Chiropractic and Degenerative Joint Disease
This page contains many articles that explain the relationship between spinal subluxations and degenerative joint disease.
Wellness and Chiropractic
This page reviews how chiropractic contributes to general health and wellness. This is just one of the many pages available at the
Conditions That Respond Well to Chiropractic Page.
The Vertebral Subluxation Complex
The Vertebral Subluxation...it's the core concept of Chiropractic. From the historical standpoint, it is how Chiropractic differs from Osteopathy, Physical Therapy, and other derivative forms of “manual medicine”. It's the term we use to describe the dis-ease/lesion/disorder/loss of function and malposition that the chiropractic adjustment is reputed to correct. Read more now.
Does Facet Joint Inflammation Induce Radiculopathy? An Investigation Using a Rat Model of Lumbar Facet Joint Inflammation
Spine 2007 (Feb 15); 32 (4): 406–412
The association between lumbar facet joint inflammation and radiculopathy was investigated using behavioral, histologic, and immunohistochemical testing in rats. Both mechanical and chemical factors have been identified as important for inducing radiculopathy. In lumbar spondylosis, facet joint osteophytes may contribute to nerve root compression, which may induce radiculopathy. Furthermore, inflammation may occur in the facet joint, as in other synovial joints. Inflamed synovium may thus release inflammatory cytokines and induce nerve root injury with subsequent radiculopathy. (In this study) when inflammation was induced in a facet joint, inflammatory reactions spread to nerve roots, and leg symptoms were induced by chemical factors. This work supports yet another aspect of the Vertebral Subluxation Complex hypothesis.
Self-reported Nonmusculoskeletal Responses to Chiropractic Intervention:
A Multination Survey
J Manipulative Physiol Ther 2005 (Jun); 28 (5): 294–302
Positive reactions were reported by 2% to 10% of all patients and by 3% to 27% of those who reported to have such problems. Most common were improved breathing (27%), digestion (26%), and circulation (21%).
Degenerative Changes Following Spinal Fixation in a Small Animal Model
J Manipulative Physiol Ther 2004 (Mar); 27 (3): 141-154
Fixed segments had more degenerative changes than nonfixed segments for all Z joint parameters (ANOVA, P <.0001). Osteophyte formation and ASD were directly dependent on duration of fixation. These findings indicate that fixation (hypomobility) results in time-dependent degenerative changes of the zygapophysial joints.
Chiropractic Subluxation Assessment: What the Research Tells Us
J Can Chiro Assoc 2002 (Dec); 46 (4): 215-220 ~ FULL TEXT
This Adobe Acrobat (68 KB) file begins: "When you speak of subluxation, the first discription that often jumps to mind is the traditional misallignment, occlusion of a foramen, pressure on a nerve, and interference (MOPI) model proposed by B.J. Palmer. In fact, there are several modern models currently in use as well."
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Neurophysiological Effects of Spinal Manipulation
Spine J 2002 (Sep); 2 (5): 357–671
Biomechanical changes caused by spinal manipulation are thought to have physiological consequences by means of their effects on the inflow of sensory information to the central nervous system. Muscle spindle afferents and Golgi tendon organ afferents are stimulated by spinal manipulation. Smaller-diameter sensory nerve fibers are likely activated, although this has not been demonstrated directly. Mechanical and chemical changes in the intervertebral foramen caused by a herniated intervertebral disc can affect the dorsal roots and dorsal root ganglia, but it is not known if spinal manipulation directly affects these changes.
Wellness Care, Health, Subluxations, and Remedial Education
J Manipulative Physiol Ther 2002 (Jul); 25 (6): 423–425 ~ FULL TEXT
The World Health Organization defines health as being “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” [4] Given this broad definition of health, epistemological constructs borrowed from the social sciences may demonstrate health benefits not disclosed by randomized controlled trials. Health benefits, such as improvement in self-reported quality-of-life (QOL), behaviors associated with decreased morbidity, patient satisfaction, and decreased health care costs, may be evaluated using such methods.
Technology Assessment of the Chiropractic Subluxation: Reprise
Topics in Clinical Chiropractic 2002; 9 (3): 10-18
Several methods have been offered to identify and measure the effects of vertebral subluxation in order to provide evidence regarding its existence. How the chiropractic profession deals with its belief systems and model building in this era of increasing accountability may be more important than the search for the subluxation itself. To assist practitioners to cope with this dilemma, an overview of selected subluxation assessment procedures is provided including a qualitative review of relevant studies examining reliability and validity of the various approaches.
Effect of Chiropractic Treatment on the Endocrine and Immune System
in Asthmatic Patients
Proceedings of the 2002 International Conference on Spinal Manipulation
The broad aims of this FCER funded study is to determine whether stress is a factor in the pathophysiology of asthma and to determine if chiropractic management of asthmatics can alleviate stress induced asthma. More specifically for this meeting, our study aims to determine whether chiropractic treatment has beneficial effects on the endocrine system through measurement of salivary cortisol and on the immune system via salivary IgA determination. You can review other articles on this topic at the Chiropractic and Asthma Page.
Chronic Pediatric Asthma and Chiropractic Spinal Manipulation: A Prospective Clinical Series and Randomized Clinical Pilot Study
J Manipulative Physiol Ther 2001 (Jul); 24 (6): 369-377 ~ FULL TEXT
After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment.
Epilepsy and Seizure Disorders: A Review of Literature Relative to
Chiropractic Care of Children
J Manipulative Physiol Ther 2001 ( Mar); 24 (3): 199-205 ~ FULL TEXT
Chiropractic care may represent a nonpharmaceutical health care approach for pediatric epileptic patients. Current anecdotal evidence suggests that correction of upper cervical vertebral subluxation complex might be most beneficial. It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients.
The Reflex Effects of Subluxation: The Autonomic Nervous System
J Manipulative Physiol Ther 2000 (Feb); 23 (2): 104-106
There is no shortage of theories to explain the role of subluxation in disease and the effect of adjustment in relieving symptoms. The autonomic nervous system has often been invoked in constructing mechanisms to account for the effects of spinal dysfunction; recent investigations justify the attention that has been focused on this component of the nervous system. Recent neuroscience research supports a neurophysiologie rationale for the concept that aberrant stimulation of spinal or paraspinal structures may lead to segmentally organized reflex responses of the autonomic nervous system, which in turn may alter visceral function.
Known and Plausible Modulators of Depressed Immune Functions Following Spinal Cord Injuries
J Spinal Cord Med 2000 (Summer); 23 (2): 111-120
This article discusses the relationship between reduced cord function and it's impact on the Immune System.
The Subluxation Complex
Journal of Chiropractic Humanities 1999; 9 (1) ~ FULL TEXT
This 4 page Adobe Acrobat (35 KB) article, by Leonard J. Faye, D.C. states “The concept of the subluxation complex was always intended as simply a heuristic device, a convention. The idea was to get the future chiropractors to think more complexly about a complex problem. It forced the integration of a much wider areas of information and knowledge”.
Vertebral Subluxation-Centered Straight Chiropractic Research
Chiropractic Research Journal 1999; 6(1): 12-13 ~ FULL TEXT
Straight chiropractic has been considered by some an anti-scientific approach to health care, because of statements made both by its proponents and its detractors(1). Indeed,
certain tenets of straight chiropractic, particularly its reliance on an innate, immaterial organizing principle, may not be testable with the scientific method, but must be taken on faith or by assumption. Still, the claim that detection and
removal of vertebral subluxation can be of benefit to humans, regardless of the mechanism of that effect, should be testable in an objective manner.
The Short-Term Effect of Spinal Manipulation in the Treatment of
Infantile Colic: A Randomized Controlled Clinical Trial with a Blinded Observer
J Manipulative Physiol Ther 1999 (Oct); 22(8) 517-522 ~ FULL TEXT
This research project found chiropractic adjusting superior to the medical use of dimethicone for the treatment of Infantile Colic.
The Role of the Chiropractic Adjustment in the Care and Treatment of
332 Children with Otitis Media
Jou Clin Chiro Ped 1997; 2 (2) Oct
To our knowledge this is the first time that tympanography has been used as an objectifying tool with respect to the efficacy of the chiropractic adjustment in the treatment of children with otitis media. In addition, the role of the occipital adjustment needs to be examined. This study begins the process of examining the role of the vertebral cranial subluxation complex in the pathogenesis of otitis media, and the efficacy of the chiropractic adjustment in its resolution.
Models of Vertebral Subluxation: A Review
Journal of Vertebral Subluxation Research 1996; 1 (1): 1-6 ~ FULL TEXT
Enjoy this Adobe Acrobat (59 KB) file from the first issue of JVSR, a review of clinical models of the vertebral subluxation, including neurobiological mechanisms. Models reviewed include the subluxation complex model, subluxation degeneration, nerve compression, dysafferentation, the neurodystrophic model and segmental facilitation. Clinical models, including the segmental, postural, and tonal approaches are discussed.
A Review of the Evolution of Chiropractic Concepts of Subluxation
Topics in Clincial Chiropractic 1995: 2 (2): 1-10 ~ FULL TEXT
This particular review traces the evolution of the subluxation concept within the context of the chiropractic profession. There is a growing body of evidence, from both within and outside the discipline, that supports many of chiropractic's basic concepts. Evidence regarding the contribution of spinal joint derangement to a number of significant health problems becomes more compelling as more is learned. The role of manual procedures, especially as performed by chiropractors, becomes more prominent each year. A new environment without the overt ostracism of political medicine and a burgeoning research enterprise within chiropractic academia and practice are helping to poise the profession for greater contributions to the health care of society as chiropractic enters its next century.
Somatic Dysfunction and the Phenomenon of Visceral Disease Simulation: A Probable Explanation for the Apparent Effectiveness of Somatic Therapy in Patients Presumed to be Suffering from True Visceral Disease
J Manipulative Physiol Ther 1995 (Jul-Aug); 18 (6): 379–397
The proper differential diagnosis of somatic vs. visceral dysfunction represents a challenge for both the medical and chiropractic physician. The afferent convergence mechanisms, which can create signs and symptoms that are virtually indistinguishable with respect to their somatic vs. visceral etiologies, need to be appreciated by all portal-of-entry health care providers, to insure timely referral of patients to the health specialist appropriate to their condition. Furthermore, it is not unreasonable that this somatic visceral-disease mimicry could very well account for the "cures" of presumed organ disease that have been observed over the years in response to various somatic therapies (e.g., spinal manipulation, acupuncture, Rolfing, Qi Gong, etc.) and may represent a common phenomenon that has led to "holistic" health care claims on the part of such clinical disciplines.
The Neurophysiological Evaluation of the Subluxation Complex: Documenting the Neurological Component with Somatosensory Evoked Potentials
Chiropractic Research Journal 1994; 3 (1) ~ FULL TEXT
The results seen in this study indicate highly significant changes for the pre vs post adjustment SSEP tests. The mean latencies decreased after chiropractic adjustment in each of the nerves tested. This would seem to indicate that the upper cervical subluxation does cause neurological compromise in nerves forming both the brachial and lumbo-sacral plexuses. The removal of the subluxation by chiropractic adjustment results in improved conduction of the neural impulses as demonstrated on the post-adjustment tests. The improvements that were observed are similar to the changes seen when neurological compromise is relieved by surgical procedures to decompress or stabilize the spine.
A Consensus Approach to Subluxation Based Chiropractic:
Phase 1 Questionnaire Results
Chiropractic Research Journal 1994; 3 (1) ~ FULL TEXT
Consensus methods have been employed by health care provider groups in an effort to standardize the management of various clinical problems.1 Such techniques are generally developed within the conceptual framework of the allopathic paradigm. Specifically , diagnostic and/or treatment strategies are developed for specific diseases or clinical syndromes. Critics of the consensus method have suggested that developing formalized standards of practice leads to the practice of "cookbook medicine."
Does The Subluxation Exist In Clinical Practice?
Today's Chiropractic: 28 (2): ~ FULL TEXT
Does this question seem absurd to you? Over 100 years of clinical experience tells us that when an adjustment is rendered properly something positive occurs to the patient. However, how much of a positive effect, and on what type of conditions, is another matter. If the subluxation does exist, and its effects are as detrimental as we claim, then our care should be effective and reproducible on a myriad of conditions. Unfortunately, this is not the case in many practices. The problem lies in objectifying the existence of the subluxation, and more importantly proving that the adjustment has corrected it. Without this knowledge, how can we properly dictate where and how an adjustment is rendered? Perhaps this is why our profession is slowly being displaced into the realm of musculoskeletal treatment and eroded as a distinct and separate form of health care.
The Vertebral Subluxation Complex
A FULL TEXT Series of Articles by Joseph M. Flesia, Jr., D.C.
Thanks to the
ICA for permission to reproduce these articles!
The Vertebral Subluxation Complex: An Integrative Perspective
The Vertebral Subluxation Complex Part II: An Outline
The Vertebral Subluxation Complex Part III: Pathogenesis
The Vertebral Subluxation Complex Part IV: Pathogenesis (Continued)
The Vertebral Subluxation Complex Part 1:
An Introduction to the Model and Kinesiological Component
Chiropractic Research Journal 1989; 1 (3): 23-36 ~ FULL TEXT
The concept of subluxation has been a cornerstone of the theory and practice of chiropractic since its founding by D. D. Palmer (1) in 1895. It is one of the most controversial concepts in health care today, and finds its supporters and critics both within and outside the chiropractic profession. The original concept of the subluxation was that of a slightly misaligned vertebra, not sufficient to be qualified as a true luxation or dislocation but substantial enough to impinge on the segmental nerves associated with it (1). While this original concept requires some modification in light of current research findings, there has been a wealth of knowledge accumulated in the past two decades that supports the concept of vertebral subluxations as a real entity (2- 9). It must be stressed that from the contemporary, scientific chiropractic point of view, the subluxation is a dynamic process, involving several tissue levels and integrative components.
The Vertebral Subluxation Complex Part 2:
The Neuropathological and Myopathological Components
Chiropractic Research Journal 1990; 1 (4): 19-38 ~ FULL TEXT
The neurological component of the Vertebral Subluxation Complex (VSC) is, for many, the cornerstone of chiropractic theory.(1) For those who see beyond the application of chiropractic and other manipulative procedures as merely a means of relieving head ache and low back pain, the nervous system is the mediator of vitality and health to the individual organs and tissues(2). Today, more than ever before, basic scientific and medical research supports this fundamental concept of chiropractic.(3-7). In chiropractic clinical practice, the prominence of the nervous system is unquestionable.
The Immobilization Degeneration & the Fixation Hypothesis
of Chiropractic Subluxation
Chiropractic Research Journal 1988; 1 (1): 21-46 ~ FULL TEXT
The literature was reviewed concerning the effects of joint immobilization on the degeneration of articular and periarticular connective tissue. Every connective tissue component of an articulation is affected by immobilization, and each major component is discussed individually; these include the articular cartilage, synovium, articular capsule, periarticular ligaments, subchondral bone, the intervertebral disc and the meninges. Particular emphasis was placed on changes in the biochemical constituents of connective tissue, collagen, proteoglycans and hyaluronic acid, and the relation of these changes to alterations in the functional and biomechanical properties of the tissues. T hus an attempt is made here to establish a molecular basis for the theory and practice of chiropractic.
Upper Cervical Spine Information
This remarkable website, designed by a former Microsoft employee, clearly defines many aspects of the Upper Cervical Subluxation, and it's impact on health.
The ANATOMY of the ATLAS SUBLUXATION
CERVICAL SPINE BIOMECHANICS
IMAGING AND RADIOGRAPHS
SKULL BASE [Craniocervical] ANATOMY
Four Articles Which Describe the Relationship Between the Upper Cervical Spine and Headaches and Chronic Head Pain
1. Atrophy of Suboccipital Muscles in Chronic Pain Patients
We have observed previously unreported muscle atrophy in the rectus capitis posterior minor (RCPMI) muscles of a group of chronic pain patients. We hypothesize that chronic pain, in this select group of patients, is a consequence of tramua that occurs to the C1 dorsal ramus during whiplash.
2. Magnetic Resonance Imaging of the Upper Cervical Spine
We are currently using MRI to investigate the functional integrity of the upper cervical spine. We started out looking for hypertonic muscles in a population of patients who were suffering from chronic head and neck pain. My first task was to collect MRI data and to identify suboccipital muscles within the MR images. So I brought together a physician and an anatomy professor to see if they could help me out. Their comments were classic. The anatomy professor said, "The reason you can't find those muscles is because they are not there." The physician immediately responded by saying, "No wonder these patients don't get any better." I had been using images that were collected from a chronic pain patient, and it was apparent that the rectus capitis posterior minor muscles were missing. When we looked at images from a control subject it was very easy to locate these muscles. At that point, the focus of our research switched from looking for hypertonic muscles to comparing muscle density between the control group and the chronic pain group.
3. Anatomic Relation Between the Rectus Capitis Posterior Minor Muscle and the Spinal Dura Mater
We observed that the PAO membrane was securely fixed to the surface of the dural tube by multitudinous fine connective tissue fibers. There was no real interlaminar space between these two structures and they appeared to function as a single entity. The influence of the RCPMI muscle on the dura mater was artificially produced in the hemisected specimen. Artificially functioning the muscle produced obvious movement of the spinal dura between the occiput and the atlas, and resultant fluid movement was observed to the level of the pons and cerebellum.
4.
Visualization of the Muscle-Dural Bridge in the Visible Human Female Data Set
SPINE Journal 1995; 20 (23): 2484–2486
It has been speculated that the function of the muscle dural bridge may be to prevent folding of the dura mater during hyperextension of the neck. Also, clinical evidence suggests that the muscle dural bridge may play an important role the pathogenesis of the cervicogenic headaches.
Modern Technologies that Validate Subluxation Based Chiropractic
William Cockburn, D.C., B.C.F.E. ~ Diplomate Forensic Examiner
There is a great deal of controversy within the chiropractic profession around the terms "subluxation", "subluxation complex", "Chiropractic Subluxation", "Medical Subluxation", and of course the "Vertebral Subluxation Complex". Is it no wonder, that the profession remains divided, apathetic and confused. The division of chiropractors is the key ingredient in the soup mix packaged by chiropractic's adversaries. Prior to a discussion of "Outcome Assessment" technologies (evidence based chiropractic), I will define these terms as I view them from a forensic standpoint, so at least, in interpreting the data I will present to the reader, a commonality of terminology within the context of this article can be achieved.
Review of the Literature Supporting a Scientific Basis for the Chiropractic Subluxation Complex
J Manipulative Physiol Ther 1985; 8 (3) Sep: 163–174
A review of the literature reveals strong evidence for both the mechanical model of disease production (structural) and the neurobiological model (functional). Outdated models which attempt to describe a scientific basis for chiropractic theory are inadequate and indeed harmful to the progress and acceptance of chiropractic.
Is the VSC the End-all of Chiropractic? Look again
Professor Louis Agassiz was a renowned zoologist, geologist and paleontologist in the 19th century. He was acknowledged by his contemporaries to be far ahead of his time, both as a scientist and a teacher. He would always tell his students, "Look! Look again. And again." I took this to mean there must always be more. Recently I read that bit of philosophy, and wondered about us in chiropractic day-in and day-out adjusting Vertebral Subluxation Complexes. Our adjustments have resulted in untold millions of happy human beings whose pain has been relieved, health restored and even lives saved. Still I wondered, should we also "Look again?"
Spinal Subluxation in Children, Part I
and
Part II
Frequently children's spinal problems may be the cause of some very common childhood complaints, few of which may appear to have anything to do with the spine. But more importantly, these undetected spinal problems in children may be the cause of serious spinal degeneration in later adult life. It is not uncommon for chiropractors, when examining x-rays of an adult's spine, to detect degenerative changes which began many years previously. This is just one reason why a childhood spinal examination is "a must" for all active healthy children.
Dump Subluxation? Give Me a Break!
The front-page headline of the September issue (volume 13, no. 12) of the Chiropractic Journal reads "Research Conference Urges Profession to Dump Subluxation." Well, I'm here to tell you that nothing even remotely of the kind happened, and I still find it hard to understand why one person, Matthew McCoy, chose to spin the story so inaccurately, especially after (silently) sitting through only one morning of an extensive three-day meeting at my invitation (and Palmer's expense). A responsible journalist who didn't hear the whole story would have checked not only his facts, but his context as well.
Health, Subluxation, Adjustment:
Semantic and Scientific Challenges Still Exist
One way to validate chiropractic theory is to consider the concepts of health, subluxation and adjustment. Subluxation is related to health; health is related to adjustment; and adjustment is related to subluxation. Regarding the nature and direction of these relationships, we say that the greater the level of health of an individual, the fewer subluxations that person has. We also say that more (or better) adjustments lead to less subluxations, and furthermore, that more adjustments yield greater health.
Stephenson's Principles Revisited in 1997
"A simple subluxated vertebra differs from a normal vertebra only in its field of motion and the center of its field of motion; because of its being subluxated, its various positions of rest are differently located than when it was a normal vertebra ... its field of motion may be too great in some directions and too small in others." In retrospect, a triad of findings reported by chiropractors and osteopaths early in the century appear to best fit with current findings of clinical research of reliability and validity of a number of tests we use in chiropractic practice. The triad of findings attributable to so-called phase 1 (pre-radiographic) spinal lesions (segmental dysfunction) includes: restricted motion, paraspinal and/or spinous tenderness, and taut muscle (or spasm).
One Step Further: The Vertebral Subluxation Syndrome
The term subluxation has been used to describe the lesion treated by chiropractors since its inception. D.D. Palmer1 described it in 1910 as "a partial or incomplete separation, one in which the articulating surfaces remain in partial contact." Because of confusion by other professions, some within the chiropractic profession would have us abandon the term.
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