Confusion About Wellness and Chiropractic

Feelings of Wellness

Despite what many may claim, "wellness" is not a potential outcome of the chiropractic adjustment. With this fact in mind, it is important to differentiate between "feelings of wellness" and a state of "wellness."

I personally have experienced "feelings of wellness" after spinal manipulation, and I have had patients who claimed a similar outcome. Such feelings are typically short-lived, and may be due to a modulation of limbic system afferentation that occurs as part of the somatosensory stimulatory nature of the adjustment.

Be sure that short-lived "feelings of wellness" do not constitute an effective therapy, and it needs to be admitted that post-adjustment "feelings of wellness" cannot be predicted. Sometimes it happens, other times it does not. "Feelings of wellness" are often the goal of alcoholics and drug addicts. Indeed, substance abusers derive a temporary "feeling of wellness" when using their substance of choice.

If you drink coffee in the morning, why do you do it? I have had many tell me they feel better with a jolt of caffeine. Does this mean coffee consumption equates to wellness? Most of you would say no to this question. Coffee drinkers derive a temporary state that can be interpreted as transient "feelings of wellness."

A State of Wellness

In contrast to "feelings of wellness," true "wellness" is defined as a state of optimal physical and mental function that is pursued by active lifestyle choices. If your patient were to look on the Internet for the definition of wellness, they would definitely not discover that it is defined as "the outcome of a chiropractic spinal adjustment."

What would they find? At www.dictionary.com and in The American Heritage Dictionary of the English Language, they would read that wellness is defined as: "The condition of good physical and mental health, especially when maintained by proper diet, exercise, and habits." In the Merriam-Webster online dictionary (www.merriamwebster.com), we read the following definition of wellness: "The quality or state of being in good health especially as an actively sought goal (wellness clinics) (lifestyles that promote wellness)."

Clearly, "wellness" is something we can pursue via lifestyle, not something we have done to us by a chiropractor or any other doctor. Wellness is about eating right, exercising consistently, sleeping well, and developing healthy relationships. Certainly, pain reduction/elimination via the passively received chiropractic adjustment can help one to pursue wellness. In other words, if I wish to exercise and cannot, due to spinal pain and headaches, and am then relieved of said pain by an adjustment, I can pursue a regular exercise program if I choose.

Chiropractic Wellness Care?

The term "chiropractic wellness care" is even odder, and is actually a physiological impossibility. This term suggests chiropractors are treating "well" spines. Our theoretic treatment goal is to reduce mechanical dysfunction with the adjustment, and for some, it is to correct subluxations. The presence of dysfunction/subluxation characterizes an "unwell" spine that should be adjusted, versus a "well" spine that should be left alone.

Lack of Wellness Created by Poor Diet

Cordain and colleagues provide an excellent review of the disease-promoting nature of the average American's diet. About 72% of the calories in the average American's diet come from foods that were not consumed by our recent hunter-gatherer ancestors. Consider that 23.9% come from grains (20.4% from refined grains), 18.6% from refined sugars, 17.6% from refined omega-6 seed oils (corn, soybean, sunflower, cottonseed, safflower, peanut, etc.), 10.6% from dairy, and about 1.4% from alcohol.¹

The remaining 28% come from a marginal intake of fruits, vegetables, nuts and legumes, and a substantial intake of domestic, feedlot, grain-fed meat. We know wild game is about 2% to 4% fat by weight, while modern feed-lot meat is 20% to 24% fat by weight. Essentially, this means we are eating unhealthy, obese animals.²

In short, our diet in America today consists of grains, sugars, omega-6 fatty acids, trans fats, sugar and obese meat, and is substantially deficient in fruits and vegetables. The outcome of this pattern of eating is the typical inflamed, swollen-looking, overweight American, who is prone to osteoporosis, osteoarthritis, chronic pain, and other chronic diseases.^1,3 Now this patient walks into your office.

It remains surprising to me when I witness this type of inflamed patient receive a chiropractic adjustment and derive a positive outcome (not all do, of course). Despite such an outcome, this patient will leave the office no more "well" than when they arrived. They are still inflamed, swollen, overweight and actively pursuing disease expression.

Is Your Office a Wellness Center?

If you are providing dietary, exercise and other lifestyle recommendations, you could accurately call your office a wellness center. That is, you encourage patients to pursue wellness as a lifestyle, and give them guidance. If, however, you provide high-quality chiropractic adjustments and make no mention of lifestyle modifications, then you do not have a wellness center, and you are not creating or promoting wellness. I think the latter office provides a valuable service - just make sure to characterize the nature of the practice properly.

References

1. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21^st century. Am J Clin Nutr, 2005;81(2):341-54.
2. O'Keefe JH Jr, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21^st-century hunter-gatherer. Mayo Clin Proc, 2004;79(1):101-8.
3. Seaman DR. The diet-induced pro-inflammatory state: a cause of chronic pain and other degenerative diseases. J Manip Physiol Ther, 2002;25:168-79.