article archive
March 2007
Subluxations -- so
what?
by Dr. Matthew McCoy
For more than 100 years, chiropractors have been proclaiming
the negative effects of vertebral subluxation as well as
the positive benefits of subluxation reduction and correction.
During those hundred years, chiropractors were labeled as
cultists for even suggesting that such an entity existed
let alone that its existence had deleterious effects on health.
Even
some within the profession (including some considered "leaders")
questioned the existence of vertebral subluxations and periodically
there are calls to do away with the term as too ambiguous,
politically charged or just simply unproven.
James Winterstein,
DC, for instance, stated that "We
must differentiate ourselves from the Straights," by
dropping the term subluxation and using the term "Functional
Articular Lesion."
("Chiropractic Medicine for Tomorrow," presentation
at New York Chiropractic College, 2/10/2005.). Dr. Winterstein,
as you may recall, is president of the National University
of Health Sciences (which used to be called National College
of Chiropractic) and serves on the editorial board of the
Journal of Chiropractic Medicine.
Most leadership within the
profession has taken a softer stance on attacking the term
over the past several years, especially following the signing
of the ACC (Association of Chiropractic Colleges) Paradigm
Statement where the presidents of all North American chiropractic
programs actually agreed upon a definition of subluxation.
While
it might seem the subluxation has once again been saved from
extinction within our vernacular, the reality is that we are
at more of a crossroads than ever. The fact is that what has
been generally accepted is more of an orthopedic definition
of subluxation ‑‑ certainly one divorced
from the early model of subluxation, which included interference
to the mental impulse as a necessary component. (see: "A
Proposed Vertebral Subluxation Model Reflecting Traditional
Concepts and Recent Advances in Health and Science" by
William R. Boone PhD, DC and Graham J. Dobson, DC, Journal
of Vertebral Subluxation Research, August 1996, www.jvsr.com/abstracts/index.asp?id=49
)
In fact, the neurological component is still unacknowledged
by many, such as Drs. Reed Phillips and Robert Mootz, who
noted "The chiropractic perspective on health and disease
emphasizes two fundamental characteristics: (1) a testable
principle suggesting that the structure and condition of
the body influences how the body functions and heals and
(2) an untestable metaphor that asserts that the mind‑body
relationship is instrumental in maintaining health and in
healing processes." ("Chiropractic in the US: Training,
Practice & Research," AHCPR)
The powers that be within
and outside the profession have in essence stated: "Okay, we'll give you that subluxations
in one form or another actually exist ‑‑ but
so what?"
That leads to a barrage of other questions, including:
*** If
subluxations exist, what evidence do you have that they have
any clinical meaningfulness?
*** If subluxations exist, what
evidence do you have that their existence leads to adverse
health outcomes?
*** If subluxations exist and you have some
evidence that their existence leads to adverse health outcomes,
what evidence do you have that you can correct subluxations?
***
And if you have evidence that you can correct them, what evidence
do you have that correcting them leads to improved health outcomes?
Given
the increased importance of evidenced-based
health care, we can no longer make unfounded claims about
vertebral subluxation and their alleged adverse effects or
that we have the ability to correct them and, in doing so,
bring about positive health outcomes.
Look at the CCGPP Best
Practices (dubbed by many as "Mercy
II" for obvious reasons) and you'll see what's coming
our way.
Those of us who hold with the traditional view that
chiropractic's purpose is to correct vertebral subluxations
because those subluxations can negatively impact health,
are being painted as unscientific religious zealots and even
frauds. As George Goodman, DC, president of Logan College
wrote in reference to the subluxation-centered fraternity,
Delta Sigma Chi: "They represent the anti-educational,
non-diagnostic
and a transitory obsessive devotion to a narrow view of chiropractic.
This group representation would be similar to a pro-abortion
organization at St. Louis University or at its medical school."
He's not alone in his disdain for subluxation-based
chiropractors. Reed Phillips, DC, stated: "If the formation
of chiropractic groups opposed to improving educational standards,
advancing our scientific research accomplishments, discoursing
intellectually with our colleagues in the various health
professions, or accepting responsibility for patient care
beyond what some may consider to be, are not myths, then
at least the unscientifically validated constructs (i.e.,
the subluxation) would represent, by Armstrong's description,
a chiropractic counterculture to the profession's scientific
and academic advancements." ("The Battle for Innate:
A Perspective on Fundamentalism in Chiropractic," The
Journal of Chiropractic Humanities, 2004).
In short, according
to him, the subluxation is merely an "unscientifically
validated construct."
To address this kind of criticism effectively, we have to
be honest with ourselves and with each other. The rank and
file and even some of the leaders in the subluxation-centered
community have acquiesced to the cartel within chiropractic
that seeks to remake us in a more "modern" image
--- an image that deliberately excludes the vertebral subluxation.
Hopefully,
the subluxation-centered community will
remember that it has a rich history and respect for science,
research and evidence and this recollection will hopefully
motivate it to do a few things immediately:
1. Support subluxation-centered research. This can
be done by subscribing to and supporting those research journals
that are subluxation-centered and by donating money
to subluxation-centered research organizations like
the Council on Chiropractic Practice.
2. Support subluxation-centered
educational institutions.
3. Get involved politically at the
state and national level.
4. Stop supporting those groups, schools,
organizations and individuals who seek to destroy you.
If you
don't think your vigilance and support are needed, just read
what Louis Sportelli, DC, former president of the American
Chiropractic Association, had to say about you: "The
need to be validated is what continues to be the key to why
these 'cult' groups continue to exist and flourish. They
have a cause and the cause is so powerful that to deny the
basis of the cause is more than many could handle. Many in
the profession, who do not openly adhere to the open 'mythos,'
still feel some kindred spirit to this thinking. Many...had
the strength of the philosophy to fall back on ALWAYS...if
the patient did not get better it was 'limitation of matter,'
if they did, it was 'the wonders of chiropractic.' If we
did not know what was wrong with the patient, what relevance
was it, 'find the subluxation and the body will heal itself'..." ("The
Battle for Innate: A Perspective on Fundamentalism in Chiropractic," Journal
of Chiropractic Humanities, 2004).
You're a member of a cult.
You're a fringe group. You're old fashioned and outmoded.
You need to be shoved aside so the chiropractic profession
can be cleansed of you. Chiropractic has nothing to do with
subluxations. If you don't stand up and fight back, that's
going to be chiropractic's epitaph.
(Dr. Matthew McCoy is one
of the founding members of the Council on Chiropractic Practice
and has been instrumental in the development of the profession's
most widely accepted set of chiropractic guidelines. He's also
editor of the Journal of Vertebral Subluxation Research and
has extensive practice, research and educational experience.
He gained international acclaim when he helped introduce chiropractic
to the Russian medical community by developing a chiropractic
spine treatment, teaching & research center in Vladivostok,
Russia. He is currently the Director of Research at Life University.
Dr. McCoy is Vice-President of RCS, serves as a member
of the WCA Board of Directors, chairs the WCA Chiropractic
Advocacy Council and was a liaison member of the National
Academy of Sciences and Institute of Medicine's Committee
on Alternative Medicine. He can be contacted via e-mail
at editor@jvsr.com)