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Chiropractic

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 (moving) 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 help treat 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 say that they are 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 pressure on the nerves from muscle spasm or abnormal position of the joints. Chiropractors claim manipulating the bones of 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. This 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 special 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 met a man who had lost his hearing in the 1890s. The man remembered that something had "popped" in his back just before he lost his hearing. Palmer reportedly touched the man's back and felt a vertebra that was out of place. Palmer later wrote in his notes that soon after he "racked [the vertebra] back into position…the man could hear as before." Although Palmer wasn't the first to move the bones of the spine, he was reported to be 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. Licensed chiropractors held between 49,000 and 53,000 jobs in the United States as of 2008; the number is projected to reach nearly 59,000 by the year 2018.

What is the evidence?

Many studies have suggested chiropractic is helpful 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. This is why 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. However, one randomized, controlled trial looked at people with frequent migraine headaches. The results suggested that those who received 2 months of chiropractic treatment had less severe migraines less often over 6 months of follow-up. They also required less pain medicine than those who were not treated with chiropractic. Further studies in large groups are needed to confirm this effect.

Are there any possible problems or complications?

Chiropractic is considered fairly safe, but some people will have mild stiffness or soreness after treatment. There have been some rare reported cases of paralysis, blindness, and, in very rare cases, death following chiropractic care. A 2010 review of prior medical publications identified 26 cases of death following chiropractic manipulation of the neck, which the researcher interpreted as resulting from damage to arteries that supply blood to the brain.

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 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 (1-800-227-2345).

Dietary Supplements: What Is Safe?

The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

References

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Aetna InteliHealth. Chiropractic, Spinal Manipulative Therapy, Spinal Manipulation. Accessed at www.intelihealth.com on December 8, 2010.

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.

Bureau of Labor Statistics. Occupational Outlook Handbook, 2010-2011 Edition. Accessed online at http://www.bls.gov/oco/ocos071.htm on December 8, 2010.

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.

Ernst E. Ophthalmological adverse effects of (chiropractic) upper spinal manipulation: evidence from recent case reports. Acta Ophthalmol Scand. 2005;83:581-585.

International Chiropractic Association. Quick Facts. Accessed at http://www.chiropractic.org/index.php?p=chiroinfo/main on December 8, 2010.

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.

Leon-Sanchez A, Cuetter A, Ferrer G. Cervical spine manipulation: an alternative medical procedure with potentially fatal complications. South Med J. 2007 Feb;100(2):201-3.

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.

World Chiropractic Alliance. The History of Chiropractic. Accessed at http://www.worldchiropracticalliance.org/consumer/history.htm on March 1, 2011.

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: 03/07/2011
Last Revised: 03/07/2011