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 By Frank M. Painter, D.C. in Acupuncture on April 2nd, 2013 at 8:09 pm
Updated Reference Guide to Dr. Richard C. Schafer’s Articles
The Chiro.Org Blog
There are now 62 different Chapters from Dr. Schafer’s various best-selling textbooks for your review, available exclusively at Chiro.Org
These learned articles by Dr. Schafer can also be found again easily by selecting the EDUCATION Category, on the right-hand side of this page, just below Recent Comments. We hope you will find them of interest.
Our thanks to ACAPress for access to these materials!
By Frank M. Painter, D.C. in Chiropractic Care on September 30th, 2012 at 4:39 pm
The Subluxation – Historical Perspectives Part II
The Chiro.Org Blog
SOURCE: Chiropractic Journal of Australia 2009 (Dec); 39 (4): 143–150
Rolf E. Peters, DC, MCSc, FICC, FACC, FPAC
Editor Chiropractic Journal of Australia
Thanks to Dr. Rolf Peters, editor of the Chiropractic Journal of Australia for permission to republish this Full Text article, exclusively at Chiro.Org!
Subluxation is a term that has been used by the chiropractic profession since its early days. The term, meaning less than a luxation, has been used for millennia, similarly so has manipulation been the preferred intervention to overcome this problem.
This paper reviews some of the early uses of subluxation and manipulation identifying highlights, to help the reader appreciate that subluxation and manipulation, both spinal and general, are as old as civilisation itself.
INDEX TERMS: (MeSH) CHIROPRACTIC; MANIPULATION, CHIROPRACTIC; HISTORY OF MEDICINE; HISTORICAL ARTICLE. (Other): SUBLUXATION.
Introduction
D.D. Palmer stated that he manipulated the spine of Harvey Lillard on 18 September 1895 and restored his hearing after 17 years of deafness, and shortly thereafter gave immediate relief in a case of heart trouble. [ 1] With the advice of a patient, the Reverend Samuel Weed, they coined the word Chiropractic from the Greek words chiro and praxis, meaning done by hand on 14 January 1896. [ 2]
In 1905 D.D., with reference to himself in the third person, stated that
…he does not, nor ever has claimed that vertebrae may be displaced and replaced. He, however, is the first to draw the attention of the public to the difference between a complete luxation known to the medical world as such, and a subluxation as known to the chiropractor as a displacement of the articular processes.
He was the first to write lengthy articles, setting forth that 90 to 95 per cent of all diseases were caused by subluxation of vertebrae, and today no other person has placed such statements in the hands of the public unless copied from those written by D.D. Palmer
He was the first person to adjust, replace vertebrae by the unique method known as Chiropractic, using the spinous and transverse processes as handles.[3] (Emphasis added)
But, what are the facts?
Continue reading …
The Subluxation – Historical Perspectives
The Chiro.Org Blog
Chiropractic Journal of Australia 2009 (Dec); 39 (4): 151–164
Meridel I. Gatterman, MA, DC, MEd
Chiropractic Consultant, Florissant, Colorado
Thanks to Dr. Rolf Peters, editor of the Chiropractic Journal of Australia for permission to republish this Full Text article, exclusively at Chiro.Org!
Subluxation is a term that continues to generate controversy into the 21st Century. This paper describes the controversy surrounding terminology arrived at through consensus in the latter part of the 20th century in addition to ongoing issues surrounding the use of the term subluxation.
Introduction
A word is not a crystal, transparent and unchanged; it is the skin of a living thought and may vary greatly in color and content according to the circumstances and time in which it is used.
– Oliver Wendell Holmes, Jr.
Historically subluxation has been central to the philosophy, science, and practice of chiropractic as the primary articular lesion treated by chiropractors. A number of issues have surrounded the use of the term subluxation including: terminology, the nature of the lesion (aberrant motion versus misalignment), and clinical, economic and political issues. The complexity of these issues precludes discrete discussion, classifying them as such, however, gives focus to much of the controversy.
Aberrant Motion versus Misalignment
The controversial nature of the chiropractic subluxation began as early as 1906 with the Palmers emphasizing vertebral displacement (misalignment) [1] at the same time that Smith Langworthy and Paxson emphasized aberrant motion as the primary characteristic of subluxation [2] They stated that:
“A simple subluxed vertebra differs from a normal vertebra only in its field of motion and the center of its field of motion.” [2]
The aberrant motion concept subsequently became more popular in Europe, However in North America, Budden [3] was using the term “fixation” when referring to a subluxation at Western States Chiropractic College by 1930.
His definition described the vertebral fixation as:
“The fixation of a joint in a position of motion, usually at the extreme of motion.” [3]
Continue reading …
By Frank M. Painter, D.C. in Announcement on June 14th, 2012 at 10:16 pm
The Subluxation Complex Saves Diagnosis for Texas Chiropractors
The Chiro.Org Blog
SOURCE: Dynamic Chiropractic
By James Edwards, DC
On April 5, 2012, the Third Court of Appeals of Texas issued a 58-page opinion in Cause No. 03-10-673-CV – the Texas Board of Chiropractic Examiners (TBCE) and the Texas Chiropractic Association (TCA) vs. the Texas Medical Association (TMA), the Texas Medical Board (TMB) and the State of Texas.
According to an April 6, 2012 communication by the Texas Chiropractic Association [1], the case presented three questions for the court:
1) Are the two TBCE rules that allow chiropractors to make certain “diagnoses” valid?
2) Can chiropractors perform MUA?
3) Can chiropractors perform needle EMG?
Here’s what the Court of Appeals had to say in the matter:
Diagnosis
On the two most important issues presented by the TCA, the Court of Appeals upheld the validity of TBCE’s Rules 75.17(d)(1)(A) and (B) (“the scope of practice rules”). The first rule, 75.17(d)(1)(A), permits chiropractors to render diagnoses “regarding the biomechanical condition of the spine and musculoskeletal system,” and lists six typical diagnostic areas as examples of what is within the scope of practice. At the district court level, Judge Yelenosky had struck down that rule, stating that it created an unlimited authorization to diagnose any disease or condition, which, he said, exceeded chiropractors’ scope of practice.
The Court of Appeals disagreed and reversed Judge Yelenosky’s decision. The court found that the TBCE rule does not exceed the scope of practice because the rule limits chiropractors to making diagnoses of the biomechanical condition of the spine and musculoskeletal system.
The second rule, 75.17(d)(1)(B), permits chiropractors to diagnose subluxation complexes of the spine or musculoskeletal system, and lists three examples of what is within the scope of practice. The Texas Medical Association and Texas Medical Board had challenged that rule, claiming that the rule allowed chiropractors to diagnose neurological conditions, and pathological and neurophysiological consequences that affect the spine and musculoskeletal system. At the district court level, Judge Yelenosky agreed and struck down the rule because he found that it expanded the scope of chiropractic beyond what was allowed in the Chiropractic Act.
Again, the Court of Appeals disagreed with District Court Judge Yelenosky. The appeals court acknowledged that a subluxation complex could have functional or pathological consequences that affect essentially every part of the body. But the court found that the rule itself only allowed chiropractors to render a diagnosis regarding a subluxation complex of the spine or musculoskeletal system. That authority, the appeals court held, was consistent with the Chiropractic Act.
Continue reading …
The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory
The Chiro.Org Blog
SOURCE: J Electromyogr Kinesiol. 2012 (Apr 16)
By Charles N.R. Henderson, DC, PhD
Palmer Center for Chiropractic Research, FL, United States
It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments. In chiropractic practice, the vertebral subluxation has been the historical raison d’etre for SM. Vertebral subluxation is a biomechanical spine derangement thought to produce clinically significant effects by disturbing neurological function.
Continue reading …
Visceral Responses to Spinal Manipulation
The Chiro.Org Blog
SOURCE: J Electromyogr Kinesiol. 2012 (Mar 20)
Philip S. Bolton, Brian Budgell
School of Biomedical Sciences & Pharmacy, Faculty of Health, University of Newcastle, Callaghan NSW 2308, Australia; Centre for Brain and Mental Health Research at the Hunter Medical Research Institute, Newcastle, Australia
While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. This controversy is due in part to the perception that there is no robust neurobiological rationale to justify using a biomechanical treatment of the spine to address a disorder of visceral function. This paper therefore looks at the physiological evidence that spinal manipulation can impact visceral function. A structured search was conducted, using PubMed and the Index to Chiropractic Literature, to construct of corpus of primary data studies in healthy human subjects of the effects of spinal manipulation on visceral function. The corpus of literature is not large, and the greatest number of papers concerns cardiovascular function.
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Posttraumatic Subluxation-Fixation Implications
Etiology, Effects, and Common Coincidental Factors
The Chiro.Org Blog
Clinical Monograph 5
By R. C. Schafer, DC, PhD, FICC
INTRODUCTION
The kinetic aspects of spinal biomechanics are an important consideration in traumatology since the totality of function is essentially the sum of its individual components. However, although reminders are frequently given, the multitude of causes and effects of an articular subluxation complex (spinal or extraspinal) will not be detailed here that is primarily directed to chiropractic clinicians and advanced students who are well acquainted with standard hypotheses. For a detailed description, the reader is referred to:
Basic Principles of Chiropractic:
The Neuroscience Foundation of Clinical Practice
Arlington, Virginia, American Chiropractic Association, 1990.
Basic Implications
The biomechanical efficiency of any one of the 25 vertebral motor units, from atlas to sacrum, can be described as that condition (individually and collectively) in which each gravitationally dependent segment above is free to seek its normal resting position in relation to its supporting structure below, is free to move efficiently through its normal ranges of motion, and is free to return to its normal resting position after movement. The degree of fixed derangement (subluxation-fixation) of a bony segment within its articular bed and normal range of motion may be an effect in the range of microtrauma to macroscopic damage. Regardless, it is always attended by some degree of mobility dysfunction; neurologic insult; and overstress of the muscles, tendons, and ligaments involved and their respective mechanoreceptors.
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What is The Chiropractic Subluxation?
Once produced, the lesion becomes a focus of sustained pathologic irritation in which a barrage of impulses streams into the spinal cord where internuncial neurons receive and relay them to motor pathways. The contraction that provoked the subluxation initially is thereby reinforced, thus perpetuating both the subluxation and the pathologic process engendered. Sensory reflex phenomena can also be involved, and they frequently are. The nerve impulse creates a multitude of cellular reactions and responses besides those of even the most intricate, subtle, and variable sensations and motor activities. Once this is appreciated, we must add the complexities of trophic effects, neuroendocrine interrelations, biochemical affinities, proprioceptive buildup, summation increments, facilitation patterns, the input of the ascending and descending reticular activating mechanisms, genetic neurologic diatheses, synaptic overlaps, demoralization and disintegration of synaptic thresholds, the neurologic spread and buildup, reflex instability, predisposition to sensorial aberrations, undue cerebrovisceral or viscerocerebral interactions, psychosomatic overtones, and those many phenomena that science is only beginning to understand or are beyond our present understanding. This underscores that the quality and sometimes quantity of nerve function relates directly or indirectly to practically every bodily function and contributes significantly to the beginning of physiologic dysfunction and the development of pathologic processes.
Structural Imbalance
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Radiologic Manifestations of Spinal Subluxations
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 6 from RC’s best-selling book:
“Basic Chiropractic Procedural Manual”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 6: Radiologic Manifestations of Spinal Subluxations
This chapter describes the radiologic signs that may be expected when spinal subluxations are demonstrable by radiography. Through the years, there have been several concepts within the chiropractic profession about what actually constitutes a subluxation. Each has had its rationale (anatomical, neurologic, or kinematic), and each has had certain validity contributing to our understanding of this complex phenomenon.
Kinetic Intersegmental Subluxations
Segmental hypomobility, also called a “ fixation subluxation” by many clinicians, may affect one or several motor units.
It is characterized by reduced motion of the “Spinal Motion Unit” (Please refer to Spinal Anatomy 101), which has been forced to the extreme of a range of motion (eg, flexion, extension, etc). See Figure 6.14. Stress views or videofluoroscopy are necessary to depict this and other kinetic subluxations radiographically, but motion palpation and some orthopedic tests may reveal their presence clinically.
Editor’s Note: In the following picture, the inferior facet of C5 fails to slide forwards and upwards upon the superior facet of C6. Because of that, the IVF cannot open more fully, and the spinous process of C5 fails to move away from the C6 spinous. All together, these are the classic signs of HYPO-mobility.
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Cerebral Perfusion in Patients with Chronic Neck and Upper Back Pain: Preliminary Observations
The Chiro.Org Blog
J Manipulative Physiol Ther. 2012 (Feb); 35 (2): 76-85
Maxim A. Bakhtadze, MD, PhD, Howard Vernon, DC, PhD, Anatoliy V. Karalkin, MD, PhD, Sergey P. Pasha, MD, PhD, Igor O. Tomashevskiy, MD, PhD, David Soave, MSc
OBJECTIVE: The purpose of this study was to determine the correlation between cerebral perfusion levels, Neck Disability Index (NDI) scores, and spinal joint fixations in patients with neck pain.
METHODS: Forty-five adult patients (29 were female) with chronic neck/upper thoracic pain during exacerbation were studied. The subjects were grouped according to NDI scores: mild, moderate, and severe. The number of painful/blocked segments in the cervical and upper thoracic spine and costovertebral joints, pain intensity using the visual analog scale, and regional cerebral blood flow of the brain using single-photon emission computed tomography (SPECT) were obtained. The SPECT was analyzed semi-quantitatively. Analysis of variance tests were conducted on total SPECT scores in each of the NDI groups (P < .05). Univariate correlations were obtained between blockage, pain, and SPECT scores, as well as age and duration. A multivariate analysis was then conducted.
RESULTS: Group 1 (mild) consisted of 14 patients. Cerebral perfusion measured by SPECT was normal in all 8 brain regions.
Group 2 (moderate) consisted of 16 patients. In this group, a decrease in cerebral perfusion was observed (range, 20%-35%), predominantly in the parietal and frontal zones.
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By Frank M. Painter, D.C. in Subluxation on September 25th, 2011 at 12:07 am
Dump Subluxation? Give Me a Break!
The Chiro.Org Blog
Dynamic Chiropractic
By William Meeker, DC, MPH, FICC
President of Palmer College of Chiropractic West, and former director of the Palmer Center for Chiropractic Research
The front-page headline of the September issue (volume 13, no. 12) of the Chiropractic Journal reads “Research Conference Urges Profession to Dump Subluxation.” (Ed: No longer available online) Well, I’m here to tell you that nothing even remotely of the kind happened, and I still find it hard to understand why one person, Matthew McCoy, chose to spin the story so inaccurately, especially after (silently) sitting through only one morning of an extensive three-day meeting (the Research Agenda Conference, aka RAC 4) at my invitation (and Palmer’s expense). A responsible journalist who didn’t hear the whole story would have checked not only his facts, but his context as well.
For example, McCoy took me to task for not defending a “hapless Palmer grad.” This person turned out to be Dr. Chuck Henderson, a graduate of Western States Chiropractic College and a member of the faculty at the Palmer Center for Chiropractic Research. Dr. Henderson doesn’t need my help; he does quite well on his own, thank you. Dr. Henderson is currently being funded by the Foundation for Chiropractic Education and Research for a $250,000 study of the effects of spinal subluxation in rats. (Ed. NOTE: This FCER grant led to the publication of 4 very important subluxation studies.) [1-4] The Palmer Center for Chiropractic Research has many other projects that focus on subluxation, health and adjustments, but I’ll save those descriptions for another column.
We’re not talking responsibility here, and we certainly aren’t talking journalism. What we are talking about is the artificial creation of intraprofessional fighting. If external forces seem beyond our control, why not start some altercations closer to home? It’s a heck of a lot easier, but why? What I have come to understand, after my first shock of disbelief at being so thoroughly and deliberately misrepresented, and after having so many of my colleagues assume that McCoy’s version was accurate, is that one easy way to build up a position is with negativity. Henry Kissinger’s memoirs make the point that Nixon knew very well how to politically help himself by defining his enemies’ positions for them, regardless of their true positions.
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By Frank M. Painter, D.C. in Philosophy on May 22nd, 2011 at 2:34 pm
Is Chiropractic At The Crossroads?
The Chiro.Org Blog
Chiropractic & Manual Therapies ~ FULL TEXT
John W. Reggars
Suite1/593 Whitehorse Road, Mitcham, Victoria, Australia 3132. School of Chiropractic and Sports Science, Faculty of Health Sciences, Murdoch University. Murdoch, Western Australia, 6150 reggars@chirofirst.com.au
Background Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia.
Discussion The 1970′s and 1980′s saw a dramatic change within the chiropractic profession in Australia. With the advent of government regulation, came government funded teaching institutions, quality research and increased public acceptance and utilisation of chiropractic services. However, since that time the profession appears to have taken a backward step, which in the author’s opinion, is directly linked to a shift by sections of the profession to the fundamentalist approach to chiropractic and the vertebral subluxation complex. The abandonment, by some groups, of a scientific and evidenced based approach to practice for one founded on ideological dogma is beginning to take its toll.
Summary The future of chiropractic in Australia is at a crossroads. For the profession to move forward it must base its future on science and not ideological dogma. The push by some for it to become a unique and all encompassing alternative system of healthcare is both misguided and irrational.
The FULL TEXT Article:
This paper is the author’s perception of the many changes which have impacted, both positively and negatively, on chiropractic and the chiropractic profession over the past 30 years. Some of those changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes, or lack of changes, have adversely affected the profession’s growth, credibility and the public utilisation of chiropractic services in Australia. It would you also appear, that the crossroads confronting the profession in Australia are not unique, as there are many parallels with what has occurred or is occurring internationally.
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By Brett Kinsler in Podcast on May 7th, 2011 at 11:59 pm
 American chiropractors are frequently directed to countries in Europe and Scandinavia for examples of science based, well integrated chiropractic. Many people assume Australia’s 3700 chiropractors must be practicing in a similar situation. What is chiropractic like down under?
Dr. John Reggars is a chiropractor in Australia who is mad as hell about the current state of affairs. The profession is at yet another crossroads with a history of making the wrong decision and he wants people to stand up and declare their intolerance for the fundamentalist anti-science. His article titled “Chiropractic at the Crossroads – or are we just going around in circles?” is sure to ruffle some feathers both down under and around the globe.
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By Frank M. Painter, D.C. in Research on April 5th, 2011 at 12:28 am
Subluxation Reviewed, Revisited, Revitalized
The Chiro.Org Blog
SOURCE: Dynamic Chiropractic
By Malik Slosberg, DC, MS
Our understanding of the biomechanics and neurology of the subluxation continues to evolve as more research is published which helps explain the nature of this lesion. Historically, the subluxation has been at the heart of the identity and purpose of the chiropractic profession.
Contemporary models provide new insights into this elusive and sometimes mysterious problem which we attempt to find by various clinical means and correct by the application of high-velocity, low-amplitude thrusts. Let’s review past models, but focus primarily on the latest evidence concerning the subluxation published in the recent scientific literature in order to improve our understanding, insight, and application of clinical interventions to improve patient outcomes with chiropractic care.
Older Models of Subluxation: Static Malposition and Pathology
Over the 115-year history of chiropractic, there have been many varied attempts to explain and clarify the subluxation. In the past, descriptions of this lesion were phrased in pathological terms and often included malposition, distortion of the intervertebral foramen and impingement of nerves as primary components. Henderson, et al., [1] described early notions of subluxation as static mechanical lesions, a misalignment or a bone out of place, as seen on a neutral radiograph. The authors explain that this static model has been vigorously challenged in the scientific literature.
Lantz [2] raised concerns about the strictly static, structural interpretation of vertebral subluxation and introduced his own hierarchical model including kinesiopathology, neuropathology, myopathology, connective tissue pathology, vascular abnormalities, as well as inflammatory response, histopathology, and biochemical abnormalities. Similarly, Dishman [3] described the vertebral subluxation complex in terms of various pathologies including neuropathology, myopathology, kinesiopathology, histopathology, and biochemical abnormalities.
Newer Terminology: Functional Spinal Lesion, Joint Dysfunction With Hypomobility, Joint Complex Dysfunction
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By Frank M. Painter, D.C. in Education on March 25th, 2011 at 10:19 am
Is the Spinal Subluxation a Risk Factor?
The Chiro.Org Blog
SOURCE: Dynamic Chiropractic
By Meridel I. Gatterman, MA, DC, MEd
Risk factors come in a variety of distinctions, from those for cardiovascular disease and some forms of cancer to those less than life-threatening but nonetheless undesirable conditions affecting the quality of a person’s life. A risk factor causes a person to be particularly vulnerable to an unwanted, unpleasant or unhealthful event. Risk factors predispose individuals to developing specific conditions. It has been suggested spinal subluxation could be considered such a risk factor. [1]
Subluxation As a Risk Factor
The following questions should be examined if the concept of subluxation as a risk factor is considered:
- Is subluxation of one region of the spine a risk factor for different signs and symptoms as opposed to a subluxation in another spinal area?
- If so, does a subluxation in one area create a different syndrome than when it occurs in a different region?
- Does clinical observation suggest there are different subluxation syndromes associated with different spinal areas? [2]
- Does a subluxation in the upper cervical region cause a different syndrome than a subluxation in the lower cervical region, and does a subluxation of the sacroiliac joint cause a different syndrome than one at a costovertebral joint? Does a patient’s symptomatic complaints and observable signs lead you to suspect a subluxation of one spinal region as opposed to another?
Subluxation Syndromes
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By Frank M. Painter, D.C. in Education on March 24th, 2011 at 9:06 am
The Vertebral Subluxation Syndrome
The Chiro.Org Blog
SOURCE: Dynamic Chiropractic
By Meridel I. Gatterman, MA, DC, MEd
The term subluxation has been used to describe the lesion treated by chiropractors since its inception. D.D. Palmer [1] described it in 1910 as “a partial or incomplete separation, one in which the articulating surfaces remain in partial contact.” Because of confusion by other professions, some within the chiropractic profession would have us abandon the term.
Others have promoted a teaching paradigm: the vertebral subluxation complex (VSC), which has grouped various components in a model focused around the dynamic component of the subluxation. Based on the works of Homewood, [2] Janse, [3] and Faye, [4] this model began being taught at CMCC in the mid-1970s and was later popularizing through the Motion Palpation Institute. [5] Other authors have revised Faye’s early model. The vertebral subluxation complex forms a paradigm for teaching the basic principles of chiropractic theory. By taking the VSC model one step further, the vertebral subluxation syndrome can be used to describe the primary clinical entity treated by chiropractors.
Syndrome has been traditionally used to describe the aggregate of signs and symptoms associated with any morbid process and constituting together the picture of disease. [10] The focus for chiropractors today should not remain the terminology used to describe the vertebral subluxation syndrome, but rather the specific mechanisms whereby this complex aggregate of signs and symptoms is produced by altered spinal joint motion.
Recently, the primary fibromyalgia syndrome has replaced the controversial term fibrositis used to describe a condition that has been written off as psychological at best, with the physiological manifestations either denied or ignored. [11] When the multiple complaints and varied systemic complaints of this condition were recognized as a syndrome, objective investigation was fostered to the benefit of the many patients suffering from the condition.
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By Frank M. Painter, D.C. in Research on January 7th, 2011 at 9:05 pm
Historical Overview and Update on Subluxation Theories
The Chiro.Org Blog
Journal of Chiropractic Humanities 2010 (Dec); 17 (1): 22–32
By Howard Vernon, DC, PhD
Introduction
Manual therapy has, arguably, best been described by a Polish medical manipulation practitioner, Arkuszewski, [1] as “a mechanical therapy with reflex effects.” The phrase mechanical therapy can be further characterized by noting that it is performed in the musculoskeletal (MSK) system. The phrase reflex effects can be further qualified, at the very least, to indicate that these are “health-beneficial.” Therefore, a revised version would read as follows:
“a manually-performed mechanical therapy to the MSK system with health-beneficial reflex effects.”
This formulation also provides a basis for describing the primary disorder posited by chiropractic theory: subluxation. Recognizing that, for chiropractic, the subluxation has always been viewed as the “thing for which adjustment (manual therapy) is done,” a first-pass definition of subluxation, a la Arkuszewski, would be:
“a mechanical problem in the musculoskeletal system with health-deleterious reflex effects.”
Since the founding of chiropractic and the other manual therapy professions, 2 fundamental issues have vexed us:
- What kind and location of mechanical problem in the MSK system qualifies as a subluxation (or any of the other terms used as synonyms within and outside of chiropractic)?
- What kind of health-deleterious effects are specifically associated with subluxation?
The author recognizes that numerous others have attempted to review the subluxation concept, including recent excellent reviews by Gatterman, [2] Peters, [3] and Ebrall. [4] These previously published discussions are not reviewed here. What follows is a nonsystematic overview of selected developments in the profession that have addressed these 2 questions.
Discussion
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By Frank M. Painter, D.C. in Diagnosis on November 20th, 2010 at 12:02 pm
Alteration of Motion Segment Integrity
The Chiro.Org Blog
Dynamic Chiropractic
By Jeffrey Cronk, DC, CICE
Sometimes the internal discourse that is common in our profession seems to get in the way of our acceptance of real help so that we can expand our profession and better serve our patients. Alteration of motion segment integrity (AOMSI) is a significant gift from the AMA that allows us to methodically locate, substantiate and objectively prove the severity of the spinal subluxation. Of course, it comes as a gift only as long as we handle it with a high level of responsibility.
Alteration of motion segment integrity is determined by exact mensuration procedure published in the AMA Guides to the Evaluation of Permanent Impairment. It is a spinal subluxation that can be objectively identified with a high degree of accuracy, especially when one acknowledges the advancements that have occurred in assessment of stress imaging (X-ray, DMX).
Please remember that some of the most significant advancements in functional radiology assessment came from information gained from our profession’s very first federal research grant, awarded in the mid 1970s. It was University of Colorado scientist Chung Ha Suh, PhD, who secured the first chiropractic funding from the National Institutes of Health (NS 12226 01A1). Suh’s main areas of research focused on the development of computerized, kinematic models of the spine and three-dimensional, distortion-free X-ray analysis. This research improved our ability to more accurately measure articular deformations such as AOMSI.
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By Frank M. Painter, D.C. in Education on June 6th, 2010 at 3:07 pm
A new paper published in the March 2010 issue of Chiropractic Journal of Australia, by the esteemed researcher Heidi Haavik Taylor, BSc (Chiro), PhD reviews the neurologic research of the last 15 years to help explain the “Neuromodulatory Effects of the Vertebral Subluxation and Chiropractic Care”. We are grateful to the Editor Editor Rolf E. Peters, DC, MCSc, FICC, FACC for permission to reproduce this full-text article exclusively on the Chiro.Org website!
Continue reading …
By Frank M. Painter, D.C. in Diagnosis on May 16th, 2010 at 8:00 pm
General Causes and Potential Effects of the Subluxation Complex
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 6 from RC’s best-selling book:
“Basic Principles of Chiropractic Neuroscience”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 6: General Causes and Potential Effects of the Subluxation Complex
This chapter reviews the concepts underlying chiropractic articular therapy, with emphasis placed on neurologic implications. General etiology, manifestations, terminology, pertinent anatomical features, and applications are described.
SPINAL SUBLUXATION: CAUSES AND EFFECTS
Until the last 2 decades, most evidence about the success of chiropractic adjustments on the correction of vertebral subluxations and their related functional disturbances was empiric. The gap between controlled research documentation and frequent clinical observation still exists, but it has greatly narrowed in recent years.
The greatest concern today is not is it effective but why is it effective and why is it effective in some cases but not in others that appear almost identical? Added to these can be the questions: what causes the positive effects in a specific body area that result from spinal adjustments that cannot be explained on an anatomical basis and what causes the indirect, far-reaching, diverse improvement in function so often witnessed?
Continue reading …
By Frank M. Painter, D.C. in Education on November 1st, 2009 at 8:26 pm
What is the Vertebral Subluxation Complex?
The Chiro.Org Blog
Submitted for your approval is an article written by Joseph M. Flesia, D.C. that is archived on our Chiropractic Subluxation Page. I hope you will find it of interest!
The Vertebral Subluxation Complex Part II: An Outline
FROM: ICA International Review of Chiropractic 1992 (Oct): 19-23
Many correlative and singular studies have been made in the areas of the five components of the Vertebral Subluxation Complex. Some researchers have used the exact titles of the individual components as mentioned in this review. Others report synonymous scientific nomenclature. Ongoing scientific research will and has added more components and subcomponents to the vertebral subluxation complex than presented in this brief outline. However, the following outline will provide the reader an excellent foundation relative to the component basis of the vertebral subluxation complex. This will allow new information to fit into this previously established, scientifically ordered model.
Component #1: Spinal Kinesiopathology (Spinal Pathomechanics, Abnormal Spinal Biomechanics, etc.)
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By Frank M. Painter, D.C. in Diagnosis on October 19th, 2009 at 4:27 pm
Neuroconceptual Models of Chiropractic
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 5 from RC’s best-selling book:
“Basic Principles of Chiropractic Neuroscience”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 5: NEUROCONCEPTUAL MODELS OF CHIROPRACTIC
by Gary C. Johnson, DC
This chapter offers a review of the highlights of preceding chapters that concern subluxation syndromes and forms a foundation of thought for following chapters.
INTRODUCTION: EXPLANATION OF CONCEPTUAL MODELS
Conceptual models are collections of ideas, principles, facts, philosophy, and experiences setting our attitudes and directing our behavior. Ideas and principles include hypotheses and theories (whether right or wrong) that generate new attitudes and behavior, the spirit of invention, and the accessibility to important facts.
Scientific facts and our philosophical hierarchy of importance (priority) provide selective (choice) groupings of knowledge and thoughts, comfortably placed in support of our experiences. How we perceive what we do, why we do it, why the results, and how the results occur set attitudes and practice activities and change our minds and activities as new concepts are developed and tested.
CLASSIC CONCEPTS OF THE CHIROPRACTIC SUBLUXATION
The structural spinal fault, the associated nerve involvement, and the ensuing functional alterations comprise classic chiropractic subluxation concepts. In contrast, limited concepts of spinal biomechanical faults, modes of possible nerve involvement, and etiologic rationales of functional changes promote narrow viewpoints, disciplines, and therapeutic approaches, as well as foster empiricism and dogma. Awareness of the varied concepts of structural lesions, neuroinsults, and the causes of abnormal functional changes promotes wider perspective for intuitive practices, multifaceted observations, and fewer practices with reliance on empiricism that is dictated by dogmatic frameworks.
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By Frank M. Painter, D.C. in Diagnosis on October 15th, 2009 at 8:14 am
Upper Extremity Technique: Adjustment of Upper Extremity Joint Subluxations-Fixations
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 2 from RC’s best-selling book:
“Upper Extremity Technique”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 2: Adjustment of Upper Extremity Joint Subluxations-Fixations
This chapter describes adjustive therapy as it applies to articular malpositions of the lateral clavicle, shoulder, elbow, wrist, and hand. Manipulations to free areas of fixation are also covered.
Screening Tests for the Upper Extremity as a Whole
The Shoulder Girdle
As with other areas of the body, it is good procedure during observation to first note the general characteristics and then inspect for details. Visualize the anatomy involved while observing the overall bilateral symmetry, rhythm of motion, swing during gait, smoothness in reach, patterns of pain, and general circulatory and neurologic signs. Inspect for gross abnormal limb rotation or adduction. Note skin discolorations, masses, scars, blebs, swellings and lumps, abrasions, and overt signs of underlying pathology. Carefully note the biomechanical relationship of the neck with the shoulder girdle and both with the thorax. Observation should be conducted on all sides.
With the patient sitting, inspect the anterior aspect of the shoulder girdle starting with the clavicle. A fracture or dislocation at either the medial or lateral end of the clavicle is usually quite obvious by the apparent change in contour and exaggerated round shoulders to protect movement. Note the normally symmetrical fullness and roundness of the anterior aspect of the deltoid as it drapes from the acromion over the greater tuberosity of the humerus. Unusual prominence of the greater tuberosity of the humerus suggests deltoid atrophy, while a sharp change in contour unilaterally suggests dislocation. A forward displacement of the tuberosity exhibits an indentation under the point of the shoulder and a loss of normal lateral contour. The most common points of abnormal tenderness are at the acromioclavicular joint and in the rotator cuff.
To test the general integrity of the shoulders, have the patient place the hands on top of the head and pull the elbows backward. This will be painful, if not impossible, in shoulder bursitis, arthritis, and rotator-cuff strains. Apley’s scratch test is another good screening procedure. Note if the scapula and humerus move in harmony.
Branch points out that spasm above or over the scapula will be readily recognized if the examiner observes the patient from the back during horizontal abduction. If such spasm exists (eg, from cervical radiculitis), horizontal abduction of the arm will occur with little motion of the scapula. However, if the origin of pain is within the shoulder, a “shrugging” motion occurs, in which the apex of the scapula sharply swings laterally but glenohumeral motion is restricted.
The Elbow and Forearm
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By Frank M. Painter, D.C. in Diagnosis on October 1st, 2009 at 9:47 am
Sports Management:
Basic Spinal Subluxation Considerations
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 19 from RC’s best-selling book:
“Chiropractic Management of Sports and Recreational Injuries”
Second Edition ~ Wiliams & Wilkins
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 19: Basic Spinal Subluxation Considerations
The concept that an “off centered” vertebral or pelvic segment parallels a unique effect upon the neuromuscular bed which may be the cause of, aggravation of, or “triggering” of certain syndromes is a major contribution to the field of functional pathology and clinical biology by the chiropractic profession.
This section discusses the basic biomechanics and effects of vertebral subluxations as related to the management of sports-related and recreational injuries .
Spinal Biomechanics
While the erect spinal column is a concern in static postural equilibrium, it is never actually in a static state in life. It is alternately changing from a state of “quiet dynamics” in the static postural attitude to a state of “active dynamics” in movement. These kinetic aspects of normal spinal biomechanics are an important consideration since the totality of spinal function is the sum of its individual component parts.
The Vertebral Motor Unit
An intervertebral motor unit consists of two vertebrae and their contiguous structures forming a set of articulations at one intervertebral level. Thus, what is called a vertebral “subluxation” in chiropractic is the alteration of the normal dynamics, anatomical or physiological relationships of contiguous articular structures. The components of the spinal column (the vertebral motor units) confer a quality and quantity of motoricity to the relationship of two vertebrae. They are firmly interconnected by the intervertebral disc and restraining ligaments, which are activated by muscles which respond to both sensory and motor stimulation.
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By Frank M. Painter, D.C. in Diagnosis on September 24th, 2009 at 11:11 am
An Introduction to the Principles of Chiropractic
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 1 from RC’s best-selling book:
“Basic Principles of Chiropractic Neuroscience”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 1: An Introduction to the Principles of Chiropractic
by Frank Zolli, D.C.
Chiropractic is that branch of the healing arts which is composed of a distinct philosophy, art, and science. Art and science may lead the practitioner to answer how and where to treat a patient, but it is the principles of chiropractic philosophy that give purpose to the adjustment. The principles of chiropractic answer the question Why?
NATURE AND SCIENCE
It has long been recognized that nature is much smarter than man. However, this fact has somehow been lost in the wake of the technologic advances that have engulfed man. This is not to say that progress should not be achieved, nor is it an argument for the maintenance of the status quo.
A prime characteristic of life is the ability of an organism to change and adapt to its environment. This adaptation mechanism is a basic component of chiropractic thought. However, as happen in any changes that occur, there are benefits and liabilities that are the direct result of these changes.
Science that exists for the sake of science, with little or no attention to the sociologic complications of its actions, may produce change. It may even produce progress, but at what cost? A world that is enhanced by nuclear power but unable to deal efficiently with the potential of a nuclear disaster is a world of fear and confusion. Perhaps if science could be sensitive to the community of people that it serves, the progress it achieves will be better integrated in the day-to-day living of the public.
Likewise, other institutions must meet the challenge of confronting technologic change and incorporating it into our daily living. Church and state should grow and evaluate its positions regarding those ideas that have long been the core of its policies. Change that is essential to an organism must also be essential to the system within which the organism exists; otherwise, there is conflict.
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Introduction to Sports-related Health Care