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Chiropractic Treatment For Low Back Pain And Other Conditions

Chiropractic is a complementary and alternative health care profession which focuses on diagnosing, treating and preventing mechanical disorders of the musculoskeletal system, their effects on the nervous system and on general health. Chiropractic%u2019s premise is that spinal joint misalignments, which chiropractors call vertebral subluxations, can interfere with the nervous system and result in many different conditions of diminished health.

Chiropractic treatments consist of a variety of techniques and methods, which chiropractors refer to as spinal adjustments. In contrast, the term subluxation, as used in conventional medicine, is usually associated with specific conditions which are a direct consequence of injury to joints or associated nerves.

Chiropractic combines the words %u201Ccheiros%u201D and %u201Cpraktikos%u201D, meaning %u201Cdone by hand%u201D. It was founded in 1895 by Daniel David Palmer, based on his assertion that all health problems could be prevented or treated using adjustments of the spine, and sometimes other joints, to correct what he termed subluxations. He, and later his son, B.J. Palmer, proposed that subluxations were misaligned vertebrae which caused nerve compression that interfered with the transmission of what he named Innate Intelligence. This interference interrupted the proper flow of Innate Intelligence from %u201Cabove, down, inside, and out%u201D to the organ to which it traveled. As a result, the human body would experience %u201Cdis-ease%u201D or disharmony which would result in loss of health.

There are four main groups of chiropractors:
Traditional straights
Objective straights
Mixers
Reform

All groups, except reform, treat patients using a subluxation-based system. Differences are based on the philosophy for adjusting, claims made about the effects of those adjustments, and various additional treatments provided along with the adjustment.



Explanation

Manipulation of the spine is the main technique in today%u2019s chiropractic adjustment, or treatment. Though its use has been documented from the time of the ancient Egyptians, spinal manipulation in an attempt to correct the theoretical vertebral subluxation is solely a chiropractic endeavor. Chiropractic%u2019s contribution to the field of manipulative therapies is the concept of applying a precise adjustment to a specific affected vertebra, as opposed to the generalized maneuvers of the early osteopaths.

While some chiropractors adhere strictly to the use of only spinal manipulation in their adjustment, others include a broad range of methods directed at correcting the subluxation and/or just relieving musculoskeletal pain. Some chiropractors specialize in treating specific musculoskeletal problems or sports injuries, or they may combine chiropractic with manipulation of the extremities, physiotherapy, nutrition, or exercises to increase spinal strength or improve overall health.

Some also use other complementary and alternative methods as a part of a holistic treatment approach. However, chiropractors do not prescribe drugs; they believe this to be the province of conventional medicine, and that their role is to pursue drug-free alternative treatments. Depending on the country or state in which the Chiropractic school is located, some train in minor surgery. When indicated, the doctor of chiropractic consults with, co-manages, or refers to other health care providers.

There is evidence that spinal manipulation is effective for the treatment of acute low back pain, tension headaches and some musculoskeletal issues, but not all studies support this conclusion. There are no objective controlled trials with definitive conclusions for or against chiropractic claims concerning other health benefits.



Chiropractic%u2019s approach to healthcare

Chiropractic%u2019s philosophical approach distinguishes it from modern medicine. Chiropractic philosophy involves what has been described as a %u201Ccontextual, naturopathic approach%u201D to health care. The traditional allopathic or medical model considers disease as generally the result of some external influence, such as a toxin, a parasite, an allergen, or an infectious agent. Where the solution is to counter the perceived environmental factor, such as using an antibiotic for a bacterial infection. By contrast, the naturopathic approach considers that lowered %u201Chost resistance%u201D is necessary for disease to occur, so the appropriate solution is to direct treatment to strengthen the host, regardless of the environment.

In contemporary clinical practice, one can find elements of both naturopathic and allopathic philosophy among all types of providers. The degree to which a practitioner emphasizes different tenets of these philosophies is one factor that determines the manner in which they practice.

Chiropractic perspectives that reflect a holistic approach to patient care are:
Noninvasive, emphasizes patient's inherent recuperative abilities
Recognizes dynamics between lifestyle, environment, and health
Emphasizes understanding the cause of illness in an effort to eradicate, rather than palliate, associated symptoms
Recognizes the centrality of the nervous system and its intimate relationship with both the structural and regulatory capacities of the body
Appreciates the multifactorial nature of influences, which includes structural, chemical and psychological influences, on the nervous system
Balances the benefits against the risks of clinical interventions
Recognizes as imperative the need to monitor progress and effectiveness through appropriate diagnostic procedures
Prevents unnecessary barriers in the doctor-patient encounter
Emphasizes a patient-centered, hands-on approach intent on influencing function through structure
Strives toward early intervention, emphasizing timely diagnosis and treatment of functional, reversible conditions

Most importantly, the chiropractic approach to healthcare stresses the importance of prevention.



Effectiveness

Most patients who visit a chiropractor do so initially with a chief complaint related to musculoskeletal problems, especially low back and neck pain, although most chiropractors say they concern themselves with the overall health of the patient.

Because chiropractors emphasize the importance of healthy lifestyles and do not prescribe drugs or perform surgery, chiropractic care is appealing to many health-conscious people. Chiropractic treatment of the back, neck, extremities, and joints has become more accepted as a result of research and changing attitudes about alternative, noninvasive health care practices. There are many who employ chiropractic practitioners as office staff to perform therapeutic activities. Massage specialists and physiotherapists are also emplyed as adjuncts to chiropractic care.

While there is still debate about the effectiveness of chiropractic for the many conditions in which it is applied, chiropractic seems to be most effective for acute low back pain and tension headaches. However, there is no convincing evidence for long-term benefits of chiropractic interventions for acute or chronic low back pain, despite some positive overall findings. But there might be some short-term pain relief, especially in patients with acute pain.

The first significant recognition of the appropriateness of spinal manipulation for low back pain was performed by the RAND Corporation. This meta-analysis concluded that some forms of spinal manipulation were successful in treating certain types of lower back pain. Some chiropractors claimed these results as proof of chiropractic hypotheses, but RAND's studies were about spinal manipulation, not chiropractic specifically, and dealt with appropriateness, which is a measure of net benefit and harms; the efficacy of chiropractic and other treatments were not explicitly compared.

Chiropractic treatment has not proved to be very effective in treating many other conditions. Studies have not find enough evidence to support or refute the claim that manual therapy, including, but not limited to, chiropractic, is beneficial for asthma. Certain clinical trials have not shown benefit from diuretics, non-steroidal anti-inflammatory drugs, magnets, laser acupuncture, exercise or chiropractic treatments. Also, there is not enough evidence to show the effects of spinal manipulation, including, but not limited to, chiropractic, for painful menstrual periods and migraine attacks. Further, the evidence that spinal manipulation is better than amitriptyline, or adds to the effects of amitriptyline, is insubstantial for the treatment of migraine. Although spinal manipulative therapy might be worth trying for some patients with migraine or tension headaches.

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