Common Paradigm and the Chiropractor’s Role as a Functional Neurological Interventionist
aka “The Memetic Evolution of the Chiropractic Paradigm” aka “Chiropractic Paradigm for Dummies, Inside the Profession and Out”
A significant controversy has surrounded the ‘chiropractic paradigm’ since D.D. Palmer first postulated the concept of spinal subluxation in his early 20th century writings. As a consequence, chiropractors have had a difficult time defining their roles in the evolving health care landscape dominated by best-practices and evidenced-based research. For years, chiropractors have maintained that at their philosophical cores, they serve humankind by detecting and correcting spinal subluxations or focal vertebral joint dysfunctions, which are postulated to attenuate some vital neurological force that is essential for survival. Traditional chiropractic philosophy argues that free from the neurological constraints caused by these subluxations, our body’s innate ability to heal and grow can express itself and free us from sickness and disease.
While this simple model seems to get to the heart of the communal chiropractic identity, it has been shown to fail under the weight of scientific scrutiny. Throughout the years, chiropractors have wrestled with the identity crisis inherently caused by their scientifically flawed world-view, as is evidenced by the now clichéd disunity between so-called ‘mixer’ and ‘straight’ practitioners. The aforementioned have elected to forsake their philosophical roots to pursue more evidenced sensory techniques for symptom relief such as physical therapies, soft-tissue interventions and rehabilitation while the latter have staunchly maintained a principled approach to holistic care by addressing only spinal subluxations as dictated by D.D. Palmer and, later, his son B.J. Because of an essentially universal scope of practice that allows chiropractors to perform manual manipulative techniques in every state in the US, often the argument about what doctors of chiropractic choose to do to address patient complaints in their respective offices becomes a matter of semantics and egos. However, as we’re beginning to see through advances in neuroscience, such semantic arguments may soon become moot.
In any form, chiropractic care is essentially sensory-based medicine designed to stimulate a receptor-driven neurological construct. Chiropractors bombard patients’ nervous systems with stimuli with the intention of creating positive change without having to use pharmaceuticals. In that regard, both ‘straight’ and ‘mixer’ approaches have valid usefulness. The intention and approach to application, as it turns out, is more important than the application itself. Non-chiropractic neuroscientists such as Paul Bach-y-Rita, Mike Merzenich, Edward Taub and Vilayanur Ramachandran as well as scientists inside the profession such as Heidi Haavik-Taylor, Burnadette Murphy and Frederick Carrick have begun to show that the human nervous system is in fact an incredibly dynamic and plastic environment that is heavily influenced by sensory input and receptor potentiation. In short, the brain has been shown to change permanently under the influence of outside forces, such as, say, a chiropractic adjustment, which sends massive amounts of afferent input into the spinal cord, brainstem, cerebellum and cerebral cortex. In this regard, it is not too much of a stretch to see how D.D. Palmer’s original subluxation concept may be have been partially accurate in spite of it’s crudeness. Chiropractors who choose to use additional sensory techniques such as massage, electric stimulation and ultrasound, to name a few, to address subclinical neurological compromise including spinal subluxations are essentially performing treatments in line with traditional chiropractic philosophy without acknowledging it.
A wide and variable scope of practice is, therefore, clearly not a detriment. Since Carrick’s first works, chiropractors have been convincingly shown to be the gatekeepers of neurological well-being in terms recognized by leading non-chiropractic neuroplasticians, regardless of their specific mode of intervention. In this regard, chiropractors have taken perhaps an unintended step away from their traditional role as spine specialists. True, chiropractors address mostly spinal complaints due to the intrinsic and powerful relationship the spine has with the central nervous system, but in reality they treat disorders relating to central neurological integration errors created by cultural, social and genetic maladaptation. In light of the current healthcare renaissance, it is vital that chiropractors embrace this functional appreciation for the care they provide. Regardless of scope, chiropractors must differentiate themselves from physical therapists and physiatrists whose roles may at times overlap. Whether we embrace wellness, pain management or preventative spine care, the intent we bring to our craft delineates our uniqueness. Varying scopes of practice fail to weaken our core philosophy as long as we remain mindful that we serve our patients by acknowledging the research that supports our paradigm and by appreciating the fact the tools at our disposal necessarily classify us as functional nervous system specialists regardless of the techniques we use or outcomes we seek.
Functional Chiropractic Neurology and ‘New-Age’ Healing: A Different Perspective on the Vitality of Clinical Nutrition
aka “The Memetic Evolution of Functional Nutrition.”
By Daniel Bronstein
Dr. Royal Lee theorized that whole food supplementation “harness[es] nutrients as they are found in nature,†and as such include naturally-occurring enzymes, co-factors and catalysts required for proper metabolism. In a society dominated by processed foods stripped of their innate genetic nutrients, it is reasonable to conclude that many modern diseases predicated upon insulin resistance, gliadin sensitivity and GI acidity may be avoided by creating complete nutritional sufficiency, not just by replacing individual nutrients suspected to be missing. It is therefore vital for health care practitioners to teach their patients to differentiate between artificial, calorically-dense foods, which trick the brain into releasing pleasure chemicals and nutritious foods that include the proper nutrients to foster metabolic integrity and create nutritional sufficiency.
For manual care specialists such as chiropractors, enforcing nutritional standards in patient care is not only recommended, but critical. Research has shown that anti-inflammatory diets predicated on raw, whole foods stimulate natural metabolic pathways synergistically. This relationship helps to detoxify, alkalize and maintain the body’s ability to mount appropriate immune responses, but most importantly, helps the body to accept and mediate sensory stimuli. This is especially important to chiropractors who use joint manipulation to stimulate their patients’ central nervous systems (CNS). The CNS requires both proper nutrition and sensory stimulation to foster healthy growth, but the brain, the pinnacle of the CNS cannot metabolically tolerate high-input sensory stimuli from manipulations if it lacks the ability to absorb, integrate and metabolize exogenous vitamins, minerals and neurotransmitters.
Chiropractors are among the most qualified healthcare specialists to tout the benefits of balanced nutrition to society because they understand the holistic nature of human homeostasis: constant, whole-body, neurological adaptive momentum towards survival. In fact we are hardwired for it. Take, for example, the innate human response to touching a hot stove burner. Recent scholarship suggests that chiropractic adjustments, in fact, create ‘neuroplasticity’ by altering what is termed the ‘central integrative state’ (CIS) of nervous structures. This means that spinal manipulation changes the brain by restoring the input it should receive from a healthy spine by gravity and motion that may be knocked out by a lack of genetic expression vis-a-vis appropriate movement. However, the CIS of any given structure is also inextricably tied to membrane permeability, gas exchange efficiency and rate of ATP production, which is in turn tied to the bioavailability of exogenously-supplied nutrients and co-factors. Consider, for example, the electron transport chain, which mediates the majority of ATP production in the body. Without adequate mitochondrial Niacin, Folate, Co-enzyme Q, a variety of other minor proteins, cytochromes and an appropriate concentration of protons (i.e. appropriate pH), the electron transport chain can break down resulting in lower ATP production and, notably, a resultant down-regulation in neuronal sensitivity to stimulus, otherwise known as ‘transneural degeneration’ (TND). In particularly neurologically unhealthy individuals, chiropractic manipulations are theorized by some researchers to produce less-than-desirable results because neuronal mitochondria cannot produce the protein and energy necessary for appropriate conduction, synaptogenesis and plasticity, and while an acute breakdown in oxidative phosphorylation may require an equally acute CoQ10 nutraceutical intervention, long term sufficiency necessitates balanced natural sources of carbohydrates, B vitamins, essential fatty acids and amino acids to fuel glycolysis.
Teaching patients to embrace whole-food diets, on which our genome is founded and has evolved around for over 10,000 years must take precedent as citizens embrace progressively unhealthy lifestyles founded upon trans-fatty acids, inflammatory meats, fruit and vegetable deficiencies and a lack of exercise. Whole food supplementation represents a still relatively untapped resource on the forefront of ‘New-Age’ healing, where reactive pharmaceutical intervention takes a backseat to a radical preventative health concept. Proper nutrition is therefore not just an ancillary therapeutic possibility, but an essential precursor to innate homeostatic expression.
