have profound effects on long term health. The chiropractor who is doing the most at the moment to urge ‘proper’ scientific research is Dr James Chestnut, who’s “The 14 Foundational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm” should really be read by every chiropractor and everyone involved with chiropractic, in order to understand what might be happening when some one is treated. The book is quite heavy going though and its style may put many off – being full of academic research.
There is also Dr Dan Murphy and in the UK Dr Simon King. All three are active in trying to find out just why chiropractic works , especially when combined with improving other lifestyle factors.
This is why I have decided to present and summarise the ideas I have learned from these chiropractors it, and added some other findings and theories that should shed further light on the way forward for chiropractic.
A Note on the title “Doctor”
Before I begin I just want to add my thoughts on whether should we call ourselves ‘doctor’.
If someone walks into a crowded room and says they are a doctor, people will mostly assume that they are a medical doctor. Because of this I think it is sensible to make a point in advertising material that we are doctors of chiropractic, as opposed to medical doctors.
On the other hand though the origins of the word actually mean ‘teacher’, and I think if we took a random sample of chiropractors and medical doctors we would find that it would be the chiropractors who are actually taking the time to teach patients about the benefits of healthier lifestyles. It is purely for this reason that I think we should stick up for putting Dr on all our advertising and promotional material if we so wish, and as long as we can prove in practice we live up to its meaning then the ASA should leave us alone.
Chiropractic Wellness for adults and children Defended
I’m going to start with a quote from Dr James Chestnut to get you thinking:
“Finding the physiological reason for most illnesses eludes medical doctors approximately 75% of the time according to their own research.”
Is it any wonder they do fail so often, when they belittle such important factors as diet, nutrition, lifestyle, functional problems, environmental toxins and mental attitude? This is despite; once again, their own research which concludes that 75% of all modern disease is caused by poor lifestyle choices. (Effects of Exercise and Diet on Chronic Disease,2005 J of Appl Physiol 98 3-30)
Perhaps two of the most dedicated chiropractic researchers that seem to be completely ignored in the UK are Dr James Chestnut, and Dr Dan Murphy.
Both have suggested neurological pathways that explain both the multitude of effects seen by practicing chiropractors and reasons why regular care of asymptomatic patients is as valid as regular dental check ups. Both have supported their theories by citing a plethora of work that firmly establishes the existence of these pathways from the spinal joints up into the brain.
Dr Simon King, here in the UK, has also written much on what he terms ‘Proprioceptive Medicine’ and I would recommend his book to anyone wishing to learn more.
Dr Murphy also clearly defines the mechanical needs of regular care as well.
My aim with this article is to introduce the ideas of Dr Chestnut and Dr Murphy to a wider audience, to add some further ideas to it and to summarise some other research into the importance of chiropractic care for babies and children.
First of all, Dr Chestnut has written 4 books for the chiropractic profession, all available from his website www.thewellnesspractice.com. The first part of each book can be read for free online, the most relevant one for this article is in “The 14 Foundational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm”.
In case you can not get online, here are the first two paragraphs in which you can see Dr Chestnuts feelings reflect my own on the polarity of opinion within chiropractic:
“When I got to chiropractic college I really had no idea what chiropractic was. I had only read my school calendar that seemed to espouse the natural healing abilities of the body and natural care to both restore health and prevent disease. It all sounded pretty good. It only took a short time however to realise that something very wrong had taken place within the profession. There were clearly two camps with what appeared to be diametrically opposing views. One was almost completely allopathic – chiropractic was really just manipulation for the relief of back pain and headaches and anything else was unscientific. The other seemed just as cult-like to me but had a very different view – chiropractic was for restoring health not treating symptoms or disease and everyone should be checked for this thing called subluxation that interfered with the nervous system that controlled and regulated the entire body.
I had just finished a graduate degree in science where I had conducted and published a study using MRI technology and presented at physiological conferences. To be honest both sides seemed more dogmatic than scientific and after my first 5 months I was ready to quit and move on to something that seemed a little more valid. Nobody could answer my questions and everybody seemed to be agitated that I was asking them. I was totally disappointed and at Christmas of my first year I had decided to quit and take a few months off before beginning Ph.D. work. I had a spot in a Ph.D. program saved for me as I had been accepted into the program at the same time I had decided to investigate chiropractic.”
Dr Chestnut then spent years reading and studying all the medical and health related journals and books he could, and came to the conclusion that yes, the subluxation exists, but maybe not as we thought. He identified 7 key questions that our research should answer:
1) What is the role of normally functioning spinal and extremity joint in local and global human physiology?
2) How is improper function of spinal and extremity joints (subluxation complex) caused? Is this common in the human experience? How do we detect it? Is it always painful or can it occur symptomatically?
3) What are the local and global physiological consequences of improperly functioning spinal and extremity joints (subluxation complex)?
4) Based on these physiological consequences what is the most accurate terminology to describe this lesion?
5) What are the physiological effects of a chiropractic adjustment?
6) What clinical care protocols are required to return spinal and extremity joints and the related proprioceptive and nociceptive pathways to normal function? (correct subluxation complex) Can this be determined solely by symptoms?
7) Based on available VALID research, is the chiropractic adjustment a safe intervention?
“The 14 Foundational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm” then goes on to answer these questions in great detail.
Before we get into the details, it would be good to get a general idea of what the major accepted causes of modern illness are. A great deal of emphasis is placed on the role of stress so let us start with basic stress physiology and the work of Hans Selye. In his book “The Nature of Stress” Dr Selye is summed up:
“Dr. Hans Selye is without question one of the great pioneers of medicine. His famous and revolutionary concept of stress opened countless avenues of treatment through the discovery that hormones participate in the development of many degenerative diseases, including coronary thrombosis, brain hemorrhage, hardening of the arteries, high blood pressure and kidney failure, arthritis, peptic ulcers and even cancer.”
Towards his later years, Selye (who worked at Montreal University and had 40 assistants) discovered what he called the General Adaptation Syndrome, which in basic terms is the change in certain vital organs over time with various stressors.
Selye described 3 main types of stressor – traumas, toxins and autosuggestion – that lead to dis-ease. In more plain terms – physical stress that comes from either acute injuries that do not heal, or chronic repetitive or postural strain (more about posture later), environmental pollution or ingested or absorbed chemicals harmful to us, and prolonged mental/emotional stress.
The effects of chronic stress on the brain and then the hormonal systems in the body are identical from each form of stress, the results being:
- increased heart rate
- increased blood pressure
- increased blood glucose
- increased blood lipids
- increased blood cholesterol (increased LDL, decreased HDL)
- increased clotting factors
- increased muscle degradation
- insulin resistance
- increased feelings of stress, fear, anxiety and depression
- decreased short term memory, ability to concentrate and learn
- increased sensitivity to pain
- decreased immunity
- decreased levels of growth hormone, testosterone, luteinizing hormone
- decreased sex drive
- accelerated aging
- bone loss
- decreased muscle mass
- weaker connective tissue such as ligaments and tendons
- poor sleep
After reading the list above (which is not exhaustive) it should come as no surprise that stress and chronic ill health cost the UK alone £100 billion (Dame Carole Alice Black, ISMA Conference 2009).
In fact stress and sedentary lifestyle are regarded as the major causes of most modern chronic illness – including arthritis, diabetes, cancer and heart disease.
It therefore makes sense that the ONLY way to effectively create health is to remove stressors, promote an active lifestyle and provide care that supports the body’s healing abilities i.e. remedies that support our physiology, not fight against it.
It is noted by Dr Chestnut that medical drugs are rarely, if ever physiologically compatible. Medicine studies sickness, not health, it provides sickness care not health care. In his words,
“Medicine does not produce healthy individuals it produces individuals with less symptoms. The physiological problem that caused them to have the symptom s in the first place is not addressed AND they are now forced to deal with the toxic drug that was prescribed. Drugs may make people FEEL better while they are sick but they will never make them FUNCTION better and get well.”
A lack of drugs and surgery has not caused the modern epidemics of disease – clearly borne out by the situation in the UK and the US which offer more drugs and carry out more surgery than any other countries in the world, yet are sicker than nations that do far less! No, the only way to restore health is to supply the body with something it needs, but is missing, and/or remove something toxic that it is getting exposed to.
Sometimes however, the body has been sick so long that recovery is no longer possible by physiologically compatible means. Dr Chestnut puts it,
“Medicine may temporarily save a body and mind from death but it can never restore health. The only way to restore health, based on the scientific laws of physiology, is to provide what the body’s cells require for proper function and remove interferences to proper cell function.”
So what has this got to do with chiropractic? Well the conclusions of Dr Chestnut, and Dr Murphy are that chiropractic adjustments change physiology for the better.
There is no controversy in the concept that spinal joints can have restricted motion and improper static and/or dynamic alignment. The problem has always been over if this type of lesion causes any physiologic disturbance. Now however, science is catching up with chiropractic (and for that matter osteopathic and Chinese medicine) in uncovering the importance of mechanoreception and proper somatosensory input.
To cut a long story short – improper motion of any joint, but particularly the spine and especially the upper cervical spine do affect changes in neural pathways, into the cerebellum and then global physiology necessary to sustain optimal function.
Now I know that most chiropractors and medical doctors, let alone the general public, will not be intimately familiar with the neurological pathways and areas of the brain involved, nor will they be aware of the body of peer reviewed scientific literature that supports the last sentence, but here is a simplified outline:
Normal movement, and chiropractic adjustments stimulate mechanoreceptors in the facet joints and surrounding muscle spindles to fire up through the spinal cord, in to the cerebellum and thalamus. From the thalamus this fires into the cerebral cortex. Fibres from the cerebellum fire into a number of different areas, including the vestibular nucleus, and then the solitary and vagus nuclei (which in turn effect visceral function) ; to the hypothalamus (effecting hormonal regulation); an into the amygdale (which will literally ‘switch off’ stress).
When a joint is not moving, what we would call fixated or subluxated, it has a detrimental effect on the brain, due to a lack of proper stimulation.
The above is a basic description, but the most important area to learn about from what I understand is the vermis of the cerebellum. It seems to be the foreman of the brain controlling/regulating all aspects of movement, learning, speech, healing, immune and hormone function. It receives massive input from the spine, in particular the upper cervical area. It is normal movement that keeps the vermis happy, and basically keeps it fueled and nourished.
The following references are found in Dr Chestnut’s book, and I think are most relevant:
MecLain Mechanoreceptor endings in human facet joints. Spine 1994:19 (5)
There are 4 types, the most relevant to chiropractic are probably
Type 1 – slow adapting, and active at extreme ranges of motion, and also in static positions in healthy joints
Type 2 – rapidly adapting, stimulated at beginning and end of joint movement
Type 3 – high threshold, very slow adapting, stimulated at extreme ranges of motion
The forth are nociceptors, and not active under normal conditions.
Meaney, M PhD 2001 Stress and Disease: Who Gets Sick, Who Stays Well. Cortex (or cortext) Educational Seminars
“The result of medical research over the past 20 years has clarified precisely how stress can promote various forms of illness.”
Hypercortisolemia – cancers, high BP, depression, obesity, diabetes
Jiang et al. Identification of the location, extent, and pathway of sensory neurologic feedback after mechanical stimulation of a lateral spinal ligament in chickens. Spine 1997;22 (1)
Dorsal root ganglia – at same level and several levels above and below on both sides
Seaman, D.R.Dysafferentation JMPT 1998;21 (4)
“Both Guyton and Nolte indicated that if afferent signals are eliminated, the cerebrum would be incapable of functioning in a conscious manner and would actually approach a permanent state of coma.”
This is massively important for all chiropractors and body workers to understand.
Afferents from spinal structures end in the cerebellar vermis, afferents from the extremities end in the intermediate cortex.
Schmahmann. The Cerebellum and Cognition. Int Rev Neuorbilology Vol 41
” A close relationship between the cerebellum and the autonomic nervous system was established early on.”
“increased somatomotor activity, as indicated by increased proprioceptive input into the cerebellar nuclei , may be relayed directly to the hypothalamus (the primary visceral centre in the brain).”
“the hypothalamus elicits immediate visceral motor responses
Videman, T . Experimental models of osteoarthritis: the role of immobilisation.
Clinical Bio-mechanics 1987; 2
“it shows beyond a reasonable doubt that immobilization is not only a cause of osteoarthritis but that it delays healing.”
“If immobilization, irrespective of its cause, cannot be avoided, it would be therapeutically logical to take every possible step to limit its extent and duration.”
Bone changes noticed within 2 weeks! Fusion happened within 4 weeks.
Terrett, A.G. Cerebral dysfunction: a theory to explain some of the effects of chiropractic manipulation. Chiropractic Technique 1993; 5 (3)
“Milne and Gorman proposed that much of humanity is suffering from decreased brain functioning due to decreased cerebral blood flow, that is so common that it is considered “normal”, and that people are unaware that they are disabled by a “mental illness” which has a simple physical cause.”
Who are Milne and Gorman? Two Australian MD’s who started manipulating cervical spines to cure headaches. They both began to see results not just in headaches, but other areas of brain function – vision, depression, reading ability, memory, alertness, energy and more. They found that the longer the patient was under care, “the list of conditions for which spinal manipulation was indicated.”
If two Australian medical doctors have done this, why haven’t chiropractic colleges expanded this research?
Seitz, J.A. I move therefore I am. Psychology Today 1993; 26
“One of the most effective ways to relieve stress, and irrational thoughts and feelings, is through so-called body therapies.”
This is something that many chiropractic patients comment on after treatment – how relaxed they feel “better in themselves” are words commonly heard in our practice.
For more details see “The 14 Foundational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm” by Dr Chestnut
The following are referenced from Dan Murphy’s Neurology UK 2002 lecture:
Osteopathic Methods and the Great Flu Pandemic of 1917-1918, JAOA – Vol.100 – No 5 – May 2000 – 309-328.
Highlights the amazing effectiveness of manipulation vs medical intervention for influenza.
Where is the Pain Coming From? Vert Moody, MD. Spine, 12(8), 1987, 754-759
“Actually the human inter-vertebral disc lives because of movement.”
Quantitative Study of Muscle Spindles in Suboccipital Muscles of Human Fetuses. Kulkarni, Chandy and Babu. Neurology India, 49, December 2001:355-359
Thalamic Neurone Theory: theoretical basis for the role played by the central nervous system in the causes and cures of all diseases. TN Lee, Med Hypotheses, 1994, Nov: 43(5):285-302
“These pathologically habituated states can be reversed by dehabituation through manipulation or modulation of the abnormal neural circuits by physical means (physical neuro modulation) like acupuncture, or chemical means (chemo neuro modulation) such as Chinese medicine, homeopathy or other modern medical techniques in a repetitious manner to mimic the habituation process.”
Dr Dan Murphy’s Mechanical Model
I mentioned Dr Murphy also had a more mechanistic theory as well, which he outlines in an article, “Validating Chiropractic” summarising a number of papers by Chiropractors, Medical researchers, neurologists and orthopedic professors.
The model he presents:
Micro-injury, macro-injury, hypo-mobility, hyper-mobility, chronic stress
Connective Tissue Fibrosis
Abnormal mechanical AND Nociceptive afferent input into the Central Nervous System
Altered Motor Patterns
Abnormal Tissue Stress
More abnormal mechanical and nociceptive afferent input into the CNS
Intervention with Chiropractic
Anti-inflammatory protocols (both Dr Murphy and Dr Chestnut are proponents of pharmaceutical grade fish oil for general health and well-being)
Connective Tissue Fibrosis
Improvement of Tissue Mechanical Function
Improvement of Mechanical and Nociceptive Neurological Afferentation into the CNS
Because most of the population lead a sedentary life and Videman (see above) showed a joint only has to be immobile for a month to become fused it makes sense to prevent this form happening, via regular check-ups on the most neglected joints in the body.
Further Studies into Chiropractic Wellness
As yet there is a stunning lack of detailed study in this area. Here are a few I found pertaining to general health and physiology, rather than specific conditions such as back pain.
Seleno, Pfleger, Grostic et al., The effects of specific upper cervical adjustments on the CD4 counts of HIV positive patients. CRJ 3 (1)
Patients on AZT where split into two groups – one received chiropractic care, the other didn’t. Those on AZT alone had a 7.96% decrease in CD4 cell levels. Those receiving chiropractic had a 48% increase in CD4 cells.
Funding and patients where pulled from a follow up study.
Surely this warrants further investigation?
2007, Journal of Hypertension: Atlas Vertebra Realignment and Achievement of Arterial Pressure Goal in Hypertensive Patients, a Pilot Study.
This study assessed the effect of chiropractic care on hypertension in 50 patients. Chiropractic care proved to be as effective as combination therapy consisting of two blood pressure medications.
The effects of the chiropractic care on blood pressure lasted for 8 weeks.
Changes in General Health Status during Upper Cervical Chiropractic Care:
Proceedings World Federation of Chiropractic, 5th Biennial Congress, Auckland, NZ, May 17-22, 1999.
This study involved 311 chiropractic patients. The study used a quality of life measurement survey. They all filled out a RAND SF-36 general well being questionnaire before starting care, at four weeks into care and at maximal chiropractic improvement. Initially the patients scored well below normal average for the general population. At 4 weeks there were improvements in their scores, but what is the most interesting is, that at maximal chiropractic improvement, these previously low scoring individuals scored above normal values.
Surrogate Indication of DNA Repair in Serum After Long Term Chiropractic Intervention; A Retrospective Study: Journal of Vertebral Subluxation Research
Serum Thiols are used to measure how well our body is repairing DNA damaged by oxidation. We measure thiols in people such as cancer patients to determine how well their body is coping with the disease. Higher levels of these thiols are better. People who are sick almost invariably have very low levels of them.
This study measured thiols in patients who have been under chiropractic care for at least six months or more and compared them to sick people and generally healthy people that are not chiropractic patients.
As expected the sick people in the study had low levels. What is fascinating is the chiropractic patients didn’t have just the regular healthy level of thiols; their levels went beyond those of the general population.
2004, J. Vertebral Subluxation Res. Spinal Hygiene and its Impact on Health and General Well Being
This was an eight week study comparing quality of life of 50 patients undergoing a spinal hygiene program and 63 that were not.
The study used the RAND 36 questionnaire.
After 8 weeks the group undergoing a spinal hygiene program had significantly higher scores in most all areas of the study. The biggest differences were not in the physical functioning portion of the questionnaire, they were in the social functioning, general health and mental health areas of the questionnaire.
This demonstrates some of the more intangible benefits of chiropractic care that many patients have mentioned but medicine has been skeptical about.
It makes sense though. Spinal hygiene exercises improve posture. We have a more positive perception of people with good posture. We may believe them to be more honest, friendly, energetic and attractive.
Leboeuf-Yde C, Axen I et al. (1999) The Types and Frequency of Improved Non-musculoskeletal Symptoms Reported After Chiropractic Spinal Manipulative Therapy, J Manipulative Physiol Ther, 22(9):559-564
A comprehensive Swedish study of non-musculoskeletal benefits following chiropractic care was published in 1999. 1504 patients and 87 chiropractors were involved. 23% of patients who were consulting a chiropractor for a musculoskeletal condition (such as back or neck pain) experienced non-musculoskeletal benefits after adjustment. The most common improvements were in respiratory disorders (26%), digestive disorders (25%), cardiac/circulatory problems (14%) and visual disturbances (14%).
Chiropractic care for patients aged 55 years and older: report from a practice-based research program.Hawk C, Long CR, Boulanger KT, et al Journal of the American Geriatrics Society 2000:48, pp. 534-45.
Patients completed a questionnaire over a 12 week time which included information on their chief complaints and health status. The Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) and the Pain Disability Index (PEDI) were also completed. Data on over 805 patients 55 years or older were collected over a 12-week period. The study revealed that for two-thirds of the patients, a chiropractor was the only provider for mild to moderate musculoskeletal complaints. 72.3% of the patients had pain related complaints (32.9% of these were for low back pain). Patients decreased use of regular prescription or non-prescription drugs by 7.3% during the 12-week period.
Chiropractic patients in a comprehensive home-based geriatric assessment, follow-up and home promotion program. Coulter ID et. al. Topics in Clinical Chiropractic 1996: 3(2): 46-55.
Out of a total population of 414 elderly people 75 years and older, a sub-population of 23 (5.65%) reported receiving chiropractic care. This figure is similar to published reports of distribution of chiropractic patients in the general population.
It was found that chiropractic users were less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs.
Study associates chiropractic with better health in the elderly. Today’s Chiropractic November/December 1996 (originally published by the Foundation for Chiropractic Education and Research).
The results of a three year randomized trial of people 75 years of age and over revealed better overall health and a higher quality of life among those who use chiropractic care. Elderly chiropractic patients report better overall health, have fewer chronic conditions, spend fewer days in nursing homes and hospitals, are more mobile in their communities and are less likely to use prescription drugs than non-chiropractic patients according to a study conducted by the Foundation for Chiropractic Education and Research through the Los Angeles College of Chiropractic.
87% of chiropractic patients described their health as excellent compared to just 67.8% of non- chiropractic patients.
Another area of research often neglected that carries great weight for chiropractic being generally good, is the study of posture.
Here are a few quotes and references:
“Loss of the cervical curve stretches the spinal cord 5-7 cm and causes Disease.” Dr. Alf Breig, Neurosurgeon (Nobel Prize Recipient)
“For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.” Kapandji, Physiology of Joints, Vol 3.
“Forward head posture leads to long term muscle strain, disc herniation’s, arthritis and pinched nerves.” The Mayo Clinic, Nov. 3rd, 2000
“90% of the stimulation and nutrition to the brain is generated by the movement of the spine” Dr. Roger Sperry, (Nobel Prize Recipient for Brain Research)
Additionally, Dr. Sperry demonstrated that 90% of the energy output of the brain is used in relating the physical body to gravity. Only 10% has to do with thinking, metabolism, and healing, so when you have forward head posture your brain will rob energy from your thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing.
“To live a long, active, energetic life, few things matter more than good posture” Rene Cailliet, MD (The Rejuvenation Strategy)
“Posture effects and moderates every physiologic function from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the most easily influenced by posture” American Journal of Pain Management, 1994;4: p36-39.
Jensen, E. Learning with the body in mind. 2000
“What the developing brain needs for successful movement and cognitive growth is sufficient activation of this motor-cerebellar-vestibular system. Without it, problems in learning can arise, which include attention deficits, reading problems, emotional dis-regulation, weak memory skills, slow reflexes, lack of impulse control, and impaired or delayed writing skills.”
Jensen, E. Brain-Based Learning: The new science of teaching and training. 2000
“Amazingly, the part of the brain that processes movement is the same part of the brain that processes learning.”
Restak, R.M. The Brain: The last frontier. 1979
Reports the findings of Dr Frank Pederson, Chief of the Section on Parent-Child Interaction of the National Institute of Child Health and Development. Comparing the effects of visual, auditory and movement stimulation on mental and psychomotor development, found that movement had the broadest, most far reaching positive effects.
The above three pieces of work establish the basis for movement being of the utmost importance for infant health and development. The next studies clearly demonstrate the roll that chiropractic can play.
Guttman G. Blocked atlantal nerve syndrome in babies and infants. Manuelle Medizin. 1987, 25
Reports on the examination and adjustment of more than 1000 infants with ‘atlas blockage’ or as chiropractors would call it – subluxation.
The symptoms of ‘atlas blockage’ ranged from, “central motor impairment and development through diencephalic impairments of vegetative regulatory systems to lowered resistance to infections, especially to ear, nose and throat infections.”
Also mentions the work of a colleague, Frymann, who examined 1250 new born babies. 211 suffered vomiting, hyperactivity and sleeplessness. Examination revealed ‘cervical strain’ in 95% of this symptomatic group. Manipulation then , “frequently resulted in immediate cessation of crying, muscular relaxation and sleepiness”.
Conclusions: 80% of children are not in autonomic balance, that the upper cervical spine should be examined and, if required, treated with specific manipulation, because, “the success of adjustment overshadows every other type of treatment.”
Biedermann H. Kinematic imbalances due to suboccipital strain in newborns. Manuel Medicine 1992; 6
600 babies with a variety of problems including postural asymmetries, motor problems (including torticollis) , loss of appetite, neck sensitivity, fevers of unknown origin and other central nervous system disorders.
Results, “All but one of our little patients treated only with manipulation of the upper cervical spine developed satisfactorily.” No complications.
“The immense pathogenic potential of the proprioceptive afferents of the suboccipital region has until now been widely underestimated.”
Jesper et al. The short term effect of spinal manipulation in the treatment of infantile colic: A randomized controlled clinical trial with a blinded observer. JMPT 1999; 22 (8)
This, and an earlier study in 1989 found, specific, finger tip adjustments to the spine relieved colic symptoms.
The Danish health authorities, already being familiar with the safety and effectiveness of chiropractic for adults, picked up on this study and instructed nurses to recommend chiropractic care for babies suffering from colic.
(As an aside, Denmark’s progressive implementation of chiropractic and a rehabilitation program have lead it to be the ONLY country to be successfully managing chronic low back pain)
Keeping in mind all the above, there seems to be clear evidence of multiple reasons as to why chiropractic care should be considered either as a main therapy for the treatment of some conditions, or as an adjunct or aid to just about any situation where healing is needed. It also seems that chiropractic is a valid means of trying to stay healthy, just like exercise and a good diet, and should be incorporated into a general improved lifestyle approach for the general population.
In order to prove chiropractic works though we have to stop asking questions like “Does chiropractic cure back pain, colic, measles etc” and start looking at the general health of chiropractic populations, or the effects of chiropractic on decreasing stress physiology, and promoting healthy homeostasis.
Getting back to one of my original points – the polarity between ‘pain relief’ and ‘wellness’ chiropractors. I am hoping now that it is clear that chiropractic can offer much more than simple pain relief, but I feel that in order to practice ‘wellness’ you must take on board and promote and active lifestyle, good diet, nutrition and cultivating a sound and happy state of mind. These are exactly the tenants taught by Dr Chestnut, his other books covering nutrition, exercise and state of mind in the importance of overall health and disease prevention. After all, even BJ Palmer built a rehabilitation gym, and the chiropractic sanatoriums used to provide exercise, social interaction and a good diet for their patients (along with ‘toggle recoil’ adjustments 6 times a day) and managed to treat and cure schizophrenia within 2 weeks (this was discovered by a psychologist working at Palmer).
Also, it is important to realise that we do not know how much chiropractic is needed to be ‘well’, and it probably varies vastly. Until we know for sure the only practical tool we really have for measuring our success is motion palpation, maybe cross referenced with X-rays.
With the overwhelming evidence that most of our health care costs in the UK are down to stress and sedentary lifestyle related diseases (heart disease, diabetes, cancer, arthritis etc.) and that chiropractic can help reduce stress in a profound way, it seems idiotic not to promote this often frowned upon practice of “wellness care”.
Again I would like to point out that most chronic disease is not really pathological processes, but are in fact INTELLIGENT adaptive physiological responses that occur
in order to deal with chronic stressors (such as smoking, lack of exercise and a poor diet!).
It is the stressors that are pathological and need removal – not the responses to them. Typical direct responses to stress are high blood pressure, raised cholesterol, and high blood sugar. Trying to treat these responses to stress and viewing them as pathological is, in the words of Dr Chestnut “physiologically unscientific and clinically impotent”. Again this is proven by the fact that once on drugs for these ‘conditions’ you are not expected to come off them until you die; whereas real diseases like infections are mostly curable after a short course of treatment.
Many ‘alternative’ health care practitioners of course encourage patients to eat better, exercise more, take appropriate supplements, and maybe even see a chiropractor; and find that their patients’ physiology normalises and they get off the drugs. So far I’ve only come across a handful of medical doctors in the UK who take the same logical approach. I think it is mainly a lack of time, but I do feel sure that if GP’s did insist on people making lifestyle changes BEFORE they offered drugs they would get great compliance and results.
Who’s the quack? The doctor who ignores physiology, or the one who works with it and seeks resolution and an end to symptomatic treatment BEFORE the patient dies?
In the words of Dr Chestnut:
“The only way to produce homeostasis and health is to decrease the chronic stress response by either reducing stressors or by improving the adaptive abilities of the host with lifestyle changes. Drugs do neither; chiropractic, practiced correctly, can do both.”
One last thought from Dr Chestnut
As the word ‘subluxation’ is perhaps too much associated with the possibly outdated ‘bone out of place’ theory, and because the word already has a medical meaning different from the chiropractic one, he has come up with the phrase “Movement deficiency syndrome”. Its not perfect, but perhaps if we change our terminology it may help us communicate to medical doctors more clearly.
Summery: A Brief validation of chiropractic wellness care
- We know that a joint that does not have proper alignment and motion will degenerate
- We know that improper joint motion and alignment are often asymptomatic (Parkkula 1992, J Spine Dis)
- We know proper joint movement is essential for optimal neurology physical function
- Chiropractic adjustments lead to homeostasis and health by restoring normal structural and neurological components to what we call subluxated joints.