Sometimes I think that common sense is inversely proportional to academic knowledge. I think this is especially noticeable within the chiropractic profession and blatantly obvious in some of chiropractic academia. It is probably because there is so much about chiropractic that is just plain common sense. With that said, here comes one of our old friends with an article entitled, “It’s Time to Move Beyond Subluxation.”
Dr. David Seamon writes that besides the beneficial effects of spinal manipulation on joint mechanics, the “modulation of segmental and suprasegmental neuronal activity…can reduce pain and visceral symptoms in certain patients.” What I gather he is saying is that a person who goes to a chiropractor with, say a digestive disorder, and gets well, does so not because correction of a subluxation allowed the innate intelligence to be more fully expressed which causes the digestive system to work better. Instead, he suggests that the spinal manipulation affected the nerves surrounding the joint which were creating symptoms of a non-existent disease (in this example, digestive problems) and the adjustment relieved those symptoms. He notes, “we all know that adjustments are not clinically beneficial for all patients” and hence, his emphasis in “certain patients.”
The article is really all about this chiropractic college professor’s now tiresome and slanderous attacks on straight chiropractic and its “notion that adjustments have magical or supernatural healing outcomes.” There is nothing magical or supernatural about the adjustment and its effects on the body unless you consider the development and birth of a baby magical or the ability to take a breath supernatural.
He offers measures to eliminate this problem. Students, early in their education, “should be informed about which patients are likely to respond best to manipulations.” He says there are clinical rules that have been developed to do this and cites seven studies that students should be familiar with in order to determine who should be manipulated. Four of the studies relate to lower back pain, two relate to neck pain and the seventh “study” is entitled Clinical Prediction Rules: Time to Sacrifice the Holy Cow of Specificity? You can draw your own conclusions about that one! That may be the most telling paper to understand his suggestion that we “move beyond the subluxation.” If all you are doing is manipulating joints to reduce pain, I guess manipulating every joint is the technique of choice. I’m just glad that none of the other health care professions are into non-specificity. Surgeons and even dentists could wreak a lot of havoc with a non-specific approach.
Common sense says that specific adjustments correct nerve interference. Even if it is only correcting modulation of segmental and suprasegmental neuronal activity, specific adjustments would be helping many people. I happen to think that we are doing much more than that. This issue needs further discussion and space does not allow it. But his philosophy affects students and their future in this profession and that is vitally important.
I feel bad for the students this professor is influencing. If students are buying this professor’s approach to chiropractic, many, in fact, most are going to be in trouble. If non-specific manipulation can accomplish his model of chiropractic ‘treatment” then we are in competition with physical therapists, D.Os, medical doctors and some massage therapists. Not everybody out there has back pain and headaches. They usually clear up very quickly (or need to be referred out, in his model). I would suggest that his model of chiropractic cannot make a living, especially with the numbers of chiropractors that are being cranked out by the colleges and his college’s system seems to be turning out the most. Already a great percentage of chiropractors never make it in practice. If we keep adding to that number to fill a market (back pain and neck pain) that will not support those numbers, well that is unfair to those unsuspecting students. It seems to me he is taking students’ money to teach them a model of chiropractic in which most cannot make a living. Now I know that the free market will have its way and already we see a drop in chiropractic college enrollments. I’m sure the professor is counting on the fact that when decreased enrollment reflects itself in faculty cutbacks, he will have tenure and be free to continue to push his limited manipulative therapy model of chiropractic until such time as we give up the subluxations, die as a profession or are absorbed by some other profession. When that happens he will pride himself in the contribution he has made to the progress of our profession because we have moved “beyond the subluxation.”
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