The word chiropractic comes from the Greek words, "chiro," meaning hand, and "practic," meaning practice, or treatment. Thus, "treatment by hand" is an appropriate definition since chiropractors typically use their hands to manipulate different parts of the body in an effort to promote healing and wellness.
A chiropractor, also known as a doctor of chiropractic (D.C.), diagnoses and treats a broad range of physical conditions in patients with muscular, nervous, and skeletal problems, especially the spine.
A branch of the healing arts concerned with disease processes, chiropractic care is a recognized form of therapy that focuses on improving your overall health and well-being without the use of drugs or surgery.
Chiropractors make use of conventional diagnostic tests, such as X-rays, MRIs, and lab work, as well as specific procedures that involve manipulation by hand of various parts of the body. Chiropractors are best known for their ability to correct misalignments of the spine, which are called subluxations. But spinal manipulation is only a small part of what chiropractors do as part of an overall plan to relieve pain and mitigate many kinds of ailments. Other kinds of treatments chiropractors are capable of providing include:
- Electric muscle stimulation
- Exercise therapy
- Heat/cold therapy
- Herbal therapy
- Lifestyle and nutrition counseling
- Manipulation under anesthesia
- Physical rehabilitation
- Stress management
Best known for their treatment of back and neck pain, chiropractors sometimes specialize in areas such as sports medicine, orthopedics, neurology, nutrition, internal disorders, and diagnostic imaging. Many back specialists consider chiropractic an integral part of an overall care plan toward treating injury and disease.
One of the main causes of pain and disease in the human body can be traced to improper alignment of the vertebrae in your spinal column. This is called a subluxation. Through carefully applied pressure, massage, and manual manipulation of the vertebrae and joints, pressure and irritation on the nerves is relieved and joint mobility is restored, allowing your body to return to its natural state of balance, called homeostasis. Put another way, when the bones in your spine are allowed to go back to their proper positions, the nerve energy can resume its normal flow and your body's natural healing processes can function properly.
In general, proper chiropractic treatment of your body's lumbar, or lower back, region, involves very little risk and the rewards can be significant.
Chiropractic or osteopathic manipulations can be especially helpful in relieving pain for facet joint injuries, osteoarthritis, and sacroiliac joint dysfunction, because such conditions respond well to mobilization. Moreover, scores of patients with chronic headaches, sinus problems, high blood pressure, ear infections, leg pain, arthritis, and many other illnesses have reported significant relief after chiropractic therapy.
Increasingly over the past few decades, the medical community has come to accept and recognize chiropractic care as a valid form of treatment for a variety of neuro-musculoskeletal conditions, and as a conservative treatment option for patients with lower back pain. Moreover, many medical doctors recognize a chiropractic diagnosis and accept it as the first line of treatment for functional disorders of the entire musculoskeletal system.
Studies by leading medical journals in recent years have confirmed the benefits of chiropractic care:
- A 1993 report by the Ontario Ministry of Health concluded that chiropractic care was the most effective treatment for lower back pain. The agency also recommended that chiropractic care be fully integrated in the Canadian government's health care system.
- In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy.
- A 1996 New England Journal of Medicine study of outcomes and costs for acute low back pain found that patients treated by chiropractors were significantly more satisfied than those who saw primary care, orthopedic or managed care practitioners.
- A 1996 study in the journal Spine echoed that study and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical doctors.
- In 2001, the Center for Clinical Health Policy Research at Duke University concluded in a study that spinal manipulation resulted in almost immediate improvement for cervicogenic headaches, or those that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.
The educational requirements for chiropractors are similar to that of medical doctors. In general, chiropractors must complete four years of undergraduate study from one of the nation's 17 accredited chiropractic colleges. During the first two years of study, students receive classroom and laboratory work in anatomy, physiology, public health, microbiology, pathology, and biochemistry. The final two years involve courses in manipulation and spinal adjustments, as well as clinical experience in areas that may include physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition, biomechanics, radiology, and natural medicine.
Undergraduate study is followed by a one-year internship at a college clinic. Many chiropractic colleges rotate interns through hospital rounds with medical students. Many chiropractors also undertake four to five additional years of advanced or post-graduate study in a clinical area.
After obtaining their Doctor of Chiropractic degree, chiropractors must complete at least two board exams‚ the National Board of Chiropractic Examiners (NBCE) exam and the board exam from the state in which they practice.
All 50 states license Doctors of Chiropractic to practice. All chiropractors must meet certain requirements, including:
- Completion of a four- or five-year chiropractic college course of study at an accredited program leading to the Doctor of Chiropractic degree.
- Satisfactory completion of board exams.
- Ongoing continuing education courses or programs offered by accredited chiropractic programs and institutions, as well as chiropractic associations.
Chiropractors also are able to obtain certification in such areas as orthopedics, neurology, sports injuries, occupational and industrial health, nutrition, diagnostic imaging, thermography, spinal rehabilitation, and internal disorders.
When all of your body's inter-related systems—including your musculoskeletal, nervous and vascular systems—are in balance and functioning properly, your body possesses a remarkable knack for healing itself. This state is called homeostasis.
Stress, accidents, sports injuries, even overexertion, can cause your spine to fall out of its natural alignment. When this happens, your nervous system ceases to function properly, and this could lead to back and neck pain, headaches, and other kinds of problems. Moreover, many types of pain and disease can be linked to problems with your spinal cord and nervous system. It is this "mind-body" connection that forms the tenet of the principles under which chiropractors practice their healing art.
The two major, underlying principles are:
- The structure and condition of the body influences how it functions and heals.
- The mind-body relationship is essential in maintaining health and healing.
Put another way:
- Your body's functions are all interrelated, and its ability to heal is contingent on these interrelationships.
- A healthy body comes from a healthy nervous system, especially a healthy spine.
Chiropractors believe in a holistic approach to patient care by focusing on a patient's total wellness, or well being, instead of specific diseases, or ailments. It is this intricate physiological and biochemical interrelationship among various parts of your body—including its spinal, musculoskeletal, neurological, and vascular systems—that chiropractors dedicate themselves to exploring and treating, with special attention to nutrition, exercise, and healthy emotional and environmental relationships. When one or more of these systems is impaired, your body ceases to function normally and your resistance to disease is compromised.
In spite of its long recognition by the medical community and the government as a safe, proven, and effective treatment, many people today still have misconceptions about chiropractic care.
Daniel David Palmer, who is known as the father of chiropractic, bore the brunt of criticism for creating this branch of medicine's healing arts. Despite Palmer's early successes in treating patients with a myriad of ailments through spinal manipulation, chiropractic adjustments were not readily accepted by the medical community. In fact, the established medical community back in the late-19th century worked hard to discredit him, and had a hand in convincing authorities to indict Palmer for practicing medicine without a license. They eventually succeeded and in 1905 Palmer was sentenced to 105 days in jail and ordered to pay a $350 fine.
The established medical community's assault on the chiropractic profession continued even as late as the 1970s, when a group of chiropractors sued the American Medical Association (AMA) and several other medical organizations for disseminating untrue and damaging information about their profession. The plaintiffs alleged that the AMA and others deliberately lied in order to destroy the chiropractic held because they viewed it as a threat, or competition, for their health-care dollars. The court agreed with the chiropractors and called the AMA's actions "lawless" and unfounded. The case was eventually heard in the United States Supreme Court, which upheld the original verdict against the AMA.
Much has changed since that landmark decision, and today, the medical community has come to recognize the value of chiropractic care.
Today, hundreds of thousands of patients routinely receive competent care - and relief from their suffering - from the nation's more than 60,000 doctors of chiropractic.
Here's a look at some of the more common misconceptions about chiropractic care.
Myth #1: Chiropractors treat back pain and little else.
Nothing could be further from the truth.
While chiropractic adjustments can be especially helpful in relieving pain for facet joint injuries, osteoarthritis, and sacroiliac joint dysfunction, scores of patients with chronic headaches, sinus problems, high blood pressure, ear infections, leg pain, arthritis, and many other illnesses have reported significant relief after chiropractic therapy. Chiropractors do more than manipulate the musculoskeletal parts of the body, and are capable of providing a myriad of services that include acupuncture, electric muscle stimulation, exercise programs and instruction, heat/cold therapy, herbal therapy, lifestyle and nutrition counseling, manipulation under anesthesia, massage, physical rehabilitation, physiotherapy, stress management, traction, and ultrasound.
Myth #2: Chiropractors prescribe medications to relieve pain and perform surgery, when needed.
Chiropractors believe that many ailments can be corrected if the body's interrelated bone, nerve and vascular systems are in balance, allowing the body to heal itself. A branch of the healing arts concerned with disease processes, chiropractic care is a recognized form of therapy that focuses on improving your overall health and well being without the use of drugs or surgery.
Myth #3: Those who undergo spinal manipulation are at high risk of injury.
In general, proper chiropractic treatment of your body's lumbar, or lower back, region involves very little risk, and the rewards can be significant. In fact, a recent study by the Rand Corporation found that a serious adverse reaction from cervical (neck) manipulation might occur less than once in 1 million treatments. The American Chiropractic Association believes slimmer—about one in every 2 million treatments—the same odds of dying in a commercial airline crash. A more recent article in the Canadian Medical Association Journal found only a 1-in-5.85 million risk that a chiropractic adjustment of the neck may result in vertebral artery dissection.
Myth #4: Chiropractors are not viewed as being in the medical mainstream.
The medical community today formally recognizes the value of chiropractic care, and medical doctors routinely acknowledge chiropractic care as a conservative treatment option for patients with lower back pain. Moreover, many medical doctors recognize a chiropractic diagnosis and accept it as the first line of treatment for functional disorders of the entire musculoskeletal system.
The prestigious Texas Back Institute (TBI), the largest freestanding spine specialty clinic in the country, once included only surgeons and other medical doctors among its staff. In the late 1980s, TBI hired its first doctor of chiropractic. Today, close to half of TBI's patients see a chiropractor first when beginning their treatment.
The National Naval Medical Center in Bethesda, Maryland, and the successful Complementary and Alternative Medicine Center at the National Institutes of Health have established chiropractic internship programs.
Myth #5: Chiropractic care is generally unsafe and ineffective.
Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustment, is both safe and effective for back pain.
In 1994, the federal Agency for Health Care Policy and Research published its Clinical Practice Guidelines, which asserted that spinal manipulation was effective in reducing pain and speeding recovery among patients with acute low back symptoms without radiculopathy (nerve roots exit the spine and enter the body; if one of these roots is sick or injured in the area where it leaves the spine, it is called a radiculopathy). A 1996 study published in the journal Spine echoed that study and found that patients who sought chiropractic care were more likely to feel that treatment was helpful, more likely to be satisfied with their care, and less likely to seek care from another provider for the same condition, compared to those who sought care from medical doctors.
Myth #6: Cervical manipulation can cause a stroke.
A 2003 study published in the journal Neurology asserted that chiropractic treatments were the culprit in a patient's stroke, claiming that a cervical adjustment led to a vertebral artery dissection (VAD). According to the American Chiropractic Association (ACA), the study is fraught with design flaws and needlessly alarms the public about a safe and effective form of treatment for neck pain and headaches. The ACA claims that VAD is a rare type of stroke associated with many other commonplace activities, such as talking on the telephone, swimming, stargazing, overhead work, hair shampooing, and even sleeping. In fact, according to the ACA, a recent biomechanical study found that the forces transmitted to the artery during cervical manipulation are less than one-ninth the force necessary to stretch or otherwise damage a normal vertebral artery.
"Based upon this study and other recent evidence, many experts now believe that it is physically impossible for a competently performed neck manipulation or adjustment, as provided by a trained doctor of chiropractic, to cause a vertebral artery dissection unless the artery already has a significant pre-existing weakness," according to the ACA.
For centuries scientists, physicians, and even philosophers have long believed that the body's spinal cord is at the root of many ailments that have nothing to do with back or neck pain.
But the birth of the chiropractic profession was not to occur until the late-19th century—September 18, 1895, to be exact—in the small offices of the Palmer Cure & Infirmary in Davenport, Iowa.
Late that day, Canadian-born Daniel David Palmer was in his office trying to have a conversation with the building's janitor, Harvey Lillard.
Palmer noticed that Lillard was nearly deaf, and asked the man what caused him to lose his hearing. Lillard didn't know, but told Palmer his hearing began diminishing after a back injury he sustained while stooping in a cramped position. Lillard remembered hearing a "pop" in his back, and suffered hearing loss for years after that.
It was a revelation that capped what Palmer had long suspected—an indubitable connection between the spine and disease—that misalignment of the spinal column interferes with normal nerve function, and thus, leads to a host of maladies. Palmer suspected that if he were able to return the popped vertebrae in Lillard's back to its original position, it would also restore his hearing. Using a technique called the "spinous process," Palmer gently repositioned the vertebra with a firm thrust.
Lillard's hearing began to return. Over the next week, Palmer continued his spinal manipulation treatment on Lillard; each day his hearing gradually improved. Palmer coined a term for his new technique: chiropractic from the Greek words chiro, meaning hand, and practic, meaning practice. He dedicated his practice from that point forward to use of the new therapy.
In the ensuing months, Palmer treated flu, sciatica, migraine headaches, stomach complaints, epilepsy, and heart trouble with adjustments he called "hand treatments"—all without the use of drugs, medications, or surgery.
Despite Palmer's early successes, chiropractic adjustments were not readily accepted by the medical community. Palmer was later indicted for practicing medicine without a license and was sentenced to 105 days in jail and ordered to pay a $350 fine.
Palmer is the author of two well-known books: The Science of Chiropractic (1906) and The Chiropractor's Adjuster (1910). He died in 1913 at the age of 68 in Los Angeles.
His son, Bartlett Joshua, carried on his father's work and was instrumental in getting chiropractic recognized as a licensed profession.
In the 20th century, the chiropractic profession grew into a respected branch of the healing arts, largely through research and recognition by the government.