Chiropractic Promotes Health? What is the Evidence?
Dr. Matthew McCoy firstname.lastname@example.org Editor – Journal of Vertebral Subluxation Research http://www.jvsr.com/
I recently testified in a case where the regulatory board hired experts to testify against the chiropractor on the issue of whether or not chiropractic care promotes health. In discussing the evidence on this issue one of the experts stated: “There is none.”
Another expert for the Board compared chiropractic to astrology and said there was no evidence of improved health outcomes and that basically if someone believes that chiropractic helps them there is no harm as long as they get the care they really need in addition to chiropractic. Yes – these were the experts hired by the chiropractic board.
Space does not permit an exhaustive review of the literature on this issue, however there are a number of significant studies and documents available that easily refute such unfounded contentions.
The 1996 Paradigm Statement by the Association of Chiropractic Colleges1-3 includes a section titled "Health Promotion" where it states that:
"Doctors of Chiropractic advise and educate patients and communities in structural and spinal hygiene and healthful living practices."
Another key aspect articulated in the ACC document concerns case management issues. It outlines, in a generic way, how chiropractors conduct themselves on a clinical level:
"Doctors of Chiropractic establish a doctor/patient relationship and utilize adjustive and other clinical procedures unique to the chiropractic discipline. Doctors of Chiropractic may also use other conservative patient care procedures, and, when appropriate, collaborate with and/or refer to other health care providers."
Chiropractic clinicians have a distinct manner in which they utilize the information, feedback and empirical results each patient case accumulates. For this reason, chiropractic care, especially subluxation based care, may not be linked to various diseases or conditions the patient may or may not have, before or after care has initiated. As we all know, the World Health Organization defines health as being "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity."
Given this broad definition of health, epistemological constructs borrowed from the social sciences may demonstrate health benefits not disclosed by randomized clinical trials. Health benefits such as improvement in self-reported quality-of-life, decreased health care costs, behaviors associated with decreased morbidity, and patient satisfaction may be evaluated using such methods.
This performance-based domain focuses the doctor-patient relationship on the standards set by personal baselines and establishes guidelines for the utility of various chiropractic techniques. This type of chiropractic care is in a context with other non-invasive disciplines and is stratified into discrete application-based domains across a spectrum of parameters related to well-being.
Techniques and methods for correcting subluxation must be judged on their intended outcome and most if not all chiropractic techniques have some physiological and/or structural outcome that measures their results.4 Further, some techniques have as their goals - improvement in quality of