Abstract
BackgroundSome chiropractors suggest that chiropractic treatment is appropriate for health issues other than musculoskeletal problems. The prevalence of such claims on individual clinic websites has previously been reported as approximately one-in-four in Denmark. The underlying rationales for such claims may reflect convictions about traditional chiropractic subluxations paradigms, but are not self-evident and has not previously been studied.MethodsAn exploratory qualitative case interview study of Danish chiropractors with websites which contain claims about chiropractic efficacy in the treatment of non-musculoskeletal disorders. Websites were identified from a nation wide random sample (57%) of all chiropractic clinic websites.ResultsOf the original 139 websites, 36 were identified as mentioning non-MSK conditions. When revisited, 19 of those clinic websites still mentioned non-MSK disorders and were contacted. Eleven (11) declined our invitation to participate. Interviews were conducted with the responsible chiropractor from each of the remaining 8 clinics.Five distinct themes were identified in the rationales for treating non-musculoskeletal disorders: ‘Positive side-effects,’ ‘Experience,’ ‘Web page,’ ‘Communication’ and ‘Conviction.’ConclusionsA minority of Danish chiropractic websites suggest that non-musculoskeletal disorders are within the chiropractic scope of practice. Those that do, do so for varying reasons—poor communication and website maintenance were commonly cited problems. An explicitly stated adherence to traditional chiropractic subluxations concepts was uncommon. By contrast, a more tempered rationale that suggested a potential beneficial side-effect of chiropractic on non-musculoskeletal health issues were more common and was typically presented in softer-language and/or with some reservations.
Highlights
The heterogeneity of the chiropractic profession includes some chiropractors who pursue mainstream integration, promoting a diagnosis driven, evidence based practiceA recent comprehensive review of the literature concluded that there is only limited evidence, but it indicates that spinal manipulation is not effective for the management of non-MSK disorders [4]
A minority of Danish chiropractic websites suggest that non-musculoskeletal disorders are within the chiropractic scope of practice
O’Neill et al Chiropractic & Manual Therapies (2021) 29:50 a recent commentary on chiropractic professional heterogeneity, LeBoeuf-Yde et al [5] observed that “Today, the division is between the ‘evidence-friendly’ faction that focuses on musculoskeletal problems based on a contemporary and evidence-based paradigm, and the ‘traditional’ group that subscribes to concepts such as ‘subluxation’”
Summary
The heterogeneity of the chiropractic profession includes some chiropractors who pursue mainstream integration, promoting a diagnosis driven, evidence based practiceA recent comprehensive review of the literature concluded that there is only limited evidence, but it indicates that spinal manipulation is not effective for the management of non-MSK disorders [4]. The readiness of chiropractors to treat non-MSK conditions could be interpreted as an indicator of their position on a professional spectrum from the traditional subluxation paradigm to the modern evidence based approach. Jensen et al examined the websites of a random sample of Danish chiropractors for any mention of non-MSK problems [6]. Similar observations have been reported elsewhere, with approximately 30% of sampled chiropractic websites in Canada mentioning asthma or allergies [7] or attention deficit disorder, premenstrual syndrome, allergies or bed-wetting [2]. Some chiropractors suggest that chiropractic treatment is appropriate for health issues other than musculoskeletal problems. The prevalence of such claims on individual clinic websites has previously been reported as approximately one-in-four in Denmark. The underlying rationales for such claims may reflect convictions about traditional chiropractic subluxations paradigms, but are not self-evident and has not previously been studied
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