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Other common
name(s): chiropractic techniques, spinal manipulation
Scientific/medical
name(s): none
Description
Chiropractic is a health care system that focuses on the
relationship between the body's skeletal and muscular structure and its
functions. Treatment often involves manipulating the bones of the spine
to correct medical problems. Other methods may also be used.
Overview
Available scientific evidence does not support claims that
chiropractic treatment cures cancer or any other life-threatening
illness. However, chiropractic treatment has been shown to be effective
in treating lower back pain and other pain caused by muscle or bone
problems. It can also promote relaxation and stress reduction.
How is it promoted for use?
Chiropractic is most commonly used for back pain and other
pain from muscle or bone problems. However, some chiropractors claim to
be able to treat health problems such as heart disease, epilepsy,
impotence, and allergies. They claim the spine plays a vital role in
nearly all health problems.
The basic concept of chiropractic is that illness stems from
underlying "subluxations," or spinal bones that are slightly out of
place. These are thought to affect the nerve bundles as they branch off
the spinal cord. Chiropractors do not treat the illness directly.
Instead, they seek to correct the spine-related cause.
Chiropractic is based on the idea that the human body has the
ability to heal itself, and that the body always seeks to maintain a
balance among its systems and organs. Practitioners claim this is
achieved through the nervous system. Illness is thought to result from
a compression of the nerves from muscle spasm or abnormal position of
the joints. Chiropractors claim manipulating the spine can correct
compressed nerves and other unnatural relationships between bones and
nerves.
What does it involve?
The chiropractor first diagnoses the person's ailment through
a personal interview, examination, and x-rays of the spine. The
person's flexibility and posture also may be examined. Electrical
activity of the nerves and muscles may be measured. The exam is
designed to pinpoint the source of the symptoms. For example, if a
person complains of a pain in the shoulder, the chiropractor may search
for the cause of the pain in the spinal column. Then the chiropractor
will try to restore proper alignment and nerve function by adjusting
the bones of the spine, called the vertebrae.
The patient usually lies down on a special treatment table.
The chiropractor stands by the table and uses hands, elbows, and
specially designed equipment to adjust and align the bones of the
spine. Some chiropractors may also use heat, ice, electrical current,
massage, vibration, traction, and other methods. They may prescribe
exercises to correct health problems, especially those that involve the
skeletal and nervous systems.
What is the history behind it?
Chiropractic comes from the Greek words cheir (hands) and praktikos
(efficient). It was practiced by priest healers in ancient Egypt and
for centuries by Asian healers. Modern chiropractic was founded by
Daniel D. Palmer, a grocer and magnetic healer. Palmer applied his
knowledge to a man who had lost his hearing in the 1890s. The man
remembered that something had "popped" in his back just before his
hearing loss. Palmer saw that a vertebra was out of place and was able
to thrust it back. After this, the man's hearing was restored. Although
Palmer wasn't the first to use this technique, he was the first to use
the vertebrae's bony bumps as levers to shift their position. Palmer
founded the first chiropractic school in 1897. In the 3 decades that
followed, other chiropractic colleges were opened and a variety of
concepts developed regarding how to approach the practice of
chiropractic.
Chiropractic colleges require at least 4 years of academic and
professional training. The Council on Chiropractic Education
establishes accreditation criteria for education. Around 60,000
licensed chiropractors were practicing in the United States as of 2005;
the number is projected to reach about 100,000 by the year 2010.
What is the evidence?
Many studies have suggested chiropractic is effective in
treating lower back pain and other pain due to muscle or bone problems.
However, one study showed that people with scoliosis, a condition in
which the spine curves abnormally, did no better when treated by
chiropractors.
Chiropractic has been studied for many conditions and is
thought to be helpful mainly for muscle and bone problems.
Unfortunately, the research methods used in studies of chiropractic
have often not meet scientific standards for clinical research well
enough to prove that there is a relationship between chiropractic
treatment and the outcome. Researchers looking at the overall quality
of studies found weaknesses in the way they were conducted and
interpreted. Because of this, most studies cannot be used to reach
strong conclusions.
Some evidence does suggest that tension headaches may respond
to chiropractic treatment. Studies of chiropractic treatment for
migraine headaches , however, have mostly shown little benefit. One
exception is a recent randomized, controlled trial of people with
frequent migraine headache. The results suggested that those who
received chiropractic care had less frequent and less severe headaches
over several months of follow-up. They also required less pain medicine
than those who were not treated with chiropractic.
Are there any possible problems or
complications?
Chiropractic is considered fairly safe. However, there have
been some reported cases of paralysis, blindness, and, in rare cases,
death following chiropractic care. There have also been reports of
misdiagnoses of patients' conditions, resulting in delayed medical care
and worse outcomes. In several people with cancer, paralysis of the
legs and full-body paralysis developed after manipulation of the spine
when cancer had spread to and weakened the bones.
People with bleeding problems or those those taking
blood-thinning medications may have a higher risk of stroke caused by
manipulation of the spine. People with cancer and chronic conditions
such as arthritis, heart disease, and weakened bones should talk to
their doctors before having any type of therapy that involves
manipulation of joints and muscles.
Relying on this treatment alone and delaying or avoiding
conventional medical care for cancer may have serious health
consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Abenhaim L, Bergeron AM. Twenty years of randomized clinical
trials of manipulative therapy for back pain: a review. Clin Invest Med.
1992;15:527-535.
Aetna InteliHealth. Chiropractic, Spinal Manipulative Therapy,
Spinal Manipulation. Accessed at: http://www.intelihealth.com on June
2, 2008.
Agency for Health Care Policy and Research. Acute pain
management: Operative or medical procedures and trauma. Rockville, Md;
1992. Publication AHCPR 92-0032.
Alternative Medicine: Expanding Medical Horizons. A Report to
the National Institutes of Health on Alternative Medical Systems and
Practices in the United States. Washington, DC: US Government Printing
Office; 1994. NIH publication 94-066.
Canter PH, Ernst E. Sources of bias in reviews of spinal
manipulation for back pain. Wien
Klin Wochenschr. 2005;117:333-341.
Cassileth B. The
Alternative Medicine Handbook. New York, NY: W. W. Norton
& Co; 1998.
Coulter ID, Shekelle PG. Supply, Distribution, and utilization
of chiropractors in the United States:Training, Practice, and Research.
Agency for Health Care Policy and Research. December 1997; Publication
No. 98-N002.
Ernst E. Ophthalmological adverse effects of (chiropractic)
upper spinal manipulation: evidence from recent case reports. Acta Ophthalmol Scand.
2005;83:581-585.
Lantz CA, Chen J. Effect of chiropractic intervention on small
scoliotic curves in younger subjects: a time-series cohort design. J Manipulative Physiol Ther.
2001;24:385-393.
Shekelle PG, Adams AH, Chassin MR, Hurwitz EL, Brook RH.
Spinal manipulation for low-back pain. Ann Intern Med.
1992;117:590-598.
Spencer JW, Jacobs JJ. Complementary/Alternative
Medicine: An Evidence-Based Approach. St. Louis, MO:
Mosby, Inc; 1999.
Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial
of chiropractic spinal manipulative therapy for migraine. J Manipulative Physiol Ther.
2000;23:91-95.
van Tulder MW, Furlan AD, Gagnier JJ. Complementary and
alternative therapies for low back pain. Best Pract Res Clin Rheumatol.
2005;19:639-654.
Wang CC, Kuo JR, Chio CC, Tsai TC. Acute paraplegia following
chiropractic therapy. J
Clin Neurosci. 2006;13:578-581.
Note: This information may not cover
all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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