Chiropractic Vertebral Subluxation Research Articles

The Chiropractic Vertebral Subluxation Part 8: Terminology, Definitions, and Historicity From 1966 to 1980

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) between the years 1966 and 1980, with an emphasis on consensus models and terminology. DiscussionThe consensus models on CVS during this time were an outgrowth of previous model building, research, and practice methods. The first consensus models were developed by the radiology diplomates of the American Chiropractic Board of Radiology. Later work was used to develop Medicare standards. Research and theory were influenced by the 1975 National Institutes of Health conference on spinal manipulation in 1975 and the workshops that followed that meeting. A new historical consciousness about the CVS, developed at the National Institutes of Health conference, which was a turning point for the profession in the use of terminology and the focus on functional pathophysiology associated with CVS. The historical view of CVS developed by Watkins, Haldeman, and Janse led to new integrative and historical developments in the profession. ConclusionTheories during this period included consensus efforts as well as new distinctions about CVS theory and terminology.

The Chiropractic Vertebral Subluxation Part 7: Technics and Models From 1962 to 1980

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) theories and models between 1962 and 1980. DiscussionThis period was marked by several innovative texts from Weiant, Homewood, and Harper, and Canadian Memorial Chiropractic College’s Segmental Neuropathy. Technique developers during this period increased the complexity of models from upper cervical to full spine. The textbooks built upon previous theories, the scientific literature, work by Speransky, and instrumentation research. The texts influenced decades of research and theory. Weiant’s book surveyed the medical and scientific literature on CVS. Harper integrated modern neurophysiology with D. D. Palmer’s theories integrated with other chiropractic models based on research such as Weiant’s photoelectric instrumentation. Homewood’s book integrated Selye, Speransky, Verner, and several other models, which led to his neurodynamic model of CVS. Segmental Neuropathy was a completely new innovation of chiropractic theory with neurophysiology. Collaboration among authors developed into several new models. Chiropractic vertebral subluxation was viewed as a global neurological phenomenon and a neurodystrophic process. Technique models from Goodheart, Nimmo, Toftness, Ward, Gonstead, Grostic, Gregory, and Pierce laid the foundation for modern practices. ConclusionThe CVS theories during this period were complex and almost unrecognizable from previous theories. The inclusion of every major theory laid the foundation for this period’s wide set of models, research, and methods.

The Chiropractic Vertebral Subluxation Part 9: Complexes, Models, and Consensus From 1979 to 1995

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) between 1979 and 1995, with an emphasis on complexes, models, and consensus. DiscussionNew models were developed and critiqued during this period. The first subluxation complex model was proposed by Faye. Other theorists such as Lantz and Dishman built upon his model. The complex models were integrated into consensus statements by the International Chiropractic Association and the American Chiropractic Association, and later by profession-wide processes. The plurality of the CVS encompassed known theories and included integration of stress models and biochemistry. The professional consensus around CVS was comprehensive as shown by the process models that included stakeholders in the profession. Calls for more empirical research and changes to terminology increased during this era. Influential articles from this period potentially contained errors and relied on older studies that may no longer be valid. ConclusionThe challenges to researching this complex entity during that time were daunting for many and pointed to challenges of using the word “subluxation" to encompass the multiplicity that defined CVS.

The Chiropractic Vertebral Subluxation Part 4: New Perspectives and Theorists From 1916 to 1927

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) between the years 1916 and 1927. DiscussionTheories during this period were shaped by many chiropractic school leaders and instructors. Unique contributions to theories during this period come primarily from 4 authors, John Craven, Jim Drain, Shelby Riley, and Ralph Stephenson. This period included the first thermographic instrumentation in chiropractic, which led to one of Craven’s modifications of CVS theory. He also added to the literature about spinal cord pressure and developed the restoration cycle. Drain and Stephenson also expanded on the cord pressure models of CVS. Drain wrote, in plain language, of many central B. J. Palmer theories and developed protocols for acute and chronic CVS. Stephenson made several contributions to models, including his expansion on B. J. Palmer’s theory of momentum of dis-ease. Stephenson’s main contribution to theory was likely his vertemere cycle, which was a precursor to proprioceptive models. Riley’s combination of Gregory’s theories with zone therapy had a significant impact on several reflex theories. ConclusionChiropractic vertebral subluxation theory during this period grew in complexity and demonstrated several new perspectives on CVS, which may be still relevant today.

The Chiropractic Vertebral Subluxation Part 6: Renaissance of D.D. Palmer’s Paradigm From 1949 to 1961

ObjectiveThe objective of this article is to review and discuss the history of chiropractic vertebral subluxation (CVS) between the years 1949 and 1961. DiscussionChiropractic texts from this period include books from 3 of D. D. Palmer’s students, Ratledge, Drain, and B. J. Palmer, and new works by Janse, Illi, Muller, and R. J. Watkins. Theories during this period included developments from B. J. Palmer’s research clinic and his final theories. The period also included the primary theories of Ratledge on etiology of CVS and Drain’s models of spinal curves and CVS patterns. Janse supported Illi’s new models of pelvic subluxation dynamics with cadaver studies and also developed lumbar research with Fox in the 1950s. The qualitative models of Muller on the role of CVS in sympathetic and parasympathetic systems was unique. R. J. Watkins further developed his initial theories on reflex system models as well as his first models of proprioception. Instrumentation was used in many chiropractic research programs to develop additional models. ConclusionThe CVS theories during this period built on previous models but also added new and innovative theories based on research and collaboration.

The Chiropractic Vertebral Subluxation Part 5: The First Research Era From 1928 to 1949

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation theories between 1928 and 1949. DiscussionTheories during this period grew in complexity and developed in 4 primary ways: upper cervical models, reflex models, global models, and models based on the work of Speransky. Authors, theorists, and technique developers during this time included B. J. Palmer, R. J. Watkins, Galen Price, John Hurley, Hugh Logan, Major Bertrand DeJarnette, Richard Van Rumpt, Roy Ashton, Joseph Janse, Henri Gillet, James Firth, and J. R. Verner. At least 8 perspectives on chiropractic vertebral subluxation were advanced through research, modeling, and applied clinical methods. By understanding the complexity of this period and analyzing the research, the modern practitioner will be able to appreciate this era. The foundations of modern clinical practice and theoretical applications have roots in this period. ConclusionTheories during this period developed in levels of complexity, expanding existing models and clinical practice methods. The theories and research from this period had an effect on the chiropractic profession for the subsequent decades.

The Chiropractic Vertebral Subluxation Part 3: Complexity and Identity From 1908 to 1915

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) between 1908 and 1915. DiscussionEvidence from the works of Daniel D. Palmer, Bartlett J. Palmer, Joy Loban, Willard Carver, James Firth, Alva Gregory, John Howard, Arthur Forster, and Harold Swanberg demonstrates that chiropractic during this period was characterized by increasingly complex theories of CVS, which contributed to defining the profession. Critiques of CVS as a central identifier of the profession begin with this early period when students of D. D. Palmer’s early graduates became school leaders and theorists. Textbooks were self-published during this period, including D. D. Palmer’s final works, 4 books from his son B. J. Palmer, and texts from their students. Chiropractic graduates of subsequent schools also contributed to emerging writings and concepts. Chiropractic vertebral subluxation was central to nearly all texts and schools. There was disagreement about what defined chiropractic, and various schools taught different practices. However, the theories from this period had an important role in the evolution of thought in the profession. ConclusionTheories presented from 1908 through 1915 built upon previous concepts from earlier years of chiropractic. The plethora of books and ideas about CVS from these early pioneers shaped the profession, and some of these viewpoints still have relevance today.

The Chiropractic Vertebral Subluxation Part 10: Integrative and Critical Literature From 1996 and 1997

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) during 1996 and 1997. The literature during this period offered critical and integrative models emphasized by a need for research into operational and functional definitions. DiscussionSeveral integrative approaches emerged, from Rome’s 296 synonyms to Bergman’s Pain/Tenderness, Asymmetry/Alignment, Range of Motion Abnormality, Tissue Tone, Texture, Temperature Abnormality, and Special Tests (PARTS) analysis adopted by the profession in the United States. Other noteworthy contributions included Ruch’s Atlas of Common Subluxations, Epstein’s introduction of network spinal analysis, and Kent’s review of CVS models. Boone’s introduction of the Journal of Vertebral Subluxation Research was accompanied by his 3-part model with Dobson. These years also included the paradigm statement of the Association of Chiropractic Colleges, which was adopted by the American Chiropractic Association, International Chiropractors Association, and World Federation of Chiropractic. Two other papers included Nelson’s critique of the CVS paradigm and Keating’s 1996 “Hunt for the Subluxation.” ConclusionThe CVS reached a new stage of complexity and critique and offered new directions for research, integration, and development.

The Chiropractic Vertebral Subluxation Part 2: The Earliest Subluxation Theories From 1902 to 1907

ObjectiveThe purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) in the chiropractic profession between the years 1897 and 1907. DiscussionThe first theories in chiropractic were developed by pioneers such as D. D. Palmer; his students, such as A. P. Davis, Oakley Smith, and Solon Langworthy; and his son B. J. Palmer. Their thoughts on CVS established foundational theories for the profession. D. D. Palmer posited his initial concept of CVS as an articular disrelationship between vertebrae causing pressure and impingement on nerves leading to too much or too little function. Palmer’s students developed additional theories. ConclusionFrom the first years of CVS, there was a diversity of theories, practices, and scientific rationale. This account of the early theories may offer insights into the historical literature.

The Chiropractic Vertebral Subluxation Part 1: Introduction

ObjectiveThe objective of this article is to present a rationale for the need of a history of chiropractic vertebral subluxation (CVS) theory based on primary sources. DiscussionThere is a dichotomy in the chiropractic profession around subluxation terminology, which has many facets. The literature around this topic spans social, economic, cultural, and scientific questions. By developing a rationale for a historical perspective of CVS theory, including the tracking of the historical development of ideas throughout the profession, a foundation for future discourse may emerge. ConclusionsBy using primary sources, ideas in chiropractic on the development of CVS theory are proposed. This introduction presents a basis for the need of a history of CVS theory and suggests how this work may be used to further philosophical dialogs in chiropractic.

Real orthopaedic subluxations versus imaginary chiropractic subluxations

AbstractThe chiropractic vertebral subluxation theory has confused the definition of the word ‘subluxation’; a common medical term. Unlike the mysterious, undetectable chiropractic ‘vertebral subluxation complex’ alleged to be a cause of disease, a real vertebral subluxation can be a cause of mechanical and neuromusculoskeletal symptoms, but has never been shown to be a cause of organic disease. The views offered in this paper may be helpful in clarifying this issue.

Asymmetry in atlas bone specimens: a pilot study using radiographic analysis

Objective Vertebral asymmetries can present a challenge to analysis of the anatomical and biomechanical misalignment component of chiropractic vertebral subluxation. The objective of this study was to determine the extent of asymmetry among 10 natural bone atlas specimens using radiographic analysis. Methods Ten natural atlas bone specimens' images were recorded using a digital radiographic system, and evaluations were made by 2 independent examiners using the system's software. Mean differences, standard deviations, and agreements were evaluated in regard to bilateral differences. Results The mean bilateral difference for both examiners was 0.96 mm, with a standard deviation of ±0.67 mm. There were no statistically significant differences between the mean values for left and right measurements. Discussion The mean of 0.96 ± 0.67 mm indicates that measurements up to 1.63 mm (1 SD) or 2.30 mm (2 SDs) are clearly within a reference range of variation for this sample. This information could be used to assist the clinician measuring lateral misalignment of the atlas in determining the amount of expected normal asymmetry for the individual patient before concluding that lateral misalignment of the atlas is present. Conclusions These 10 specimens showed an average difference of 0.95 mm ± 1 SD (0.67 mm) or 2 SDs (1.34 mm) between the left and right sides of the atlas vertebrae. Differences found on radiographs may be due to asymmetry and not actual misalignment. On the average, for these 10 vertebra specimens, a lateral disposition of 1.62 mm on either side should be allowed when arriving at a conclusion for lateral displacement of the atlas.

Chiropractic treatment of otitis media with effusion: a case report and literature review of the epidemiological risk factors that predispose towards the condition and that influence the outcome of chiropractic treatment

Objective: Comparison of the risk factors identified in one patient and the outcome of treatment, with the epidemiological risk factors identified in the literature that predispose to otitis media with effusion that can potentially influence the outcome of chiropractic treatment. The aim of this case study is to focus practitioners when taking a case history, in order to aid an individual prognosis and treatment plan for each patient. Clinical features: A 3 1 2 -year-old boy presented to a chiropractic clinic with a 10-month history of continuous discharge with a distinctive smell emanating from both his ears. Upon a routine 3-year check-up for his hearing, 4 months prior to consultation, a slight hearing deficit had been identified. This was being reviewed in 2 months’ time with consideration for myringotomy and tympanostomic tube insertion. Cervical and thoracic segmental dysequilibrium was found on static motion palpation, suggesting the presence of a chiropractic vertebral subluxation complex at these levels. Intervention and outcome: The patient was treated 4 times using cervical paediatric adjusting. Activator technique was applied to the thoracic region. Discharge from the ears disappeared immediately after the first visit. An improvement in hearing was identified at a hearing test 3 months after cessation of chiropractic care. Consequently, myringotomy and tympanostomic tube insertion was considered inappropriate. The patient now uses oil drops to prevent cerruminum accumulation. At 6 years old, he has had no further recurrences of OME and no speech or hearing problems are apparent. Conclusion: Of the risk factors identified with the onset of otitis media with effusion, this patient exhibited the following: premature birth, breech presentation, low birth weight, time spent in intensive care, exclusive formula feeding, day care attendance and 2 or 3 recurrent episodes of ear infection for which antibiotics were prescribed. Despite these factors, the patient made rapid symptomatic improvement in a single treatment.

The Question of Theology for Chiropractic: A Theological Study of Chiropractic's Prime Tenets

The purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) between the years 1916 and 1927.Theories during this period were shaped by many chiropractic school leaders and instructors. Unique contributions to theories during this period come primarily from 4 authors, John Craven, Jim Drain, Shelby Riley, and Ralph Stephenson. This period included the first thermographic instrumentation in chiropractic, which led to one of Craven’s modifications of CVS theory. He also added to the literature about spinal cord pressure and developed the restoration cycle. Drain and Stephenson also expanded on the cord pressure models of CVS. Drain wrote, in plain language, of many central B. J. Palmer theories and developed protocols for acute and chronic CVS. Stephenson made several contributions to models, including his expansion on B. J. Palmer’s theory of momentum of dis-ease. Stephenson’s main contribution to theory was likely his vertemere cycle, which was a precursor to proprioceptive models. Riley’s combination of Gregory’s theories with zone therapy had a significant impact on several reflex theories.Chiropractic vertebral subluxation theory during this period grew in complexity and demonstrated several new perspectives on CVS, which may be still relevant today.

Reflex effects of vertebral subluxations: The peripheral nervous system. An update

Background: The traditional chiropractic vertebral subluxation hypothesis proposes that vertebral misalignment cause illness, disease, or both. This hypothesis remains controversial.Objective: To briefly review and update experimental evidence concerning reflex effects of vertebral subluxations, particularly concerning peripheral nervous system responses to vertebral subluxations.Data Source: Information was obtained from chiropractic or scientific peer-reviewed literature concerning human or animal studies of neural responses to vertebral subluxation, vertebral displacement or movement, or both.Conclusion: Animal models suggest that vertebral displacements and putative vertebral subluxations may modulate activity in group I to IV afferent nerves. However, it is not clear whether these afferent nerves are modulated during normal day-to-day activities of living and, if so, what segmental or whole-body reflex effects they may have.

CHIROPRACTIC “PHILOSOPHY”

The objective of this article is to present a rationale for the need of a history of chiropractic vertebral subluxation (CVS) theory based on primary sources.There is a dichotomy in the chiropractic profession around subluxation terminology, which has many facets. The literature around this topic spans social, economic, cultural, and scientific questions. By developing a rationale for a historical perspective of CVS theory, including the tracking of the historical development of ideas throughout the profession, a foundation for future discourse may emerge.By using primary sources, ideas in chiropractic on the development of CVS theory are proposed. This introduction presents a basis for the need of a history of CVS theory and suggests how this work may be used to further philosophical dialogs in chiropractic.