Terry A. Rondberg, DC | Wellness for Mind and Body

In recent years, chiropractors have once more turned their attention to the neurological component of the subluxation. After decades of concentrating on musculoskeletal aspects, it’s a move that is as timely as it is important. In the years to come, our understanding of how we impact the brain will be the key to becoming the leader in the wellness revolution.

It’s a trend we’re seeing in other non-medical fields as well. In fact, a British research study published earlier this year in the journal Brain Research revealed that acupuncture has a significant effect on specific neural structures.

The researchers explained that when a patient receives acupuncture, it triggers a sensation called deqi (literally, the arrival of chi, pronounced duh-chi). Scientific analysis shows that this energy impulse deactivates areas within the brain that are associated with the processing of pain.

Dr. Hugh MacPherson, of the Complementary Medicine Research Group in the University of York’s Department of Health Sciences, noted: “These results provide objective scientific evidence that acupuncture has specific effects within the brain which hopefully will lead to a better understanding of how acupuncture works.”

Neuroscientist Dr. Aziz Asghar, of the York Neuroimaging Centre and the Hull York Medical School, added: “The results are fascinating. Whether such brain deactivations constitute a mechanism which underlies or contributes to the therapeutic effect of acupuncture is an intriguing possibility which requires further research.”

Last summer, following research conducted in York, acupuncture was recommended for the first time by the National Institute for Health and Clinical Excellence (NICE) as a treatment option for NHS patients with lower back pain. NICE guidelines now state that GPs should “consider offering a course of acupuncture comprising a maximum of 10 sessions over a period of up to 12 weeks” for patients with this common condition.

Current clinical trials at the University of York are investigating the effectiveness and cost-effectiveness of acupuncture for Irritable Bowel Syndrome (IBS) and for depression. Recent studies in the US have also shown that acupuncture can be an effective treatment for migraines and osteoarthritis of the knee.

The York team believes that the new research could help to clear the way for acupuncture to be more broadly accepted as a treatment option on the NHS for a number of medical conditions. “Our results show the importance of collecting and accounting for needle sensation data in neuroimaging studies of acupuncture,” researchers concluded.

There’s an equally important need to collect information on the neurological impact of chiropractic adjustments, such as that being collected by doctors who use the NeuroInfiniti equipment.

ABSTRACT:  “Acupuncture needling sensation: The neural correlates of deqi using fMRI.” Brain Research, Vol. 1315, 22 February 2010, Pages 111-118.

AUDIO: Dr. Hugh Macpherson, from the University of York, discusses new research into the effects of acupuncture on the brain published in Brain Research.

by Terry A. Rondberg, DC

Based on my previous articles on the subject, it’s clear there is a lot of interest about chiropractic neurology. What’s it all about? I’m posting this blog in frequently asked question (FAQ) format to ensure you can quickly find the answers you need.

Q. What’s chiropractic neurology?

A. According to the American Chiropractic Neurology Board (ACNB), chiropractic neurology is defined as “the field of functional neurology that engages the internal and external environment of the individual in a structured and targeted approach to affect positive changes in the neuraxis and consequent physiology and behavior.”

Q. So what does that mean in plain English?

A. It means that a chiropractic neurologist examines how the nervous system is functioning (or malfunctioning). If the system is out of balance, chiropractic treatment focuses on repairing the imbalance, such as vertigo, Autism, attention deficit disorder (ADD), to restore the patient to health.

Q. What others types of disorders can chiropractic neurology address?

A. Chiropractic neurologists may treat the above conditions, as well as dizziness, disequilibrium and imbalance, dystonia, tremors, chronic pain syndromes, back pain and movement disorders. They may also treat behavioral disorders such as Tourette’s Syndrome, as well as changes in personality or motor, sensory or cognitive impairments resulting from head traumas, accident injuries, traumatic brain injury (TBI) and mild TBI.

Q. So what’s the difference between a chiropractic neurologist and a medical neurologist?

A. According to the ACNB, the chiropractic neurologist provides the same manner of consultation as a medical neurologist, with the major difference being that the therapies and applications are performed without the use of drugs or surgery. So, a medical neurologist or neurosurgeon will prescribe medications, injections or brain surgery to correct a disorder or condition. On the other hand, the chiropractic approach is to therapeutically change brain and nervous-system function.

Q. How is a chiropractic neurologist different than a “traditional” chiropractor?

A. Most chiropractors are trained in the detection and correction of spinal dysfunction. But spinal function is just one of many influences on the nervous system. A neurologist not only has completed the doctor of chiropractic program, but must receive three years of additional training and testing to become a board-certified neurologist in the chiropractic profession. The extra training is specific to the field of neurology and includes the study of neurophysiology and clinical and diagnostic techniques.

Q. What are the benefits of chiropractic neurology?

A. Simply put, many conditions of the brain and nervous system do not respond well to aggressive interventions such as drug therapy or surgery. Both drugs and surgery are often associated with increased risks for serious complications or dangerous side effects. Thus, the approach taken by chiropractic neurologists can be highly beneficial in treating brain and nervous system disorders using safe and effective methods with lasting health benefits.

Part Three of three articles.

In a previous Journal article, although medical authorities acknowledge neurological complications may occur as a result of subluxation, classical chiropractic definitions mandate the presence of a neurological component.  Researcher, Charles Lantz, PhD, DC, writes, “Common to all concepts of subluxation are some form of kinesiological dysfunction and some form of neurological involvement.”

Nevertheless, we’re often ignoring that neurological involvement.  As a result, we are known as back-pain doctors and used the same way as aspirin or exercise equipment: to relieve musculoskeletal stiffness and pain.  One reason is we were sold a bill of goods to find a “niche” market. Back pain, we were told, was a lucrative market, with nearly eight of every ten adults suffering from it at one time or another. We thought the medical profession would allow us to treat back pain as long as we did not invade their territory.

It was also less complicated to describe how chiropractic could ease back pain than it was to explain the entire vitalistic philosophy.  It was also easier to advertise.  All we had to do was show a person with red lightning bolts radiating from his or her back or neck and we were in business!

The final reason we ignored the neurological component was that we didn’t have the scientific research to prove what we knew from clinical experience.  As Dr. Davila says, “We need to show a neurological connection to the subluxation so we have the proof we have talked about over the years and then tie that connection to functional improvement.”
Why then is so much of our current research focused on back pain and similar musculoskeletal conditions?  Here, for instance, is the complete list of all the projects funded by FCER last year:

• “Chiropractic Dosage for Lumbar Stenosis”
• “Chiropractic and Acute Neck Pain: A Practice-Based Study”
• “Preventive Care of Chronic Cervical Pain and Disabilities: Comparison of Spinal Manipulative Therapy and Individualized Home Exercise Programs”
• “Does Chiropractic Care Decrease Fall Risk in Older Adults?”  (The grant description notes that: “It is proposed that balance, the risk factor for falls, is adversely affected by both musculoskeletal function and low back and lower extremity pain — which have been found to be responsive in previous studies to chiropractic intervention.”)

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Do you see the pattern here?  Instead of locking our profession in the miniscule musculoskeletal box, we need to reclaim the missing component of subluxation: neurological involvement. The World Chiropractic Alliance is dedicated to this mission.  We must discuss with our patients and members of the community, integrating it in our patient education programs. It is also necessary to redesign our advertising so we are not reinforcing the old, erroneous idea of back pain doctors. Furthermore, we should demand that our colleges and research institutions stop plucking the low-hanging fruit by examining the connection between chiropractic and back pain! Field doctors need to start using the NeuroInfiniti instrumentation to accurately measure a patient’s neurological response before and after subluxation correction, and learn to document vital information for use not only in research but for the government and all insurance companies.

In the hundred-plus years since DD Palmer discovered chiropractic, we’ve lost much of the spirit and substance of chiropractic. If we lose the neurological component of the subluxation, we will lose our original identity and possibly, our future.

I don’t want to wait until someday for chiropractic validation. Certainly, you do not wish to wait to transform your office into a smooth-running and modern, scientific evidence-based practice, with easy-to-use technology that maximizes your patient outcomes AND your bottom line! However, we do not need to wait until that elusive someday.  We can have it all NOW.

About the Author – Terry A. Rondberg, DC.
As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is known worldwide as one of the chiropractic profession’s leading proponents. After receiving his Doctor of Chiropractic (DC) Dr. Rondberg began publishing The Chiropractic Journal, a leading publication in the field. In addition to publishing the Journal—which continues to be an authoritative reference for chiropractic practitioners and professionals —Dr. Terry Rondberg has written a number of best-selling books on the subject of chiropractic.

Part Two of three articles.

Understanding the brain is fascinating, but I must caution that despite stunning achievements, scientists know little about how we apply our knowledge to real-world settings. If we understood how the brain knows to pick up a glass of water to drink, that would be a major achievement. Non-scientists understand even less. I encourage everyone to be a bit skeptical about what they read in the popular press. Occasionally, I read an article that states the new brain science can improve business practice, and I’ll say, “Really?” We use our brains in business management, but it’s premature to predict how the revolution in neuroscience will affect the way executives manage their organizations.

Some things we’ve learned have great practical value. Let’s examine the impact of stress on the brain. Stress hurts the brain, which inevitably affects workplace productivity. The brain was created to survive jungles and grasslands and to endure acute stress. For instance, a saber-toothed tiger will either eat a human or force him to run away. In either case, the stress level decreases in less than a minute. One can have several of these spikes throughout the day and cope. In fact, stress is beneficial since it makes our muscles move. But man was created to handle stress for only 30 to 60 seconds. Today, our stress level is measured not in moments with mountain lions, but in hours, days, and months, as we experience hectic careers, screaming toddlers, marital issues, and financial problems. Our bodies aren’t built for this kind of ongoing stress. If you have the tiger at your doorstep for years, then various internal mechanisms break down, from sleep rhythms to specific parts of the immune system. Enduring chronic stress resembles taking an airplane and sticking it in water. Just like the airplane wasn’t built to be in water, the brain wasn’t built to endure chronic stress.

The biggest disgrace of modern medicine involves physicians prescribing unnecessary drugs that have not been thoroughly researched and performing unproven procedures on patients. This is one reason why more than 100,000 people die each year in the U.S. due to the medical care they are given.  Thank God for chiropractic.  But are we any different? We adjust patients on the premise that subluxations have a negative affect on their health, but do we have valid, scientific evidence to support this claim? We know this is true from our first hand clinical experience and we have some research for corroboration, but we do not yet have the necessary, indisputable evidence that accompanies large-scale clinical outcomes. We expect that someday we will prove to the world that the neuromusculoskeletal changes resulting from chiropractic adjustments can result in life-enhancing affect on all organic functions. Research will show that chiropractic strengthens the immune system, aids the body to defend against a variety of diseases and conditions, while improving the quality of life which we believe leads to a longer, healthier and happier life.

Too often chiropractic is viewed as a treatment for musculoskeletal disorders, disregarding the neurological aspect. When I first read The Chiropractic Journal’s commentary, “Do you want to re-define medical necessity?” by John Davila, DC, I found myself nodding vigorously in agreement, especially when he states, “The neurological component of the subluxation is our greatest weapon to expanding the definition of medical necessity.”

We will see in the next article how ignoring the neurological component of chiropractic is harmful to the profession.

About the Author – Terry A. Rondberg, DC.

As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is known globally as one of the chiropractic profession’s leading figures. For decades, he has shown tremendous commitment to the chiropractic profession. After receiving his Doctor of Chiropractic (DC) Dr. Rondberg began publishing The Chiropractic Journal, a professionally edited news source for chiropractic. In addition to publishing the Journal, Dr. Rondberg has written a number of best-selling books on the subject of chiropractic.

Part One of three articles.

Achieving positive results from chiropractic care is easier than explaining why or how such results are accomplished. This has led the profession to accept that, “Even if we can’t prove why we get good results, we know it works and that’s good enough.” This notion is no longer acceptable. Our critics claim we are unscientific and invalid. We urgently need credible and objective evidence that is published in scientific peer-reviewed journals!

Chiropractic care continues to seek valid instrumentation to demonstrate the connection between chiropractic adjustment and neurological change. Our first attempt at instrumentation was Radiology. The dated concept of vertebral mal-position correction being the field of Chiropractic, lead to X-Ray pictures proving the adjustment shifted the bone. But questions remain:

• Do static radiographs provide proof and/or correction of cause?
• Is the vertebral mal-position the cause or is it an effect of cause?

According to B. J. Palmer, the Vertebral Subluxation is a result of neurological influence and not the cause.

Today we have the next generation of instrumentation to address the cause of abnormal neural activity, which leads to abnormal muscle activity and creates abnormal joint mechanics. Such upgraded instrumentation provides information about neurological function at both the cortex (brain function) and at the Limbic System level (sympathetic/para-sympathetic responses). It is designed to test these over time and assess stress and recovery. It is a test for a dynamic system which deals directly with cause and can demonstrate the ability and power of chiropractic to alter neural function. The NeuroInfiniti was developed by chiropractors to provide research findings and has been used in chiropractic offices for the past several years. It is scheduled for its third upgrade even though it is already light years ahead of anything on the current market. The non-reproducibility of static sEMG and/or thermal scans has created many challenges, including third-party pay not covering the costs, which leaves many of the old sEMG/thermal units either gathering dust or used as a marketing tool at mall displays.

One can hardly escape reading about neuroscience in the press, and it’s easy to see why the topic fascinates some. Intellectual capital is the foundation of business in the knowledge economy. Yet as with any new field of knowledge, there’s much hype about the benefits of recent developments in brain science. For example, one notion claims that executives can become better leaders by emulating the management secrets of the human brain. Unfortunately, if one emulates the management secrets of the brain, one can create an organization that operates like the stock-market floor on Black Friday.

In the next article, we’ll move from the theoretical to the practical application of neurological activity.

About the Author – Terry A. Rondberg, DC.

As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is widely regarded as one of the chiropractic profession’s leading figures. For decades, he has shown unparalleled commitment to the chiropractic profession, bringing exceptional fervor and youthful vigor to his many endeavors and contributions. After receiving his Doctor of Chiropractic (DC) Dr. Rondberg began publishing The Chiropractic Journal, a professionally edited source for news and features for chiropractic practitioners and professionals.