Chiropractic is a therapy that focuses on the relationship of the spinal column to the nervous system and on its effects in maintaining good health. Chiropractic seeks to properly align the vertebrae of the spine in order to restore the normal functioning of the nervous system and thus allow the body to heal itself.

In little more than a century, chiropractic has gone from a curious cult-medicine status to an internationally recognized alternative treatment. Founded in 1895 by a Canadian-American, Donald David Palmer (1845-1913), chiropractichad its origins in Palmer's cure of a deaf janitor by putting one of his vertebrae back into its normal position. Palmer continued to refine his work andeventually based an entire medical philosophy on the notion that the vertebrae of the spine must be properly aligned in order for people to achieve and maintain health.

Misalignments, or what he called "subluxations," interfere with the normal transmission of nerve impulses from the brain to the body's organs and tissuesand can affect health. Chiropractic techniques offered many what they considered a safe and economical alternative to conventional medicine. Since Palmer's days, chiropractors have grown into the third largest health-care profession, after physicians and dentists. By the mid-1990s, they were licensed to practice without supervision or referral from medical doctors in every state, and Americans spent nearly $2.5 billion annually on chiropractic care. Also, 1in 20 Americans visit a chiropractor each year, and some 30 U.S. hospitals have chiropractors on their staff.

The word chiropractic is derived from the Greek word cheir meaning hand, and prakticos meaning done by or skillful use of. Chiropractic focuses virtually all its efforts on the physical manipulation of spine and joints. It does not use drugs or surgery, and it does not diagnose diseases or ailments or even claim to treat them specifically. Rather, it believes that thebody possesses its own innate healing capability and that healing occurs fromthe inside out. Further, when the body is in balance -- and specifically when the vertebrae of the spine are kept in proper alignment -- good health ensues because the body's immune system is working properly. Chiropractic attributes a damaged or inefficient immune system to the impairment of normal nervetransmission caused by spinal misalignment.

Within the framework of chiropractic there are several schools or philosophies that differ according to their methods and goals. Two contrasting schools -- the "mixers" and the "straights" -- differ in the actual methods employed.As the simpler, more traditional school, straight chiropractic relies exclusively on spinal adjustments to correct vertebral misalignments and therefore restore nerve function. Straights account for only about 15% of all chiropractors. The other chiropractic philosophy, whose proponents are called "mixers,"believes in blending or mixing other available therapeutic methods with traditional chiropractic. Thus, these individuals also use other adjunctive therapies such as massage, applied kinesiology, acupressure, nutritional counseling, and ultrasound among many others, seeking to employ whatever works best. Athird branch of chiropractic follows the teaching of John McTimoney (1914-1980). This philosophy says that the entire musculoskeletal system of the bodyis as important as the spine, and it therefore treats the joints of the entire body. A McTimoney chiropractor will examine, and work on if necessary, allareas of the body where joints can become misaligned.

A visit to a chiropractor begins very much like one to an orthodox physician.A detailed medical history precedes a physical examination, during which thechiropractor takes the patient's pulse and blood pressure, and checks theirreflexes. Blood and urine tests may be ordered. The physical exam concentrates primarily on the spine, and the patient will be instructed to perform a number of movements while the chiropractor both carefully watches and palpates (probes with pressure) certain areas. This allows the chiropractor to focus ondetecting muscle strength or weakness, the range of spinal motion available,incorrect posture, or any structural deformities. Most chiropractors now also x-ray the patient's spine if they complain of pain, and these x rays allowthem to locate vertebral misalignments.

Treatment for a specific problem is always tailored to the individual's age,weight and build, overall condition, and even level of pain tolerance, and itconsists of what are called adjustments. These are hands-on treatments in which the chiropractor manipulates the patient's spine. Depending on what partof the body is being treated, the patient will be asked to stand, sit, or liedown. Manipulation is done quickly, with each adjustment taking only seconds. It is here that the chiropractic technique differs from regular physical therapy and massage, for the practitioner typically performs a special, high-velocity thrust maneuver that places many pounds of force to a part of the spine for only the briefest time. Although this usually does not cause pain, it often results in popping sounds similar to knuckles being cracked. For patients who are not comfortable with high-velocity techniques, indirect thrust maybe used. Indirect thrust uses a gentle stretching motion to manipulate the joint over a towel or padded block. Finally, depending upon the nature of the problem being treated, heat or cold may be applied.

Despite the generally wide acceptance of chiropractic health care, there is little solid evidence for its benefits beyond back care. Still, many people simply do not care as long as they get some relief from their problems. Supporters say that it is only a matter of time until such evidence appears, and inthe meantime, patients take fewer drugs, have less surgery, and have fewer hospital stays with chiropractic care. This certainly accounts for much of itsbroad appeal.

Patients with known bone diseases, fractures, or bone cancer should not see achiropractor. Pregnant women with back pain can be treated, but should neverallow themselves to be x-rayed.

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