Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine

Abstract

Chiropractic is a large and well-established health care profession in the United States. In this overview, we briefly examine the development of chiropractic from humble and contentious beginnings to its current state at the crossroads of alternative and mainstream medicine. Chiropractic has taken on many of the attributes of an established profession, improving its educational and licensing systems and substantially increasing its market share in the past two decades. The public increasingly uses chiropractic largely for spinal pain syndromes and appears to be highly satisfied with the results. Of all the so-called alternative professions, chiropractic has made the largest inroads into private and public health care financing systems and is increasingly viewed as an effective specialty by many in the medical profession. Much of the positive evolution of chiropractic can be ascribed to a quarter century-long research effort focused on the core chiropractic procedure of spinal manipulation. This effort has helped bring spinal manipulation out of the investigational category to become one of the most studied forms of conservative treatment for spinal pain. Chiropractic theory is still controversial, but recent expansion in federal support of chiropractic research bodes well for further scientific development. The medical establishment has not yet fully accepted chiropractic as a mainstream form of care. The next decade should determine whether chiropractic maintains the trappings of an alternative health care profession or becomes fully integrated into all health care systems.

Cloth-covered chiropractic treatment tables as a source of allergens and pathogenic microbes

“…1,2 At some point, about one third of people with low back pain will consult a doctor of chiropractic for their pain. 2 Although chiropractic care may involve a variety of physical medicine procedures, the typical treatment will use manipulation to the spine with the patient placed prone on a specialized treatment table that has a split facial piece to accommodate the head with the spine in a neutral position. Usually, tables are covered in a vinyl surface; but some tables are covered in cloth fabric.…”

Chiropractic management of a 47-year–old firefighter with lumbar disk extrusion

“…39 Noteworthy to this patient's case was that he was misdiagnosed while under previous chiropractic care with a piriformis syndrome, and disk pathology was not suspected. Side posture HVLA is the most common treatment modality used by chiropractors, 40,41 as was the initial care in this case. Therefore, it is questionable as to whether other techniques would have been used had a pathologic disk been suspected regardless of the primary diagnosis.…”

Analgesia adjuvante e alternativa

“…Esta massagem antiálgica alternativa não exclui a terapêutica clínico-cirúrgica clássica, pois sua eficácia ainda não está plenamente estabelecida em ensaios clínicos mais rigorosos. Sua prática é aceita nos sistemas de saúde com base numa dupla crença: que o sistema nervoso é o mais importante determinante da saúde; que muitas algias lombares, dorsais, cervicais e da cabeça são causadas por subluxação espinal que responde de modo favorável à manipulação adequada [43][44][45][46][47][48][49][50][51][52][53][54][55][56] .…”