The next step in Chiropractic research – proof of Chiropractic’s BIG PICTURE
STEP 1 in UNDERSTANDING – 2015
In a recent published article by Sampath et al (2015) titled Measurable Changes in the neuro-endocrinal mechanism following spinal manipulation, the authors states “A theory is proposed that spinal manipulation as the potential to be used as a tool in restoring the autonomic nervous system balance.” This is an important first step in researching the effects of the chiropractic adjustment on the autonomic nervous system. We have all experienced these types of changes, but being able to influence academics and politicians takes proof, whether you like it or not, that is the way it is. Let’s take a quick look at the “flow” of chiropractic theory over the years.
Subluxation – “Bone out of Place” – this was the “Green Book” territory [1895 – 1960] and was the foundation of our profession. I won’t be going into this in depth, since every one of you “gets this”. The point that I would like to make, is not about the details of this paradigm, but its sequella. Every one of these theories has the same consequences in the end, that is mechanical and nervous system dysfunction. This model had provided a very primitive explanation of a complex problem, that was consistent with the times and the science we had available to study and answer these questions. All scientific concepts require evolution and your profession is no different.
Biomechanical/Fixation/Spinal Compensation Model – this was the next major chiropractic model that started somewhere in the late 1960’s and into the 1970 and carried us into 2005-2010. The focus was on spinal segment joint fixation and spinal compensatory changes. The basic overview of these concept was from an engineering and structural model. There are very good concepts within this model, this was the one that I was educated on at National 1994-1997. The issue was however that there was such a focus on mechanics that we left out the effects on the central and autonomic nervous system. This type of approach was expanded upon by doctors such as Faye and groups like the Motion Palpation Institute out of California.
Gate Control Theory of Pain – this theory of pain modulation is not a chiropractic theory, it is the most current model of how pain is regulated in the central nervous system – this is posted in the Video Section and was the topic I presented to the neurology residents at University of Buffalo Medical School. Most of the current research coming out is showing the following, 1: there is a “threshold” to the chiropractic adjustment in relation to stimulation of the CNS, that is why “mobilization” does not work. 2: Adjustment in one area of the spine can affect all other areas of the body, reducing pain sensitivity, 3: Chronic dysfunction of the spinal system has a negative effect on the CNS’s ability to regulate itself. This is important since it is setting the stage for maintenance chiropractic care as spinal dysfunction left unregulated can result in increased pain sensitivity and as you will see in the next model’s description, physical changes in the CNS.
Neuro-endocrine Model – this is THE MODEL that shows chiropractic’s BIG PICTURE and subsequently ties everything we have observed and learned. Each of these models are important and all play a role, I don’t think there is a single unifying theory at this point, each one plays a particular role in the care path of the patient. In this model the theory discusses the effect on the autonomic nervous system, this is where we discuss visceral responses to spinal dysfunction and chiropractic’s ability to help regulate blood pressure, anxiety, depression etc. This model was the #1 item on the agenda in the Vegas 2015 seminar and will continue to be at the front of our seminars and consultations. This information is above the heads of most medical providers, not because they don’t necessarily understand the concept, it has more to do with lack of time in busy practices and lack of good formal continuing education. If you were in Las Vegas you got copies of the latest article in The American Chiropractor (TAC) in which Dr. Studin and myself had published an in-depth discussion on this theory. You can search TAC to find the article. Stay tuned for more information, I just found an article that was listed on Spine’s Published Before Print list that discusses the increased incidence of depression in scoliosis patients. Interesting, seems that dysfunction of the spine has profound effects on the human nervous system.