Most first year chiropractic students are told that the chiropractic profession has always maintained that the adjustment influences the nervous system, whereas osteopaths originally believed that manipulation influenced the vascular system. Indeed, for the past 100 years, all first trimester/quarter students were taught that subluxation and the adjustment influence the nervous system in some fashion.
We have all heard the terms nerve interference, nerve insult, nerve irritation, and many others. To this day, I do not know the precise meaning of these terms or how they specifically relate to joint dysfunction/subluxation and the adjustment. I have been given numerous conflicting definitions by students, practitioners, and faculty members at chiropractic colleges. I have been told that joint dysfunction, joint fixation and subluxation are different. Are they really? How?
I recently attended a golf show where a chiropractor had a booth. There was a big white banner with red writing that said "impotence." I couldn't figure out the purpose of the sign or its relationship to the golf swing. I went over to the booth, explained that I was involved in fitness, and asked the attending chiropractor some layman-like questions. I was told that subluxation occurred at C1-C2 and caused pressure on the brain stem which reduced the transmission of mental impulses to the cells of the body. According to this DC, brain stem pressure by subluxation can also cause a callous to form. Regarding neurology, everything this DC talked about had to do with reduced motor nerve impulses. I asked about the inflammation associated with injury to the spine or extremities. I suggested that pain caused by injury would be due to increased nerve activity at the site injury, which is an accurate statement. This DC told me that this is not necessarily the case and that I should get a copy of Guyton's Physiology; it would explain everything he told me. Sadly, I said thanks and walked away.
So, is it a subluxation, a subluxation complex, a fixation, joint dysfunction, or a misalignment? Are these the same or are they different? Who knows? Does "whatever it is" cause nerve irritation, nerve interference, nerve pressure, brain stem pressure, or does it cause a callous to form on the brain stem? Who knows? Details regarding these topics are rarely discussed so it is nearly impossible to develop a rational knowledge base.
The new definition of subluxation put forth by the chiropractic college presidents (see the insert in the February 24, 1997 issue of DC) does not help to clear up the confusion. They state:
"A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health."
What exactly does neural integrity mean? What components of the nervous system can have their integrity compromised? What does compromise mean in this definition? How does the compromise occur? These questions need to be answered, and the answers need to be a part of their definition of subluxation.
The college presidents state: "The body's recuperative power is affected by and integrated through the nervous system." If the definition does not describe neural function/dysfunction, how can it relate to the principle of chiropractic? Without details and supportive data, these words have no meaning.
With all due respect, it appears that the presidents' definition is a compromise. It is neutral and nonoffensive, unfortunately it is also clinically and functionally useless. For example, this new definition would in no way dissuade someone from suggesting that a brain stem callous is a common outcome of subluxation. Moreover, this new definition does not provide sufficient information to explain why joint dysfunction/subluxation is rarely, if ever, associated with brain stem compression or a brain stem callous. It should not be a surprise that students and doctors run off to bizarre seminars for answers to their unanswered questions.
At the present time, the nature of the spinal condition that chiropractors adjust is not agreed upon, and confusion still abounds regarding the spinal condition's relationship to the nervous system. This problem must be resolved to help avoid another 100 years of running around in circles. It is up to the colleges and associations to organize an effort to clearly, thoroughly, and accurately define the relationship between the chiropractic spinal lesion and the nervous system. At the present time such a relationship is not clear, which means that the nervous system is not a focus in chiropractic.
David Seaman, DC
Lake Lure, North Carolina
