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THE ART AND SCIENCE OF By Dr. Issam Ayache
Hippocrates wrote numerous books on healing, and mentioned the importance of Manipulation and "On Setting joints by Leverage". He said “look well to the spine, for many diseases have their origin in the dislocations of the vertebral column”. Indians, Chinese, Polish, Hungarians, Arabs and Mexicans, all knew the benefit of joint manipulation. One of these early pioneers was Daniel David Palmer the founder of Chiropractic. The word comes from the words “Cheir” and “Praktikos”which means HAND and EFFICIENT. Chiropractic is an old / new health profession, old in its inception, new in its popularity. The profession was founded in September 18th 1895 in Davenport, Iowa, USA, when D.D. Palmer placed his hands upon an irregular protrusion “ misalignment” of the neck of Harvey Lillard who had at that time hearing loss , and with a forceful thrust reduced this irregularity. As a result Mr. Lillard claimed “I hear the wagons on the street” something he could not do prior to receiving this manipulative treatment. Palmer took a keen and profound interest in the spine. Timing was superb. Interest in the nervous system was at that time was quite high in the scientific circles, and the discovery of X-rays helped palmer at that time too. He opened the first chiropractic school where 15 students enrolled, 5 of the students were MDs. If we take a quick look at 19th century America , we see that health care was more of a craft than an art. Science was lacking in the treatment and training methods. Competing Practitioners such as magnetic healers, hydrohealers, bonesetters... Homeopaths... leeches... lances... tinctures and plasters were rampant... it was an era of complete disarray. This era provided the seed bed for new ideas... A . T. Still started Osteopathy And DD Palmer started Chiropractic. But in the early part of the 20th century allopathic physicians obtained greater cultural authority and support from politicians and decision makers, the medical profession charged that Chiropractors were practicing medicine without a licence... Chiropractors retorted that practicing chiropractic and practicing medicine were different... The doctor of Chiropractic rejected the use of drugs and never incorporated surgery... And ultimately the profession was received as a more of a NATURAL APPRAOCH to healing... Drawing upon the body’s innate recuperative powers. Feud continued for a long time , the AMA promoted licensing regulations , with basic science exams, and national boards in an attempt to eliminate the chiropractic profession.... Chiropractors upgraded their schools, hiring Ph.D. levels to teach ..increased their hours and developed their boards , agencies, and research .... And in the early part of the 1970, 4 Chiropractors took more of an offensive posture and sued the AMA and eleven other medical agencies accusing them of conspiracy to eliminate the profession ...... the case went all the way to the supreme court which ruled in favor of the 4 chiropractors and found the AMA and other medical agencies guilty of fraud and conspiracy... Well ...now the atmosphere is better. DCs ( doctors of chiropractic ) and MDs enjoy a more professional relationship, working in the same medical centers and in many hospitals in the USA. In the last 25 yrs Chiropractic has blossomed becoming a large and mature profession, Established in more than 70 countries in the world, and is the 3 rd largest health care profession in the western world after medicine and dentistry. From 100 DCs in the early part of the 1900 to over 100,000 in the latter part of the 20th century. From one adjustment ( treatment ) in 1895 to more than 450 000 000 ( four hundred million treatments ) now. From one tiny school in Davenport, Iowa USA to over 50 colleges all over the world. DEFINITION: CHIROPRACTIC IS A HEALTH CARE DISCIPLINE WHICH IS CONCERNED WITH HUMAN HEALTH AND PREVENTION OF DISEASE, IT EMPHASIZES THE INHERENT RECUPERATIVE POWERS OF THE BODY TO HEAL ITSELF WITHOUT THE USE OF DRUGS OR SURGERY. DOCTORS OF CHIRPRACTIC ( DCs ) CONSIDER MAN / WOMAN AS AN INTEGRATED BEING, BUT GIVE SPECIAL ATTENTION TO SPINAL BIOMEHANICS, ( PRIMARILY THE SPINE ) AND FUNCTION ( AS COORDINATED BY THE NERVOUS SYSTEM ) AND HOW THIS RELATIONSHIP AFFECTS THE PRESERVATION AND RESTORATION OF HEALTH. SCIENTIFIC THEORIES OF CHIROPRACTIC: Chiropractic is based upon three related scientific theories:
One significant element of this definition is the exclusion of drugs and surgery from the chiropractic practice. This is different from osteopathy in north America , which began as a drugless profession but changed in the 1960s. The purpose of the chiropractic care is not merely to relieve a symptom or address a cause of that symptom, important as these things may be to the patient, But to provide HOLISTIC CARE. It is to treat the whole person and to optimize his health. Therefore Doctors of chiropractic use a variety of conservative methods of management including manual care, nutrition, exercise, advice on lifestyle, and posture and patient counseling and motivation. In addition doctors of chiropractic recognizes the values and responsibility of working in co-operation with other health care practitioners when in the best interest of the patient,. The majority of chiropractic colleges are found in the USA, colleges in Canada, a college in South Africa, college in France. A college in the United Kingdom ADMISSION: Admission to US Chiro. colleges require a minimum of 2 - 3 years of college or university level after high school, with emphasis on biological science, assessment of academic transcripts, a “ B “ or better average, letters of recommendation and an interview. CHIROPRACTIC STUDENTS: Total enrolment in the US colleges in 1995 was 14040 students CURRICULUM: A chiropractic program consists of 4-5 years... that is after the 2 - 3 years in a college or university. The Program is divided into: 2 - Clinical Education...........3380 hrs....70 % The clinical courses are: SPECIALTY TRAINING Specialty training is available in US colleges, a part time or a full-time residency program which last from 1 to 3 yrs Post graduate courses are available in : CONTINUING EDUCATION 47 of the 50 states have mandatory continuing education requirements to maintain and renew the license , it ranges from 12 to 50 hrs per year. LICENSURE AND SCOPE OF PRACTICE The practice of chiropractic is licensed in all 50 states and in more than 70 countries in the world. TYPES OF CONDITIONS TREATED
Diagnostic methods are similar to all other health care practitioners:
The most important part of a chiropractic treatment in a practice is : A definition of an Adjustment is: A dynamic thrust applied to a particular joint, with high or low velocity, short or long lever, high or low amplitude; may or may not involve the cavitation or gapping of a joint, which moves the joint into the paraphysiological range. The corrective structural adjustment by a chiropractic physician should not be confused with other forms of manipulation . Allopathic manipulation is usually little more than putting a joint through its normal range of motion by the therapist in order to stretch muscles and break adhesions. Osteopathic manipulation is designed to increase joint motion and relieve fixation. On the other hand CHIROPRACTIC CORRECTIVE ADJUSTMENT is delivered in a specific manner to achieve a predetermined goal. It is a precise delicate manoeuvre requiring special bio engineering skills and deftness not unlike that required for other specialties, Rarely is the process painful. Most chiropractic adjustment involve the articulations of the spinal column and extremities. Some techniques , however are light touch reflex adjustments that involve the neurovascular, neurolymphatic and neuromuscular system, gentle manipulation and passive mobilization. The objectives of the adjustment are : Removal of any fixation between the joints Is the chiropractic treatment (adjustment) dangerous? With rare exceptions, the answer is “no” . While any form of health treatment contains a degree of inherent risk, there is little danger in chiropractic care administered by a licensed chiropractor. Statistics show that patient risk is substantially lower in chiropractic as opposed to other forms of health care, where the iatrogenic threat of prescription drugs and surgery pose a greater risk. The relative safety of chiropractic care is amply documented and studied,. The incidence of a negative result following a chiropractic adjustment is 2 to 3 cases per million treatment. This compares with the 1.5 percent risk of paralysis from neurosurgery on the cervical spine often performed for similar degenerative conditions. EXAMPLES OF CHIROPRACTIC TECHNIQUES:
Many studies have shown that the benefits of Chiro.manipulation when accompanied with appropriate modification inline style are long term.
Since the majority of problems seen in chiropractic offices are of low back pain, neck pain. The studies were done on this aspect. ROLE OF CHIROPRACTIC IN HEALTH CARE: The role of chiropractic in health care is characterized by direct access, longitudinal, integrated, conservative ambulatory care of patients health care needs, emphasizing neuro musculo skeletal conditions, health promotion, and patient centered diagnosis and management. Chiropractors posses the diagnostic skills to differentiate health conditions that are amenable to their management from those conditions that require referral or co-management.. Chiropractic provide conservative management of neuro-musculo-skeletal Disorders and related functional manifestations including, but not limited to , back pain, neck pain and headaches, Chiropractors provide patient evaluation and instructions regarding prevention and health promotion through proper nutrition, exercise and lifestyle modification among others. Chiropractic diagnostic and therapeutic goals should be achieved as safely, quickly and economically as possible to promote patient health and independence Chiropractic recognizes the multifaceted aspects of health , disease, aetiology and related patient care.
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