Unit 5 CAM Project

Lesson 1 Lecture

Lesson Summary: This lesson addresses the question, "What is chiropractic care?"
by going over the definition of chiropractic medicine. It also discusses the ancient
and modern history of chiropractic care.

 Lesson Content:
 What is Chiropractic Care?
Do you know what Chiropractic care is? While many people have accepted
Chiropractic care as a normal part of their healthcare, most people don’t actually
know what it is. Chiropractic is actually a combination of Greek words that simply
means “done by hand” (UM, 2020). Chiropractic care is a modality of
Complimentary and Integrative Medicine that focuses on the spine and many other
joints within the body and their connection to the nervous system (UM, 2020). This
is a broad statement about what Chiropractic care does and to understand it better
we need to take a look at how Chiropractic care started.

Ancient History of Chiropractic Care

Chiropractic care actually has a pretty interesting back story that could play out on
the big screen. In its modern form, chiropractic care originated in the late 1800’s
but we have some evidence of spinal manipulative therapy being used by many
ancient cultures (UM, 2020). As far back as 400 B.C., Hippocrates, the father of
Greek medicine, believed in the use of manual treatments to help with spinal
conditions (UM, 2020). There are also Buddhist temples from over 2000 years ago
that contain evidence that lumbar spine manipulation was being used at that time
(UM, 2020).

Modern History of Chiropractic Care

Fast forward to the 1500’s in Europe and we find that spinal manipulation was
being practiced by “bone-setters”, who were skilled tradesman that learned their
trade from family apprenticeship (UM, 2020). The medical community at the time
considered these tradesmen to be uneducated but Sir James Paget published an
article titled “Cases that bonesetters cure” in 1867 in the British Medical Journal that
gives evidence to Chiropractic usefulness. This leads to the emergence of the
chiropractic profession in Davenport, Iowa in 1895 (UM, 2020). A gentleman named
Daniel David “D.D.” Palmer created the profession after adjusting a deaf person’s
spine and claimed that it restored the man’s hearing (UM, 2020). According to the
University of Minnesota (2020), “Palmer’s description of his intervention as an
“adjustment” differed from spinal manipulation in that it aimed to reposition
subluxated vertebrae, which he claimed interfered with the function of the nervous
system”. Following his discovery, Mr. Palmer created the Palmer School of
Chiropractic in order to teach his methods to the first true chiropractors and his
school still operates today (UM, 2020). The Palmer School of Chiropractic gave rise
to Mr. Palmer’s son, Bartlett Joshua “B.J.” Palmer, who is given credit for further
developing the profession into the first part of the 20th century (UM, 2020). This is
in large part because D.D. Palmer, the founder, was in jail for the unlicensed practice
of medicine and this left B.J. to take over as president and owner of the Palmer
School of Chiropractic (UM, 2020). B.J. Palmer was far more vocal and purchased
radio stations and traveled to give speeches in order to promote the many benefits
of chiropractic care (UM, 2020). The field of chiropractic care suffered through
many trials due to being persecuted for practicing medicine without a license. This
lead to the establishing of chiropractic licensure in all states in 1905 but this would
not come to fruition until 1974 (UM, 2020). This giant gap in time lead to many
being arrested, fined, and serving jail time because of their refusal to stop serving
their patients just because they didn’t have a medical license. All of this culminated
into a U.S. Court of Appeals Trial in 1990. The University of Minnesota (2020)
reveals that “the American Medical Association (AMA) was found guilty of anti-trust
violations while attempting to eliminate the profession of chiropractic as a
competitor in the U.S. healthcare system”. This is huge because it proved that the
American Medical Association tried to inhibit cooperation between medical doctors
and chiropractors. This leads us to chiropractic care in its modern format and
leaves us asking exactly what does a chiropractor do? This is where we will pick up
next week.
 Unit 5 CAM Project
Lesson 2 Lecture

Lesson Summary: This lesson will outline the philosophies of chiropractic care. We
will explore innate intelligence as well as the biopsychosocial model. This lesson
will also reveal the scope of the chiropractic care practice.

 Lesson Content:
 Innate Intelligence
There are a great deal of theories that attempt to explain how chiropractic care
actually creates a clinical effect. The first of these is innate intelligence. According
to the University of Minnesota (2020), innate intelligence is “a natural force within
us responsible for the organization, function, and self-healing of the human body”.
Chiropractic care believes that when innate intelligence is disrupted by subluxated
vertebrae an interference within the nervous system is produced and that the
body’s ability to self-regulate and heal is reduced (UM, 2020).

Biopsychosocial Model
A more modern theory is the biopsychosocial model for pain. Chiropractic care has
understood for many years that pain is complex and that there are many factors that
influence it (UM, 2020). Thus, they created the biopsychosocial model for pain in
order to recognize the “complex interplay between biological, psychological, and
social factors that influence health and disease” (UM, 2020). This model lead to the
creation of biological mechanisms through the research of spinal manipulative
therapy (SMT). The University of Minnesota (2020), proposes that “several
biomechanical, neurophysiological, and psychological mechanisms have been
proposed to explain the clinical effects of SMT”. Some of the effects include
“disruption of adhesions within the zygapophysial joints of the spine, normalization
of neuromuscular control, and alteration of the neurophysiological pain response”
(UM, 2020). These are all really fancy ways of saying that chiropractors can help
with many different ailments.

Scope of Chiropractic Care

The scope of practice for chiropractic care is tremendous but in general, a simple
explanation combined with a hands-on approach, and quality time spent with each
patient generally provides comfort and peace of mind for chiropractic patients.
Chiropractic care encompasses the science, philosophy, art, doctoral research,
medical practice, and clinical application of chiropractic medicine. Chiropractic care
is recognized as a legal profession in all jurisdictions of the United States. The scope
of practice, authority, and responsibility are established by the laws in each
individual state. Administrative agencies regulate the chiropractic practice by
establishing rules and requiring licensure and enforcing laws. All states require
licensure. In all states, chiropractic physicians have a legal obligation to get a
patient history, physical exam, develop a diagnosis, and care for their patients. A
chiropractor can provide patient management through treatment, referral, or co-
management with another healthcare provider. Treatment by chiropractors can
include manipulation or adjustment of the joints of the spine and other articulations
of the body, muscle and fascial work and other soft tissue procedures, rehabilitation,
lifestyle counseling, nutritional therapy, vitamins, botanicals, enzymes and minerals,
stem cell injections, and the use of other physical therapy modalities. So, how
available is chiropractic care? We will look at this next week.
 Unit 5 CAM Project
Lesson 3 Lecture

Lesson Summary: This lesson will outline chiropractic care today. We will explore
the social and economic impact of chiropractic care. We will also research some
evidence in the uses of chiropractic care as well as some of the innovative new
processes in chiropractic care.

 Lesson Content:
 Social and Economic Impact
The social and economic impact of chiropractic care is absolutely measurable and
one definitely affected the other. According to the University of Minnesota (2020),
“each year, approximately 1 out of every 10 U.S. adults visits a chiropractor,
chiropractic services account for 3.3% of all office based healthcare expenditures in
the U.S., and the vast majority of visits to chiropractors are for musculoskeletal
complaints”. It is also reported that “patient satisfaction with chiropractic care is
consistently rated amongst the highest of all healthcare professionals for the
management of spinal disorders” (UM, 2020). The social acceptance of chiropractic
care is continuing to rise with no evidence of it slowing down. With this many
people seeking chiropractic care it leads one to ask about the economic impact and
availability. Over the past 40 years, chiropractic services have become a standard
part of major medical insurance plans (UM, 2020). Medicare has covered spinal
manipulative therapy since the 1970’s and Medicaid and Workman’s Comp
insurance plans cover chiropractic services in all 50 states (UM, 2020). What about
those with private insurance? Most major health insurance plans now include
chiropractic care and services (UM, 2020). This is a wonderful and necessary step
forward in integrating chiropractic care with modern western medicine but do we
have any evidence that it actually works?

Evidence in the Uses of Chiropractic Care

To prove that chiropractic care actually works we will look at two studies. The first
study is one that deals with spinal manipulative therapy for low back pain
(Bussières, 2018). According to Bussières (2018), “the objective of this study was to
develop a clinical practice guideline on the management of acute and chronic low
back pain in adults”. The cool part about this study is it directly compared the use of
spinal manipulation therapy with other common used conservative treatments
(Bussières, 2018). This comparison gives strong evidence of whether spinal
manipulative therapy actually makes any provable difference. According to
Bussières (2018), the study found conclusively that “a multimodal approach
including SMT, other commonly used active interventions, self-management advice,
and exercise is an effective treatment strategy for acute and chronic back pain”. The
second study is one that deals with chiropractic spinal manipulative therapy for
migraines (Chaibi, 2017). This study is awesome because it researched the
effectiveness of SMT in the prevention and frequency of migraines as well as it use
in treating an active migraine. According to Chaibi (2017), the study found that
“migraine days were significantly reduced in all groups from baseline to post-
treatment”. The study also showed that “migraine duration and headache index
were reduced significantly” (Chaibi, 2017). These studies are amazing and only two
of the many available to read. Both studies give clinical evidence to the many
benefits of chiropractic care.

Innovation and Advancement of Chiropractic Care

Chiropractic care and medicine continues to make many major advancements.
Today, chiropractic care can include stem cell injections, cryo-technology therapies,
weight loss therapy, INSiGHT Scanning Technology, K-Laser Therapy, or the
ProAdjuster. These advancements continue to show the relevance and necessity
into chiropractic care.