Chiropractors are best known for treating back and neck pain. But can their hands-on manipulations of the spine also help with colic, asthma, ear infections, allergies and digestive issues?
Though it’s a controversial notion, some chiropractors are aggressively marketing themselves as holistic, primary-care healers who can treat a broad scope of ailments ranging from acid reflux to infertility. Others in the field say chiropractors should focus on musculoskeletal disorders such as back pain, where evidence for efficacy is the strongest.
The internal philosophical divide has given the profession a confusing image, making it difficult for consumers to know when, if ever, they should visit a chiropractor.
“We often hear from chiropractors that ‘chiropractic is more than just back pain.’ But is it?” Rhode Island chiropractor Donald Murphy asked in a commentary published last year in the journal Chiropractic and Osteopathy. “And more importantly, does it have to be?”
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Though conventional practitioners have often scorned them for making unfounded claims, chiropractors are now established as mainstream health-care providers. Many health plans and Medicaid now cover their services, and they regularly care for clients ranging from the chronically ill to professional and Olympic athletes. An estimated 8.6 percent of adults in the United States use chiropractic or osteopathic manipulation, according to the National Center for Complementary and Alternative Medicine.
Chiropractors typically apply a sudden force to a region of the spine to help loosen a stiff joint, which they say allows the body’s natural healing process to take over. During an initial visit, the chiropractor typically takes a health history and performs a physical exam, focusing on the spine. X-rays may be taken, and spinal “adjustments” may be applied with a patient lying face-down or sideways on a table.
Experts say there is evidence the treatments can lessen lower back pain, even if researchers have yet to figure out exactly why.
A non-drug, nonsurgical approach, the manual treatments can be “a good adjunct to musculoskeletal care,” said Dr. Joel Press, medical director of the Spine and Sports Rehabilitation Center at the Rehabilitation Institute of Chicago, which employs two chiropractors.
At Chiro One Wellness Centers, however, spinal adjustments are used to treat a wide variety of ailments seemingly unrelated to the spine. Moreover, anyone is encouraged to come in for regular maintenance to prevent disease from occurring.
“We call it spinal hygiene,” said chiropractic physician Ashlin Gasiorowski, clinic director of the Chiro One center in Evanston, Ill., one of 38 locations in Illinois and Kentucky. As many as 180 people a day visit his strip mall-based clinic for quick adjustments. “A lot of our patients are here for wellness.”
The Chiro One philosophy stems from a concept of chiropractic manipulation from the late 1800s that many view as unscientific and outdated. The theory holds that the spine is the key to our overall health and that human illnesses arise from “subluxation,” a term chiropractors use for misalignment of the spine. That distortion allegedly interferes with the ability of the brain to control the body.
“The premise was and still is that the spine and the nervous system are the master systems which control and coordinate all function in the body,” said Chiro One Chief Executive Stuart Bernsen. “If there is interference in the communication between the brain and the spinal cord to their end organs or tissues, then those end organs or tissues cannot function properly.”
The subluxations can be caused by physical issues such as falling or repetitive movements, as well as mental and emotional stress, Bernsen said. They “affect the health of your nerves, ligaments, discs and joints, weaken your muscle and alter the energy that flows from your brain and nerves to all parts of your body,” the Chiro One promotional literature says. “Your internal organs may get less blood, even your brain may get less oxygen!”
Chiropractors can help, according to the subluxation theory, by removing the pressure.
Ultimately, Bernsen wants Chiro One to be the dominant provider of chiropractic care so it can “define for the public what (chiropractic medicine) is, how to use it and how to benefit,” he said.
“Chiropractic is very ill-defined,” Bernsen said. “You can go to five chiropractors and have five different experiences. We want to shift the paradigm of how consumers use a chiropractor.”
But only a minority of chiropractors still adhere to the original theories of the spine as a source of ill health. On the other end of the spectrum are chiropractors who use a more modern, evidence-based approach that focuses on the diagnosis, assessment and treatment of musculoskeletal conditions using a variety of techniques, with the exception of prescription drugs and surgery.
“This business of ‘all disease stemming from spine,’ there’s no evidence to support that,” said chiropractic physician Jim Winterstein, president of the National University of Health Sciences in Lombard, one of 18 accredited chiropractic schools in the country. “And I’d never suggest the adjustment of spine is the answer to human ailments. It plays a role like exercise and nutrition and lifestyle changes. All are tools.”
Winterstein also disputes claims that regular adjustments can help improve overall health, again citing a lack of science.
“We have anecdotal evidence that people seem to get healthier – when you manipulate the spine and affect the nervous system, dramatic things sometimes happen — but that’s the most we can say at this point,” he said. “I release people (from treatment) when they become symptom-free, and they can come back for regular adjustments, but it’s their choice.”
Skokie’s Jordan Sims, 72, a regular at Chiro One for four years, credits his back and neck adjustments with treating his sciatica and lowering his blood pressure and says his entire body feels better. “I need the constant care,” he said. “If you go away, you eventually get out of balance.”