Answers to Questions about Chiropractic:
Should I Continue with Chiropractors
Who Claim I Have Subluxations?

Samuel Homola, D.C.

Question

I am 40 years old. My first visit to a chiropractor was encouraged by visiting a booth at an Outdoor Sports Expo where I was given a certificate a free exam. I have always had some minor lower back discomfort, even though I have always been very athletic. Recently, I have been experiencing tightness between my shoulder blades.

On my first visit to the chiropractor, I was talked into a full-spine x-ray which showed that my spine was crooked and that two of my lumbar vertebrae were closer together than they should be, which he suggested may be the cause of my lower back pain. He also did a Static Scan SEMG which showed high activity in T5, T7, T9, and T11, moderate activity in C2, C4, T3, T5, T9, T11, and L1 and low activity in C2, C4, T1, L1, L3, and L5. He suggested a treatment plan, told me to stretch, drink lots of water, and to try to start sleeping on my back.

Everything he told me seemed to make sense, and he spoke quite a bit about subluxations (there were posters all over the office regarding subluxations). He gave me the impression that I should seek chiropractic care for the rest of my life because the spine is always changing and reacting to life's stresses, which need to be relieved with adjustments. Also, I was told that an adjustment will "hold" for only about two to three weeks and that other physical ailments, such as ulcers and asthma, have been cured by chiropractic care.

I saw this chiropractor for about a year. Each time, he looked at my leg length and made a lumbar adjustment. Then he would feel my spine and make adjustments in my mid back and finally my neck. I did feel relief between my shoulder blades and in my lower back.

He did another SEMG after 12 visits. There was some change in the readings; some improved and some worsened, which he said was normal. I again asked him if I would ever get better and not need his care. He repeated what he said before about stresses and that I needed "preventative chiropractic care."

After a year, my insurance changed and I had to go to another chiropractor. I have been seeing a new chiropractor for almost a year now. On the initial exam, this chiropractor also did a SEMG. The readings had changed a bit but still indicated tension in my neck, mid back, and lower back. This chiropractor also talked quite a bit about subluxations.

I have been receiving adjustments every three to four weeks. I now experience more tightness in my neck and in the muscles running into the rhomboid region. My mid back is not quite as tight, but I have been told that I have a lot of tension in my rhomboid and trapezius area. My lower back does feel better, but I notice that if I go longer than three weeks without an adjustment, stiffness and minor pain returns.

After reading your website and your consumer guidelines, I have these questions:

Your website says that if I have not experienced relief in three weeks, I should discontinue spinal manipulative therapy. Well, I do experience relief, but it eventually returns. What does this mean? Do I keep returning? Will I ever get better? Am I going to the right chiropractor or should I find one who is a member of the National Association for Chiropractic Medicine (NACM)?

The two chiropractors I have seen disagree with immunizations and prescription drugs, x-ray all of their patients, and claim subluxations exist. According to your website, I should avoid these practitioners. So what do I do now?

Currently, I am concerned about the tightness in my neck and upper back, which seems to be getting worse. But I'm also concerned about the reports of strokes caused by chiropractic neck adjustments. I don't know what to do about continuing chiropractic care or where to turn. What should I do?

Answer

Forget about the "subluxations" and SEMG findings. And forget all the stuff about lifetime adjustments or "preventive maintenance" to prevent such ailments as ulcers, asthma, and so on. This is all nonsense.

At age 40 or so, it is not unusual to have degenerative changes in the spine that will cause chronic or recurring back pain. It's okay to go for occasional manipulation when such symptoms are present, but you should not be going on a regular basis. Most of the time, we can live with these symptoms. Too much manipulation can aggravate degenerative changes in the spine, causing the symptoms you are trying to relieve.

Try going without the adjustments for a few months to see how you get along. If you feel that you need manipulation to relieve the stiffness in your back, try to find a chiropractor whose practice is limited to the care of musculoskeletal problems and who will allow you to come for treatment only when you feel you need it. Not all such chiropractors are NACM members. Some are listed in the Chirobase directory, but most are not affiliated with either group. If neither of these sources proves fruitful, our advice on how to choose a chiropractor may help you.

A good physical therapist can often provide appropriate treatment. Disregard all the subluxation, and preventative maintenance advice you have been given. I would not recommend any chiropractor who tells you that you have subluxations that can cause illness, who routinely does a full-spine x-ray exam, or who opposes immunization or prescription drugs.

You stated that the tightness in your neck and upper back seems to be getting worse and that minor pain and stiffness in your lower back returns three to four weeks after you get an adjustment. It sounds as if you are experiencing arthritic-like symptoms. Other than temporary relief, it's unlikely that regular adjustments will prevent these symptoms as degenerative changes progress. I would certainly advise against regular neck adjustments, since risk may outweigh benefit.

If your symptoms persist or worsen, see an orthopedic specialist for a definitive diagnosis. In order to avoid further exposure to x-ray radiation, collect your x-rays from your chiropractors so that the orthopedist can review them.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This article was posted on February 13, 2003.