Commentary:
Chiropractic Theory: Outdated concepts in subluxation theory

Virgil Seutter, DC. editor, Chiro.org's ChiroZine (chiro.org; 9 apr 2003)

One of the basic concepts in subluxation theory involves the notion of a linear, wiring system schema that somehow operates under principles of electrical conductivity; that a peripheral stimulus from the periphery (e.g., sciatic nerve) may traverse the length of that wiring system to the spinal cord and ultimately the brain. The operational essence of the theory mandates a linear system in which conductivity occurs as a straight-line phenomenon. In the context of a straight-line approach to neurological function, the subluxation is explained as an obstacle to that conductivity in that restriction (pressure, trauma, inflammation, etc.) produces a mechanical interference to that nerve and a dysfunction manifests as a local phenomenon from the spinal cord to the periphery (e.g., meric, reductionist approach to inquiry).

The absolute confirmation in the reductionist inquiry for the existence of a subluxation has been difficult to verify. More confusing to the chiropractor (and the science community) is the fact that mind/body relationships in neuroscience studies are opening doors to new concepts to explain neurology as part of a vitalistic essence of morphological development. And yet, the chiropractor refuses to upgrade his theory to accommodate new findings; that insistence upon 'innate' function prohibits further inquiry into a scientific methodology to inquire beyond the subluxation and its complex; that vitalism is gradually being replaced by nonlinear inquiry into nonreducible phenomenon in mind/body coordination with the environment. The receptor diffusion in the organization of the postsynaptic membrane suggests that another mechanism is involved in the "subluxation" mechanism; that the adoption of a nonlinear schema to explain the subluxation may be necessary to explain the existence of the various techniques utilized by the chiropractic profession; that nutrition and acupuncture all play a part in how and why chiropractic is effective in treating 'disease' as part of an adaptative aberration in coordinated function of the nervous system.

How this manifests might best be illustrated through example. The idea that a reaction - diffusion principle may exist in surface analysis of the body has been discussed in previous articles. The encompassing of synaptic plasticity may be linked in some way to chemical, molecular reactions have also been elaborated upon. That the existance of a secondary system of communication superimposed upon a linear wiring system has been difficult for the profession to accept, let alone understand. However, to claim that chiropractic can treat allergies is difficult to explain by simple reference to a linear, wiring system schema and the pinched nerve idea.

The very idea that chemical, molecular diffusion principles exist in nervous system function ought to provide some basis for understanding that possible explanations might exist (if the profession can upgrade to more sophisticated, scientific explanation rather than retain vitalistic, mystical beliefs that can never be confirmed). But even this remains confusing in terms of explanation, since we tend to continue our explanations in linear fashion; that we "desensitize" to an allergen makes sense in the linear, reductionist mode of thinking (thinking in terms of titration principles and how attenuation of chemicals might alter strength of solutions, etc.).

That another mechanism could exist doesn't even occur to the chiropractor. [But that may not be his fault since his education involves axioms that are never questioned, manifesting as tautological observations]. The possibility that desensitization is not even involved in the process of treatment is not even considered; indeed, never questioned.

Allergies

So, what is the explanation for allergy treatment by a chiropractor? The possibility that the body might react to substances in its environment in which it becomes "sensitive" is part of the principles involved in allergic reactions. And while we might cling to the idea that similarity exists in chemical identification of allergens to body reactions, it may be that none of this really explains the 'functional' reaction to the allergen and the apparent ability to desensitize to the substance. Indeed, if one considers that the brain/body connection involves mechanisms for self - preservation, one might suspect, in principle, that the allergy reaction might be nothing more than body defense in action; that muscles and respiratory reactions could be nothing more than a nonlinear, physical response to a substance as part of the brains cognitive awareness to an allergic substance (i.e., it has 'learned' to react to the substance).

Now, chiropractic explanation is different from a chemical desensitization in which one would think in terms of gradual tolerance to the chemical. If, indeed, the brain enters into this equation in terms of communication, then one might assume that something else enters into this equation; that a "de-learning" response to the chemical offender could be just as appropriate in explanation than the chemical sensitization concept. After all, the chemical would suggest a direct response while the pathway through the brain suggests that it involves more nonlinear functions than previously anticipated; at least for the chiropractor.

The possibility that chiropractors could be assisting the body through the mechanism of plastic reaction / adaptation changes in "rewiring" the brain/body response might also be an acceptable idea for explanation. [much of this is often explained through the acupuncture system and apparent changes with acupuncture in allergy responses. This same mechanism is part of the chiropractic involvement with touch that has been discussed in other articles].

Emotions

The idea that emotions play some part in musculo - skeletal complaints has not gone unnoticed, at least by the insurance companies. That chiropractors might influence emotional mechanisms is speculative, but certainly within theoretical boundaries when viewing the effects of placebo, etc. That chiropractors continue to view leg - length changes as a "real" observation conflicts with the idea that an illusion could manifest in this observation. Or, in the observance of changes in iliac crests in association with contact challenges to the ventral surface of the body and different levels of spinal changes should not ignore the changes in these same contacts when certain emotions manifest in the thought process, or consciousness. That emotions and chemistry are intimatedly related is the medical premise to treatment; that emotions and chemistry are intimately related in the chiropractic premise is based upon morphological reaction diffusion principles that manifest as a physical expression.

Recurrence of Subluxations

Additional comment should be made here in reference to the above protocol in which hand contact to a designated ventral portion of the body as the individual twists his spine in standing may be important to understand weaknesses in some of the arguments relating to subluxations and treatment thereof.

To begin an illustration, one must assume that certain techniques 'work.' In this demonstration, I will use a manual instrument to achieve changes in the spine (either a spring loaded hand instrument, manual load, or an electrical instrument, single burst instrument).

Changes in posture (altered iliac crests with symptomatic complaints in low back) altered after use of the chosen instruments (i.e., iliac crests level, back pain 'gone.' ) Further testing to ventral portions of the body surface rechallenge the iliac crests only to find that 'another' group of subluxations manifest by demonstrating change as altered level of the iliac crests. (this would be similar to leg length change but in or as a dynamic challenge to body posture). This same process may occur when the chiropractor challenges for allergens, or for emotional linkage to musculoskeletal complaints.

What I'm getting at is this: that, as an osseous lesion, the subluxation may not be a reliable indicator of disturbed function as much as reflexive, neurological challenges to the body (as through touch, etc.). In other words, the areas previously recognized as subluxations, and corrected with manipulation using instrumentation (and with visible changes in posture and patient complaint), manifested as a recurrence after challenging with other factors such as allergens or emotional overlay, etc.

One Other Problem - Knowing What to Adjust

The 'linear' perspective in chiropractic theory is satisfied that palpation of the spine is sufficient to demonstrate the existance of a subluxation and that manipulation / adjustment of a spinal segment is sufficient. If one considers the nonlinear perspective in which reflexive coorelations to the dynamics of muscle groupings, then one must consider that treatment of a subluxation takes on a different perspective; that multiple, adaptative, coordination patterns could exist and that if there is any 'power' to the adjustment of the spine, it is through the networking of neurological communication patterns that could be more important.

Virgil Seutter, D.C.
9 April 2003

More: The role of receptor diffusion in the organization of the postsynaptic membrane Daniel Choquet & Antoine Triller. Neurotransmitter receptor movement into and out of synapses is one of the core mechanisms for rapidly changing the number of functional receptors during synaptic plasticity. Recent data have shown that rapid gain and loss of receptors from synaptic sites are accounted for by endocytosis and exocytosis, as well as by lateral diffusion of receptors in the plane of the membrane. These events are interdependent and are regulated by neuronal activity and interactions with scaffolding proteins. Here we focus on the physical laws that govern receptor diffusion and stabilization, and how this might reshape how we think about the specific regulation of receptor accumulation at synapses. (nature; 10 apr 2003)