Medical Definition of Subluxation

Once again, I spent my five minutes on Facebook and found a ripe topic to share with you. There is a trend in the subluxation denier movement, to dismiss the chiropractic vertebral subluxation because chiropractors don’t use the standard medical definition of the term “subluxation.” This approach is wrong on several levels most notably that it is ahistorical and lacks adequate evidence. For those of us who aspire to being evidence-informed, this is important to discuss.

The First Call to Dismiss Subluxation because of Medical Definition

Let’s start with the literature. The first time this approach was attempted in the chiropractic literature was 1984 and 1985. That’s right – the tactic is not new. If you care about evidence, you should know your own literature.

If you study Part 9 of my new set of papers on The Chiropractic Vertebral Subluxation, you will read the section called Review of Critical Literature. In that section, I point out that Brantingham proposed that the profession get rid of the term “subluxation,” because the ways in which the profession uses the term did not meet the medical definition. Without demonstrating any real perspective on the chiropractic literature up until that point, by 1988, Brantingham proposed we adopt the osteopathic term, “somatic dysfunction,” and get rid of the term subluxation.

Brantingham’s proposal was refuted by subluxation theorists from that time, namely Lantz and Keating. Lantz called him out in terms of his lack of references. Keating suggested a better approach would be to develop an operational definition of vertebral subluxation.

The Chiropractic Vertebral Subluxation Stands Alone

While the profession still confronts the issues that Keating brought up, effective operational definitions are needed, we also face the same types of unsubstantiated dismissivism as Lantz critiqued.

If you read Part 10 of the papers, you will see Keating’s proposals in more detail, including his call for systematic and well-planned case studies throughout the profession. You will also learn about Boone and Dobson’s idea that we need to start with a functional definition of vertebral subluxation. That will lead to testable and multiple operational definitions. You will also learn about Kent’s proposal that multiple techniques within chiropractic should lead to different operational definitions.

This all leads to the real issue, that the chiropractic profession, which is one of the largest health professions in the world, has developed its own lexicon over the course of 125 years (give or take a few years).

To dismiss the chiropractic vertebral subluxation because you are stuck on the medical definition of the term “subluxation” is an approach lacking in evidence. An evidence-based approach to this question must include reference to the profession’s development of the term. That development is mapped out in the 10 papers, which included a history of theory and research along with the internal debates. Read it. And, don’t confuse the word subluxation with the term “chiropractic vertebral subluxation.”

Some References

Brantingham, J. A review of some current and past literature regarding basic chiropractic hypotheses. Dyn Chiropr, 2 (8) (1984), p. 6

Brantingham, J. A survey of literature regarding the behavior, pathology, etiology, and nomeclature of the chiropractic lesion. ACA J Chiropr, 19 (8) (1985), pp. 65-70

Brantingham, J. A critical look at the subluxation hypothesis. J Manipulative Physiol Ther, 11 (2) (1988), pp. 130-132′

Lantz, C. A critical look at the subluxation hypothesis: to the editor. J Manipulative Physiol Ther, 13 (1) (1990), p. 42

Keating, J. A critical look at the subluxation hypothesis: to the editor. J Manipulative Physiol Ther, 13 (6) (1990), pp. 350-351

Brantingham, J. In reply. J Manipulative Physiol Ther, 12 (2) (1989), p. 154

Senzon, S. Chiropractic Vertebral Subluxation Part 10: Integrative and Critical Literature: 1996-1997. J Chiro Hum. 25(Dec) (2018), pp. 146-168.

Senzon, S. Chiropractic Vertebral Subluxation Part 9: Complexes, Models, and Consensus: 1979-1995. J Chiro Hum. 2018, 25(Dec);, pp. 130-145.

Faulkner, Foley, and Senzon. Palmer Chiropractic Green Books: The Definitive Guide. The Institute Chiropractic. 2018.

Rome, P. Medical evidence recognizing the vertebral subluxation complex. CJA. 2016; 44.

Rome, P. Terminology relating to the vertebral subluxation complex and the manipulative sciences. Part 1. CJA 2017;45:73-89.

Rome, P. Terminology relating to the vertebral subluxation complex and the manipulative sciences. Part 2. CJA 2017;45:90-129.

Kent, C. Models of Vertebral Subluxation: A Review. AVSR. 1

Boone and Dobson. Vertebral Subluxation Model. AVSR. 1-3

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Comments
  1. Lots of good stuff here Simon, I love the idea of aligning the curriculum with the philosophy with holism, non-linear dynamics, subtle energy, and so on.

    I was lucky enough to attend Parker College of Chiropractic and so there was a philosophical bend to most classes, even classes like physiology and biochemistry.

    I think it would be wonderful if the chiropractic technique classes were taught by an instructor authorized to teach that particular technique. Of the ten techniques we were taught at Parker, only one instructor met that criteria.

    One thing that I would love the legal ability to do as a practitioner is to write MRI reports. I see no reason why MRI interpretation could not be included in the chiropractic curriculum to make this so.

    Hans Conser
    Chiropractor in Bozeman MT

  2. I certainly envision all chiropractic science courses taught within the context of vitalism. The science of epigenetics is the logical offshoot of the role of vitalism in the preservation of health.

  3. Peter Kevorkian

    you are a master Simon. Thank you for this article and all you do for TIC. I am at the board at Sherman and it is indeed a conundrum to satisfy CCE and reform the curriculum to resemble chiropractic. I do not believe the current structure allows us to graduate chiropractors – they are clearly medipractors who can manipulate!! I plan on a reformation of the curriculum at Sherman – one that the CCE cannot refute and one that has real TIC in it. I would love to bounce some ideas off of you in the next few weeks. Hugs,
    Peter

  4. Thank you Simon for mentioning a visionary curriculum and referencing it with MCQI.ORG.

    You are doing an amazing job. Please resend me the info to sign up for your philosophy course. I will take it this summer as I will have more time.

    LOVE;

    ARNO

  5. Hiya! awesome weblog! I happen to be a everyday visitor to your website (somewhat much more like addict ) of this web site. Just wanted to say I appreciate your blogs and am looking forward for more to come!

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