Wham, bam see you later M’amadmin
Or why Chiropractic has a bad name
It is easy for some Chiropractors to think that the profession has a bad name because if it’s somewhat strange and, dare we say it, outlandish, beginnings. But the truth is that many modern Chiropractors are not doing the discipline any good either. It doesn’t get talked about. Maybe for fear of triggering the debate, maybe out of misplaced loyalty. But a practitioner’s loyalty should surely be to his patients, and not having the discussion is only doing them a disservice. But before we talk about the difficulties faced by today’s practitioners, let’s have a look at the origin of Chiropractic, and why it began as a bit of a black sheep.
The discipline of Chiropractic has it’s origins in America during the second industrial revolution. Thanks to groundbreaking work by Louis Pasteur and Charles Darwin, medical practitioners were moving away from ‘Heroic Medicine’ – blood letting, purges and sweating designed to ‘shock’ the body back to heal. But scientific practices within the community had not yet caught up. Esoteric disciplines like vitalism, herbalism and magnetisim began to gather popularity. The sale of tinctures and nostrums with no documented or proven effectiveness abounded. In other words, quacks were everywhere.
It was into this atmosphere that DD Palmer, himself a Magnetic Healer, began to make tentative moves into a type of healing he referred to as “a science, an art and a philosopy”. In the early days Palmer compared his practices to Osteopathy – founded by Andrew Stills – as an alternative to the unproven drugs being pedaled by unlicenced quacks. Both Palmer and Stills viewed the body as a ‘machine’. But in the atmosphere of the day, scientific proof of efficacy was not expected.
Perhaps surprisingly, by the 1930’s Chiropractic was the largest alternative healing profession in the US.
Do you take your Chiropractic Straight or Mixed?
In 1906 DD Palmer’s son BJ took over the School of Chiropractic. He worked hard at promoting professionalism in the discipline, and overcome resistance to medical technology like X-rays. However, around this time a divide developed.
In simplistic terms, BJ was what is known as a ‘straight’. That is, he relied solely on spinal adjustments, according to his father’s teachings. But a growing group of Chiropractors – known as ‘mixers’ began to combine spinal adjustments with other treatments. Eventually, the two groups parted ways, forming separate professional associations to govern their particular flavor of chiropractic treatment. The ‘mixers’ began to incorporate alternative treatments, and look for evidence-based treatment objectives. Dr Solon Langworthy wrote the first scholarly work on Chiropractic “Modernized Chiropractic”, thereby introducing Chiropractic to the scientific arena. However, it would be years before the science really caught up.
Chiropractic Comes to Australia
Around this time Chiropractic finally made it to Australia, some 10 years after it began in the US, in the form of Henry Otterholt, a student of DD Palmer. The Sydney College of Chiropractic was founded in 1959 and in 1990 was the absorbed into Macquarie University, making it the first Chiropractic course in a mainstream university in the world. Chiropractors study a minimum of 5 years to become registered.
And Now for the Science
Although during the 1980’s Chiropractic had begun to receive mainstream recognition, as recently as 1987 the American Medical Association called Chiropractic ‘an unsafe cult’. However, a 1975 Conference generated an interest in the discipline, and serious research began. By the mid 1990’s there was a growing scholarly interest in the relationship of the spine and central nervous system, to overall health. Today, research continues to support the techniques and modalities taught in Chiropractic degrees and practiced by modern Chiropractors.
Why You Should be Wary
While the concept of ‘mixers’ and straights’ is hugely oversimplified, it still exists today. As with everything in life, there are no black and white distinctions. Chiropractors exist on a bell curve with pure straights on one end, and extreme mixers on the other.
These days only about 15% of Chiropractors can be classified as pure ‘straights’. Many (though not all) can be identified by their unwillingness to incorporate additional therapies into their practice, and by their claims to be able to cure conditions such as asthma with Chiropractic. A great many of them are anti-vaccination. They generally do not utilize medical technology such as MRIs and CTs and an appointment with them will involve adjustment only, and usually take only a few minutes. This type of treatment does not take into account any muscular skeletal issues, and so does not incorporate any soft tissue work on muscles that may have been damaged through activity. Neither does it allow for the potential that the nerves of the peripheral nervous system can be impinged in any of the joints through which they travel – not just those of the central nervous system in the spinal column. This concentration on adjustment of the spine means appointments are very brief – often you will spend as little as 5 minutes with the practitioner. Wham, bam, see you later m’am.
It is not uncommon for patients of these practitioners to never get ‘better’. The objective is for them to see their practitioner every week or month for the rest of their lives. These are often the practitioners who generate the media hype about the unsafe nature of Chiropractic treatment. It is these practitioners who ensure the discipline is still having trouble getting out from under the shadow of its somewhat murky inception.
At the other end of the spectrum we have the extreme mixers – some of whom no longer even attempt adjustments of the spine. These Chiropractors are more like physiotherapists than anything else in their approach to health care.
And in the middle we have the sweet spot. Most Chiropractors educated in Australia today would be classified as ‘mixers’, and the greater proportion of them sit somewhere in the middle of the bell curve. These practitioners have been highly trained – with a minimum of 5 years at university.
Mixers – today more correctly known as Musculoskeletal Chiropractors – will utilize the current medical diagnostic technology available to them to help identify the problem being presented. Treatment will be drawn from a range of modalities to best suit a patient’s needs, from standard adjustments to soft tissue work, IASTM, dry needling, laser and shockwave therapy and exercise prescriptions. All treatments are evidence-based and specifically ‘prescribed’ for the individual patient. Appointments may take anywhere from 20-40 minutes, and care is taken to treat the whole patient, not just the spine. The focus is correcting the problem so the patient can get on with their daily activities, pain and restriction free.
At the end of the day, what Chiropractic should be about is treating the patient. If you are looking for a Chiropractor, take a good long look at their website. Are they focused only on adjustments, or will they use a range of modalities? How long are the appointments? What additional services are offered? If you are still in doubt, call their clinic and have a chat to the staff. They will soon tell you what the philosophy of the clinic is. Look at Google reviews, ask your friends for recommendations. Then weigh up all the evidence and decide for yourself.
If you think you might need Chiropractic treatment, don’t be put off by the small minority of ‘Wham Bam’ practitioners or the sensationalist hype. A visit to a good Chiropractor might just leave you feeling pain and restriction free.