Science In Brief

Chiropractic Literature Review

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The Study: The prevalence of the term subluxation in chiropractic degree program curricula throughout the world

The Facts:

a. The use of the term subluxation causes great debate and The International Chiropractic Education Collaboration has decided to only “teach subluxation in a historical context”.

b. The authors sought to determine how many chiropractic institutions still used the term chiropractic in their curricula.

c. They obtained their list of chiropractic institutions from the World Federation of Chiropractic Educational Institutions list and set about determining how many of these chiropractic institutions used the work chiropractic in their curricula.

d. It appears that they worked diligently at the task and attempted to answer the question in a thorough and complete manner through the search of institutions’ websites and when additional information was needed they sent out e-mails.

e. “Professionalization and development of cultural authority can involve changing educational curricula as has occurred in the medical profession.”

f. Included in this can be the act of “defining what is and is not science.”

g. This can be termed “boundary-work.”

h. By the use of boundary-work scientists can exclude pseudoscience.

i. The authors note that boundary-work appears to be at play in the chiropractic profession and that it “may be separating the scientific academics from the practicing

field and more vitalistic academics.”

j. The authors indicate that this boundary may be centered on the concept of subluxation.

k. They state that “vitalistic” academics think there is sufficient evidence for subluxations when in fact there is not such evidence.

l. In the US, Life University used the word the most at 25 times, Sherman was next at 17 Palmer Florida at 16. But when the three “Palmer institutions were combined subluxation was mentioned 29 times.”

m. National and Southern California did not use the term subluxation.

n. For the non US schools the authors had more difficulty in obtaining data but it could be said that the term subluxation was used much less at approximately an eighth to a ninth the amount, depending on what areas were being searched.

o. The authors concluded, “Unless these outdated concepts are rejected, the chiropractic profession and individual chiropractors will likely continue to face difficulties integrating with established health care systems and attaining cultural authority as experts in conservative neuromusculoskeletal health care.”

Take Home:

Use of the word “subluxation” is a problem and the U.S. institutions use it more than non US institutions. The word causes the profession to look unscientific and not be accepted by the medical profession.

Reviewer's Comments:

Why did I pick this article? Mostly because I was bored today and just wanted to see blood pressures rise around the world. So let me get in trouble. If you think most doctors take literally BJ Palmer’s statement that chiropractors “work with the subtle substance of the soul”, then the authors’ concerns are probably justified. On the other hand, if you think what we have traditionally referred to as “subluxation” is simply an inaccurately named and as yet poorly understood biomechanical problem for which chiropractic has a lot to offer, then the authors are perhaps making a bit much of the issue. Somewhere between Palmer’s unbridled vitalism and Deyo’s (New England Journal of Medicine) opinion that chiropractic is as about as effective as a ten cent self help hand out, is a great and wonderful middle ground. That middle ground is where the vast majority of the profession practices. Every day, reasonable, dedicated DCs read the scientific literature, practice to the best of their current state of knowledge and provide effective care to millions of patients.

Reviewer: Roger Coleman DC

 

Editor: Mark R. Payne DC

 

Reference: Funk MF, Frisina-Deyo AJ, Mirtz TA, Perle SM. The prevalence of the term subluxation in chiropractic degree program curricula throughout the world. Chiropr Man Therap.2018 Jul 2;26:24. doi: 10.1186/s12998-018-0191-1. eCollection 2018

 

Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/29988608

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