Published: 2009-09-05 16:58:35
Author: Julie Deardorff | Chicago Tribune | August 4, 2009
As
both a chiropractor and medical doctor, Dr. Ralph Gay has
an unusual perspective on the legendary rift between the two
professions. He took some time out of his busy schedule as the director
of the Spine Biomechanics Research Group at the Mayo Clinic to shed
some light on what chiropractors can do for back pain and to address
some common misconceptions for my story, "Chiropractors: Beyond the spine." Q:
Chiros are best known for treating back and neck pain, but some say
they can treat all disorders, since "the spine and nerve system is the
master system, controlling everything in the body." Please talk a
little about whether you think chiropractors can and should be treating
conditions such as ear infections, asthma, insomnia and cancer.
A: Traditional chiropractic theory posits that by correcting spinal abnormalities (subluxations) a chiropractor can effect all organs of the body. It is a good theory and there is some experimental work in animals that tends to support the premise. But, there is little evidence in the literature that chiropractic is effective for problems other than musculoskeletal conditions.
Q: How does chiropractic care work?
A: Good question but not a straightforward answer. Why does any form of treatment work?
Q: What are the main criticisms of chiropractic care?
A: The chiropractic profession has taken a lot of criticism during its existence. The criticisms it faces today are often generalizations that are not necessarily based in reality. Some of the common criticisms are:
Chiropractors have an inferior education: Chiropractic has a highly developed educational system that is regulated and standardized to a great degree. Although some portions of a curriculum may lack rigor, most are of good quality. The weakest part of chiropractic education is the clinical post-doctoral period...there is no requirement for an internship or residency prior to licensure as there is in medicine and osteopathy.
Chiropractic does a poor job of self policing:Although state boards regulate chiropractic practice in all 50 states, most chiropractors have a solo practice. This lack of "rubbing shoulders" with colleagues provides little incentive for practitioners with a typical behavior to change.
Chiropractors just want you to keep coming back: There is some truth to this. The chiropractic practice model suggests that multiple treatments over a period of weeks to months is necessary to get a maximal benefit. But this is not unlike physical therapy, acupuncture or massage practice. Although some chiropractors let their business model dictate treatment more than clinical evidence, most limit treatment to what is needed for each individual patient based on their response to care.