The founder of chiropractic was a man called DD Palmer. His son BJ Palmer (BJ) was born in Iowa in 1882 and from 1904 until his death in 1961 BJ was head of the original chiropractic college his father founded. Now BJ’s idea was very simple. He said that “chiropractors do not concern themselves with disease”.
His idea was that it was for medical doctors to make a diagnosis and base a medical treatment on that diagnosis. He saw chiropractors as properly focusing on the alignment of the patient only. So BJ’s answer to “what problems can chiropractors treat” wouldn’t be a list of problems like low back pain. His answer would be chiropractic properly treats a person’s misalignment. So, one imagines, BJ wouldn’t particularly be interested if a patient had for example, back pain or even any pain at all.
BJ would just want to work on any misalignment he found in the patient. And if the patient’s pain was due to misalignment (and the treatment was effective) one would hope the patient would get better but if misalignment wasn’t involved, one would expect the treatment not to be effective. Whilst BJ’s approach had the merit of simplicity, most would agree with Hamlet that “there are more things in heaven and earth….than are dreamt of in your philosophy”!
These simple days are long behind us. Indeed they were long behind us even in BJ’s lifetime. In England and Wales, the General Chiropractic Council which regulates the chiropractic profession nowadays rightly expects chiropractors to either make a diagnosis or form a “clinical impression” about what’s happening with a patient.
Also, chiropractors themselves have moved on from the simple view of just considering skeletal alignment. For example, some chiropractors now adjust from a more biomechanical perspective – for example, by adjusting with the intention of “unlocking” a particular blocked joint and assisting its range of movement.
So, chiropractors are in a long process of evolving from being mono-focussed alignment specialists to musculoskeletal specialists with a particular focus on alignment. Alignment can be considered at the whole body level with the patient typically standing or it can be examined at a more local level by physical palpation of adjacent bones.
But nowadays the assessment of alignment would only be a starting point. Chiropractors can work in quite different ways but it would be usual (depending on the person’s problem) for the chiropractor to carry out some of the standard orthopaedic or neurological tests. For example, disc patients sometimes may loose a reflex. So, a chiropractor may for example wish to use a neurological hammer to lightly tap the patient to see if, for example, the knee jerk reflex or ankle jerk reflex is still present.
Depending on the results of such tests, the chiropractor might like to see how well the patient moves. Looking at how they walk. Can they stand on their toes? Can they stand on their heels? Can they squat down or rise easily from a chair? The chiropractor will also often wish to do a hands-on check of the mobility of certain of the patient’s joints. Also, the quality of the patient’s muscles may be palpated so see if a muscle has retained its proper elasticity. Finally, it may be appropriate for the chiropractor to manually test the strength of some of the patient’s muscles. From all this information the chiropractor will then be able to try to work out the best plan of treatment for the patient.
Just as the way chiropractors assess their patients has considerably expanded, so too has the way that chiropractors manually treat their patients. Many chiropractors no longer rely on chiropractic adjustment alone.
Many chiropractors effectively offer a “combination” therapy and will use “adjunctive therapies” such as mobilisations to assist joint mobility, soft-tissue release for tight muscles and may well prescribe corrective exercise for muscles which are found to be too weak. Chiropractors are very aware that most of us lead far too sedentary lives to be properly healthy and will use hands on care as a way to restore their patients to the possibility of physically more active lives.
Today the spine is still the primary focus for the chiropractic profession and low back pain remains the number one reason why patients will seek out the services of a chiropractor. If you are based in London and looking for a chiropractor in Canary Wharf, please call the Hunter Clinic on 07855 916 602 for a musculoskeletal (including alignment) assessment and to discuss your best way forward.