Traditionally, chiropractic viewed illness and disease as caused by misalignment of
the spinal vertebrae, referred to as vertebral subluxation, leading to irritation and
dysfunction of nerves and blood vessels. The disrupted flow of impulses was thought
to interfere with normal muscle function, respiration, heartbeat, arterial tone, diges-
tion, and resistance to disease. A more recent theory is that of intervertebral motion
dysfunction. This motion theory contends that loss of mobility in the facet joints,
rather than misalignment, is the key factor in the concept of subluxation. Subluxa-
tion can be caused by just about anything—falls, injuries, genetic spinal weaknesses,
improper sleeping habits, poor posture, obesity, stress, and occupational hazards.
Although this “one cause” philosophy has been a central concept in chiropractic his-
tory, few chiropractors today would endorse this simplistic formulation of illness.
They recognize the existence of bacteria and viruses in creating disease, especially in
a susceptible person. Susceptibility depends on many factors, one of which is spinal
misalignment. Although it now embraces a multifaceted explanation of disease, the
chiropractic treatment of choice is spinal adjustment.
About Chiropractic Treatment
Ninety percent of those seeking chiropractic have neuromusculoskeletal symptoms
or disorders, primarily back pain, neck pain, and headaches. The central focus of
chiropractic diagnosis is the determination of when and where spinal manual ther-
apy (SMT) is appropriate. The diagnostic process also determines what type of
adjustment would be most appropriate. Unlike conventional medicine, which typi-
cally assumes that the site of a pain is the site of its cause, chiropractors evaluate
the site of pain in a regional and whole-body context. Joint pain in the upper
extremities, for example, can be caused by injury or pathology in the joint but may
also originate from cervical spine dysfunction. Similarly, the source of joint pain in
the lower extremities can be in the lumbar spine. The chiropractic assumption is
that the source of the pain should be sought along the path of the nerves leading to
and from the site of the symptoms. This whole-body approach is a hallmark of chi-
ropractic.
The Chiropractic Assessment
A detailed history is the first step in chiropractic diagnosis. The chiropractor asks
about the pattern and quality of the pain and its chronology. Is the pain constant or
intermittent? Is the pain a dull ache, a nagging sensation, or a burning sensation?
What causes the pain to get worse? What causes the pain to get better? The answers
to these types of questions are key to the diagnostic process.
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