August 5, 2011

Chiropractors are practitioners of the complementary and alternative medicine approach known as chiropractic. (Chiropractic is both a noun and an adjective.) They trace their roots to September 18, 1895, when David Daniel Palmer—a magnetic healer— used his hands to thrust on a bump on the neck of his janitor and in the process cured the janitor’s deafness. The apparent healing is especially miraculous when one examines the distribution of the cranial nerves and discovers that the auditory nerve does not extend to the neck. But chiropractors have not historically emphasized conventional scientific approaches to knowledge.

From the apparent healing of the janitor, Palmer developed chiropractic (see entry Chiropractic). Palmer based the practice of chiropractic on his belief that a vital force infuses every cell of the body, that nerves are the paths through which this life force flows, and that misaligned joints (subluxations) disrupt the flow of the life force. He further believed that using the hands to manipulate various joints of the body—especially those in the spinal column—could restore disruptions of the life force and thereby allow the body to heal.

Despite the Flexner report in 1910, which brought reform to traditional medical education in the United States, chiropractic education was caught in conflict among competing ideas until it was finally standardized in the late 1950s and early 1960s. Most chiropractic schools now require at least 2 years of undergraduate education and 4 years of chiropractic school. Chiropractic education is criticized by members of mainstream medicine, however, for its tendency to emphasize untestable hypotheses and techniques for building a successful business at the expense of basic science. Despite the standardization of chiropractic education, chiropractors are not trained in the same kinds of diagnostic tests and treatments that physicians and surgeons are taught to use. In fact, chiropractors would be practicing outside of their legal authority if they were to use many of the tests and procedures that are common in medical practice.

Chiropractors today usually belong to one of three associations according to their beliefs about illness and its proper treatment. Members of the International Chiropractors Association are often referred to as straights, because they adhere to Palmer’s belief that almost all diseases are caused by misaligned vertebrae and that manipulation of the spine can prevent or cure most diseases. Members of the American Chiropractic Association are known as mixers, because they mix Palmer’s ideas with other ideas about the causes of diseases. While they may acknowledge the influence of germs and other biological factors in disease, they still tend to consider disturbance of the life force as the underlying cause of disease. A third group, and the smallest, is the National Association for Chiropractic Medicine. This group requires members to sign a written pledge to openly renounce the foundational chiropractic idea that disturbance of the life force caused by misaligned joints is the cause of disease. The pledge also requires members to limit their work to neuromusculoskeletal conditions of a nonsurgical nature.

Chiropractors today often seek to be primary care providers, and they offer a wide range of prevention and treatment services. Due to the limitations of their training, however, they cannot provide the range of services offered by physicians, and patients who rely on them for primary care may be at risk for misdiagnosis and mistreatment. Despite claims to the contrary, evidence for the effectiveness of chiropractors in treating most medical conditions has yet to be demonstrated under conventional scientific standards. However, customer satisfaction appears strong. The right of chiropractors to licensure and their right to practice were established on narrow legal grounds, not on the scientific merits of their approach. As with other complementary and alternative medical practices, the potential chiropractic patient is best advised to learn about a chiropractor’s approach to healing and obtain references before entering into a therapeutic relationship.

SEE ALSO: Chiropractic care, Complementary and alternative health practices, Healers, Occupational therapists, Physical therapy

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