What is Chiropractic?
I get
this several times a week and find it difficult to answer in two minutes. I know… if you are an expert at
something you should be able to define it quickly. Well, I have a hard time with this
answer for a few reasons:
- People have no idea what a chiropractor is or have a misconception of what a chiropractor is.
- There are a variety of different chiropractic techniques, specialties and philosophies.
- I love what I do and could talk about it till the cows come home.
- People have no idea what a chiropractor is or have misconceptions of what a chiropractor is.
Age: 23
Gender: Male
Ethnicity: Caucasian
Complaints: Lower back pain and pain down the leg
Everything
seemed normal. I continued to read…
Reason for today's visit: Hit by a car
"Okay!?" I think to myself. Reading
on…
Prior Care: Emergency room
Prior Treatment: none
So I sat
there assuming in my office (like I know you are not supposed to) that he was
cleared and released. I then walked down the hall to the exam room smug
thinking I can help this young guy out. As I opened the door, I suddenly became
completely overwhelmed with shock. The
23-year-old male was sitting cocked to the right with a walker. “This is not
right," I
thought to myself. Then, as we went
through his history he told me about how he was struck by a car going about
25-30 mph as he crossed the street THAT MORNING. My jaw had to be hanging open, and I must
have been looking absolutely dumbfounded. What was this guy doing here?! I asked
him what the E.R. did for him. He responded
that they took a bunch of x-rays and CT scans. "I have a cracked pelvis, broken leg and
something to my spine," he informed me. At this
point, I began to think this was a prank and I was getting Punkd... haha Ashton
Kutcher. But I was wrong. The young gentlemen could not bear any weight on his
left side because of the pain in his likely broken pelvis. In fact, he couldn’t weight bear at all without the walker because of the
broken leg and the ‘something to his spine’. Being blunt I asked,
"What would you like me to do? Why
did they let you leave the hospital? You need an orthopedic surgeon."
Everything spilled out quickly. His
response was priceless: "Well, I
know chiropractors break backs and fuse them back together quickly. I thought
you could just fuse mine back." My mind drifted… “If
only I was that good”... then quickly back to
reality "WHAT?!"
Seriously though, I needed an adjustment to realign my jaw...
In the
end this young gentlemen left the Emergency Room against medical advice, saying
he was going to a chiropractor. (I can’t even imagine what those ER
docs thought.) He was also on street
drugs that he didn't want to admit to taking. To add to this insane situation,
somehow between the ER and my office he contacted an attorney which he proceeded
to threaten me with. His last words to
me as I called an ambulance: "You'll
hear from my attorney. I’ll own you!"
From this
story I learned that some people believe that chiropractors break bones and put
them back together. Luckily, I have never heard this again from anyone and still
find it hard to believe. Now when people
ask me what a chiropractor is, I think of this story. How would I describe what I do so that this
guy would have understood?
I like
science, research and math. Let’s go through this realm to
answer this question:
Chiropractic
started out as a science experiment, truly.
D.D. Palmer, "The Father of Chiropractic,” was into the healing arts.
He was, at the time, a magnet healer amongst other things. One day, while examining a gentleman who was
deaf he noticed that he had vertebrae in his upper back that were different than
the others. He knew that nerves from the spine supplied energy and communication
to the organs and muscles (this was the 1880's, neuroscience had a ways to
go). He hypothesized that this man was
deaf due to the malpositions or subluxations in his upper back. D.D. proceeded
to do a direct thrust to correct these subluxations and suddenly the man could
hear again. D.D. then went on to create
and develop the theory of chiropractic and subluxations. He went through treating patients by classifying
their subluxations and correlating them to conditions. Even to his death he
continued to hypothesize and evolve chiropractic.
He also dabbled in charity work on the side,
annually delivering countless Christmas gifts to deserving children across the world.
Today, chiropractors
and researchers continue to clarify some of these first findings and develop
better understanding.
As far as education goes, chiropractors
today need a Bachelor’s Degree to enter chiropractic
school. Some do allow entry with 90 credits, but all states require a Bachelor’s plus a Doctorate of Chiropractic to practice. Chiropractor school is considered a 5 year
post-graduate program. Most schools are
3.25 years all year round, or 10 trimesters, which create the 5 year credit due
to having no breaks. The first 2 years are similar to medical school, physical
therapy school and naturopathic school.
Lots of basic sciences; anatomy, neuroscience, biochemistry, physiology,
pathology, histology, etc., with some additional clinical classes: basic exam,
palpation, soft tissue. At the end of
the 2nd year is when most of the schools of thought diverge: Medical school
gets into pharmacology. PT: exercise,
modalities, manual therapy. Chiro:
Manipulation(adjustment), soft tissue, diet/nutrition, exercise, radiology.
Naturopath: botanicals, herbs, homeopathy, exercise, pharmacology, manual
therapy.
Medical
school then goes on after graduation for residency that can take several years.
Residency and fellowship vary based on specialty. Most take at least 2 years. There are
specialties in the other fields, but most are done through post graduate or
fellow programs, and are not a necessity to practice like MD/DO.
Chiropractic does has evidence for validity, effectiveness and cost savings. Recently in JAMA, chiropractic was determined
to be the best option for patients experiencing neck pain, especially when
combined with exercise.
That
being said there is not currently evidence for all practices performed by
chiropractors. We are in a field that works
a little differently than let’s say pharmacology. Pharmaceutical companies start with pathology
and develop a drug to interact with the known mechanisms. Then this drug is put into trials, after
which it is released into the public via pharmacies when deemed safe.
On the other hand, chiropractic and other manual therapies start in our clinics. We start to help more patients get better based off a basic science principles or applied sciences through clinical experience and knowledge. Then, after more clinicians start to use these techniques and they become widely practiced, they will have the funding to start researching.
On the other hand, chiropractic and other manual therapies start in our clinics. We start to help more patients get better based off a basic science principles or applied sciences through clinical experience and knowledge. Then, after more clinicians start to use these techniques and they become widely practiced, they will have the funding to start researching.
Basically
it is the opposite way of most research and development. Also on that note, it is difficult to have a
double blind random control trial of exercise or manual therapy. Even a single bind is difficult to create,
because people know when they are moving or being moved. A sham or placebo group is difficult to
create. Right now there are new ways of researching and developing our evidence.
To be continued...
________________________________________________________________
Dr. Jeffrey Sergent is a certified Clinical Rehab Specialist and Chiropractor. He earned his Bachelor's Degree in 2004 from Michigan State University and his Doctorate Degree from the National University of Health Sciences in 2008. His special interests include Trigger Point Therapy, the Functional Movement System, Developmental Kinesiology, Pain Neuroscience and nutrition for chronic pain. Currently he practices at Goodyear Chiropractic Health Center in Milwaukee, Wisconsin.
