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A few individuals within the profession contend that the existence of subluxation is questionable and have chided the CCP Panel for not addressing their contention in its earlier publication.79-81 While the CCP Panel acknowledges that certain individuals and groups within the profession do make such an assertion, the Council does not take such contentions seriously. The above review of the subluxation within the chiropractic profession, government, state law, chiropractic educational bodies and scientific literature serves as evidence of its entrenched status. Further, according to Rome there are 296 variations and synonyms of subluxation used by medical, chiropractic and other professions leading him to remark "It is suggested that with so many attempts to establish a term for such a clinical and biological finding, an entity of some significance must exist."82 Additional discussion to shed light on the concept of subluxation continues below.

Health Issue Addressed and Defined by the Guidelines

Vertebral Subluxation

The term subluxation has a long history in the healing arts literature and it may be used differently outside of the chiropractic profession. The earliest non-chiropractic English definition is attributed to Randall Holme in 1668. Holme defined subluxation as “a dislocation or putting out of joint.” 83 In medical literature, subluxation often refers to an osseous disrelationship which is less than a dislocation.84 However, B.J. Palmer, the developer of chiropractic, hypothesized that the “vertebral subluxation” was unique from the medical use of the term “subluxation” in that it also interfered with the transmission of neurological information independent of what has come to be recognized as the action potential. Since this component has yet to be identified in a quantitative sense, practitioners currently assess the presence and correction of vertebral subluxation through parameters which measure its other components.85 These may include some type of vertebral biomechanical abnormality,86-92 soft tissue insult of the spinal cord and/or associated structures93-127 and some form of neurological dysfunction involving the synapse separate from the transmission of neurological information referred to by Palmer. As noted, chiropractic definitions of subluxation include a neurological component. In this regard, Lantz136 stated “common to all concepts of subluxation are some form of kinesiologic[al...sic] dysfunction and some form of neurologic[al...sic] involvement.” In the position paper of The Association of Chiropractic Colleges they defined subluxation as follows: “A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.” 128-135 137

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_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision

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