Analysis and Adjustment of Vertebral Subluxation as a Separate and Distinct Identity for the Chiropractic Profession: A Commentary

Abstract

ObjectiveThe purpose of this paper is to discuss various statements related to chiropractic identity from1 D. D. Palmer2; selected chiropractic organizations, associations, and colleges; and3 attitudes and perceptions of chiropractic from chiropractic students, practitioners, and patients.DiscussionFor comparison purposes, identity statements and perceptions from the various chiropractic associations and colleges, as well as from students and patients, were explored. Identity statements for chiropractic were searched in various sources such as Palmer’s 1910 textbook, recent literature on viewpoints from chiropractic students and practitioners, and websites for chiropractic colleges and organizations. Palmer taught that the chiropractor’s focus was on vertebral subluxation. Today, a number of chiropractic colleges and organizations continue to include the vertebral subluxation model in their instruction, with a majority of students and practitioners subscribing to the model. Conversely, a number of other colleges and organizations portray chiropractic as being essentially about the treatment of back and neck pain, which is what patients associate with chiropractic. However, settling on any particular identity for the chiropractic profession will likely be met with resistance by some, given the plethora of opinions among chiropractic professionals as to what the identity of the chiropractic profession should be. Common ground between the different factions within the chiropractic profession might be found in a unifying expression such as “functional neurology.”ConclusionWhen a profession’s identity is not clear with respect to its area of interest and mission, then the public may be less inclined to seek its services. Identifying the chiropractic profession with a focus on vertebral subluxation would give the profession uniqueness not duplicated by other health care professions and, therefore, might legitimatize the existence of chiropractic as a health care profession. An identity having a focus on vertebral subluxation would also be consistent with the original intent of the founding of the chiropractic profession.

The prevalence of the term subluxation in chiropractic degree program curricula throughout the world

“…The professional identity rationale argues that the subluxation is what separates the profession from other health care professions. Without the subluxation (and its accompanying philosophy), it is argued that chiropractors would be nothing more than physical therapists who use spinal manipulation [ 9 ]. In the US alone, there are 18 chiropractic college programs.…”

Vitalism in contemporary chiropractic: a help or a hinderance?

“…Callender argues for a vitalistic chiropractic paradigm because it is a good fit with contemporary general systems theories [135]. Well into the twenty-first century Hart suggests the profession's identity should be in line with the vitalistic founding principle of analysis and adjustment of vertebral subluxation to enhance wellbeing [136]. Similarly, Richards, Emmanuel and Grace posit that vitalistic chiropractic is a viable replacement for what they argue is a failing biopsychosocial model of health care [8] as does Russel [137].…”

Chiropractic students’ cognitive dissonance to statements about professional identity, role, setting and future: international perspectives from a secondary analysis of pooled data

“…The most documented contemporary ideological subgroups within the chiropractic profession can be broadly characterised by those who support a vitalistic philosophy with a focus on the ‘chiropractic vertebral subluxation’ and those who advocate for a science-based, biopsychosocial and musculoskeletal/spine focus [ 2 , 3 ]. It is argued that detection and correction of ‘chiropractic vertebral subluxation’ is a separate and distinct paradigm [ 4 ] that provides chiropractic with a unique (vitalistic) identity [ 5 ]. Conversely, others argue that an ongoing devotion to vitalism is an impediment to providing best clinical care and inclusion in multi-disciplinary models of practice [ 6 – 8 ].…”