According to David Seaman, MS, DC, DACBN in a recent article entitled, “It’s Time to Move Beyond Subluxation” published in Dynamic Chiropractic, the term subluxation has no place in the 2007 vernacular since we can’t measure pre- or post-adjustment changes. (Really?) Worse, “certain patients” don’t respond as expected after a so-called “treatment” for subluxation. (Of course.) Thus, subluxation is an anachronistic term we should put behind us; a remnant of an unenlightened bygone era.
This will be a tough sell, since according to a recent survey, an overwhelming majority of chiropractors said they want to retain the term “vertebral subluxation complex.”
“We need to give up the notion that adjustments have magical or supernatural healing outcomes,” continues Dr. Seaman.
I couldn’t agree more. But probably for different reasons.
While it’s tempting to construct a recipe for relief (adjust here for sciatica, there for headaches, etc.), this approach is far too linear and mechanistic for something as dynamic and complex as a human being. As is so often the case among chiropractors who take a cookbook approach to patient care, they forget two key elements affecting the results they (and the patient) can expect from chiropractic care:
1. What physical, chemical or emotional stressor(s) precipitated the survival strategy and defense posture that most of the profession (and chiropractic licensing boards) call vertebral subluxation, and
2. Is that physical, chemical or emotional stressor still present?
These issues are not only inconvenient, but potentially messy. Practitioners who experience the giddy self-affirmation of hearing, feeling or visualizing the patient’s spine responding to their intervention, are inclined to overlook these critical distinctions. They love delivering the adjustment so much and get such a “do-gooder” high from superimposing their egotistical notion upon the patient’s spine, that they blindly thrust away. When patients don’t respond as they expect they either thrust more vigorously, blame the patient’s poor compliance or search for a “better” (meaning more predictably consistent) adjusting technique.
Naturally, the more forceful adjusting, patient blaming and technique searching rarely provide comfort. However, it does give technique instructors steady work and career paths for those who, for a fee, will teach you the scripts and procedures for 100% Peter Piper patient compliance.
My earliest chiropractic mentors taught me that there is a difference between chiropractors and medical practitioners. Medical practitioners looked at the person’s problem, but chiropractors looked at the person with the problem. Maybe that’s the issue at play among those who would prefer abandoning the “S” word. Because if you focus on the symptom (fixation, reduced range of motion, pain syndromes, etc.) rather than the person (poor diet, over weight, unfulfilling career, broken relationships, lack of restful sleep, etc.) you can easily fall into the my-intervention-isn’t-effective trap. Of course it’s ineffective. You’re dealing with a severely impaired patient!
But how many “I-just-want-to-adjust-I’m-not-a-counselor” crowd want to discuss these psychosocial issues with patients? And even if they did, most feel poorly equipped and even fewer can justify the time. As a result, they fall into the trap of treating the “boo-boo,” rather than caring for the person.
If you ignore the chemical and emotional causations and merely address the symptoms (subluxation), your certainty will suffer, your fulfillment will wane and you will become increasingly ineffective with patients. All because you’ve inappropriately attached a strict cause and effect relationship to a circumstance that has way too many variables.
In the process of testing Einstein’s equation, some unexplainable results started showing up in the lab. It was this sort of conundrum that prompted physicists to invent a new branch of physics called quantum mechanics. Their old Newtonian model was no longer capable of explaining the events they were observing. Same thing here. If you’ve got one foot in the old school medical model, chiropractic results are fairly easy to explain. But what is perceived as chiropractic “failures” are more troubling.
Perhaps it would be more helpful to think of chiropractic as quantum medicine.
But let's not lose the subluxation! It's a word rich with meaning that makes chiropractic different and unique. It may be tempting to excise the "S" word from chiropractic, either from political correctness or from drinking the Kool-Aid of scientism. Many who have busied themselves with this task overlook that the spirit doesn’t conform to a tidy equation or a simple, “if-this-than-that” expression. And reducing chiropractic to the mechanical "non-allopathic lesion" not only makes the big idea small, it degrades patients to soulless chemical reactions, cellular replications and CO2 producers.
It’s not time to move beyond subluxation. It’s time for the rest of the culture to finally catch up with it!