Chiropractic care is a form of integrative medical treatment concerned with mechanical disorders of the musculoskeletal system. D.D. Palmer founded chiropractic treatment in Davenport, Iowa in 1890. His son B.J. brought it to prominence in the early part of the 20th century. The World Health Organization defines chiropractic as a health care profession concerned with the diagnosis, treatment, and prevention of disorders of the neuromusculoskeletal system and study of the effects of these disorders on general health.

The basis of chiropractic discipline is the philosophy that spinal joint dysfunction interferes with the body’s overall function. There is a belief that spine health and general health are related in a fundamental way. This relationship between spine health and general health is mediated through the nervous system, as per this theory.¹ Vertebral misalignment, which Palmer called subluxation (Fig. 34-1), causes altered spinal nerve vibration (Fig. 34-2), that can be too tense or too slack, affecting the tone (health) of the organ attached to that particular spinal nerve. As per chiropractic teaching, vertebral subluxation is thought to interfere with the “innate intelligence” exerted via the human nervous system and is believed to be a primary underlying risk factor for many diseases such as diabetes, coronary artery disease, and hypertension.

Chiropractic treatment sessions involve manual therapy of the spine, joints, and soft tissue. Therapeutic care also emphasizes a variety of lifestyle modifications – including diet and nutritional programs – as well as self-care and coping strategies for the patient experiencing pain.

Chiropractors divide themselves into two groups, “straights” and “mixers.” The “straight” philosophy, taught by D.D. Palmer, considers vertebral joint subluxation to be the primary cause of all disease. The focus of straight chiropractors is to detect and correct vertebral subluxation via manual adjustments and not mix other types of traditional medical management. A survey of North American chiropractors in 2003 revealed that 62% believed vertebral subluxation significantly contributed to disorders of the internal organs (heart, lung, or stomach).² Mixers, who are now the majority of chiropractors, incorporate mainstream medical evidence. They believe subluxation to be just one of many causes of disease.