Chiropractic, a form of alternative medicine, focusing on the diagnosis and treatment of mechanical disorders of the muscular scale system, originated in late 19th century. The rich history of chiropractic has deeply imbedded roots through the healthcare industry. Although chiropractic is known historically for its passive modalities and services for treatment, it has grown to establish further effectiveness by offering numerous evidence-based services to optimize patient’s outcomes.
Chiropractic’s Origin
To understand present day chiropractic, it is important to know its origin. The founder of chiropractic, DD Palmer, established the first chiropractic school in 1897 in Davenport, Iowa. Initially chiropractic treatment consistent of spinal manipulations or adjustments to correct to misalignments in the spine, believed to interfere with the bodies, natural healing abilities. When Palmer performed the first chiropractic adjustment on a partially deaf janitor, it reportedly led to a significant improvement in his hearing. This event marked the beginning of chiropractic as a distinct form of healthcare. Palmer theorized that misalignments or ‘subluxations’ could cause disruptions in the nervous system, leading to various health issues. Through spinal adjustments, chiropractic aimed to restore proper alignment and joint function to facilitate the bodies self-healing mechanisms.
In the early years, chiropractic faced skepticism and opposition from the medical community due to its non-traditional approach to healthcare. However, overtime, chiropractic gained recognition and acceptance as a viable treatment option for musculoskeletal conditions such as back pain, neck pain, and headaches.
Past chiropractic care historically was focused on achieving optimal spinal health to promote overall well-being. Chiropractic has believed that spinal health was integral to maintaining a healthy nervous system, which controlled and coordinated all bodily functions. Addressing spinal misalignments and improving nerve function, chiropractic care aimed to enhance the body’s ability to heal and function optimally.
Present Day Chiropractic
Through the following 100+ years, chiropractic has stayed to the foundational principles of joint manipulation techniques, but the philosophical beliefs have modernized with the integration of the health care and medical industries. Chiropractic has gradually been recognized as a practice of patient centered and evidence-based care through the utilization of meta-analyses and systematic reviews combining thousands of treatment case studies. Analyzing these case studies has been established as the gold standard for understanding patient outcomes with various forms of non-invasive treatment. Chiropractic has learned through these various case studies that the acceptance and utilization of soft tissue treatment, spinal manipulation, and exercise therapy have been integral to patients improvement.
The study of chiropractic has changed in numerous ways since its origin as well. Chiropractors are required to participate in 3.5+ years of graduate school studies through 4200+ hours of courses and hands-on labs that include honing diagnostic and treatment skills. Coursework through the graduate degree involves a heavy focus on anatomy, physiology, diagnosis, pathology, biochemistry, biomechanics and clinical research.
Modern day chiropractic students are trained to recognize not only the pain patterns of various musculoskeletal ailments but also to alter biomechanical dysfunctions that may have created the source of the pain in the first place. Through numerous movement pattern protocols and diagnostic processes, chiropractors have learned how to diagnose and treat the numerous causes of pain and how to provide answers and avoid these pains with recovery care.
A New Understanding
Changes have been made with chiropractic philosophy and verbiage that may have been confusing to medical practitioners in the past. One term that has been a focus of many medical and healthcare discussions is the ‘subluxation’. In medical understanding the term subluxation has meant the dislocation of a joint within the body causing sprains and strains of surrounding tissue causing further instability and higher risk of a joint dislocation. In the past chiropractic philosophy, subluxation was deemed a malposition of a spinal joint leading to neurological dysfunction that causes effects on a local and systemic scale. Many chiropractors today have accepted the modern medical understanding of the term although the neurological implications behind the past chiropractic used ‘subluxation’ remains to be disproven.
Terminology isn’t the only modification chiropractic has made throughout the years. It has utilized additional modalities aside from spinal manipulation or “adjustments” for its patients. The reason for chiropractic adopting treatment processes with multiple services is because the evidence supports it. A collection of 1,176 treatment cases analyzed between 2000-2017 have brought non-invasive phD researchers to this determination: (1) “There is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe. Multimodal programs may be a promising option.” Another research study investigating spinal manipulation with exercise therapy for 301 patients in a 12 week trial revealed (2) “For chronic low back pain, supervised exercise was significantly better than chiropractic spinal manipulation and home exercise in terms of satisfaction with treatment and trunk muscle endurance and strength.” This evidence further verifies the importance of knowledge with corrective exercise and why it’s been implemented in the modern chiropractic grad-school curriculum.
In conclusion, chiropractic has come along way since its inception, involving a comprehensive healthcare discipline that combines traditional philosophies with contemporary treatment approaches. By embracing its roots of spinal manipulative therapy along with the integration of evidence-based care and patient centered focus, chiropractic continues to place a significant role in muscular skeletal health and overall well-being.
Works Cited
1) Coulter, Ian D, et al. “Manipulation and Mobilization for Treating Chronic Low Back Pain: A Systematic Review and Meta-Analysis.” The Spine Journal : Official Journal of the North American Spine Society, vol. 18, no. 5, 2018, pp. 866–879, www.ncbi.nlm.nih.gov/pubmed/29371112, https://doi.org/10.1016/j.spinee.2018.01.013.
2) Bronfort, Gert, et al. “Supervised Exercise, Spinal Manipulation, and Home Exercise for Chronic Low Back Pain: A Randomized Clinical Trial.” The Spine Journal, vol. 11, no. 7, July 2011, pp. 585–598, https://doi.org/10.1016/j.spinee.2011.01.036. Accessed 6 May 2019.
Prepared and written by Dr. Parker Grundman
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