We agree with the basic principles of chiropractic, namely, that a patient’s health is greatly influenced by the state of their nervous system. Structural problems in the spine do lead to back pain and many other conditions.
However, we strongly disagree with:
- the methods used to diagnose the underlying problem;
- the diagnosis that is invariably given;
- the methods used to treat the patient.
Firstly, palpation represents a very crude method of diagnosis (palpation is sometimes used in Orthopaedic Medicine, but never as primary method of diagnosis). In theory, chiropractors can identify problems in spinal position and mobility, but the accuracy of the diagnosis is generally very poor.
Part of the problem here, is that the definition of a subluxation is extremely vague. Given the anatomical structure of the spine, it is manifestly obvious that problems with the spinal joints will affect the nerve-roots (thereby leading to back pain, and other adverse conditions).
Unfortunately, this crude diagnosis does not lend itself to a targeted, and accurate, form of treatment.
In the vast majority of cases, the actual form of treatment used, is a chiropractic adjustment or manipulation, a high velocity thrust, designed to restore normal function to the joint.
The exact nature, and existence, of subluxations is actually highly contested (both outside, and within, the chiropractic community).Most traditional chiropractors believe that subluxations exist and that they are readily visible (on x-ray film). Others define them more loosely; they believe that they exist, but do not believe they are visible. Finally, a few chiropractors reject the theory of subluxation completely.For a sceptical view on subluxation-theory, please refer to this Article in Chirobase.
Unfortunately, these are relatively violent. The joint is often moved beyond its natural range of motion, leading to a significant amount of trauma in the surrounding structures.
Chiropractic may yield reasonably favourable outcomes for patients suffering from short term, acute pain, which may be the result of accident or injury. In this case, the risk of trauma might be outweighed by the potential benefits. However, chiropractic is not suited to the treatment of long term, or chronic, back pain, where the patient’s symptoms will be aggravated (and prolonged) by a high velocity thrust.