To better understand the reality of small animal chiropractic, it helps to better understand chiropractic in general, as well as how it all began. If you're patient enough, and curious enough, I can take you on that journey now! It is absolutely fascinating. This may become a tough read at times, especially given the amount of verbatim quotations and links that are in this article. Try to bear with me, though, and you'll hopefully understand why it is being done this way.
Origins
The history of chiropractic is “rooted in quasi-mystical concepts.” Bonesetters of various types are part of folk medicine of most cultures, and bonesetting also helped form the basis on which chiropractic developed, all the way back on September 18, 1895. On that day, D.D. Palmer manipulated the spine of a deaf janitor by the name of Harvey Lillard, allegedly curing him of his deafness. Palmer's second patient, a man suffering from heart disease, was also cured. About one year later, Palmer opened the first school of chiropractic.
There is evidence to suggest that D.D. Palmer had learned manipulative techniques from Andrew Taylor Still (1828–1917), the founder of osteopathy. He combined the skills of a bonesetter with the background of a magnetic healer and claimed that “chiropractic was not evolved from medicine or any other method, except that of magnetic.” He coined the term “innate intelligence” (or “innate”) for the assumed “energy” or “vital force,” which, according to the magnetic healers of that time, enables the body to heal itself. The “innate” defies quantification. “Chiropractic is based on a metaphysical epistemology that is not amenable to positivist research or experiment.”
The “innate” is said to regulate all body functions but, in the presence of “vertebral subluxation,” it cannot function adequately. Chiropractors therefore developed spinal manipulations to correct such subluxations, which, in their view, block the flow of the “innate.” Chiropractic is “a system of healing based on the premise that the body requires unobstructed flow through the nervous system of…innate intelligence.” Anyone who did not believe in the “innate” or in “subluxations” was said to have no legitimate role in chiropractic. [source]
"The kind of dis-ease depends upon what nerves are too tense or too slack." - D.D. Palmer
“Innate intelligence” evolved as a theological concept; the representative of Universal Intelligence (i.e.: God) within each person, which could respond to appropriate physical stimuli for positive or negative physical changes. Palmer seemed convinced he had discovered a natural law that pertained to human health in the most general terms. Originally, chiropractic manipulation was not a technique for treating spinal or musculoskeletal problems, but was a cure for all human illness: “95% of all diseases are caused by displaced vertebrae, the remainder by luxations of other joints.” Early chiropractic pamphlets hardly mention back pain or neck pain, but assert that, “chiropractic could address ailments such as insanity, sexual dysfunction, measles and influenza.” Palmer was convinced that by developing chiropractic he had “created a science of principles that has existed as long as the vertebra.” Chiropractors envision man as a microcosm of the universe where “innate intelligence” determines human health as much as “universal intelligence” governs the cosmos; the discovery of the “innate intelligence” represents a discovery of the first order, “a reflection of a critical law that God used to govern natural phenomena.” [source]
Early chiropractic displayed many characteristics of a religious cult. Both D.D. Palmer and his son, B.J. Palmer, seriously considered establishing chiropractic as a religion. Chiropractic “incorporated vitalistic concepts of an innate intelligence with religious concepts of universal intelligence,” which substituted for science. Palmer declared that he had discovered the answer to the age old question, “what is life?” and added that chiropractic made “this stage of existence much more efficient in its preparation for the next step - the life beyond.”
"We must have a religious head, one who is the founder, as did Christ, Muhammad, Joseph Smith, Jr., Mary Baker Eddy, Martin Luther and other who have founded religions. I am the fountain head." - D.D. Palmer, May 4th 1911
Most early (and many of today's) chiropractors agree: “Men do not cure. It is that inherent power (derived from the creator) that causes wounds to heal, or a part to be repaired. The Creator uses the chiropractor as a tool - chiropractic philosophy is truly the missing link between Religion or Power of the various religions.” [source] Today, there is a notable division, with some chiropractors continuing to relate the “innate” to God, while others warn not to “dwindle or dwarf chiropractic by making a religion out of a technique.”
Initially, the success of chiropractic was considerable. By 1925, more than 80 chiropractic schools had been established in the United States. Most were “diploma mills” offering an “easy way to make money,” and many “were at one another's throats.” Chiropractors believed they had established their own form of science, which emphasized observation rather than experimentation, a vitalistic rather than mechanistic philosophy, and a mutually supportive rather than antagonist relationship between science and religion. The gap between conventional medicine and chiropractic thus widened “from a fissure into a canyon.” The rivalry was not confined to conventional medicine; “many osteopaths asserted that chiropractic was a bastardized version of osteopathy.”
Rather than arguing over issues such as efficacy, education, or professional authority, the American Medical Association insisted that all competent health care providers must have adequate knowledge of the essential subjects such as anatomy, physiology, pathology, chemistry, and bacteriology. By that token, the American Medical Association claimed, chiropractors were not fit for practice. Some “martyrs,” including D.D. Palmer himself, went to jail for practicing medicine without a license. Chiropractors countered that doctors were on the defense for obvious financial reasons (ironically, chiropractors today often earn more than conventional doctors) and that orthodox science was morally corrupt and lacked open-mindedness. They attacked the “death producers” and promised a medicine “destined to the grandest and greatest of this or any age.”
Eventually, the escalating battle against the medical establishment was won in “the trial of the century.” In 1987, sections of the U.S. medical establishment were found “guilty of conspiracy against chiropractors,” a decision which was upheld by the U.S. Supreme Court in 1990. In other countries, similar legal battles were fought, usually with similar outcomes. Only rarely did they not result in a victory for chiropractic. In 1990, a Japanese Ministry of Health report found that chiropractic is “not based on the knowledge of human anatomy but subjective and unscientific.”
Internal Conflict
These victories came at the price of “taming” and “medicalizing” chiropractic. In turn, this formed the basis of a conflict within the chiropractic profession - the dispute between “mixers” and “straights” - which continues to the present day.
The “straights” religiously adhere to D.D. Palmer's notions of the “innate intelligence” and view subluxation as the sole cause and manipulation as the sole cure of all human disease. They do not mix any non-chiropractic techniques into their therapeutic repertoire, dismiss physical examination (beyond searching for subluxations) and think medical diagnosis is irrelevant for chiropractic [Keating Jr. of Los Angeles College of Chiropractic, Whittier, CA]. The “mixers” are somewhat more open to science and conventional medicine, use treatments other than spinal manipulation, and tend to see chiropractors as back pain specialists. Father and son Palmer warned that the “mixers” were “polluting and diluting the sacred teachings” of chiropractic. Many chiropractors agreed that the mixers were “bringing discredit to the chiropractic.”
The “straights” are now in the minority but nevertheless exert an important influence. They have, for instance, recently achieved election victories within the British General Chiropractic Council. Today, two different chiropractic professions exist side by side; one that wishes to preserve the non-empirical, non-positivist, vitalist foundations (the straights) and the other that wishes to be reckoned as medical physicians and wishes to utilize the techniques and mechanistic viewpoint of orthodox medicine (the mixers). The International Chiropractic Association represents the “straights” and the American Chiropractic Association the “mixers.”
The three core hypotheses of modern chiropractic have been summarized as follows:
There is a functional relationship between the spine and health mediated through the nervous system.
Subluxations adversely affect health.
Correction of subluxation by spinal manipulation improves or restores health.
“Give me a simple mind that thinks along single tracts, give me 30 days to instruct him, and that individual can go forth on the highways and byways and get more sick people well than the best, most complete, all around, unlimited medical education of any medical man who ever lived.” - B.J. Palmer
The above remark by B.J. Palmer implies that naivety is required to accept the implausibility of chiropractic concepts. The founders of chiropractic created myths and denied scientific discoveries. B.J. Palmer, for instance, rejected the existence of the sympathetic nervous system, and early chiropractors denied the existence of the germ theory of disease, which has important implications for public health. [source]
The “mixers,” however, saw the insistence on the “innate” as “religious baggage.” Today many chiropractors are anxious to sever all links with this concept, fearing that it might jeopardize chiropractics' acceptance into the mainstream. [source]
Subluxation
Some chiropractors prefer terminology such as “vertebral subluxation complex,” “manipulable spinal lesion,” “chiropractic lesion,” or “vertebral blockage,” yet most modern chiropractors accept the concept of subluxation. The term as used in chiropractic means something different from subluxation in regular medicine. Here, I refer to the term as used in chiropractic. For D.D. Palmer, it was “a static malalignment of a single vertebra.” Subluxations are believed to impinge on spinal nerves, therefore blocking the flow of the “innate intelligence” (according to “straights”) or causing disease in some other way (according to “mixers”).
Several theories have been advanced to explain how subluxations might cause health problems, for example, through edema around intervertebral foramina or twisting the dura mater. However, none of these have been independently confirmed and the specific mechanisms involved are not known. In fact, subluxations have never been proven to constitute a relevant entity. Critics have repeatedly pointed out that even severe nerve root compression does not cause organic disease.[source] Regardless of such doubts, the U.S. Association of Chiropractic Colleges reached a consensus in 1996 that “chiropractic is concerned with the preservation and restoration of health and focuses particular attention on the subluxation. A subluxation is a complex of functional and/or pathological articular changes that compromise neural integrity and may influence organ systems function and general health.” One year later, the U.S. Foundation for Chiropractic Education and Research published a monograph stating that subluxation “embraces the holistic nature of the human body, including health, well-being, the doctor/patient relationship, and the changes in the nerve, muscle, connective tissue, and vascular tissues which are understood to accompany the kinesiologic aberrations of spinal articulations.”
Today, 88% of U.S. chiropractors believe that subluxation contributes to over 60% of all visceral ailments and 90% think it should, therefore, not be limited to musculoskeletal conditions. In other countries, for example, Canada, these percentage figures are usually lower. [source]
Spinal Manipulation
Subluxations can be corrected with spinal manipulations or “adjustments,” a term preferred by some chiropractors. Today most chiropractors agree with D.D. Palmer that spinal manipulation has to be specific, that is, at the correct spinal segment. There is, however, less agreement on the optimal direction or the level of manipulation. Chiropractors even disagree about the term spinal manipulation. In its broadest definition, it describes the “application of force to specific body or tissues with therapeutic intent.”
Spinal manipulation moves vertebrae beyond their physiological range of motion (chiropractors speak of “end feel” and “paraphysiological space”) but not far enough to destroy joint structures: “between the normal range of motion and the limits of its normal integrity.” Chiropractors believe that spinal manipulation breaks fibrous adhesions within joints, or that it “releases small tags from the joint capsule that might be entrapped within the joint,” or that it affects the mechanoreceptors of the joint, or that it modulates central nervous system excitability, or that it inhibits C-fiber mediated pain perception. The hypotheses are plentiful, but not supported by sound evidence.
Diagnostics
The reliability of diagnostic techniques used by chiropractors is generally poor, making known variability levels that are higher than would be considered acceptable in other fields of study and diagnosis. Plain static radiograph and functional radiograph investigations are viewed as the most reliable methods for diagnosing subluxations. Thus, practically all new (96.3%) and most continuing (80%) U.S. chiropractic patients undergo radiography. Yet guidelines state that a competent chiropractor “does not do routine radiographs” The majority of U.S. chiropractors (86%) have their own X-ray equipment. Most experts today caution that radiographic investigations for nonspecific back pain are frequently unnecessary, often expensive, and harmful. Making matters worse, many U.S. chiropractors also do blood and urine analyses and some engage in minor surgery. In Oregon, chiropractors are even allowed to deliver babies following a one week class to attain a birthing certification due to them already having a medical license. Because of these types of medical shenanigans, conventional U.S. doctors are statistically unlikely to make formal referrals to chiropractors, instead opting for scientifically-backed physical therapy.
Research
The terms “research” and “science” appear frequently in the chiropractic literature with a variety of meanings unfamiliar to most scientists. Many early chiropractors felt the need to obtain an “aura of scientific respectability” as marketing ploys for promoting their practice to the public. This attitude is still quite prevalent. A leading Canadian chiropractor, for instance, was quoted saying that research “is something that you have to do, no question. We have to have the research to be accepted properly.” The concept that research is a means of improving future health care, as it is in other medical fields, does not seem widespread within the chiropractic profession.
The little research that did take place during the early years of chiropractic was of remarkably low quality. Research was initiated to prove rather than to test chiropractic. The data that thus emerged were subject to “zealous overinterpretation." For instance, observational studies were wrongly characterized as controlled clinical trials. The current chiropractic research literature continues to be overtly biased. An evaluation of the 29 recent reviews of spinal manipulation for back pain concluded that those authored by chiropractors tended to generate positive results, whereas the others failed to demonstrate effectiveness.[source]
Today's “straight” chiropractors believe that research “never establishes truth” and deny the relevance of science to chiropractic. “We cannot second guess whether the innate intelligence of the body can heal a disease.” [Joseph Strauss] Belief in subluxation is an essential prerequisite for any chiropractor—so much so that questioning this belief is grounds for banishment from the profession; therefore, scientific investigation of chiropractic, which obviously requires questioning that belief, is (by definition) not possible for chiropractors.
Efficacy
Overtly aggressive marketing is deliberately aimed at misleading patients and the public regarding the efficacy of chiropractic care. [source] In fact, unsubstantiated claims regarding the efficacy of chiropractic continue to be made, not merely by overenthusiastic individuals but also by official organizations.
Numerous controlled clinical studies of chiropractic are now available, but their results are far from uniform. Rather than selecting single studies according to their findings, it is, therefore, preferable to consider the totality of this evidence. [source] These systematic reviews usually include trials of spinal manipulation regardless of who administered it. Thus, they are not exclusively an evaluation of chiropractic. Collectively, their results fail to demonstrate that spinal manipulation is effective. The only possible exception is back pain. For this condition, manipulation may be as effective (or ineffective) as standard therapy.
Direct Risks
“Chiropractic is safe." In the chiropractic literature, statements like this can be found abundantly. Currently, chiropractors almost ubiquitously deny that spinal manipulation can cause harm and they actively to trivialize its risks.
In 2001, a systematic review of five prospective studies concluded that mild-to-moderate, transient adverse effects are experienced by about half of all chiropractic patients. Local or radiating pain, headache, and tiredness are the most frequent adverse effects. Since then, two further prospective studies reported that such adverse effects occur in 61% and 30% of patients. Therefore, there is undeniable evidence that chiropractic is associated with an exorbitantly high incidence of minor adverse effects.
Surgeon Reacts to Chiropractic Accidents & Injury - Dr. Chris Raynor
The current chiropractic literature also continues to promote “hostile opposition to health prevention based upon immunization procedures” and repeatedly stresses that immunization is hazardous and ineffective. In doing so, facts are distorted: “Smallpox vaccination was stopped in the U.S. and U.K. because it was realized that the vaccinated suffered the worst effects of the disease" or the risks of immunization are exaggerated: “The dangers of vaccination to the young child are profound… in some cases, the vaccine acts non-specifically to increase a child's pre-existing chronic disease tendency.”
A U.S. survey was aimed at identifying chiropractors' attitudes toward immunization and found a "significant minority" who exhibit anti-vaccine tendencies. A random sample (1%) of all U.S. chiropractors was provided with a choice of policy statements. One-third of the sample agreed with the statements that there is no scientific proof that immunization prevents disease, that it causes more disease than it prevents, and that contracting an infectious disease is safer than immunization. Another survey was performed on 150 licensed chiropractors from Boston. Approximately 30% of them reported to recommend active immunization and 7% recommended their clients against immunization. A Canadian interview study recently confirmed that some chiropractors provide to their patients “information of a negative, anti-vaccination nature.” With such rampant anti-science sentiments among professionals seeking to be taken seriously by science-based medical institutions, this should be cause for concern.
If you've made it this far, I bet your wondering when we'll start covering small animal chiropractic. Now. We're doing it now.
The frequency of chiropractic implementations on pets in the United States has skyrocketed. Chiropractic practitioners are targeting and systematically overcoming limitations to their scope of practice with the explicit goals of acquiring unrestricted access to animals, eliminating the need for veterinary supervision or referral, and to stop “regulatory harassment” from veterinary medical boards and some of their fellow human chiropractors. [source: video below]
"Chiropractic is a separate and distinct profession outside of medicine."
Each year, they gain more ground. For example, the 2023 American Veterinary Medical Association (AVMA) State Legislative Update lists abundant activity on the topic of chiropractic in Arizona, Iowa, Missouri, New Hampshire, Oklahoma, and Texas. A few states, such as Colorado, have already capitulated to chiropractors, granting direct access after meeting minimum requirements. Some chiropractors even see canine patients without ever even completing any sort of additional training.
Chiropractic adjustments for non-human animals may make a joint move more freely, but for certain conditions (e.g. neoplasia, spondylosis, and cervical instability), rapid thrusts could fracture or kill an animal. Even for relatively healthy individuals, no reliable standards exist specifying how much force one can safely apply to an animal’s spine, joints, or head. Continuing education programs teaching animal chiropractic have varying “takes” on how much force a thrust should have and whether instrument-assisted treatment is acceptable. No legitimate published evidence whatsoever attests to the safety of chiropractic adjusting for non-humans or even clearly defines a “subluxation” as it pertains to chiropractic.
VET NEUROLOGIST REACTS TO ANIMAL CHIROPRACTOR
There is a growing push for veterinarians to take proactive steps to protect patient and expose the real-life consequences of animal chiropractic via the creation of a national database of veterinarian-reported outcomes and injuries. The stated goals of such a database would be to gather data to aid in determining what non-human chiropractic can and can not do, then publish the findings in reputable journals in the hopes of promoting safe and effective treatments of animals based on science and evidence, thereby countering thus-far unfounded claims about chiropractic cures. Confidence in the medical world is shaken, especially since the COVID pandemic, and pet owners often also harbor similar suspicions about veterinary medicine as they do human medicine. Hopefully, with consistent and accurate information and even potentially the formation of the aforementioned database, pet owners will lean a bit less on unfounded claims and more on evidence-backed medicine.
VET NEUROLOGIST REACTS TO ANIMAL CHIROPRACTOR AGAIN
References:
Rather than listing all of the references for this article and the further reading, I've listed them in a convenient Google Drive document that can be accessed here. Given the amount of opposition I anticipate in regards to the article's topic and information within it, I felt it best that the reference list was as exhaustive as possible. This is also why so many quotations and hyperlinks are included throughout the article.
With a fervor similar to that of a religion (ironic), chiropractic is steeped in the minds of millions of people as legitimate medical science. They will be quick to share anecdotes and stories of videos they've seen of it working on humans, dogs, and farm animals. They will speak with convincing sureness. Remain skeptical, dear readers, for they know not the science. Can forcefully moving joints slightly beyond their natural stop contribute to a temporary improvement in dexterity? Often, yes. Can it fix digestive issues, prevent cancer, and cure musculoskeletal ailments? No.
**Scholar links often break. If this happens and you need the source, just let me know and I can update the broken link for you! I will be periodically checking the list to update any changed links.
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