Modern Chiropractic: Understanding its Origin, Development and Current State
Like many people across the world, chances are you’ve probably encountered an episode of lower back pain in your life that was so bothersome that it made you desperate to seek relief. The World Health Organization has reported that “In 2020, low back pain (LBP) affected 619 million people globally and it is estimated that the number of cases will increase to 843 million cases by 2050.”
The question that arises is who should you see that can help best?
While you have many options for help, have you ever thought about visiting a chiropractor? Perhaps you have; perhaps you considered it at one point but then caught wind of some of the negative stigma regarding chiropractic care. Many people have wonderful experiences with chiropractic care and have fallen in love with one of its many respectable practitioners, however it's still common to hear the stigma surrounding it.
Admit it, we’ve almost all heard the criticisms leveled at chiropractors over the years. You might next be thinking, is it true, and are ALL chiropractors the same? Why is there this perception that chiropractic is an archaic form of pseudoscience? Are there any good ones?
Well, in order to understand this, it's important to first delve into where chiropractic came from, what it was, and what it has come to be.
Now, chiropractic as a profession has existed for over a hundred years, with its claim to fame, “spinal manipulation” – the back cracking– having arguably existed in many cultures for hundreds more. No doubt, it is clear to expect an evolution in the scope and approach of the chiropractic profession over this lengthy course of time.
Indeed, the discipline of chiropractic has a rich history filled with countless debates regarding its own models, theories and applications. As such, there exists a multitude of different approaches to clinical chiropractic care that can be categorized into two broad, overarching groups. Each of which represents a distinct set of beliefs and practices.
The Old Approach
As much as we’d prefer to forget, unfortunately, in the profession there does exist a style of chiropractic based on primitive beliefs and theories regarding the underlying cause of unwellness and malady. Members of this loosely-defined group may incorporate philosophical beliefs that all health is determined primarily by the alignment of the spine. Spinal integrity to them, allows the flow of an innate “life-force” – which if disrupted by any means, would lead to symptoms of unwellness. This vital ‘life-force’ is similar to the Chinese concept of Chi, which is the flow of energy, strength and health throughout the body.
This type of practitioner traditionally focuses solely on the manipulation/adjustment of the spine in order to address disruptions in alignment and hopefully restore balance to the body. These hypothetical disruptions to the spine, known to some as spinal “subluxations” are thought by them to negatively affect the nervous system, which they believe is the vessel for the aforementioned “life-force”.
This crude belief system was once pioneered by the founders of chiropractic over a century ago, at a time where most health-related disciplines were bound by theories considered laughable in today’s age of modern science!
Seriously, one hundred years ago a frequent practice amongst medical doctors was to forcibly bleed you out in order rid the body of the most common illnesses and diseases! Bloodletting has since fallen out of common practice thankfully, outside of a few very particular indications for use. But we shouldn’t judge a profession on what it used to be… Right?
Relying on traditional views of old however, this group of chiropractors, sometimes referred to as “vitalistic” or “straight chiropractors” are likely in the vast minority these days. And some of these problematic assumptions and models still provide the basis of some of these practitioners' clinical approach. Fortunately, like other health professions which embrace the boldness of their pioneers while continuing to challenge past concepts and innovate in the profession, chiropractic has seen its fair share of evolution, progression and modification leading up to the modern day.
The New Approach
The opposing school of practitioners, which many would refer to as “modern chiropractors”, has been steadily growing in recent decades. This group, colloquially referred to as “mixers” or “evidence-based” practitioners intend to shed the garb of chiropractic’s old dogmas in favor of a more scientifically-infused approach. Embracing the scientific method to modern chiropractors was the cornerstone to their profession, allowing them to incorporate different models and techniques in favor of out-dated or pseudo-scientific principles masked as philosophy. Decades of research, study and innovation allowed them to transform the profession from a philosophical dogma to an evidence-based system of healthcare.
As opposed to traditional chiropractic philosophy, modern chiropractic considers a biopsychosocial approach to healthcare which serves to view health as more than a simple lack of disruptions in the spine but also considers a patient's wellbeing in context of interconnecting biological, psychological and social factors.
Although modern chiropractors still largely incorporate spinal manipulation in their repertoire, it serves as a supplementary therapy to improve patient’s conditions, not simply the solution itself. In fact, many modern chiropractors may choose not to adjust the spine at all during visits! After all, there are cases where there is a more beneficial approach.
Additionally, to this group, spinal manipulation does not “restore” or “realign” the patient’s spine, but rather it is believed, based
on scientific investigation, to restore proper motion and functionality to spinal segments that can have a myriad of positive neurophysiological outcomes such as:
- pain reduction
- increased range of motion
- stiffness or spasm relief
- increased functional strength
A general consensus of modern chiropractic is that spinal manipulation, or manipulation of any joint of the body, is most effective when used in conjunction with other therapies such as physical exercise, lifestyle modification, nutritional advice and patient education.
Considering this multimodal approach of evidence-based chiropractors, it is important that they be viewed as more than simple spine-specialists who are champions of manual manipulations, but rather as primary care neuromusculoskeletal experts who incorporate a variety of patient-centered approaches to help people attain their specific healthcare goals.
As such, a chiropractor’s scope of practice can reflect further specializations such as:
- sports-injury management
- concussion care
- orthotics and gait assessments
- nutrition counseling
To modern chiropractors, health isn’t seen simply as the absence of disease or spinal misalignment but rather the ability to live a meaningful, functional life. A good chiropractor will investigate what is meaningful to YOU, what you want to do most, and how to allow you to do it. In this sense, visiting a chiropractor shouldn’t be a passive experience, rather it's also an active engagement to give you the tools to live your most fulfilling life possible! Ask us how the modern chiropractic approach can help serve YOU.
About the author: Dr. AJ Husain is an evidence-based Chiropractor with a passion for helping people achieve their healthcare goals. He has worked with a broad range of patient-types and has a particular interest in sports medicine and physical rehabilitation.