The Crazy, Unadulterated History of Chiropractic & Spinal Manipulation
It’s a fact: chiropractic works.
There’s a reason why over a million chiropractic adjustments are performed every single day in America. Study after study after study shows that chiropractic (by itself or combined with active physical therapy) is hands-down your best – and most cost-effective – bet for back pain relief. In fact, recent studies have shown that low back pain sufferers get better 4x more often when they add chiropractic to their medical treatment.
The science shows it works. If you’re a patient at Brookfield chiropractor Ascent Chiropractic, you know it works. Even the American Medical Association (they’ll pop up again later) knows it works – in a 2017 review even they endorsed spinal manipulation for low back pain over other mainstream treatments.
But the beginnings of chiropractic – along with osteopathy and manipulative physiotherapy – are, well, wild.
The Origins of Spinal Manipulation
“Spinal manipulation” of one form or the another has existed since antiquity. The earliest historical record dates back to ancient Greece in 400 BCE, but spinal manipulation has been part of traditional medicine throughout Indonesia, India, and much of Asia, as well as in northern regions like Russia and Norway for almost 4,000 years.
Hippocrates wrote about using manual manipulation techniques to reduce dislocations and treat a wide range of health problems. If his name sounds familiar, the Hippocratic Oath is taken by all doctors when they swear to uphold the principles and proper conduct of the medical profession.
“Look well to the spine for the cause of disease.”
– Hippocrates
Of course, what he was doing looked a little different from modern spinal manipulation – Hippocrates was strapping people to boards to traction their spines and using his hands and feet to push on what he described as ‘prominent vertebrae’. Interestingly, Hippocrates noted that it was essential that this treatment be followed by strengthening exercises at home.
“No, no, it’s supposed to feel like that”
It was, like most things in 400 BCE, pretty primative. But remember that in a time when most health problems were dealt with by sacrificing goats, this was revolutionary enough to earn the guy the title ‘the father of medicine’. Hippocrates’ work was wholly instrumental in setting in motion the development of physical medicine.
Over the next two millenia, manipulative therapy fell in and out of favor with mainstream physicians. But by the 1700’s, it was firmly “out” – most likely due to the epidemic-level proportions of spine-weakening tuberculosis present at the time.
That is, until the late 1800’s, when Andrew Taylor Still (the father of osteopathy) and D.D. Palmer (the father of chiropractic) made their entrance. Both of these men were what you might describe as ‘eccentric’ and had major issues with the state of mainstream medicine.
Now, in the 19th century the medical profession was unbelievably barbaric. The rapid progress in other sciences during this time had had little impact on medicine, which one historian called “the withered arm of science”.
Medicine was regarded as a ‘low’ profession, with most doctors poorly trained – if at all. Training for regular physicians usually only required two semesters of formal medical school, and medical books were rare.
Through most of the 1800’s, they popularized ideas like humoral theory (needing to balance the 4 humors by purging/eliminating), miasma (smelly air as the cause of disease), and racial theories of disease.
It would be more than fifty years before procedures like lobotomies and drugs like thalidomide and mercury were eliminated from mainstream medicine. Medical blistering was a commonly accepted treatment for a wide range of medical issues. Smoking was good for you. And even though methods of measuring body temperature and blood pressure had been developed in the 1700’s, medical professionals didn’t think they were even worth using until a century later.
Think that’s crazy? The most prominent physicians of the time were advocating “bloodletting” patients to treat fevers. Moderate bloodletting caused temperature regulation, relaxation, etc, and the more “heroic” doctors recommended bloodletting to unconsciousness. Since it modified common symptoms quickly, it was basically a panacea for every disease. This was popularized to an extreme degree by Benjamin Rush, who claimed its success in multiple yellow fever pandemics and as a cure-all.
Hey, it looked like it worked – their feverish patients went from being hot and delirious to cold and euphoric. The approach was so popular that the instrument used to perform bloodletting – the lancet – had its name adopted by one of the world’s most prestigious medical journals.
It wasn’t exactly a secret that the medical approach of the day was often more harmful than if they simply left it alone.
The Founding Fathers
A.T. Still
Andrew Taylor Still was an apprentice physician in Kirksville, Missouri, who found the field uninspiring and was well aware of just how frequently ineffective and sometimes downright harmful modern medical practice was. After losing three of his children to a bout of spinal meningitis, he became totally disillusioned with mainstream medicine.
He left the medical profession and developed a treatment philosophy based on the theory that health was dependent on maintaining normal function of the musculoskeletal system and that disease was a result of restricted blood flow. This was referred to as the “Rule of the Artery”.
“When blood and lymphatics flow freely, the tissues can perform their physiologic functions without impedance. With the occurrence of trauma (physical or emotional), the tissues contract, twist, and compress, and the fluid flow becomes obstructed.”
–Dr. Andrew Taylor Still
Beginning in 1874, Still began using spinal manipulation to treat patients in clinical practice as “the Lightening Bone Setter”, combining his new theories on biomechanics with some pretty out-there ideas on magnetic and spiritual healing. His drugless, non-surgical approach to the treatment of disease rapidly gained acceptance among the general public and by 1892 he had established the American Osteopathic College.
D.D. Palmer
D.D. Palmer, on the other hand, spent years as a practitioner of magnetic healing in Davenport, Iowa, “treating” ailments by manipulating a magnetic field surrounding the patient’s body.
In 1895, in the building where Palmer worked, a janitor mentioned to Palmer that while lifting a heavy object he had strained his back and heard a distinctive “pop.” He said he had been deaf ever since. On examination, Palmer noticed a vertebra that appeared to be “out of alignment.” He thrust on the vertebra, reportedly immediately improving the janitor’s hearing – the first chiropractic adjustment.
Palmer began to reason that when a vertebra was out of alignment, it caused compression on nerves. He developed a philosophy based on the idea that altering nerve impulses affects organ and tissue function, leading to disease. This became known as the “Law of the Nerve”.
“Pressure on nerves causes irritation and tension with deranged health as a result. Why not release the pressure? Why not adjust the cause instead of treating the effects?”
–D.D. Palmer
Palmer maintained that this fundamental principle of his philosophy was passed along to him during a seance by a long-dead doctor. Basing your philosophy of health on your discussions with a ghost? Oh yeah, totally normal.
Nonetheless, like Still, Palmer was getting results with patients who had found dead-ends with mainstream medicine and the chiropractic method of treatment grew rapidly. He actually intended to keep his techniques a secret until a train accident nearly took his life and his son B.J. convinced him to open a university in 1897 so that the practice could spread.
The bottom line is that Still and Palmer were revolutionary in identifying the musculoskeletal system as a key element of health. They recognized the body’s ability to heal itself and stressed preventive medicine, eating properly and keeping fit instead of simply treating symptoms.
Modern Medicine’s Response
Earlier I described Still and Palmer as ‘eccentric’. If we’re being honest, the truth is today they’d both likely be seen as total kooks. While Still and Palmer were both justifiably openly critical of the medical profession, the tendency by both to claim incredible cures (Still once claimed he caused a bald man to grow hair three inches long in a week) and incorporate quasi-religious concepts into their respective philosophies did little to encourage acceptance from the established medical community.
In fact, after being thrown in jail for practicing medicine without a license in 1906, Palmer made the case that chiropractors should be permitted to treat patients on religious-freedom grounds. He described chiropractic as “an educational, scientific, religious system” that “imparts instruction relating both to this world and the one to come.”
It’s no surprise that both Still’s and Palmer’s views brought the wrath and disdain of the medical community.
But Palmer and Still were getting results for conditions that the medical community wasn’t, even if they didn’t understand exactly how.
It’s not the first time it’s happened in the history of healthcare. Take aspirin, literally the most widely prescribed medicine of all time. Though it was first introduced in 1897, doctors had no idea how it worked until almost a century later, after prescribing it to billions of patients. Scientists initially thought it influenced the central nervous system (totally wrong) until 1971 (when we discovered that it’s actually through inhibition of prostaglandin production).
The Evolution of Osteopathy & Chiropractic
Osteopathy
Osteopathy quickly moved on from its ‘alternative medicine’ origins. Two of Still’s original students were medical physicians who struck a deal that if Still taught them osteopathy, they would teach Still’s students medicine and anatomy. Over the next several decades in the United States, osteopathy coalesced with mainstream medicine, who found osteopaths to be a convenient solution to the growing problem of finding healthcare providers for underserved (and undesirable) rural areas.
By the late 1960’s, osteopathy and osteopathic colleges had fully aligned themselves with the orthodox medical profession. The status of osteopathic physician is now equivalent to a ‘regular’ medical physician with most osteopaths undertaking prescribing and surgical duties in addition to their osteopathic practice.
Interestingly, osteopathy didn’t find quite as warm of a reception in England – it actually took until 1998 for osteopathy to be legally recognized. Instead, osteopaths there began educating physical therapists in the art and science of spinal manipulation.
Chiropractic
The chiropractic profession, on the other hand, remained autonomous for most of its existence. But that didn’t save them from a century of drama within the profession. Since the beginning, Doctors of Chiropractic have argued whether the profession is best served following Palmer’s original philosophies (the ‘straights’) or by embracing evidence-based practice and incorporating other approaches, notably soft tissue and physiotherapy modalities (the ‘mixers’) like we do at Ascent Chiropractic.
They also faced direct opposition from the American Medical Association, who attempted to contain and eliminate chiropractors for much of the 20th century. The AMA waged an ongoing campaign against chiropractors, using the popular media, medical journals, and any other source that could be used to describe chiropractic as a cult. It took a 1976 anti-trust lawsuit to finally end the fight between the AMA and the chiropractic profession.
While it took some years for old conflicts to fade away, in the current era medical doctors and chiropractors openly refer to each other for diagnostic services, treatment, and co-management of cases, and chiropractors serve alongside medical practitioners in clinics and hospitals all over the country.
Today, chiropractic care is recommended as a first-line treatment option for back pain by the National Institutes of Health, the National Institute of Health and Care Excellence (NICE), Towards Optimized Practice (TOP), the Journal of Orthopedic and Sports Physical Therapy (JOSPT), the American College of Physicians (ACP), Harvard Medical School, and even the same American Medical Association who literally established a Committee on Quackery to undermine the chiropractic profession 50 years ago.
Quite a wild ride to get to where we are today.
The Bottom Line
Today I work with MD’s, osteopaths, physical therapists and orthopedic surgeons nearly every day to provide integrated and patient-centered care for my patients. They love what I do because it gets long-term results, reduces reliance on medication, and saves patients from requiring surgery. On the other hand, there are a huge number of conditions that are totally out of my scope of practice that I need to refer to them to treat. It’s a win-win situation, and we’re only becoming more integrated as time goes on.
Got back pain? Even if you’re already being treated by your primary care physician, it’s time to make an appointment.
At Brookfield chiroprator Ascent Chiropractic we’re committed to not just relieving symptoms but to correcting their cause and optimizing your body to function better than it ever has before. Our unique, low-force, evidence-based approach to chiropractic care combined with the best of physical rehabilitation therapies allows us to get unmatched, long-term results.
Discover the difference personalized, comprehensive care at Ascent Chiropractic makes. To schedule an appointment, call us at 262-345-4166 or use our online scheduling app.
About the Author
Awesome article, as a physiotherapist, running physiotherapy clinics from last 14 years I can feel the importance of a great chiropractic adjustment for back pain.