Bonesetting, Chiropractic, and Cultism: Postscript (2000)

Chiropractic Today

©2000, Samuel Homola, D.C.

January 1, 2000

In 1963, when I published Bonesetting, Chiropractic, and Cultism, I had been in practice for seven years. At that time, it appeared to me that while the “spinal adjustments” used by chiropractors were beneficial in the treatment of back pain, there was no reason to believe that such treatment would cure any disease. Chiropractic treatment was based on the theory that certain misaligned or “subluxated” vertebrae caused “nerve interference” that resulted in certain diseases. Simple observation of chiropractic literature and chiropractors at work was enough to generate doubt. A great variety of inconsistent chiropractic adjustive techniques, all presented as the best treatment for disease or ill health, failed to indicate a valid basis for chiropractic treatment. It appeared that the definition of chiropractic was based on a belief system. I felt that chiropractic must be reformed by making changes in the theories and treatment methods taught in chiropractic schools.

Thirty-seven years have passed since the book’s publication. The educational requirements of chiropractic colleges have improved. All 17 North American chiropractic colleges require at least two years of undergraduate college credits as an entrance requirement. Despite improvement in educational standards, chiropractic remains problematic. Large numbers of chiropractors still use a variety of scientifically unsupportable diagnostic and treatment methods, most based on subluxation theory.

Claiming to be alternative primary care physicians, many chiropractors continue to offer spinal manipulation as a treatment for visceral problems, even though no evidence supports such treatment. There is considerable evidence in today’s scientific literature to indicate that spinal manipulation can relieve some types of back pain and related musculoskeletal problems, but few chiropractors present themselves as back specialists. Those who do are necessarily limited to use of physical treatment methods over a narrow scope of practice.

In 1996, the presidents of the North American chiropractic colleges signed a position paper paper affirming that “Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.” By clinging to subluxation theory, the profession seems to be trying to maintain the status quo. Failure of the chiropractic colleges to define and teach chiropractic as a limited specialty perpetuates the inappropriate use of manipulation by practicing chiropractors. The result may be that appropriate manipulation will eventually become a part of physical medicine, separated from the practice of chiropractors who claim the exclusive right to “adjust vertebral subluxations.”

Totally frustrated with the chiropractic profession, I wrote Inside Chiropractic: A Patient’s Guide (Prometheus Books 1999), updating my views on the good and the bad in chiropractic. I hope this book will help protect consumers as well as stimulate reform of the chiropractic profession. Because of the nature of chiropractic, however, and the subluxation theory that sustains chiropractic as a “separate and distinct profession,” change is slow and painful. Some observers doubt that chiropractic will ever change sufficiently to earn recognition as a properly limited specialty, forcing it to remain on the sidelines as an “alternative” method. Patients seeking chiropractic manipulation for back pain will have to learn how to make an informed choice if they are to avoid inappropriate treatment by chiropractors.

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This page was posted on January 5, 2000.