Chiropractic Care Quiz

Chiropractic is a form of alternative medicine that focuses on the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially of the spine, and is based on several pseudoscientific ideas.

The main chiropractic treatment technique involves manual therapy, especially manipulation of the spine, other joints, and soft tissues, but may also include exercises and health and lifestyle counseling.

Systematic reviews of controlled clinical studies of treatments used by chiropractors have found no evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.

Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "Innate Intelligence", and consider vertebral subluxations to be the cause of all disease; and "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.

Vertebral subluxation, a core concept of traditional chiropractic, remains unsubstantiated and largely untested, and a debate about whether to keep it in the chiropractic paradigm has been ongoing for decades.

While some chiropractors limit their practice to short-term treatment of musculoskeletal conditions, many falsely claim to be able to treat a myriad of other conditions.

Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery, with special emphasis on the spine.

Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues.

Chiropractic is well established in the United States, Canada, and Australia, and overlaps with other manual-therapy professions such as osteopathy and physical therapy.

There is not sufficient data to establish the safety of chiropractic manipulations. It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.

Although mixers are the majority group, many of them retain belief in vertebral subluxation as shown in a 2003 survey of 1,100 North American chiropractors, which found that 88 percent wanted to retain the term "vertebral subluxation complex".

Chiropractic has had a strong political base and sustained demand for services. In the last decades of the twentieth century, it gained more legitimacy and greater acceptance among conventional physicians and health plans in the United States.

During the COVID-19 pandemic, chiropractic professional associations advised chiropractors to adhere to CDC, WHO, and local health department guidance, but a small but vocal and influential number of chiropractors spread vaccine misinformation.Chiropractic Care: Overview, Practice Guidelines, Effectiveness, and Safety

Overview:

• Chiropractic has attributes of both mainstream and alternative medicine, and there is no agreement on how to define the profession.
• Chiropractors are not considered primary care providers by mainstream healthcare and governmental organizations, although many believe they are.
• Chiropractic overlaps with other forms of manual therapy, including massage therapy, osteopathy, physical therapy, and sports medicine.
• Common patient management involves spinal manipulation (SM) and other manual therapies, rehabilitative exercises, health promotion, and lifestyle advice.

Practice Guidelines:

• Evidence-based guidelines outlining standards for chiropractic treatments have been created, but there is a divide among chiropractors in their acceptance and application.
• Specific guidelines for treating nonspecific low back pain are inconsistent between countries.

Effectiveness:

• Research into the effectiveness of chiropractic care has been of poor quality and reviews by chiropractors tend to find positive conclusions while reviews by mainstream authors do not.
• There is no conclusive evidence that chiropractic manipulative treatment is effective for any medical condition except for some types of back pain.

Safety:

• Chiropractic care is generally safe when employed skillfully and appropriately, according to the World Health Organization.
• Spinal manipulation is associated with frequent, mild, and temporary adverse effects, while serious adverse events are rare but have been reported.
• Vertebrobasilar artery stroke (VAS) is associated with chiropractic services in persons under 45 years of age, but it is similarly associated with general practitioner services.
• Chiropractors sometimes employ diagnostic imaging techniques that rely on ionizing radiation, which increases cancer risk.Chiropractic: Risk-Benefit, Cost-Effectiveness, Education, Licensing, Regulation, Ethics, and Reception

Risk-Benefit

• A 2012 systematic review concluded that no accurate assessment of risk-benefit exists for cervical manipulation.
• A 2010 systematic review stated that there is no good evidence to assume that neck manipulation is an effective treatment for any medical condition.
• A 2009 review evaluating maintenance chiropractic care found that spinal manipulation is associated with considerable harm and no compelling evidence exists to indicate that it adequately prevents symptoms or diseases.
• A 1999 review of 177 previously reported cases concluded that "The literature does not demonstrate that the benefits of MCS outweigh the risks."
• Physical therapists were involved in less than 2% of all cases, with no deaths caused by PTs. Chiropractors were involved in a little more than 60% of all cases, including 32 deaths.

Cost-effectiveness

• A 2012 systematic review suggested that the use of spine manipulation in clinical practice is a cost-effective treatment when used alone or in combination with other treatment approaches.
• A 2011 systematic review found evidence supporting the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain.
• A 2006 systematic cost-effectiveness review found that the reported cost-effectiveness of spinal manipulation in the United Kingdom compared favorably with other treatments for back pain.
• The cost-effectiveness of maintenance chiropractic care is unknown.

Education, Licensing, and Regulation

• In the U.S., chiropractors obtain a non-medical accredited diploma in the field of chiropractic. Chiropractic education in the U.S. has been criticized for failing to meet generally accepted standards of evidence-based medicine.
• Requirements vary between countries. In Canada, applicants need a minimum of three years of undergraduate education and at least 4200 instructional hours of full-time chiropractic education for matriculation through an accredited chiropractic program.
• Upon graduation, there may be a requirement to pass national, state, or provincial board examinations before being licensed to practice in a particular jurisdiction.
• In the U.S., chiropractic schools are accredited through the Council on Chiropractic Education (CCE) while the General Chiropractic Council (GCC) is the statutory governmental body responsible for the regulation of chiropractic in the UK.
• Regulatory colleges and chiropractic boards in the U.S., Canada, Mexico, and Australia are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance, and maintenance of competency.

Ethics

• The chiropractic oath is a modern variation of the classical Hippocratic Oath historically taken by physicians and other healthcare professionals swearing to practice their professions ethically.
• According to a 2015 Gallup poll of U.S. adults, the perception of chiropractors is generally favorable.
• The US Office of the Inspector General (OIG) estimated that for calendar year 2013, 82% of payments to chiropractors under Medicare Part B, a total of $359 million, did not comply with Medicare requirements.

Reception

• Chiropractic is established in the U.S., Canada, and Australia, and is present to a lesser extent in many other countries.

• In Australia, most private health insurance funds and the federal government funds chiropractic care when the patient is referred by a medical practitioner.

• In the UK, chiropractic is available on the National Health Service in some areas,Chiropractic: Origins, Utilization, Controversy, and Public Health

• Patient satisfaction rates for chiropractic care are higher than for medical care.

• Utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.

• Chiropractic was founded in 1895 by Daniel David (D.D.) Palmer in Davenport, Iowa.

• Early chiropractors believed that all disease was caused by interruptions in the flow of innate intelligence, a vitalistic nervous energy or life force that represented God's presence in man.

• Chiropractors faced heavy opposition from organized medicine.

• The longstanding feud between chiropractors and medical doctors continued for decades.

• Serious research to test chiropractic theories did not begin until the 1970s.

• Within the chiropractic community, there are significant disagreements about vaccination.

• A significant portion of the profession rejects vaccination, as original chiropractic philosophy traces diseases to causes in the spine and states that vaccines interfere with healing.

• Early opposition to water fluoridation included chiropractors, some of whom continue to oppose it as being incompatible with chiropractic philosophy and an infringement of personal freedom.

• Throughout its history chiropractic has been the subject of internal and external controversy and criticism.

• Chiropractic remains controversial, though to a lesser extent than in past years.