The safety and effectiveness of pediatric chiropractic: a survey of chiropractors and parents in a practice-based research network.

From the National Scoliosis Foundation's website:

Chiropractic

The word "chiropractic" is a compilation of two Greek words which are interpreted to mean "efficient hands". In 1898 David Daniel Palmer, the originator of chiropractic, set up the Palmer College of Chiropractic in Davenport, Iowa. Today, there are fifteen accredited institutions and programs in the US offering the Doctor of Chiropractic (DC) degree. Following is an explanation of the nature, practice, and basic theories of chiropractic as defined by the Council of Chiropractic Education, and the Massachusetts Chiropractic Society. Nature and Practice Chiropractic is a system of treatment based on the principle that a person's health is determined largely by the nervous system and that interference with this system impairs normal functions and lowers resistance to disease. Chiropractors treat patients primarily by manual manipulation (adjustments) of parts of the body, especially the spinal column. Because of the emphasis on the spine and its position, most chiropractors use X-rays to aid in locating the source of patients' difficulties. In addition, most chiropractors use supplementary measures such as water, light, ultrasound, electric and heat therapy, and prescribe diet, supports, exercise, and rest. State laws specify the types of supplementary treatment permitted. Chiropractors do not use prescription drugs, nor do they perform surgery.   Basic Theories Simply stated the science of chiropractic is based on the following principles: There are two hundred and nine bones and numerous adjacent structures, such as muscle, tendon and ligamentous tissue, within the human body, most of which are capable of movement, particularly where two bones come together to form a joint, and each bone has a particular position and its own predetermined range of motion. Many of these moving parts, like the moving parts of a finely tuned machine, may become subluxated or misaligned and deviate from their normal position. Such misalignments are apt to occur as the result of external trauma, a sudden and forceful movement of the body such as a quick turning of the head, a whiplash injury, heavy sneezing, or the lifting, pushing or pulling of a heavy object. These deviations, which are usually referred to as a "subluxation complex", can cause contact, irritation, pressure or tension on surrounding nerves. Pressure or pinching on a nerve may cause abnormal function, such as limitation of movement and pain, to the locally affected area; however, the pain is also likely to radiate along the involved or nerves and cause distress and functional instability to other parts of the body. A subluxation usually can be corrected by means of adjustment or realignment whereby the disjointed member is restored to its proper position, thereby alleviating or eliminating the pressure or irritation to the nerve that is the source of discomfort. It is also a basic tenet of chiropractic that the elimination of nerve interference and the restoration of the body to its normal and natural function in a significant number of cases enables the inherent recuperative powers of the body to operate without interference or impediment and restore the afflicted area to good health. Of all the moving parts of the human body, among the most delicate and the most likely to fall into displacement are the numerous joints of the spinal column, and it is for this reason that the chiropractor is usually thought of specifically in terms of conditions of the spine and is not always considered when an abnormality is experienced in other parts of the body. However, the spinal column with its infinite network of branching nerves can serve as a vehicle by which pain is radiated to various parts of the body. Consequently, there are situations in which a pain in the arm, neck, hand, foot, leg or elsewhere may be properly and successfully treated by a chiropractor. It is the function of a chiropractor, after taking the patient's case history, to diagnose by way of physical examination, X-ray and palpation or probing by hand, a possible subluxation or a misalignment as a cause of nerve interference, and to eliminate that condition by corrective manipulative adjustment. Since the nerve system is the very essence of chiropractic healing, a brief description of its three major components is necessary. First, the brain acts as the central computer where information from all parts of the body is processed, stored and acted upon. Second, the spinal cord, an extension of the brain, acts as a facilitator in the transmission of information between the brain and various parts of the body; Finally, the peripheral nerve system connects the spinal cord directly or indirectly with virtually all the tissues of the body. The spine is composed of twenty-four movable vertebrae, which house and protect the spinal cord, but because they are movable, they can interfere with the spinal cord and nerve roots they were created to protect. There are many things that can interfere with the nerve system, such as drugs, physical trauma, poisons, or toxic environments. However, the chiropractor is concerned with the misalignment of the vertebrae known as the Vertebral Subluxation. The Vertebral Subluxation is a condition where a vertebra has lost its normal juxtaposition with the one above or the one below or both, to the extent that it impinges nerves and interferes with the normal flow of nerve impulses from brain to tissue cells. The Vertebral Subluxation usually distorts the normal curves and motion of the spine, and causes interference to the nerve system. Vertebral Subluxations are usually corrected by means of a Spinal Adjustment. The Spinal Adjustment is a specific concussion of forces given by the chiropractor along the spinous or transverse processes of the vertebra into that vertebra's normal facet angle. The restoration of that vertebra to its proper position will alleviate or eliminate the pressure or irritation to the nerve and restore normal function to the spinal motor unit. Chiropractic and Scoliosis Charles A. Lantz, D.C., Ph.D. is Director of Research at the Life Chiropractic College West in San Lorenzo, California. Dr. Lantz and his colleagues are currently conducting a scoliosis research project to explore the effectiveness of chiropractic in the management of children ages 9-15 with mild to moderate scoliosis (less than 25" curve). This is the first clinical trial ever to look at the effect of chiropractic on scoliosis. NSF first met Dr. Lantz. and his associate Jasper Chen, D.C. in conjunction with the 1994 Northern California Spine Conference. This was the beginning of a series of dialogs regarding the need for scientifically valid information about chiropractic treatment of scoliosis and the value of working together with the Scoliosis Research Society to enhance the credibility and acceptance of the design and outcomes of such a study. We applaud Dr. Lantz in his efforts to spear- head a major randomized controlled trial with a collaborative team which includes S.R.S. members, Dr. William Bunnell, Loma Linda University; Dr. Ronald Blackman, Kaiser Hospital, Oakland; Dr. Peter Slabaugh, Children's Hospital, Oakland; and Dr. Serena Hu, U.C. San Francisco. "Virtually no formal research exists documenting chiropractic's effectiveness in managing scoliosis. We are excited about the potential benefits of this study and we believe the scoliosis community is well served by a collaborative effort such as this. This is perhaps best expressed in their project grant application, "Given that chiropractic has long claimed success in treating patients with mild scoliosis, it seems reasonable and timely to validate the extent to which that claim is valid." In his in-depth article titled Conservative Management of Scoliosis which was published in the October 1994 issue of Chiropractic: The Journal of Chiropractic: Research and Clinical Investigation, Volume 9, Number 4, Dr. Lantz underscores the need for large randomized clinical trials for both adolescents and adults with scoliosis: "Chiropractic management of scoliosis has classically consisted of spinal adjustments or manipulation sometimes augmented with exercise and postural counseling, as well as heel lifts. Electrical stimulation has recently come into the chiropractic armamentarium as well. Virtually no formal research exists documenting chiropractic's effectiveness in managing scoliosis, although anecdotal reports abound. Several well-conducted case studies suggest that chiropractic is, indeed, effective in managing scoliotic curves, but the definitive studies are lacking. It is widely stated that chiropractic care is effective in alleviating the pain and discomfort associated with adult scoliosis, however, no studies to date have adequately documented this effect." Dr. Lantz concludes his article by pointing out the need for immediate attention by the Chiropractic community to questions such as, "Should adults with scoliosis be treated in the same way as adolescents or juveniles with scoliosis? What are the indications for care, and what types of care are most suited to which types of scoliosis for which age groups?" Scoliosis often seems to be a condition which has more questions than answers. This appears to apply to the issue of chiropractic management of scoliosis as well. We are grateful for Dr. Lantz and others like him who are dedicated to asking the questions and committed to finding the answers. Link here