What Is Chiropractic Anyway?

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November 16, 2006

WICA (18) Chiropractic Market

Why the pharmaceutical industry appears to be so successful, is because it understands its market. A sensory overload of physical, mental, or emotional stress results in a constellation of symptoms. These symptoms can be dermatological, cardiovascular, diabetic, thyroid, gastrointestinal, renal, rheumatic or even musculoskeletal. It's understood that one does not want to necessarily experience these signs for any given period, thus creating a need, and the need is met with a fast-acting, caffeine-enhanced nugget of solidified powder, which will either mask or alter the signs. The need is met adequately, I'd say, because pain is a perception. It's a culmination of things that are organic, psychological, psychosocial and environmental, accumulated and perceived in and by the brain. Nowhere else. There is also an emotional overlay to every experience: How you feel about how you feel. And more often than not, this is the long lasting cause of any painful experience which continues to repeat, and repeat , and repeat itself in your mind and body long after the event. For years sometimes. Nerves that fire together, wire together - like learning. Even traumatic stress of a physical nature is known to manifest in changes to limbic (emotion), memory and other relevant stress centres in the brain. So now something that was just a single incident at one point in time in your life, has become a repetitive miscreation within your psychosomatic makeup and continues to pulsate its energy throughout your being time and again. Barring mystical meridians that might convey pent-up energy to any part of your body, let's bear in mind that one's physical, emotional architecture extends out the brain, through the skull and half way down your back in the form of your spinal cord.

With all this in mind now, the chiropractic market seems obscurely backward to me. From a general public perspective, chiropractic and pain seem to go hand-in-hand nowadays, and this is most often why treatment is sought. Low back pain costs the US about US$40 billion, and NZ around NZ$1.5 billion per annum, and is the second most common reason to visit a general practitioner next to upper respiratory tract infections. People hear that chiropractors deal with backs somehow, so after bravely overcoming whatever fear or misconception they may own, they trundle along to experience pain relief chiropractic style. Yet if we understand the natural history of low back pain, 70-80% of people will undergo remission of pain within three months regardless of treatment sought. One of the UK's largest randomised trials of 1334 patients [1], in assessing the effectiveness of physical treatment for back pain, cites in the British Medical Journal that the difference in functional outcome between exercise alone, and spinal manipulation therapy, after three months is so small that it questions the cost of therapy. Furthermore, it seems there is little evidence to support the long term benefits of spinal manipulation therapy for chronic low back pain. So what the heck does that mean? One, the cause of back pain must be something other than segmental, and two:

Chiropractic must do something else.

But chiropractic plays the numbers game and markets itself to the astronomical figure of back pain suffers. Probably by default because the profession doesn't advertise itself as anything other. Shh... wellness is our little secret... let's hope others pass it on. And let's also surreptitiously hope that we can convert a back pain suffer into a lifetime wellness patient while we're at it. Unlike the pharmaceutical industry, it doesn't sell the opportunity of improved life experience through different brain function - like it should - it offers back pain relief because this is all people understand. It offers relief for something that will ultimately take care of itself. What the?

Okay, let's return to the beginning: A sensory overload of physical, mental, or emotional stress resulting in a constellation of symptoms. Chronic pain is associated with stress [2], and it's a matter of fact that stress affects systems of the body both musculoskeletal and non-musculoskeletal. There are hundreds of cases on the internet outlining chiropractic case management of non-musculoskeletal problems such as those mentioned in the first paragraph. These are issues mediated by stress responses that are oftentimes below your level of awareness. And like pain, the stress is perceived by areas in the brain and brainstem, to which your body responds accordingly by pumping a myriad of hormones and chemicals into circulation in order to deal with it. Dealing with this stress for long periods of time takes its toll on the body. And in modern day living, we all do it; we all expose ourselves to severe stress for long periods of time. Protein stores are depleted and the immune system becomes depressed. You get sick. Regardless of the season.

Chiropractic has its role in somatopsychic healing - from body to mind. Chiropractic has the potential to improve life experience through different brain function by virtue of changing these perceptions of stress within the body. It means you don't have to be in pain to be adjusted. Back pain is a symptom, not a cause. Of course chiropractors have always embraced this idea philosophically, but neither is there evidence to support that spinal derangements can cause prolonged, aberrant neurological reflexes [3]. Sadly, only one in two hundred chiropractors contributes to scientific literature [4] to give credence to their peers' work and help re-establish their position within the marketplace of healing and well being. Chiropractic needs these individuals to re-brand the profession as multifaceted biopsychosocial healing art; to provide a deeper understanding of function and to project philosophical ideas to new heights. The world is ready for what chiropractic has to offer, but if it's only the same one in two hundred that keep up with the literature, then I'm afraid it's the chiropractors that aren't ready, and the profession will drown in the deluge of misinformation that's fed to the public and be expunged because of it.

New Zealand

Notes and references

United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ, doi: 10.1136/bmj.38282.669225AE, 19 Nov 2004.
Melzack, R., Pain and stress: A new perspective. 1999, New York: Guilford Press. 89-106.
Hardy, K. and H. Pollard, The organisation of the stress response, and its relevance to chiropractors: a commentary. Chiropractic & Osteopathy doi: 10.1186/1746-1340-14-25, 2006. 14(25).
Leach, R.A., The chiropractic theories: A textbook of scientific research. 4th ed. 2004, USA: Lippincott Williams & Wilkins.
I'm off to Sunshine Coast, Australia, for five days. A much welcomed break. Happy holidays everyone.
Past issues are now available at: http://understandingfunction.blogspot.com
If you received this letter as a 'forward' and would like to be added to the mailing list directly, please send an e-mail to neil.nzchiro@gmail.com with 'add me' in the subject line.

posted by Neil Bossenger # 3:26 pm

November 03, 2006

WICA (17) The Product

In my quest to always deliver something outlandish, witty, and contemporary with a hint of credibility, these letters usually take me three to four hours to create. Unfortunately though, this exam period ill affords me that availability of time to come up with fresh and funky material. But then again, in terms of hearing what chiropractors actually do, I'm always hard pressed to find fresh and funky material anyway. Point in case: I think it relevant one understands one's product, if one wishes to sell it, yes? And what better place to begin to understand this, than defining the area of the body chiropractors choose to address when they make a contact. Further to that, understanding what it is they're trying to achieve. That's all I ever want to know, personally.

In my ever-graceful demeanour of passive-aggression, let me say that I'm a little embarrassed the word energy doesn't feature in any definitions of 'subluxation' I've ever read. For one, that puts the profession 90 years behind the times, since Time's Person of the Century first introduced the Theory of Relativity and altered the way scientists view the world forever. For another, is it just me, or does anyone take notice of the fact that certain changes in any individual post-adjustment are instantaneous? It doesn't make sense to constantly give subluxation the qualities of a lesion because these are time-dependant factors. Meaning: If inflammation and pressure were damaging nerves in some way, leading to degeneration, then this would require time to reverse. Reversing axonal degeneration is not an instantaneous process - the one chiropractors witness every single time they adjust someone. Please, keep your lesion.

Energy is not an airy-fairy concept. It's been around since the dawn of anything remotely scientific. In some instances it can even be measured: Enthalpy is the sum of internal energy plus the pressure energy in the environment. What more is subluxation than a symptom of environment energy pressure an individual experiences? The process of subluxation occurs at the interface of mindbody and environment. The tools we use to perceive our environment are our senses (a major component of this being the nervous system), so when the senses are under pressure, stress manifests in the body. Anywhere. It's different for everybody. This stress alters the way you perceive the world, and compromises your ability to respond to it. Stress begets stress. A difficult cycle to break out of unless you have someone to help you. Thankfully, I know just the person.

This is a little something I threw together last year the day before it was due at college. I still like it. It's my definition of the service I sell; how I help people; why chiropractic is for anyone and everyone; and it allows me to make friends with professionals beyond the supposed scope of chiropractic. Before you read further though, riddle me this: Where and how are memories stored?

A bit of old school, a bit of new school. For those in the game, here ya go...

Subluxation:

A correctable phenomenon, caused by a number of factors, most notably trauma, toxin and autosuggestion [D.D. Palmer], resulting in dysponesis* [C. Kent].

* Dysponesis [dys- + Gr. Ponesis Toil, exertion] a reversible physiopathological state consisting of unnoticed, misdirected neurophysiologic reactions to various agents (environmental events, bodily sensations, emotions, and thoughts) and the repercussions of these reactions throughout an organism. These errors in energy expenditure, which are capable of producing functional disorders, consist mainly of covert errors in action-potential output from the motor and premotor areas of the cortex.

Trauma, toxin and autosuggestion only elicit characteristics of dysponesis when the mindbody is unable to integrate their forces. The "unintegrated" state arises at a suprasegmental level, as well as at the level of consciousness, since the flow of information in living systems is from "above, down, inside and out" [ D.D. Palmer].

Information is perceived by each of the fifty trillion cells that comprise the human body. Each bit of information is interpreted in particle or wave format, which offers room for explanation of transfer and transduction of the energy in forms of chemical or mechanical stimuli, or in the form of what can be described as mental impulse (spirit).

Interference patterns of wave-like information might be able to explain dysponesis as a result of autosuggestion, or perceived stressors in one's environment, because information is most certainly integrated at a level of consciousness - not just that which is merely a physical force or chemical acting on matter. Karl Pribram suggests that the brain (and central nervous system) functions with holographic properties because of the innumerable connections of neurons and their branches, setting up a kaleidoscope of criss-crossing electrical wave patterns throughout the body. And since the central nervous system is said to be the master control system, this wave-front nature of brain-cell connectivity could offer explanation for a type of information sharing, considering especially how each cell functions by virtue of the information it receives at a membranous level, according to Dr. Bruce Lipton. Aberrations in interference may result in dysponesis, and hence dysautonomia and dyskinesia.

It is not yet known why or how this unintegrated form of information/energy manifests somatically, in specific areas, such as the spine for example, but the chiropractor is aware that the phenomenon is evidently correctable by virtue of the stimulation the chiropractic adjustment offers. Specific and appropriate stimulation is able to restore equilibrium to function of the autonomic system, simultaneously providing input to the cerebellum and cortex, which may have been under or over-stimulated. In an article by David R. Seaman [1], it was postulated that the chiropractic adjustment might normalize afferent input to the nervous system - currently experiencing a habitual behaviour of dysafferentation - and therefore re-establish nociceptive and kinaesthetic reflex thresholds. All-in-all, harmony is brought to the system, functional disorders and motor and premotor outputs are corrected, energy expenditure and environmental response is appropriated, and thus dysponesis is reversed :)