Prevention and Health Promotion by Chiropractors
SOURCE: American J Lifestyle Medicine 2008; 2 (6): 537–545
Daniel Redwood, DC, and Gary Globe, MBA, DC, PhD
Cleveland Chiropractic College–Kansas City,
10850 Lowell Avenue,
Overland Park, KS 66210
Chiropractic care includes a variety of minimally invasive approaches, with both treatment and prevention as essential elements of clinical practice. Although chiropractic adjustment (manipulation) is the signature therapy and best-known identifier of the profession, the practice of chiropractic involves more than manual therapeutics. In general, chiropractors seek to bring a holistic worldview to the doctor–patient encounter, seeking not only to relieve pain and restore neuromusculoskeletal function but also to support the inherent self-healing and self-regulating powers of the body.
Aside from applying their diagnostic training to the evaluation of a variety of physical disorders and delivering manual adjustments and related therapeutic interventions, many chiropractors encourage patients to take an active role in restoring and maintaining health, with particular emphasis on doctor-guided self-care through exercise and nutrition. In this review, the authors summarize the peer-reviewed literature on chiropractic and prevention, describe health promotion and wellness approaches currently taught at chiropractic colleges and used in chiropractic clinical settings, discuss duration of care, emphasize the importance of interprofessional cooperation and collaboration, and address the hypothesis that chiropractic adjustments yield preventive effects.
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Keywords chiropractic; primary prevention; health promotion; complementary medicine; alternative medicine
When a niche in the health care ecosystem remains unfilled by medical physicians and their associated paraprofessionals, in some cases, a new profession emerges to fill the gap. In the United States in late 19th century, the chiropractic profession arose to meet a need for alternatives to “heroic medicine,” the conventional care of the time. This reflected a pragmatic need for spine-focused manual therapeutics coupled with a paradigmatic need for a healing philosophy based on minimally invasive (nonpharmaceutical, nonsurgical) methods that included a strong emphasis on preventive approaches. Over the past century, chiropractic has grown and evolved, gradually moving toward mainstream status while largely maintaining its original mission and tenets.
Preventive health care includes primary prevention (averting illness before it begins, chiefly through diet, exercise, stress management, and avoiding destructive behaviors such as smoking) and secondary prevention (detecting and treating disease in its early stages to cure it or halt its progression or efforts designed to prevent recurrence of illness or injury). Historically, chiropractors have recognized the importance of both primary and secondary prevention, but implementation has been inconsistent. Although some chiropractors devote a substantial part of their clinical efforts to nutrition and/or therapeutic exercise and rehabilitation and perform various types of screenings and risk assessments, others show less interest in these topics. Similarly, although the biopsychosocial model of health is now broadly accepted and evidence-based prevention data on problems such as smoking cessation, overexposure to sunlight, and unprotected sexual activity are widely available, some chiropractors counsel patients on such issues, whereas others address them rarely or not at all.