The intimate relationship between the spine/nervous
system and health has been a part of healing for thousands
of years and has been the basis of chiropractic since its
Scientific discoveries continue to dissolve the borders between the different body systems: between the mind and the body, and between body matter and body energy. We are rediscovering the ancient wisdom that we are holistic beings, and that true healing cannot ignore this relationship.
An interesting paper on the relationship is: Thalamic Neuron Theory: Theoretical Basis for the Role Played by the Central Nervous System (CNS) in the Causes and Cures of All Diseases by T.-N. Lee in Medical Hypothesis 1994; 43: 285-302.
From the Abstract:
The Thalamic Neuron Theory (TNT) postulates that the central nervous system (CNS) is involved in all disease processes, as the CNS not only processes incoming physical and chemical information from the periphery, it also sends out physiological commands to the periphery in order to maintain homeostasis for the entire body. Inherent in its capacity to learn and adapt (i.e. to habituate) is the CNS’ ability to learn to be sick (pathological habituation) by looking in certain deranged central neural circuitries, leading to chronic disease states.
These pathologically habituated states can be reversed by dehabituation through manipulation or modulation of the abnormal neural circuits by physical means (physical neuromodulation) like acupuncture, or by chemical means (chemoneuromodulation) such as Chinese medicine, homeopathy or other modern medical techniques in a repetitious manner to mimic the habituation process….the entire CNS functions like a composite homonculus which controls the physiological functions of the entire body. TNT further postulates that the master homunculus takes the shape of a curled up embryo with its large head buried close to its pelvic region, with its chain in the homunculus representing acupuncture points in the periphery. The neuronal chain itself represents a meridian and Chi is nothing more than the phenomenon of neurotransmissions…Many difficult to explain clinical observations in modern medicine, Chinese herbal medicine, acupuncture and homeopathy can now be adequately explained using TNT. Based on this model, new therapeutic techniques can be launched to combat a whole host of intractable diseases.
The relationship between health and the neuro-musculoskeletal system has been explored by Professor Irvin M. Korr, Ph.D. Among his many papers: Osteopathic principles for basic scientists Journal Of The American Osteopathic Association, July 1987, 87(7) is a must read for all chiropractors and chiropractic students. This short (less than 3 pages) article reflects a lifetime of researching human physiology and well describes the empirical or vitalistic therapeutic philosophy from which chiropractic, osteopathy, acupuncture and homeopathy spring as opposed to the mechanistic or rationalist therapeutic philosophy of orthodox medicine.
The most thorough discussion of the vitalist/empirical versus the mechanistic/rationalist approach through history is found in the work of Harris L. Coulter, Ph.D. in his four volume opus Divided Legacy A History of the Schism in Medical Thought Vols. 1-4 (Washington, DC: Center for Empirical Medicine and Berkeley, CA: North Atlantic Books).
Dr. Coulter, a medical historian, writes of the ancient/modern philosophical split as only a master could. Fluent in nearly a dozen languages, Dr. Coulter reviews original writings to take the reader on a 2,500 year historical journey through the world of healing.
An early twentieth century study correlating visceral disease to spinal column distortions was by Henry Winsor, M.D.
Henry Winsor, MD was inspired by chiropractic and osteopathic literature to dissect human and animal cadavers to see if there was a relationship between any diseased internal organs discovered on autopsy and the vertebrae associated with the nerves that went to the organs. As he wrote:
The object of these necropsies [dissections] was to determine whether any connection existed between minor curvatures of the spine, on the one hand, and diseased organs on the other; or whether the two were entirely independent of each other.
The University of Pennsylvania gave Dr. Winsor permission to carry out his experiments. In a series of three studies, he dissected a total of seventy-five human and twenty-two cat cadavers. The following are Dr. Winsor’s results:
221 structures other than the spine were found diseased. Of these, 212 were observed to belong to the same sympathetic [nerve] segments as the vertebrae in curvature. Nine diseased organs belonged to different sympathetic segments from the vertebrae out of line. These figures cannot be expected to exactly coincide . . . for an organ may receive sympathetic filaments from several spinal segments and several organs may be supplied with sympathetic [nerve] filaments from the same spinal segments.”
In other words, there was nearly a 100% correlation between “minor curvatures” of the spine and diseases of the internal organs. Let us examine some of these disease categories:
Stomach Diseases: All nine cases of spinal misalignment in the mid-dorsal area had stomach disease.
Lung Disease: All twenty-six cases of lung disease had spinal misalignments in the same spinal area.
Liver Disease: All thirteen cases of liver disease had misalignments in the same spinal area.
Gallstones: All five cases with gallstone disease had spinal misalignments in the same spinal area.
Pancreas: All three cases with pancreas disease had spinal misalignments in the same spinal area.
Spleen: All eleven cases with spleen disease had spinal misalignments in the same area.
Kidney: All seventeen cases with kidney disease had the same area out of alignment.
Prostate and Bladder Disease: All eight cases with prostate and bladder disease had the lower back vertebrae misaligned.
Uterus: The two cases with uterine conditions had the second lumbar misaligned.
Heart Disease: All twenty cases with heart and pericardium conditions had the upper five thoracic vertebrae misaligned.
Dr. Winsor summarized his research in two studies: The Evidence of the Association, in Dissected Cadavers, of Visceral Disease with Vertebrae Deformities of the Same Sympathetic Segments. Winsor H. Sympathetic segmental disturbances—II. The Medical Times, Nov. 1921, 49:267-271 and
The Prevalence of minor curvatures and deformities of the spine in man. Also in other vertebrates. appeared in The Medical Times, Oct.1921, pp.237-239.
Studies with similarities to Winsor’s appear below:
Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. Nathan H. Spine, 1987;12:527-532.
A wide variety of visceral symptoms may originate from vertebral osteophytes compressing sympathetic nerves.
In this study the presence of osteophytes compressing sympathetic structures (sympathetic nerves, sympathetic trunk nerves and ganglia, rami communicantes) in the thorax was found in 655 (65.5%) of 1000 cadavers. In 60.4% of the affected cases, compression was on the right side, and in 36.9%, it was bilateral, although the right side was more severely affected. In 2%, compression was on the left side only. According to the authors, this could account for a wide variety of visceral symptoms seen in the elderly population.
Paraspinal autonomic ganglion distortion due to vertebral body osteophytosis: a cause of vertebrogenic autonomic syndromes? Giles G, Journal of Manipulative and Physiological Therapeutics, Vol 15,No. 9, Nov/Dec, 1992.
In order to determine any relationship between autonomic nerves, nerve ganglia and spinal body growths (osteophytes). Giles examined the lumbosacral spines of three elderly cadavers. The author wrote:
Recent scientific studies have suggested that a relationship may exist between abnormal vascular changes and neural tissue degenerative changes within the intervertebral foramen, and these findings may well go far toward explaining what has been observed by chiropractors, osteopaths and medical manipulators that, following spinal manipulation for spinal pain of mechanical origin, some patients report having noted relief from visceral dysfunction...."
Other studies exploring mechanisms relating spinal relationship to visceral and physiologic function include:
Effects of a chiropractic adjustment on changes in pupillary diameter: A model for evaluating somatovisceral response. Briggs L., Boone WR. Journal of Manipulative and Physiological Therapeutics 1988; 11:181-189.
The relationship between a cervical chiropractic adjustment in subluxated vs. unsubluxated subjects and autonomic response monitored as change in pupillary diameter was evaluated in 15 subjects.
The results indicate that:
a) a successful adjustment elicits either a parasympathetic or sympathetic response;
b) the vertebral level at which the adjustment is administered has undetectable specificity for the parasympathetic or sympathetic input to the pupil;
c) unsubluxated subjects generally exhibit no change in pupillary diameter following a sham adjustment and
d) subluxated subjects exhibit variable readjustment papillary diameters with significant pupillary diameter changes in response to an adjustment. These data suggest that autonomic input to the pupil may be influenced by subluxation, as well as the magnitude and direction of the force exerted during the chiropractic adjustment. An anatomic pathway through which the observed responses may occur is proposed.
Comment by Dr. Koren: This work is significant for a number of reasons. The sympathetic and parasympathetic nervous systems (autonomic nervous system) are in a state of dynamic balance to permit the body to maintain homeostasis so it may adapt to its environment.
Also, the spinal analysis located specific subluxations and the adjustment was specific, that is, a certain vertebrae was adjusted after it was determined to be subluxated. While an obvious requisite for chiropractic care and research, such a procedure is often absent in the chiropractic research literature. Instead non-specific “manipulations” are too often performed, irrespective of whether the involved segment was truly subluxated or merely compensating for subluxations located elsewhere.
Spinovisceral reflexes evoked by noxious and innocuous stimulation of the lumbar spine. Budgell B. Hotta H. Sato A. Journal of Manipulative and Physiological Therapeutics 3:122-131, 1995.
From the paper:
There is a wealth of anecdotal evidence that biomechanical disorders of the spine can affect the functions of visceral organs. However, although some relevant work has been performed on peripheral joints, there is a striking paucity of research concerning the spinovisceral reflexes, which are hypothesized to cause or facilitate visceral symptomatology accompanying spinal complaints. In the present study, both saline (0.9% NaCl) and capsaicin, a potent chemical algesic were injected into the lumbar interspinous ligaments and facet (zygapophyseal) joints to make Wistar rats generate reflex cardiovascular responses. Responses elicited from the interspinous ligaments and facet joints differed in both qualitative and quantitative terms. In particular, in central nervous system (CNS)-intact animals, noxious chemical stimulation of the interspinous ligaments caused a pronounced elevation of mean arterial pressure (MAP) and a prolonged depression of sciatic nerve blood flow (NBF).
Lantz CA: The vertebral subluxation complex. International Review of Chiropractic. Sep/Oct 1989 pages 37-61.
Korr IM (ed): The neurobiologic mechanisms in manipulative therapy. (Plenum Press: New York) 1978.
The Chiropractic Theories. Leach RA: Williams and Wilkins. Baltimore, MD. 1980.
Cauwenbergs P: Vertebral subluxation and the anatomic relationships of the autonomic nervous system. In Gatterman M (ed): Foundations of Chiropractic Subluxation. (Mosby-Year Book, Inc.: St. Louis) 1995.
Wiles MR, Diakow P. Chiropractic and visceral disease: a brief survey. J Can Chiro Assoc 1982; 26:65-68.
Wiles MR: Visceral disorders related to the spine. In Gatterman M (ed): Chiropractic Management of Spine Related Disorders. (Williams and Wilkins: Baltimore, MD) 1990.
Comment by Dr. Koren: Irvin Korr, Ph.D., has written about the possible mechanisms of how spinal distortions can cause disease. Korr’s model discusses increased firing of the sympathetic nervous system - or facilitation of sympathetic pathways leading to “high sympathetic tone.” This reminds us of D.D. Palmers statement: “life is an expression of proper tone.” Indeed, Palmer states in his book, The Chiropractors Adjuster, that chiropractic was “founded on tone.”
Korr described sympathetic facilitations as being caused by “lesioned” segments of the spinal cord (the osteopaths like to use the term spinal lesion.) This increase in sympathetic firing of the nerves to viscera and blood vessels that go to the viscera “May alter organ and tissue responses to hormones, infectious agents, and blood components. It alters cellular metabolism and may eventually lead to serious pathologic changes.” Korr IM: The Andrew Taylor Still memorial lecture: research and practice -- a century later. J Am Osteopath Assoc 1974 73(5):362.
The reflex effects of spinal somatic nerve stimulation on visceral function. Proceedings of the scientific symposium of the World Chiropractic Congress. May 4-5, 1991. Toronto, Canada.
Sato has shown evidence that mechanical pressure applied to rat spines caused alterations in blood pressure, pulse rate, renal and adrenal sympathetic nerve activity.
The reflex effects of spinal somatic nerve stimulation on visceral function. Sato A. Journal of Manipulative and Physiological Therapeutics, Jan. 1992, 15(1).
From the abstract:
This paper studies somatovisceral reflex responses in the cardiovascular organ, gastrointestinal tract, urinary bladder and adrenal medulla in anesthetized animals after eliminating emotional factors following somatic sensory stimulations....
Viscerosomatic reflexes: A review. Beal MC. Journal Of The American Osteopathic Association, 1985; 85:786-801.
From the author’s abstract:
The concept of viscerosomatic reflexes is presented and supporting documentation from the basic and clinical sciences is reviewed. The somatic manifestations of visceral disease, including their autonomic segmental reference sites, are described. Also discussed are the palpatory findings that are consistent with diagnosis of a viscerosomatic reflex, as well as their predictive value. In addition, the principles and results of manipulative treatment for visceral disease, as well as the effect of surgery on viscerosomatic findings are reviewed. The study of viscerosomatic reflexes is reviewed from an osteopathic perspective. The rationale for manipulative therapy in visceral disease is discussed.
The above two papers deal with one of the more researched mechanisms of somato-visceral stimulation, the reflex. Originally pioneered by Irvin Korr, Ph.D., the concept of the spinal cord reflex following adverse afferent sensory bed stimulation (one of the components of the vertebral subluxation complex) is one of the more popular somato-visceral mechanisms discussed today.
Pathogenesis of visceral disease following vertebral lesions. Burns L, Chandler, LC, Rice RW. Chicago, American Osteopathic Association, 1948, pp.226-233.
Neurologic basis for the practice of medicine by Speransky. This classic text discusses the role that the C.N.S. plays in the organism’s defense against disease. Among his experiments, Speransky, working with animal models to lesion the nerves going to the viscera, observed the formation of disease processes in various internal organs.
Man’s nervous system and disease. Wolf HG. Archives of Neurology, Sept. 1961, 5:17-25. Discussion of the nervous system relates to all categories of disease. The term psychosomatic is an artificial one and should be properly investigated in relation to the nervous system.
New perspectives in medicine: the role of the nervous system in disease. Wright HM. Journal Of The American Osteopathic Association, Aug. 1963,62:1057-1063.
Discussion of the relationship between every organ and tissue of the body and its anatomical and physiological relationship to the neuro-musculoskeletal system. Disease is not a local entity but the manifestation of a breakdown in our homeostatic mechanisms. Also discussed is manipulative therapy’s role in eliminating critical impediments to the function of the nervous system.
Functional considerations of spinal manipulative therapy. Brunarski D. ACA Journal of Chiropractic, May 1980,14: S-63.
A good literature review documenting research on the relationship between visceral disease and the nervous system.
Orthopedic Medicine - A New Approach to Vertebral Manipulations by Robert Maigne, R M.D. Translated and edited by W.T. Liberson, M.D., Ph.D., Professor Physical Medicine and Rehabilitation, Abraham Lincoln Medical School, University of Illinois, Chicago, then also Vice President, North American Academy of Manipulative Medicine. Published by Charles C. Thomas: Springfield, IL, 1972.
Robert Maigne, the French leader in the science of “manipulation,” was founder of the French Society of Manual Medicine, President of the International Federation of Manual Medicine, Director of Physical Medicine and Rehabilitation Service, Hotel Dieu Hospital, Paris, and lectured on the Faculty of the affiliated University of Paris School of Medicine. Conditions, from a medical perspective, which Maigne claims respond to “manipulations” include: “maintenance treatment, cervical pain/Barre-Lieou Syndrome/Vertigo(p.160 and pp.192-193), discal sciatica (p.162), cervico-osteoarthritis (p. 207), headache (pp.181-182), migraine (pp.188-189), “functional reactions” including constipation, digestive pains, pseudo-ulcers, asthma, false asthma in infants and mastodynia (pain in breast) (p.164 and p.153-155).
Mobilization of the Spine, Grieve, GP Churchill Livingstone, London/New York, 4th edition, 1984. P.22-23.
All those experienced in manipulation can report numerous examples of migrainous headaches, disequilibrium, subjective visual disturbances, feelings of retro-orbital pressure, dysphagia, heaviness of a limb, extra segmental paraesthesia, restriction of respiratory excursion, abdominal nausea and the cold sciatic leg being relieved by manual or mechanical treatment of the vertebral column.” P. 22-23.
“While these effects are noted, and the underlying mechanisms investigated with the purpose of understanding better what we do, they are insufficient reason to put the cart before the horse. In other words, the prime impulse for physical treatment of the vertebral column is properly vertebral column disorder, and not visceral disorder. “
Functional Disorders of Internal Organs Due to Vertebral Lesions, Kunert W (1965) CIBA Symposium 13(3): 85-96.
Kunert, a German cardiologist has written that spinal examination should be performed for individuals with presumed cardiac pain. As he wrote
“Lesions of the spinal column…are perfectly capable of simulating, accentuating or making a major contribution to organic diseases. There can…be no doubt that the state of the spinal column does have a bearing on the functional status of the internal organs.”
Commission of Inquiry into Chiropractic. Chiropractic in New Zealand. Government Printing, Wellington, New Zealand, 1979 P.57-58.
“A number of medical experts told the Commission that the results chiropractors and their patients claimed in Type O (organic) cases were unlikely to be the results of spinal manual therapy…However, at the same time no medical expert was prepared to say that such results were impossible, simply because knowledge of neurophysiology had not advanced to a point where the possibility of such results from spinal manual therapy-however remote he might think they were-could positively be excluded.”
Manipulative Therapy in Rehabilitation in Locomotor Systems by Karel Lewit, MUDr. Doc, Dsc. Butterworths: London and Boston (1985).
This Czechslovakian M.D. is one of the most famous medical manipulators of Eastern Europe. Some quotes from his text include:
“...There are both somatic and autonomic responses to pain...The somatic response consists mainly of muscle spasm...at the central level it may affect respiration, the cardiovascular or the digestive system. These central effects are understandable for pain is also a stress factor.”(p.2).
“...There is a strong case to be made for manipulative treatment (for the purpose of prevention) in children, physically very exposed individuals, etc.” (p. 182 and p. 350). “Manipulative treatment is indicated if there is movement restriction (blockage) of a joint or a spinal mobile segment, and if this is considered relevant to the patient’s symptoms...No specific disease or complaint need be indicated for manipulation (headache, lumbago, etc.) but only a pathogenic lesion (i.e. lesion) which should, however, be relevant to the patient’s problem.” (p.178). Other conditions that Lewit mentions are tonsillitis, respiratory problems, heart disease, digestive problems, gynecological disorders, migraine, vertigo/dizziness. p. 336-342).
Lewit also sees manipulation as valuable for health maintenance:
“The possibility of indicating manipulation for the purpose of prevention must also be considered. True, manipulation is indicated only if we think the movement restriction is clinically relevant...there is a strong case to be made for manipulative treatment, for example, in children, physically very exposed individuals, etc.” (p.182).
Copyright 2004 Koren Publications, Inc. & Tedd Koren, D.C.
Top of Page