Vertebral artery dissection (stroke), compression fracture, death
Related fields
Osteopathy, vitalism
Original proponents
D. D. Palmer
Subsequent proponents
B. J. Palmer
MeSH
D002684
This article is part of a series on
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v
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Chiropractic is a form of alternative medicine[1] concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine.[2] It has esoteric origins[3] and is based on several pseudoscientific ideas.[4]
Many chiropractors, especially those in the field's early history, have proposed that mechanical disorders of the joints, especially of the spine, affect general health,[2] and that regular manipulation of the spine (spinal adjustment) improves general health. The main chiropractic treatment technique involves manual therapy, especially manipulation of the spine, other joints, and soft tissues, but may also include exercises and health and lifestyle counseling.[5] A chiropractor may have a Doctor of Chiropractic (D.C.) degree and be referred to as "doctor" but is not a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.).[6][7] While many chiropractors view themselves as primary care providers,[8][9] chiropractic clinical training does not meet the requirements for that designation.[2]
Systematic reviews of controlled clinical studies of treatments used by chiropractors have found no evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.[8] A 2011 critical evaluation of 45 systematic reviews concluded that the data included in the study "fail[ed] to demonstrate convincingly that spinal manipulation is an effective intervention for any condition."[10] Spinal manipulation may be cost-effective for sub-acute or chronic low back pain, but the results for acute low back pain were insufficient.[11] No compelling evidence exists to indicate that maintenance chiropractic care adequately prevents symptoms or diseases.[12]
There is not sufficient data to establish the safety of chiropractic manipulations.[13] It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.[14] There is controversy regarding the degree of risk of vertebral artery dissection, which can lead to stroke and death, from cervical manipulation.[15] Several deaths have been associated with this technique[14] and it has been suggested that the relationship is causative,[16][17] a claim which is disputed by many chiropractors.[17]
Chiropractic is well established in the United States, Canada, and Australia.[18] It overlaps with other manual-therapy professions such as osteopathy and physical therapy.[19] Most who seek chiropractic care do so for low back pain.[20] Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues.[8] Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "Innate Intelligence", and consider vertebral subluxations to be the cause of all disease; and "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[21]
D. D. Palmer founded chiropractic in the 1890s,[22] after saying he received it from "the other world";[23] Palmer maintained that the tenets of chiropractic were passed along to him by a doctor who had died 50 years previously.[24] His son B. J. Palmer helped to expand chiropractic in the early 20th century.[22] Throughout its history, chiropractic has been controversial.[25][26] Its foundation is at odds with evidence-based medicine, and has been sustained by pseudoscientific ideas such as vertebral subluxation and Innate Intelligence.[27] Despite the overwhelming evidence that vaccination is an effective public health intervention, among chiropractors there are significant disagreements over the subject,[28] which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.[29] The American Medical Association called chiropractic an "unscientific cult" in 1966[30] and boycotted it until losing an antitrust case in 1987.[9] Chiropractic has had a strong political base and sustained demand for services. In the last decades of the twentieth century, it gained more legitimacy and greater acceptance among conventional physicians and health plans in the United States.[9] During the COVID-19 pandemic, chiropractic professional associations advised chiropractors to adhere to CDC, WHO, and local health department guidance.[31][32] Despite these recommendations, a small but vocal and influential number of chiropractors spread vaccine misinformation.[33]
^Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B, et al. (eds.). Principles and Practice of Chiropractic (3rd ed.). McGraw-Hill. pp. 111–34. ISBN 978-0-07-137534-4.
^ abcNelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T (2005). "Chiropractic as spine care: a model for the profession". Chiropractic & Osteopathy. 13 (1): 9. doi:10.1186/1746-1340-13-9. PMC 1185558. PMID 16000175.
^Cite error: The named reference Swanson2015 was invoked but never defined (see the help page).
^For an explanation regarding the description of chiropractic as a pseudoscience, see:
Singh, Simon; Ernst, Edzard (2008). "The Truth About Chiropractic Therapy". Trick or Treatment? Alternative Medicine on Trial. London: Bantam Press. ISBN 978-0-593-06129-9. OCLC 190777228.
Hall, Harriet (March 11, 2008). "Science and Chiropractic". sciencebasedmedicine.org. New England Skeptical Society. Archived from the original on May 12, 2019. Retrieved 2020-02-15.
Hansson, Sven Ove (2017-06-01). "Science denial as a form of pseudoscience". Studies in History and Philosophy of Science Part A. 63: 39–47. Bibcode:2017SHPSA..63...39H. doi:10.1016/j.shpsa.2017.05.002. ISSN 0039-3681. PMID 28629651.
Ernst, Edzard (2009-04-01). "Complementary/alternative medicine: engulfed by postmodernism, anti-science and regressive thinking". The British Journal of General Practice. 59 (561): 298–301. doi:10.3399/bjgp09X420482. ISSN 0960-1643. PMC 2662117. PMID 19341568.
Hall, Harriet (May 2020). "Applied kinesiology and other chiropractic delusions". Skeptical Inquirer. 44 (3): 21–23.
Novella, Steven (March 22, 2017). "Cracking Down on Chiropractic Pseudoscience". sciencebasedmedicine.org. New England Skeptical Society. Archived from the original on December 19, 2019. Retrieved 2019-12-19.
Williams, William F. (2000). Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy. Facts on File Inc. p. 51. ISBN 1-57958-207-9
^Mootz RD, Shekelle PG (1997). "Content of practice". In Cherkin DC, Mootz RD (eds.). Chiropractic in the United States: Training, Practice, and Research. Rockville, MD: Agency for Health Care Policy and Research. pp. 67–91. OCLC 39856366. AHCPR Pub No. 98-N002.
^"The DC as PCP? Drug Wars Resume – Science-Based Medicine". sciencebasedmedicine.org. 2019-12-18. Archived from the original on 2019-12-18. Retrieved 2020-03-27.
^Bellamy, Jann (December 20, 2018). "Legislative Alchemy 2018: Chiropractors rebranding as primary care physicians continues". sciencebasedmedicine.org. Archived from the original on December 19, 2019. Retrieved 2019-12-18.
^ abcErnst E (May 2008). "Chiropractic: a critical evaluation". Journal of Pain and Symptom Management. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. PMID 18280103.
^ abcCooper RA, McKee HJ (2003). "Chiropractic in the United States: trends and issues". Milbank Quarterly. 81 (1): 107–38, table of contents. doi:10.1111/1468-0009.00040. PMC 2690192. PMID 12669653.
^Posadzki P, Ernst E (2011). "Spinal manipulation: an update of a systematic review of systematic reviews". The New Zealand Medical Journal. 124 (1340): 55–71. PMID 21952385.
^Cite error: The named reference Lin2011 was invoked but never defined (see the help page).
^Cite error: The named reference ErnstMaintenance2009 was invoked but never defined (see the help page).
^Cite error: The named reference Gouveia was invoked but never defined (see the help page).
^ abErnst E (2007). "Adverse effects of spinal manipulation: a systematic review". Journal of the Royal Society of Medicine. 100 (7): 330–38. doi:10.1177/014107680710000716. PMC 1905885. PMID 17606755. Archived from the original on 2010-05-16.
Christian Nordqvist (2007-07-02). "Spinal Manipulation Should Not Be Routinely Used, New Study Warns". Med News Today.
^Cite error: The named reference Haynes was invoked but never defined (see the help page).
^Cite error: The named reference Ernst-2010 was invoked but never defined (see the help page).
^ abErnst E (2010). "Deaths after chiropractic: a review of published cases". International Journal of Clinical Practice. 64 (8): 1162–65. doi:10.1111/j.1742-1241.2010.02352.x. PMID 20642715. S2CID 45225661.
^Cite error: The named reference global-strategy was invoked but never defined (see the help page).
^Cite error: The named reference Norris was invoked but never defined (see the help page).
^Hurwitz EL, Chiang LM (2006). "A comparative analysis of chiropractic and general practitioner patients in North America: findings from the joint Canada/United States Survey of Health, 2002-03". BMC Health Services Research. 6: 49. doi:10.1186/1472-6963-6-49. PMC 1458338. PMID 16600038.
^Cite error: The named reference Kaptchuk-Eisenberg was invoked but never defined (see the help page).
^ abMartin SC (October 1993). "Chiropractic and the social context of medical technology, 1895-1925". Technology and Culture. 34 (4): 808–34. doi:10.2307/3106416. JSTOR 3106416. PMID 11623404. S2CID 23423922.
^Cite error: The named reference Religion was invoked but never defined (see the help page).
^Lazarus, David (June 30, 2017). Column: Chiropractic treatment, a $15-billion industry, has its roots in a ghost story. Archived July 19, 2020, at the Wayback Machine --- "Daniel David Palmer, the 'father' of chiropractic who performed the first chiropractic adjustment in 1895, was an avid spiritualist. He maintained that the notion and basic principles of chiropractic treatment were passed along to him during a seance by a long-dead doctor. 'The knowledge and philosophy given me by Dr. Jim Atkinson, an intelligent spiritual being ... appealed to my reason,' Palmer wrote in his memoir The Chiropractor, which was published in 1914 after his death in Los Angeles. Atkinson had died 50 years prior to Palmer's epiphany." Los Angeles Times. Retrieved: September 25, 2019.
^DeVocht JW (2006). "History and overview of theories and methods of chiropractic: a counterpoint". Clinical Orthopaedics and Related Research. 444: 243–49. doi:10.1097/01.blo.0000203460.89887.8d. PMID 16523145. S2CID 35775630.
^Homola S (2006). "Chiropractic: history and overview of theories and methods". Clinical Orthopaedics and Related Research. 444: 236–42. doi:10.1097/01.blo.0000200258.95865.87. PMID 16446588.
^Cite error: The named reference History-Primer2 was invoked but never defined (see the help page).
^Busse JW, Morgan L, Campbell JB (2005). "Chiropractic antivaccination arguments". Journal of Manipulative and Physiological Therapeutics. 28 (5): 367–73. doi:10.1016/j.jmpt.2005.04.011. PMID 15965414.
^Campbell JB, Busse JW, Injeyan HS (2000). "Chiropractors and vaccination: a historical perspective". Pediatrics. 105 (4): e43. doi:10.1542/peds.105.4.e43. PMID 10742364.
^Cite error: The named reference Chiro-PH was invoked but never defined (see the help page).
^WFC Public Health Committee and WFC Research Committee (March 17, 2020). COVID-19 Advice for Chiropractors World Federation of Chiropractic.
^Robert C. Jones, et al. Not Business as Usual: A Safe, Responsible Response to COVID-19 American Chiropractic Association
^MICHELLE R. SMITH, SCOTT BAUER and MIKE CATALINI (October 8, 2021). Anti-vaccine chiropractors rising force of misinformation. Associated Press.
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system...
Throughout its history, chiropractic has been the subject of internal and external controversy and criticism. According to magnetic healer Daniel D. Palmer...
a chiropractic "vertebral subluxation" may or may not be visible on x-rays. The term is used in the fields of medicine, dentistry, and chiropractic. There...
The history of chiropractic began in 1895 when Daniel David Palmer of Iowa performed the first chiropractic adjustment on a partially deaf janitor, Harvey...
Chiropractic education trains students in chiropractic. The entry criteria, structure, teaching methodology and nature of chiropractic programs offered...
In chiropractic, a vertebral subluxation means pressure on nerves, abnormal functions creating a lesion in some portion of the body, either in its action...
Daniel David Palmer (March 7, 1845 – October 20, 1913) was the founder of chiropractic. Palmer was born in Pickering Township, Canada West, but emigrated to...
This list of chiropractic schools is organized alphabetically by country. In those countries with functioning, specialized, accrediting agencies, the colleges...
Palmer College of Chiropractic is a private chiropractic college with its main campus in Davenport, Iowa. It was established in 1897 by Daniel David Palmer...
of spinal manipulation (known as chiropractic adjustment) as their primary treatment method, with non-chiropractic use of spinal manipulation gaining...
Veterinary chiropractic, also known as animal chiropractic, is chiropractic for animals – a type of spinal manipulation. Veterinary chiropractors typically...
Sports chiropractic is a specialty of chiropractic. It generally requires post-graduate coursework and a certification or diplomate status granted by...
E. Williams. The university was founded in 1974 by Williams as "Life Chiropractic College" on the site of a placer gold mine, next to Southern Technical...
Doctors holding the DC (Doctor of Chiropractic) degree may claim numerous credentials, denoted by letters placed after the doctor's name in official correspondences...
British Chiropractic Association (BCA) v Singh was an influential libel action in England and Wales, widely credited as a catalytic event in the libel...
Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths...
chiropractic in San Diego, California, Rob opened his own chiropractic wellness clinic in the Philippines in 2016. In addition to their chiropractic clinic...
Life Chiropractic College West is a private chiropractic school in Hayward, California, US, known for its Doctor of Chiropractic degree program. Founded...
adjunctive to chiropractic care and is not performed in a chiropractic clinic. Chiropractors may not infer or imply that the Danish chiropractic profession...
and University Commission. Originally a chiropractic school, SCU began as Los Angeles College of Chiropractic (LACC) at its founding on October 18, 1911...
Texas Chiropractic College (TCC) is a private chiropractic college in Pasadena, Texas. Founded in 1908, it is the fourth-oldest chiropractic college in...
areas such as chiropractic, health sciences and education. It was previously named Columbia Institute of Chiropractic and New York Chiropractic College before...
Anglo-European College of Chiropractic, renamed in 1969 to the Anglo-European of Chiropractic (AECC). The Anglo-European College of Chiropractic was established...
Canadian Memorial Chiropractic College (CMCC) is a Canadian private chiropractic education school in the North York, Toronto, founded in 1945. CMCC awards...
disciplines. HSU Chiropractic Program is accredited by The Council on Chiropractic Education Australasia. The Department of Chiropractic is also member...
NUCCA is an acronym for the National Upper Cervical Chiropractic Association. It was founded in 1966 by chiropractor Ralph Gregory and based primarily...
on the health sciences. The university offers professional degrees in chiropractic and naturopathic medicine, master's degrees in acupuncture and Oriental...