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

4
Comments
  1. Very well written, Dr. Senzon. Working with Dr. Keating for as long as I have, I, too, disagree with what Dr. Perle mentioned about DD’s evolving theories. Those evolved over the entire time from 1895 until his death, not just the last decade of life. It is true that DD did not come up with the phrase vertebral subluxation, Solon Langworthy did, with his compatriots, Oakley Smith and Minora Paxson. As far as the development of the many techniques in our profession, each can point to one of DD’s theories as the philosophical basis of why it focuses on what it does. It was not in Modernized Chiropractic where the term innate intelligience came from, as you rightly stated. With the combined work of Keating, yourself and the rest of us in the field of Chiropractic History, conclusions made by one of us will undoubtedly be reviewed by the rest of us. Chiropractic Philosophy is not a pseudo religion, it helps to explain WHY we do what we do. We do not worship it. Again, your reply was well written and researched.

  2. Great post Dr. Senzon. It seems the harder our profession tries to come together the harder some camps try to prove why there perspective is correct. I to think it is time for some honesty in these discussions.

  3. Thanks for this thoughtful post, great Monday-morning reading.
    The problems in thinking are more serious than the problems in perspective. Many people don’t want to see or consider the other perspective[s] because they know cognitive dissonance waits around the corner. This is evident in today’s national politics where “being right” and defending personal/party dogma is more important than being accurate, cooperative, or solution-oriented.
    There seems to be a growing trend of taking pride in being dumb these days. You only stand a chance of developing 3rd, 4th, 5th person perspective if you are open and willing to do so. As I see it, many on the medipractor end aren’t willing to do this… and I’m sure they’d say the same about me (us).
    Thanks again, keep up the good work.

Leave a Reply

Your email address will not be published. Required fields are marked *

© 2020 The Institute Chiropractic - Senzon Learning, Inc.