Chiropractic Scope of Practice in the 21st Century
Chiropractic manipulation expands to other massage modalities
No specific medical profession is the “owner” of spinal manipulation (SM); however, whether a chiropractor is a “Mixer” or a “Straight” they are restricted to only diagnosing and performing SM. Although some clients may perceive chiropractors as medical doctors, the World Health Organization (WHO) has defined chiropractors as members of Complementary and Alternative Medicine (CAM) (Chiropractic, n.d.). Chiropractors are neither licensed to write prescriptions nor perform surgery. They may, however, recommend dietary supplements, prescribe other therapies such a massage or acupuncture, and suggest dietary or fitness plans. These last are only performed by “Mixers”.
Cautions Regarding Chiropractic Therapy
Although chiropractic therapy is the number one CAM procedure, it cannot be labeled as the safest, nor most effective form of therapy. According to Peacock, Blouin, & Bryans (2005), chiropractic therapy is safe only when performed correctly; when it is not, problems may arise. Peacock, et al, explain, “new or worsening pain…stiffness in the affected region…SM performed in upper regions of the spine can…lead to permanent disability or death” (p. 7).
The occurrences of these dangers are within the range of 34% to 55%, with 80% waning within 24 hours (Thiel, Bolton, Docherty, Portlock, p. 10, 2005). According to Ernst (2007), however, the numbers reported by Thiel, et al, are unrealistic due to “high levels of underreporting and to the difficulty of linking [SM] to…stroke, which is a particular concern” (p. 333). These types of complications are not surprising considering that chiropractic therapy was “invented” by D.D. Palmer, a man with no medical training.
Safe Chiropractic Procedures
What are considered most useful determinants in locating capable chiropractors? Gonstead’s grandson, Mark LaRue, himself a chiropractor, provides the following tips to help clients choose chiropractic care wisely. His first caution is that adjustments should not be accompanied by that “popping” sound. LaRue explains that chiropractors who make that “popping” sound with each adjustment “either had poor teachers or did not hear them say that audibles are no proof of a positive change” (LaRue, n.d., p. 3).
LaRue continues “a good adjustment …[allows a muscle, or joint to]…relax enough that…real adjustments are possible…with no noise…just a feeling of movement that the patient…and doctor can experience” (LaRue, p. 3, n.d.). This is most important in cases of whiplash: LaRue makes clear that chiropractors applying sudden applications of force will cause injuries. In these cases, the chiropractor often neglects to palpate the injured area, and continually over stretches clients’ ligaments, which if continued may cause the client serious injury.
To locate a safe chiropractor visit Gonstead.com and click on “find a Doctor”. The chiropractor’s website will appear, which will contain a summary of philosophy and practice methods. Specific questions can be asked via email. Another source helpful in locating a professional chiropractor is RateMDs. This site provides a compilation of ratings from clients from 1=poor to 5=excellent. The site also includes specific comments from clients.
References
Ernst, E. (2007, July, 2). “Adverse effects of spinal manipulation: A systematic review”. Medical News Today 100(7), 330-338
LaRue, M. (n.d.). The significance of the term. Retrieved on 3/17/09 from http://www.drlarue.com
Peacock, E., Blouin, J.S., Bryans, R. (2005). Chiropractic clinical practice guideline: Evidence-based treatment of adult neck pain. Journal of Canadian Chiropractic Association 49(3), 158-209.
The Gonstead System: Welcome to the World of Health. (n.d.). Retrieved on March 13, 2009 from Gonstead website.
Thiel, H.W., Bolton,J.E.,Docherty, S. Portlock, J.C. (2007). Safety of chiropractic manipulation of the cervical spine. Spine 32(21), 2375-8.
What do you think about this article?
More in Health & Wellness
Latest Articles