Autonomy and independence have always been important to the chiropractor. After all, it is precisely because of chiropractic's uniqueness that the art and science has survived.
The art of chiropractic has undergone numerous changes and variations over the years, but the science has remained constant even though our understanding of vertebral subluxation has been only partially revealed. Whatever one chooses to call subluxation, it is surely responsible for far more than mechanical low-back pain. It affects and is affected by the function of the nervous system. We know that the chiropractor is the one most qualified to detect and correct that entity.
How is it then that chiropractors, by tradition and design, the antithesis of allopathy, could even consider the utilization of medication in their practice?
Certainly the use of pharmaceuticals is not chiropractic. Acupuncture is not chiropractic; physical therapy is not chiropractic, nor is nutrition. However, many DCs will use one or more of these therapies in their practice. And if they so choose, why not?
Well, you might say that many MDs don't know much about using physical therapies, don't give much credence to acupuncture, and aren't up on nutrition. And chiropractic, well, some MDs just think that might be good for some kinds of low-back pain.
Wrong! If you have not heard, MDs (at least in Colorado) are, by statute, free to use "alternative" modes of care without fear of repercussion from their medical societies. This means that if they want to use acupuncture or herbs or manipulation, they will do just that, and being qualified is not necessarily required. I do not know if this extends to alternatives for cancer therapy, such as chelation, but adjustments and other therapies will surely be advertised as being available by a physician (understanding that most people think that only an MD or DO can be a true "physician").
I feel that it is paramount to ensure that spinal adjustment remain the foundation and purpose of chiropractic care. However, I see a place in the practice of chiropractic for utilization of certain classes of medication administered and applied by the DC.
Considering myself a chiropractic physician, not a "back-pain technician," I direct my concern to the whole person -- a person who feels and responds to pain. It is not enough to try to take away pain, only to fail and force the patient to seek medical help.
In my effort to correct the spinal subluxation, I find absolutely no fault in assisting the patient with pain relief. Taking a brief course of anti-inflammatory medical or a short-term muscle relaxant while recuperating does not, in spite of what some may have learned in chiropractic college, delay healing, make a person toxic, or destroy the kidneys.
Having been initiated into health care from strictly an allopathic perspective and in the emergency-room setting, I've had the opportunity to see and care for degrees of pain and illness as a medical practitioner that would never fall within the scope of most medical doctors' offices, let alone the office of the chiropractic physician. And though I talk about subluxation to my patients, I use my medical training to augment the adjustment, by prescribing appropriate medication when I feel it to be necessary.
Honest DCs would not deny that when a patient is in severe pain, they would like the opportunity and the ability to alleviate that person's pain. We all know the adjustment won't always do this. Adjunctive therapy won't do it, and medication won't always be successful, either. But we must try.
If we are to continue to compete as a viable choice for prospective patients, we must practice more than just dogma. We must practice conservatively and with compassion, and assist our patients with the tools we have. Becoming doctors of medicine is not an option or a desired end. Why should it be? After all, medical doctors can't adjust (and probably would not want to learn how to), just as I think that many DCs would not choose to learn to prescribe medications. But for those in both professions who do both, the public will perceive that practitioner is more likely to be of help to them.
There are certainly problems with medications. But since 1976, which is when I started in the medical profession, the only times that anti-inflammatories and muscle relaxants became problematic to any significant degree was when there was either chronic use or misuse of a substance. I would think that because of who doctors of chiropractic are, overprescribing would be an extreme rariety.
Problems with spinal adjustments occur, don't they? Correctly administered or not, problems will happen to the best of us. Even the most properly administered adjustment has a chance, though infinitely small, of producing an undesirable side effect.
However, with appropriate training and judicious use of select pharmaceuticals, not just to cover symptoms but to assist the patient in the healing process, the physician, whether chiropractic or medical, will be a true patient advocate seeking the cause of disease and dysfunction. He/she will be successful and will be a true healer.
M.L. Malmgren, DC, PA
Englewood, Colorado
(303) 721-9984
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