CHIROPRACTIC THERAPY

The Rationale for Chiropractic Care.

(keywords: chiropractic therapy, chiropractic adjustment, chiropractic subluxation, leg length inequality )

Premise: Chiropractic therapy centres around the maintenance of appropriate movement of the spinal joints and optimizing biomechanics throughout the musculoskeletal system.

Components of the Vertebral Subluxation Complex (VSC).

Dyskinesis (hypomobility)
Altered biomechanics (cellular damage)
Physiological and biochemical changes
Altered nervous system activity
Altered motor patterns...

CHIROPRACTIC THERAPY

So what does that mean in English?

For one reason or another, a joint becomes fixated. It's less mobile, or HYPOmobile. That could be due to sitting too long, sleeping on your stomach, a leg length inequality, an injury ... we could go on. And on ...

Take this lady's foot for example. She fell down the stairs and subluxated in the cuboid bone in her right foot. Compare it with the left - can you see the difference:

The calcaneo-cuboid joint is reduced and the cuboid is displaced? Believe me, it's less mobile, or hypomobile.
That changes the way the whole foot works, altered biomechanics. What's more these changes work their way up the kinetic chain - it has knock-on effects in the knee, hip, sacroiliac joints, and all the way up to her skull. She gets bad headaches since the fall. Just watching her walk and you can see it.
This brings about biochemical changes: can you see the whiteness along the edges of the bones in that joint, compared to the normal left foot? That's hyaline cartilage dying, starved of normal nutrients.
Within this little joint are dozens of tiny mechano- and chemoreceptors. They are detecting these changes and bombarding the spinal cord. The spinal cord starts firing off via a tract called the STT to the parietal lobe of the brain (pain), to the limbic system (emotion). What's more, they bombard the autonomic system; it's been proved that they particularly affect blood flow.
Pain and fixations in the foot change the gait. That's what will usually bring the patient to the Chiropractor - change of gait starts to cause pain elsewhere, often in the pelvis.

Case management protocol includes…..

A thorough examination to include physical, neurological, orthopedic examinations
Specific spinal analysis before Chiropractic Therapy:
Specific restoration of normal biomechanics by means of the adjustment
Specific rehabilitation program
Referral for co-management if appropriate
Appropriate attention to ergonomical considerations and other possible causes of biomechanical dysfunction.

The purpose of chiropractic therapy (the "adjustment") is…

"... to restore normal movement and resolve the resultant biomechanical, physiological and neurological effects of segmental hypomobility."

Other adverse neurological effects

Other strange and not easily explained things happen after chiropractic adjustments of the spine. A patient with six months diarrhoea after taking anti-inflammatory drugs for a few days after a fall is suddenly cured, women who are for years infertile fall pregnant, blood pressure drops, menstrual cramps and abnormal bleeding normalises, babies with infantile colic... Chiropractic researchers are only now beginning to investigate these less easily explained adverse neurological effects of subluxations. Read for example this Rib Pain Treatment CaseFile ... RIB PAIN TREATMENT CaseFile ...

Notice the tracts from proprioceptors (bottom left) within the joint capsule - those that feed into the Ventral Horn, and thence via tracts within the cord to the Dorsal Horn. These tracts have an INHIBITORY effect on the Dorsal Horn.

HYPOMOBILITY >>> DECREASED PROPRIOCEPTOR activity >>> DECREASED IBHIBITION OF THE PAIN (and other) NOCICEPTOR ACTIVITY firing via C fibres into the Dorsal Horn.

Simultaneously,
BREAKING DOWN OF CELLS in the Hypomobile Joint >>> INCREASED firing of SPINAL CHEMOSENSITIVE NOCICEPTORS >>> Inflammation AND Increased input into the Dorsal Horn.

Double wammy: Increased noxious input into the dorsal horn + Decreased inhibition from Proprioceptors.

Nett result:

Greatly increased input into the Spinal Thalamic Tract >>> Thalamus >>> Parietal brain where pain is perceived.

Biomechanical Effects of Hypomobility

Altered intersegmental movement patterns
Results in compensatory changes in motor patterns, etc.
Creates cellular damage in sites of biomechanical stresses
“ Immobilisation Arthritis …”

"Loss of normal motion within a joint results in changes in every structural component of the joint; subchondral bone to the synovium, from meninges to the ligamentum flavum."

References:

Amiel D, et al. Acta Ortho Scand, 1982
Palmoski M, et al. Arth Rheum, 1979
Paine & Haung. J Neurosurgery, 1972
Lantz C. Chiro Res J, 1988
Enneking & Horowitz. J Bone Joint Surg, 1972
Evans EB, et al. J Bone Joint Surg, 1960

Current orthopedic literature recognizes that changes in the pattern of forces transmitted through joints, which occurs during the immobilization process, is universally recognized as contributing to connective tissue degeneration and local changes in the chemical composition of that tissue…

We also know that mechanical failure of ligaments, discs, capsules and other connective tissue can result from local variations in chemical composition.

"Measurable changes within the joint complex occur within one week of the onset of hypomobility."

Effects of hypomobility on the IVD ....

The nucleus pulposus is the the area of the disc most susceptible to dessication. It is dependent on movement for nutrition and survival...

Lack of appropriate intersegmental spinal movement can significantly reduce the dynamic pressure gradient between the intradiscal tissues and the subchondral areas of spongiosa in the vertebral bodies...

This sacrifices the key mechanism by which nutrients and water replenish the disc and by which metabolic waste leaves the disc...

Putting it together...

Loss of normal movement leads to…
Changes in how all tissues involved are stressed and replenished, which causes…
Chemical changes within those tissues and…
Predisposes them to mechanical failure giving us…
A good reason justifying chiropractic therapy to restore normal movement through spinal chiropractic adjustments.

ANTI INFLAMMATORY DRUGS and CHIROPRACTIC THERAPY

Chiropractors in general are not against the sensible use of drugs, but they are so abused, and cause soooooo many deathsssss and serious distressesssss that we seriously question the way Medicine dishes out bucketfuls of pills.

Research done on 37 000 people who suffered from a stroke found a 20%- 250% increase in the incidence of stroke if they had taken anti-inflammatory drugs (depending on the drug) in the previous 30 days.

CHIROPRACTIC BOOKS

Chiropractors are often a breed apart. It takes a special kind of person to go into a profession where you know you'll may be labelled as a quack by many in the medical fraternity, where there still remains a great deal of suspicion about the safety and effectiveness of your therapy. Such is Dr Bernard Preston. Read about his experiences as a chiropractor in the land of the windmills. STONES IN MY CLOG ...

INITIAL CLINICAL CONSULTATION FEE Could a too-high first consultation fee be the limitating factor in the growth of your practice? New patients are the life blood of every practice...

INITIAL CLINICAL CONSULTATION FEE ...

Starting out

Making a solid start is important for any new graduate. Here a few thoughts in response to a letter.

Starting out Chiropractor ...

LINKS @ CHIROPRACTIC THERAPY

In grateful acknowledgement

Dr. Lisa K. Bloom, D.C.

Diplomate of the International Board of Chiropractic Neurology

Diplomate in Applied Chiropractic Sciences

Associate Professor, Diagnosis and Practice Department of New York Chiropractic College.

APPLICATION OF CHIROPRACTIC THERAPY

The beauty of being a chiropractor is that days are filled with challenging cases. Many have been treated medically for years without success. Research shows most can be helped with chiropractic, some not. Few are "cured" whatever the therapy, hence the need for Chiropractic Maintenance care ...

Sometimes it might be a serious whiplash injury, other times a hereditary condition, often a combination of factors as in this very serious case.

TINGLING IN FEET AND LEGS CASEFILE ...

MORE INTERESTING LINKS @ CHIROPRACTIC THERAPY

Physical Therapists providing a "Chiropractic adjustment?"

With many insurance companies now only paying for Physical Therapists to provide a "Chiropractic Adjustment", in the face of powerful research proving that inclusion of Chiropractors to provide the Chiropractic Adjustment would save them a good deal of money, one has to conclude that political Medicine has gone off on another tack to contain Chiropractic.

And it's being successful, with some Chiropractors quitting. In recessionary times, the going is tough when the insurance won't pay.

Is the time approaching for a new Wilk vs AMA and the Insurance Companies?

CHIROPRACTIC THERAPY

Effects of hypomobility on the IVD ....

Physical Therapists providing a "Chiropractic adjustment?"

MORE LINKS

Consulting a chiropractor