The Great Chiropractic Rift: “Subluxation”

(Originally posted on bcotoronto.com on Mar 1st, 2012)

To date I have tried to stay non-biased in my blog but on this issue I definitely take one side. This week I would like to give you a little glance into the world of chiropractic and explain one reason why your experience with chiropractic can be so drastically different between doctors sometimes. Obviously I do fall squarely on one side of this debate but I will attempt to present this issue in as unbiased a way as possible.

If you have been to a chiropractor before you may have heard the word Subluxation used. For those of you how have not let me give a little background here. A Subluxation is what chiropractors treat. Or at least that used to be the popular opinion about twenty to thirty years ago. When you break it down, a Subluxation is a partial dislocation coming from the prefix “sub” meaning less than or partial and “luxation” which is a medical term for dislocation which is rarely used anymore (I’m not sure what its root is). The use of this word to describe what chiropractors treat originated with the idea that chiropractors are putting a bone back in place and is around a hundred years old now.

Chiropractic has changed since those days. As societal standards have required (rightly so) more research behind treatments, this research has shown that although bones are moved during a manipulation the idea that they were “out of place” is a bit of an exaggeration. Muscles and ligaments can hold a joint or limit its mobility but the bones are still within their normal range of motion. This has lead to the use of the terms “Fixation” or “Restriction” to describe what we treat as chiropractors but there is much fighting about this within the profession.

Really there are two sides to the debate; those who believe we cannot abandon the traditional teachings of chiropractors and those who believe that as the understanding of the physiology of the body changes the stance we take as professionals needs to change. Of course, as with any range of beliefs it is a sliding scale of grey and not an issue of black and white. Some say that Subluxation is the basis of all disease while others say that we need to distance ourselves from that word all together. So really is that surprising that we cannot work together as a profession to present a good public image and improve the public’s knowledge of chiropractic like other medical professions have? This lack of cohesion is what has made us look like we don’t actually know what we are doing for a long time.

This couldn’t actually be farther from the truth. No matter what we call it or how we describe it, the one thing chiropractors agree on is that neurological functioning is altered due to this lesion in the spine either through pressure on the nerve or sensory feedback mechanisms.

Some groups have searched for a neutral term that all chiropractors can agree on and the closest anyone has gotten is calling it a “Functional Articular Lesion” but those on the traditional end of the scale think that this is an insult to the profession and those on the other end aren’t convinced we have fully defined what it is yet and so can’t name it. Also, that’s a big mouthful and gets even more weird looks from patients than saying Subluxation.

So when you are talking to your local chiropractor ask them what they think Subluxation means and get their opinion. Personally, I think Subluxation is an outdated term that gives the wrong impression of what we do but Fixation or Restriction are just fine with me.

Thanks for reading,
Dr. Ben

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