Now let's take the medical disease treatment model advocated by many of the medically inclined practitioners in our profession. Using their model, how many chiropractic "treatments" would a patient have to receive for the "treatment" of ulcers, epilepsy, sciatica, brachialgia, etc. Well, first we'd have to prove that there is "scientific" validity in the chiropractic "treatment" of ulcers, epilepsy, sciatica, brachialgia, or muckyhuckywuckywuc disease -- a never ending task. Then we certainly would have to qualify the results according to age, deterioration/degeneration, vertebral instability, family background, trauma, etc. But really, doctors, this is all unnecessary as chiropractic care does not treat disease, It works in the reduction and correction of vertebral subluxations. This can be clearly seen on before and after x-rays regardless of what Drs. Winterstein, Triano, and Sportelli have to say. Yes, it is a measurable entity, measurable in both millimeters and in degrees. "Oh," but you say such a small misalignment is not significant. Doctors, when a facet joint opens (separates) by less than one millimeter, it is a significant insult to the joint, the capsular ligament, and the foramina it borders. Facet joints, like all other true joints, are meant to function in a closed state. As an example, let's say that we would place a device on your finger and separate one of the joints by one millimeter and lock it in that position. Think of the pain and swelling that would ensue. The same is true of the facet joint, and this swelling of the joint's capsular ligament is a major cause of nerve root encroachment. Allow me to quote Sir Sidney Sunderland, MD, on this subject:1
"Narrowing of the lumbar intervertebral distance, whatever the cause, results in the subluxation of the apophyseal joints in which the facet of the vertebra above is displaced inferiorly across the surface of the facet of the vertebra below. As a result of this displacement, the medical branch of the lumbar dorsal ramus, which is fixed in this region, is involved in two ways:
- "Inflammatory swelling of the joint reduces the lumen of the tunnel containing the neurovascular bundle.
- "The inferior articular pedicel comes to press directly on the nerve."
There you have it my friends, hard bone upon soft nerve (2) and soft tissue pressing on soft nerve (1). Furthermore biochemical products of inflammation irritate the nerve and turgidity may further complicate the picture; not to mention the tension on the intra- and interforaminal ligaments. By the way, did you also notice Dr. Sunderland's description of a disc wedge subluxation? And must I mention that a disc wedge can be measured in degrees?
Yes, my friends, subluxation and its reduction can be proven on x-ray. It may be measured by disc wedge analysis, rotational analysis, and the analysis methods used for retro, anterior, and lateral lesthesis. The most accurate rotation analysis medically speaking is the Bunnel method.2 This, by the way, is the same method I developed in 1960 and have published in my writings and texts since that time. It is a modification of H.B. Logan's method which has been taught in chiropractic colleges for decades. And, in respect to the atlas/axis subluxation, if you don't care for chiropractic analysis, how about "vertical subluxation" of the odontoid and separation of the odontoid from the fovia dentalis ("horizontal subluxation") named and measured medically.3
Do we need more research on our subluxation analysis and x-ray determination of subluxation? Most certainly, and it's about time our research focused on what chiropractic is all about -- the detection, location, analysis, control, reduction, and correction of the vertebral subluxation. And do you know what, doctors? "It works." Subluxations exist; they can be reduced and corrected, and it is demonstrable radiographically.
Now, in comparison to setting a chiropractic standard of care for disease treatment, wouldn't it be much simpler to set a standard of care for the location, detection, analysis, control, reduction, and correction of the vertebral subluxation?
Cast aside your paranoia and insecurity fellow chiropractors, our philosophy states that dis-ease starts first as malfunction; malfunction results in the diseases named by the medical profession ad nauseam. Center stage as the cause of malfunction in the human system is the vertebral subluxation complex. This is a much more tenable explanation for the diseases that plague mankind than the fault-ridden medical germ theory of disease. Yes, the chiropractic adjustment for the vertebral subluxation works, and regardless of what my friend, Dr. Keating, says, "Chiropractic Works in All Disease." As long as the patient has a subluxation, we can be of help. We should be proud of our unique model of health care. Let us ameliorate our unique model of health care; our future will depend on it.
References
- Sir Sidney Sunderland: Nerve and Nerve Injuries, Churchill Livingston, 1978.
- Russell, Ravo, Hill, Mclvon: A comparison of four computerized methods for measuring vertebral rotation. Spine, 15(1):1990.
- Brainstem compression in rheumatoid arthritis. JAMA, 238(24):December 12, 1977.
"Enuf said,"
Fred H. Barge, DC, PhC
La Crosse, Wisconsin