Answers to Questions about Chiropractic:
Why Do You Say That Vertebral Subluxations
Do Not Cause Organic Disease?

Samuel Homola, D.C.

Question

I have read some of your articles in which you say that pinched spinal nerves or vertebral subluxations do not affect general health or cause organic disease. What about cauda equina syndrome, which is caused by pressure on spinal nerves? And what about numb areas on the skin when a nerve is pinched?

Answer

There is no credible evidence to support the chiropractic theory that a vertebral subluxation or pressure on a spinal nerve can affect general health or cause internal organs to become diseased. Spinal nerves are commonly compressed by bony spurs and herniated discs. However, even the most severe compression of a spinal nerve, which may cripple the supplied musculoskeletal structures, does not cause organic disease. In the absence of fracture or pathology such as disc herniation or osteophyte formation, vertebral misalignments rarely affect spinal nerves.

Spinal nerves supply the sensory and motor (voluntary) functions of musculoskeletal structures. Involuntary function of the body's organs are regulated by autonomic nerve ganglia and plexuses located outside the spinal column and by autonomic cranial and sacral nerves that pass through solid bony openings. The vagus nerves are autonomic (parasympathetic) nerves that originate in the brain stem, traversing openings in the base of the skull to pass down through the neck, thorax, and abdomen to supply organs along their path. Preganglionic autonomic fibers, which emerge from the spinal cord and pass through spinal segments from the first thoracic vertebra to the second lumbar vertebra, terminate in sympathetic trunk and splanchnic ganglia located outside the spinal column. The vagus nerves along with autonomic ganglia and nerve plexuses provide overlapping sympathetic and parasympathetic nerve supply from many directions and sources (in concert with chemical, hormonal, and circulatory factors) to assure continued function of the body's organs, independent of spinal nerves. This is why severance of the spinal cord in the neck area, shutting off brain impulses to spinal nerves, can cause paralysis of muscles from the neck down while the body's organs continue to function. Transplanted organs function without reconnection of severed nerves.

A serious transverse spinal cord lesion above C5 (upper neck) can cause respiratory paralysis and often death. Since the spinal cord ends at the level of the 2nd lumbar vertebra, spinal nerves pass down from the spinal cord (like the hair on a horse's tail) to exit openings between the lumbar vertebrae and from openings in the sacrum. The spinal nerves supplying bladder and bowel sphincter muscles pass through the solid bony openings of the sacrum (a pelvic bone at the bottom of the spine) and are not subject to compression by a subluxation. But they can be compressed by protrusion of a lower lumbar disc into the spinal canal, affecting voluntary control of sphincter muscles (cauda equina syndrome).

An elusive chiropractic vertebral subluxation or "joint dysfunction" alleged to cause disease by interfering with nerve supply to organs cannot be equated with a real orthopedic subluxation, a partial dislocation that causes musculoskeletal symptoms.

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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 page was posted on June 29, 2013.