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Chiropractic


Overview :

Origins

Spinal manipulation has a long history in many cultures but Daniel D. Palmer is the founder of modern chiropractic theory, dating back to the 1890s. A grocer and magnetic healer, he applied his knowledge of the nervous system and manual therapies in an unusual situation. One renowned story concerns Harvey Lillard, a janitor in the office where Palmer worked. The man had been deaf for 17 years, ever since he had sustained an injury to his upper spine. Palmer performed an adjustment on a painful vertebra in the region of the injury and Lillard's hearing was reputedly restored. Palmer theorized that all communication from the brain to the rest of the body passes through the spinal canal, and areas that are poorly aligned or under stress can cause physical symptoms both in the spine and in other areas of the body. Thus the body has the innate intelligence to heal itself when unencumbered by spinal irregularities causing nerve interference. After his success with Lillard, other patients began coming to him for care, and responded well to adjustments. This resulted in Palmer's further study of the relationship between an optimally functional spine and normal health.

Palmer founded the first chiropractic college in 1897. His son, B. J. Palmer, continued to develop chiropractic philosophy and practice after his father's death. B. J. and other faculty members were divided over the role of subluxation in disease. B. J. saw it as the cause of all disease. The others disagreed and sought a more rational way of thinking, thus broadening the base of chiropractic education. From 1910 to 1920, many other chiropractic colleges were established. Other innovators, including John Howard, Carl Cleveland, Earl Homewood, Joseph Janse, Herbert Lee, and Claude Watkins, also helped to advance the profession.

DANIEL PALMER (1845–1913)

Chiropractic inventor, Daniel David Palmer, was born on March 7, 1845, in Toronto, Ontario. He was one of five siblings, the children of a shoemaker and his wife, Thomas and Katherine Palmer. Daniel Palmer and his older brother fell victim to wanderlust and left Canada with a tiny cash reserve in April 1865. They immigrated to the United States on foot, walking for 30 days before arriving in Buffalo, New York. They traveled by boat through the St. Lawrence Seaway to Detroit, Michigan. There they survived by working odd jobs and sleeping on the dock. Daniel Palmer settled in What Cheer, Iowa, where he supported himself and his first wife as a grocer and fish peddler in the early 1880s. He later moved to Davenport, Iowa, where he raised three daughters and one son.

Palmer was a man of high curiosity. He investigated a variety of disciplines of medical science during his lifetime, many of which were in their infancy. He was intrigued by phrenology and assorted spiritual cults, and for nine years he investigated the relationship between magnetism and disease. Palmer felt that there was one thing that caused disease. He was intent upon discovering this one thing, or as he called it: the great secret.

In September 1895, Palmer purported to have cured a deaf man by placing pressure on the man's displaced vertebra. Shortly afterward Palmer claimed to cure another patient of heart trouble, again by adjusting a displaced vertebra. The double coincidence led Palmer to theorize that human disease might be the result of dislocated or luxated bones, as Palmer called them. That same year he established the Palmer School of Chiropractic where he taught a three-month course in the simple fundamentals of medicine and spinal adjustment.

Palmer, who was married six times during his life, died in California in 1913; he was destitute. His son, Bartlett Joshua Palmer, successfully commercialized the practice of chiropractic.

The theories of the Palmers receive somewhat broader interpretation today. Many chiropractors believe that back pain can be relieved and health restored through chiropractic treatment even in patients who do not have demonstrable subluxations. Scientific development and research of chiropractic is gaining momentum. The twenty-first century will likely see the metaphysical concepts such as innate intelligence give way to more scientific proofs and reform.

Many people besides the Palmers have contributed to the development of chiropractic theory and technique. Some have gone on to create a variety of procedures and related types of therapy that have their roots in chiropractic, including McTimoney-Corley chiropractic, craniosacral manipulation, naprapathy, and applied kinesiology. Osteopathy is another related holistic discipline that utilizes spinal and musculoskeletal manipulation as a part of treatment, but osteopathic training is more similar in scope to that of an M.D.

Initial visit

An initial chiropractic exam will most often include a history and a physical. The patient should be asked about the current complaint, whether there are chronic health problems, family history of disease, dietary habits, medical care received, and any medications currently being taken. Further, the current complaint should be described in terms of how long it has been a problem, how it has progressed, and whether it is the result of an injury or occurred spontaneously. Details of how an injury occurred should be given. The physical exam should evaluate by observation and palpation whether the painful area has evidence of inflammation or poor alignment. Range of motion may also be assessed. In the spine, either hypomobility (fixation) or hypermobility may be a problem. Laboratory analysis is helpful in some cases to rule out serious infection or other health issues that may require referral for another type of treatment. Many practitioners also insist on x rays during the initial evaluation

Manipulation

When spinal manipulation is employed, it is generally done with the hands, although some practitioners may use an adjusting tool. A classic adjustment involves a high velocity, low amplitude thrust that produces a usually painless popping noise, and improves the range of motion of the joint that was treated. The patient may lie on a specially designed, padded table that helps the practitioner to achieve the proper positions for treatment. Some adjustments involve manipulating the entire spine, or large portions of it, as a unit; others are small movements designed to affect a single joint. Stretching, traction, and slow manipulation are other techniques that can be employed to restore structural integrity and relieve nerve interference.

A new use of technology with traditional chiropractic care has been introduced. Using a hand-held device that is pressed to the spine or joints, a chiropractor may soon be able to detect and manipulate the skeleton not only with his or her hands but with the computer-linked device that uses harmonic frequencies to detect a misalignment in the spine. The new technology was not widely accepted in 2004, however.

Length of treatment

The number of chiropractic treatments required will vary depending on several factors. Generally longer-term treatment is needed for conditions that are chronic, severe, or occur in conjunction with another health problem. Patients who are not in overall good health may also have longer healing times. Some injuries will inherently require more treatments than others in order to get relief. Care is given in three stages. Initially appointments are more frequent with the goal of relieving immediate pain. Next, the patient moves into a rehabilitative stage to continue the healing process and help to prevent a relapse. Finally, the patient may elect periodic maintenance, or wellness treatments, along with lifestyle changes if needed to stay in good health.

Follow-up care

Discharge and follow-up therapy are important. If an injury occurred as a result of poor fitness or health, a program of exercise or nutrition should be prescribed. Home therapy may also be recommended, involving such things as anti-inflammatory medication and applications of heat or ice packs. Conscious attention to posture may help some patients avoid sustaining a similar injury in the future, and the chiropractor should be able to discern what poor postural habits require correction. A sedentary lifestyle, particularly with a lot of time spent sitting, is likely to contribute to poor posture and may predispose a person to back pain and injury.

Types of practitioners

Some practitioners use spinal manipulation to the exclusion of all other modalities, and are known as straight chiropractors. Others integrate various types of therapy such as massage, nutritional intervention, or treatment with vitamins, herbs, or homeopathic remedies. They also embrace ideas from other health care traditions. This group is known as mixers. The vast majority of chiropractors, perhaps 85%, fall in this latter category.




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