This was posted by Former UCA President Frank McBride who like myself resigned from the General Chiropractic Council register because of their efforts to covertly medicalise chiropractic
There is a view within the profession that sees chiropractic as a therapy for pain relief, and that once relief of pain has been achieved, patient care should end. Implicit in this view is that a chiropractor who continues with care beyond the resolution of a patients symptoms is somehow being unethical.
This fundamental lack of understanding of chiropractic principles, and the basic principles of the biological organism, coupled with intolerance of any other view or approach, plus an ideology that is immutable, can and does lead to the persecution of colleagues who do not hold to these same views.
Ultimately, debates about whether the subluxation complex is associated with pain and debates about the existence of the subluxation complex illustrate that our profession has not adequately applied the principles of pathology and neuroscience to the spine.
Pain is a symptom that is considered a component of subluxation syndromes, but it need not be present for the subluxation complex to exist. Similarly, heart disease, cancer, diabetes, alzheimer’s disease, cirrhosis, osteoporosis, and all other chronic diseases are known to exist long before symptoms appear. Why should this be any different for the subluxation complex? Research has clearly demonstrated that pathologic changes of the spinal column, which we call the subluxation complex, may exist without symptoms. Consider that significant disc herniations can be present in individuals without back pain and that atrophic changes and fatty infiltration of spinal muscles exist in 45% of asymptomatic individuals.
Strained and biomechanically stressed tissues will release chemical mediators of inflammation that constitute the biochemical changes of the subluxation complex. It is known that the cells of injured discs and joint tissue release chemical mediators, such as proinflammatory eicosanoids (prostaglandin-E2, leukotriene-B4, thromboxane-A2) and proinflammatory cytokines such as interleukin-1 and tumour necrosis factor. These biochemical changes that we associate with the subluxation complex can stimulate spinal nociceptors and generate the back pain we commonly encounter. Initially, such biochemical changes can occur without obvious signs of degeneration, inflammation, and nociception and without the generation of symptoms – the way that every chronic disease begins.
Considering the fact that nociceptive input reaches subcortical areas, such as the brainstem and hypothalamus, it is also likely that a wide variety of neuroendocrine responses and seemingly unrelated symptoms could develop in response to a sensitised nociceptive system (or a system with decreased mechanoreception to inhibit nociception). In other words, pain may not be the symptomatic outcome of nociceptive stimulation of spinal structures. Such a conclusion has profound implications for the chiropractic profession.
Clearly, patients do not need to be in pain to be candidates for spinal adjustments.
In summary, it is clearly inappropriate to equate the subluxation complex with low back pain; rather, the subluxation complex should be viewed as a promoter of low back dysfunction and as component of the deconditioning syndrome. Moreover, it is important to understand that treatment of the subluxation complex and the deconditioning syndrome does not end merely because back pain resolves.
Chiropractic is based on the now scientifically proven hypothesis that proper structure of the spine is required for proper function of the nervous system as it relates to the control and regulation of global physiology and health. Chiropractic has never been and can never be defined as manipulation to reduce symptoms.
