Chiropractic: A Holistic Health Care Paradigm
by Dr. Mathew Wilding, Assistant Editor of Chiropractic/AK
As Dr. Gangemi’s introductory definition of chiropractic stated, chiropractors focus on spinal health in order to restore normal function to the nervous system. The value of a properly functioning spine and its role in a properly functioning nervous system has been the foundation of the debate between contemporary western medicine and the chiropractic profession for several decades, but the evidence published in major scientific journals in recent years has put an end to that debate. Unfortunately, practitioners of both chiropractic and medicine are, for the most part, unaware of the evidence and therefore continue to nurture the rift that has existed between the two professions for generations. The best evidence has been produced not by chiropractors, but rather neuroscientists, and very few chiropractors or medical doctors read the neuroscientific journals during their leisure time.
The intricate details of neurological function are far beyond the scope of this article, but we can gain an adequate and accurate
understanding of the global effects of chiropractic care by understanding a few basic concepts. The first concept that must be understood is that the nervous system is responsible for coordinating and controlling every single function that takes place within the body. The brain ‘runs the show’, in other words. Therefore, anything that damages the nervous system or reduces its ability to thrive will inevitably have a detrimental impact on the rest of the body.
The brain and spinal cord represent what is known as the central nervous system, and the nerves that branch out from the spine comprise what is known as the peripheral nervous system. As it turns out, the cells that make up the nervous system (called neurons) not only require oxygen and nutrients to survive (like all other cells) but also activation. If you don’t use it, you lose it in this case. A tremendous amount of activation/stimulation of various parts of the nervous system comes from movement, and this is the key to understanding chiropractic.
We usually think about the function of the muscular system as simply providing us with the ability to move around and perform work. The truth is, the muscular system is also a massive sensory organ. When we use our muscles to move us about, we are subsequently sending a tremendous amount of information to the brain. There are nerve receptors called mechanoreceptors, muscle spindle cells, and Golgi tendon organs that are constantly sending information to the brain pertaining to our body position and movement, and since the brain needs activation to survive, it is this feedback from the muscular system that is crucial to the nervous system’s health. We also have pain receptors called nociceptors that send pain signals to the brain when we are injured or there is damage done to our tissue for any reason. Herein lies the first major concept behind chiropractic’s whole body effect: when there is a decrease in movement (mechanical feedback) in the muscular or skeletal system, there is automatically an increase in pain feedback (from nociceptors) to the brain. This is why studies have shown that the most effective treatment for people suffering with fibromyalgia or most other chronic pain syndromes is aerobic exercise, and why the most vigorous athletes (such as hockey players) have a far higher tolerance to pain than the more sedentary athletes (such as baseball players). If you were to accidentally slam your fingers in the car door, you would instinctively shake your hand and rub your fingers to dull the pain. By doing this you are increasing the mechanical feedback to the brain and therefore decreasing the pain perception by the brain. These are simple examples, but are sufficient to explain why millions of people around the world have achieved tremendous pain relief under chiropractic care. Whether or not chiropractic care has an analgesic effect is not even a question at this point in time as there are numerous studies from around the world that demonstrate this effect. Pain may be reduced as a side effect of chiropractic care, and this is very valuable, but it is not the ultimate goal of care at all. If this were the case, then chiropractic would only be useful as long as there were no safe and effective drugs for pain relief, and if there were ever such a drug developed then chiropractic would be obsolete in the health care arena.
Once you understand that lack of movement anywhere in the body (or of the whole body) will always lead to increased pain signals sent to the brain, you are half way to understanding the 
whole-body effect of chiropractic care. The next concept to be familiar with is the fact that increased feedback from nociceptors (pain receptors) will be largely unconscious and without symptoms. This lack of symptoms does not change the fact that the increase in nociception will increase the body’s stress response, and this leads to what is known as a state of catabolism (breakdown). This is how aberrant motion or position in the spinal or extremity joints can lead to joint and muscle degeneration. This is why people will often go to the chiropractor with their first incidence of serious back pain, and x-ray examination will reveal major degenerative changes in the spine that have been taking place for years without pain or any other conscious symptoms. It has been very well documented that a joint that does not have proper motion and alignment will degenerate, and this improper motion or alignment will typically take place without symptoms until significant damage has been done.
We are designed in such a way that the number (density) of mechanical receptors that constantly feed information back to the brain dramatically increases with proximity to the spine. In other words, there is less impact on the brain when a finger has lost normal range of motion or position when compared to a shoulder that has lost normal range of motion or position. The shoulder would have an exponentially greater effect on the central nervous system than the finger, due to the dramatic increase in the number of mechanical receptors around the shoulder. The same holds true for a spinal joint that has lost its normal range of motion or position as compared to the shoulder. The measurable impact on the central nervous system is dramatically increased. Since a decrease in mechanical feedback to the brain automatically increases the stress response due to increased nociception, and the closer a body part is to the midline (spine), the greater the amount of mechanical feedback is provided (or lost due to abnormal movement), then the importance of spinal joint integrity becomes abundantly clear. In addition, the muscles that are responsible for the movement of a finger or shoulder are under voluntary control, and therefore can be activated by simple conscious intention (such as flexing a bicep or bending a finger), but the muscles that are responsible for the motion and position of each vertebra in the spinal column are involuntary and need to activated by an external influence (such as a chiropractic adjustment).
Increased nociception (pain/damage feedback to the brain) will lead to an increased sensitivity of the nociceptive pathways to the brain. This sensitization results in lowered pain thresholds over time, which means that there will be an enhanced stress response in the body as it relates to that body part. It is important to understand that an increase in nociception does not always lead to an increase in conscious pain. There can be a great deal of nociceptive input that does not reach the conscious brain. Whether there is conscious awareness or not, the body responds to nociceptive input by increasing the stress response, which involves the release of stress hormones such as epinephrine, norepinephrine, and cortisol, which in turn will lead to detrimental changes in thinking and learning, immune function, muscle function, and visceral organ function. If the nociceptive input reaches the brain cortex, then the conscious emotion of pain will also occur.
We will examine the stress response and its effect on health more closely in another article, but for now suffice it to say that this
detrimental stress response is ameliorated by body motion. The failure to respond to, and eliminate, the stress response whether it has reached the symptomatic stage or not, will culminate in an overall lowered health status and increased risk of virtually all disease states.
To summarize:
• Our nervous system controls and coordinates all functions within the body, right down to the cellular level.
• For the nervous system to maintain its optimum level of function, it depends on activation/stimulation as much as it depends on oxygen and nutrients.
• The vast majority of this stimulation/activation comes from feedback from nerve receptors in ligaments, tendons, and muscles that are only activated by movement.
• If there is a lack of movement in even a small region of the body, such as a joint in the arm or leg, there will be a subsequent decrease in the amount of sensory feedback to the brain from that region.
• The closer the fixated joint or muscle is to the midline of the body (the spine), the greater the detrimental impact on the nervous system (in terms of loss of sensory feedback) due to the exponentially increasing number of mechanical receptors found with greater proximity to the spine.
• Spinal segments that have lost normal range of motion will cause a loss of normal function of the muscles associated with those segments, which will result in a dramatic decrease in sensory feedback to the nervous system, which will result in an increased stress response in that region of the body. Since the muscles that maintain position and motion of spinal segments (vertebra) are involuntary, an external stimulus is required to change their function (such as a chiropractic adjustment).
• The accumulation of joint and muscle restriction due to lack of physical activity, elevated emotional stress, poor nutrition, environmental exposure to toxins, and major or minor physical traumas that occur over the course of a person’s lifetime will inevitably lead to reduced activation of the nervous system through a loss of sensory feedback. Therefore, the nervous system suffers an overall reduction in its functional integrity, similar to a person that has been starved and dehydrated. It is not possible to function at optimum capacity in that state of distress.
Since the nervous system controls and coordinates all other systems within the body, a reduction to the integrity of the nervous system must lead to a reduction in the overall integrity of the body as a whole.
Chiropractic care, in its most basic form, seeks to find and remove barriers to normal joint and muscle function, thereby dramatically increasing the sensory feedback to the nervous system and consequently improving the control and coordination of all systems within the body. This is the essence of any holistic approach to health: removing interferences to the body’s natural state of homeostasis (perfect health). Chiropractors refer to these barriers as “subluxations”, whether they occur in spinal joints or those in the extremities. The associated effects on the nervous system and therefore the entire body are addressed as the “vertebral subluxation complex”, and no matter what technique the chiropractor employs (there are literally dozens), this is the ultimate goal of chiropractic care.
All chiropractors agree that spinal joints can have restricted motion and improper alignment whether at rest or during particular movements. This fact is well recognized and accepted in any field dealing with biomechanics or orthopedics. The debate occurs only when discussing the whole-body importance of such a joint compromise. But as science continues to uncover the crucial importance of proper sensory input from mechanical receptors and nociceptors, and the fact that this input can only be provided in an environment of proper joint motion and alignment, the whole-body benefit of chiropractic care is emerging.
Chiropractic care is based on the scientifically proven basis that proper structure of the spine is required for proper function of the nervous system as it relates to control and coordination of all physiological functions within the body and therefore overall health. Chiropractic has never been and should never be defined as manipulation of the body to simply alleviate pain. Considering the amount of scientific literature that has shed light upon the impact of the chiropractic adjustment, it would be irresponsible and inaccurate to define chiropractic in such terms.
About the Author
Dr. Mathew G. Wilding, our ATH Assistant Editor of Chiropractic/AK, has been practicing chiropractic in North
Carolina since 1998. Throughout his professional career, he has worked with thousands of patients suffering with a wide variety of health problems, and has achieved great success with the vast majority by combining traditional chiropractic care with clinical nutrition. His practice places a priority on patient education in conjunction with any treatment that is provided. Dr. Wilding strives to remain abreast of the most recent research available, and he spends the majority of his free time lecturing on a variety of current health care issues.
Dr. Wilding's commitment is to health restoration and wellness for all his patients.