Jul 26th, 2007 by Norman
Why chiropractic doesn’t works, when it doesn’t works.
Of course there are many reasons, but perhaps we can lump them into two major groups: one, the problem doesn’t stem from spinal misalignment, and, two, while the problem does stem from spinal misalignment, the chiropractic techniques employed are not addressing the problem. Oh, and thirdly, the problem might be too intense, too severe, to address chiropractically at that moment.
One: the problem doesn’t stem from spinal misalignment. While spinal misalignment is probably the most common cause of spinal pain and discomfort, it is not the only cause.
With disc herniations (“slipped discs”) chiropractic is usually of little benefit. Indeed, rotation (see below) can be dangerous. Disc problems most often heal themselves over time (typically, six weeks to six months!).
Inflammation in the organs, for instance the kidneys, can refer pain to the back – and further more, that referred pain can cause muscle tension, muscle spasms, which are then in their turn painful in themselves.
Ligaments, muscles and/or tendons can be torn and/or inflamed.
In major trauma a vertebra can be fractured, while trauma and osteopenia (bone loss) can lead to vertebral body collapse (compression fractures).
These are the major non-chiropractic sources of back and neck pain that spring to mind. Oh, and I guess muscles can just be tired, exhausted, tense – though the joints are usually then also involved. When the cause of back pain is not due to vertebral malalignment, chiropractic may be of little relevance.
Two: the chiropractic techniques employed may not address the problem.
Keith Innis, before he was defrocked, was my chiropractic mentor and he introduced me to the concept of specificity in adjusting, and to the Gonstead Technique of Chiropractic.
Specificity: when a joint is out of place it needs to be put back in its natural position. Further, when a joint is misaligned it is not going to move properly. It will be stuck, “hypomobile”. When a joint is stuck, the joints around it are going to tend to take up the slack, move more then they otherwise would and they may become “hypermobile”. Hypermobile joints jam up out of place very easily, and are also easily repositioned. (When we adjust ourselves, that’s usually what we are doing; adjusting the hypermobile joint.) Repositioning hypermobile joints may bring some degree of relief for a short while, but it will not address the underlying problem. Many chiropractors just adjust anything and everything that moves easily. You might feel better for a day or two but it doesn’t fix the problem.
Keith Innis used to talk about the “key log”. In a log jam there is usually one key log causing the jam. The experienced lumberjack blast that key log to unblock the jam. Likewise, with back problems we need to find the vertebra that is jammed and free that up, nudge that back into place.
Sagittal corrections: Dr. Gonstead discerned that when the spine failed, a vertebra (and those stacked above it) slipped backwards off its disc. He designed techniques for moving the vertebra forward (“P to A” we say, posterior to anterior) back into place. Unfortunately these techniques are hard to learn so that, particularly up here is Canada, very few chiropractors learn these techniques.
“Sagittal” (P top A, rather than rotational) adjustments are more comfortable, safer, and much more effective than many other techniques. Which is not to say that the other techniques don’t sometimes work. They do, sometimes. But not infrequently I’ll see a patient who has been to half a dozen other chiropractor and had his neck or back rotated to no avail – indeed I have had the experience myself. Then one sagittal correction can but that vertebra back where it needs to be and bring relief. Well, this at east is my experience and my belief.
Dr. Gonstead’s motto was: “find the ‘subluxation’, correct it, and leave it alone,” and indeed, one or two corrections are often all that is needed. So, I believe that chiropractic sometimes doesn’t work because the “posteriority” is not corrected.
Recently posted: why chiropractic works, when it works.
– why joints are exquisitely sensitive.
– An anecdote about short term pain and long term relief with specific correction of a chronic lesion