Chiropractors function almost entirely in free-standing private practice. Some con-
tinue their education with postdoctoral training in specialty areas such as radiology,
orthopedics, neurology, behavioral medicine, family practice, occupational health,
and sports medicine.
How Does Chiropractic Work?
The assumption underlying all chiropractic treatment is that spinal misalignment
impairs the transmission of information—nerve impulses—through the spinal cord,
causing pain and disruptions throughout the central nervous system and the entire
body.
Anatomy
The adult spinal column is comprised of 26 vertebrae: 7 cervical (in the neck), 12
thoracic (upper back), 5 lumbar (lower back), 1 sacral (at the hips), and 1 coccygeal
(at the tailbone). These vertebrae provide attachment for various muscles and pro-
tection for the spinal cord; they are separated by intervertebral disks. Several curves
in the vertebral column increase its strength. The spinal cord, housed in the verte-
bral canal, conducts sensory and motor impulses to and from the brain and controls
many reflexes. It connects to the rest of the body through the 31 pairs of spinal
nerves originating from the cord.
The vertebrae, with the exception of the first and second cervical, are much alike
and are composed of a body, an arch, and seven projections called processes. See
Figure 10.1. Vertebrae are connected at the processes by a cartilaginous structure
called a facet joint, which is encased in a strong, fibrous joint capsule that prevents
the joint from coming apart. The structure and health of these connections are the
primary concern of chiropractic. The other anatomical feature that is of concern to
chiropractic is the sacroiliac joint, which is formed where the sacrum attaches to the
ilia.
Foundations of Chiropractic Treatment
Chiropractic believes that the body possesses a unique internal wisdom that continu-
ally strives to maintain a state of health within the body. This body wisdom means
that every person has an innate healing potential. Accessing this internal healing
system is the goal of the healing arts. In addition, it is believed that a balanced, nat-
ural diet and regular exercise are essential to proper bodily function and good
health. The assumptions of chiropractic are as follows:
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