© 2010 Dr. Dale Peterson & drdalepeterson.com

I grew up on a farm in East Central Minnesota. Our family doctor was Dr. Nygren, who could have posed for a Norman Rockwell painting. He was a M.D.; a graduate of the University of Nebraska medical school. He provided womb to tomb care, delivering babies, performing operations, setting broken bones, suturing lacerations, and treating a wide variety of diseases. My family turned to him for assistance when we faced health challenges, and so it was natural for me to follow his example when I decided to become a doctor.

My family did not use a chiropractor. I remember asking my mother what a chiropractor was at one point in my childhood. I don’t recall her exact answer, but it was clear that she did not approve of the chiropractic profession.

My medical school professors supported my mother’s position. So did the book “At Your Own Risk: The Case against Chiropractic” that appeared while I was in medical school. I accepted the view that chiropractic was a dangerous and unscientific practice. Although it could generate a strong placebo effect through the laying on of hands, it could provide no practical benefit.

I am quite certain that I would have been content to go through life without any personal investigation of chiropractic philosophy or techniques had I not faced a personal challenge for which I could find no answers in my mainstream medical practice.

My difficulty began on a long weekend trip to Texas. As we were preparing to leave I noticed that a piece of metal had broken loose and was hanging down under our vehicle. I got some wire, crawled underneath and made a stopgap repair. Problem solved, or so I thought. By the time we reached our destination, my right shoulder was aching and felt weak.

I did not make a connection between the vehicle repair and my shoulder issue at that time. I initially thought that I had over-used the shoulder muscles over the course of the drive, and I expected that the discomfort would resolve with rest.

The shoulder problem did not resolve over time. The weakness persisted. If I carried a bag of trash out to the dumpster I did not have enough strength to use my arm for the rest of the day. Pain was present, but rarely in the same spot two days in a row. At times I felt as though I had bursitis, and at other times tendonitis. In the end all I could say was that my shoulder was sick and I did not know why.

I tried non-steroidal anti-inflammatory drugs. I tried infusing the painful spots with cortisone. I saw a physical therapist. I used warm compresses and I attempted strengthening exercises. Nothing I did provided any lasting benefit. My shoulder remained sick.

Finally, after approximately three months of misery, in an act of desperation, I made an appointment with a local chiropractor of whom several of my patients had spoken highly. I approached him with humility.

“Steve,” I began, “I don’t know if you can help me, but I know I don’t have any answers.” I then related the symptoms I had been experiencing.

“Actually,” Steve replied, “the cause of many shoulder problems is found in the neck.” He did an examination that revealed my neck range of motion was restricted. He also obtained an x-ray of my neck, which was normal.

Steve had me lie on his table and did a few quick manipulative movements of my neck. The effect was immediate. It would take several weeks for my strength to return to normal, but as I walked out of Steve’s office the pain was gone and it was clear that my shoulder wasn’t sick anymore. As I began to back out of my parking space I was amazed to note that I was able to turn my head far enough to see out of the rear side window. I couldn’t recall ever being able to see past the support between the front and rear windows prior to the treatment. (It’s amazing I hadn’t been in an accident due to my inability to adequately check my “blind spot” when changing lanes.)

It was only after the visit that I realized what had caused the shoulder to become sick. When I had crawled under my vehicle to repair the loose part I had held my head in an awkward position. One of the joints had become locked. The resulting inflammation had put pressure on one of the nerves supplying my shoulder muscles and the compromised nerve supply had caused my shoulder to become sick. Had I sought treatment to unlock the joint immediately I would have avoided three months of shoulder pain and weakness.

I thought of the many times I had seen people with what is called a wry neck. In most cases, they had awakened in pain, unable to move their neck. I had treated them the same way I had attempted to treat myself, and with as little success. I now realized that the cause of a wry neck is the locking of a joint, usually related to a particular sleep position. All of them could have obtained immediate relief with a simple manipulative technique.

I asked Steve to teach me how to identify joints in the spine or rib cage that are not moving freely. (The chiropractic term for this is a subluxation.) He explained that when a subluxation is present the pelvis on that side of the body will be pulled up causing the leg on that side to appear shorter than the other. Patients had reported from time to time that a chiropractor had lengthened their short leg, but, knowing that it is impossible to make a leg grow instantaneously, I had written off the report as some sort of parlor trick. Now that I understood what was causing the leg to appear shorter their stories made perfect sense.

Shortly after I had learned the value of restoring joint movement one of my daughters awoke in excruciating chest pain. Using my newly learned examination skills I was quickly able to determine that one of her rib joints was locked. Steve graciously agreed to see her on an urgent basis and with one adjustment her pain was gone. I knew that had I attempted to relieve her pain with medications, gels, and warm compresses she would have suffered for weeks.

I discovered that challenges that appear to be unrelated to a spinal abnormality may be correctable with chiropractic adjustments. After I had learned to look for subluxations, a man in his early fifties presented with wheezing. He reported that the wheezing was a new phenomenon; he had not had asthma as a child nor had he ever been bothered by hay fever or other types of allergy. He was not a smoker.

I asked him if anything unusual had happened around the time the wheezing began. He thought for a minute and then recalled that he had slipped and hit his chest against a counter a few days before his breathing difficulty had begun. I examined his rib cage and found that some ribs were not moving normally. Rather that prescribing an inhaler to relax the bronchial tubes as I would have done in the past I referred him to a chiropractor who restored normal rib movement and cured the man’s asthma in a single visit. If I had not recognized the underlying cause of the wheezing the man might have required asthma treatment for the rest of his life.

Over time I have come to recognize that a wide range of health challenges can benefit from chiropractic treatments. This is often due to a direct effect of a locked joint on body function, but at other times it is related to improved energy flow within the body. Since I have changed my view of chiropractic over the years, an article that appeared in the July 2010 edition of the International Journal of Clinical Practice caught my attention.

The article was titled “Deaths after Chiropractic: A Review of Published Cases.”

The author searched four electronic databases of medical articles and found reports of twenty-six deaths following chiropractic manipulation between 1934 and 2003. Most were related to strokes believed to be due to injury of arteries in the neck. The paper concluded with the statement, “The risks of chiropractic neck manipulations by far outweigh their benefits. Healthcare professionals should advise the public accordingly.”

I do not question the relationship of the strokes and resulting deaths to the chiropractic treatment received. Strokes have also been reported from the act of extending the head backward over a sink while having the hair washed and rinsed in a beauty parlor. I do, however, disagree vehemently with the study author’s conclusion.

The author found twenty-six reported deaths following chiropractic treatment over a period of seventy years. While I do not like to see any preventable deaths occur, I cannot help but contrast the results of the chiropractic death analysis with that of the 2003 analysis of deaths caused by conventional medicine. That study found the total number of deaths caused by conventional medicine to be nearly 800,000 per year. That means that approximately 2,400,000 deaths occur from conventional medical diagnosis and treatment for every death related to chiropractic neck manipulation. In the light of those statistics, the recommendation that conventional healthcare professionals advise the public against the use of chiropractic manipulations seems rather hypocritical.

The reason that the author was able to make that absurd recommendation is that he believes that chiropractic adjustments offer no benefit. Since no benefit can result from treatment, any adverse outcome, however rare, cannot be justified. In his view, medications and surgical procedures always offer benefits and thus adverse consequences, no matter how massive, can be always be justified.

As the examples I have given demonstrate, the evidence does not support the author’s belief that chiropractic manipulations are incapable of providing any benefit. Chiropractic treatment can offer tremendous benefits and, as the numbers in the study show, it is significantly safer than conventional medical treatment. It is not, however, completely free of risks. Just as I have benefitted from chiropractic treatment, I have been injured by chiropractic adjustments. As a result, I have become selective about who I will allow to work on me when challenges arise.

I have been injured on two occasions; in both instances I was attending a workshop in which chiropractic physicians were in attendance. In both cases I was paired with a chiropractor to practice one of the techniques that was being taught when he decided to throw in a manipulation of my neck without warning. The first unexpected manipulation resulted in a locking of a neck joint that triggered pain and muscle spasms. I was fortunate enough to convince a kinder, gentler, chiropractic physician to undo the damage done by the first.

The second injury occurred when the chiropractor with whom I was working gave a sudden tug on my head. The force of his “adjustment” was so violent that a loud pop was heard by people in the back of the conference room. His action tore many of the soft tissues in my neck. This time the damage could not be corrected easily. I spent the next six weeks in pain, unable to move my neck more than a few degrees in either direction.

Chiropractic adjustments are a key component in the treatment of many health challenges. They can, however, cause more harm than good when done inappropriately. It is therefore important to choose a chiropractic physician as carefully as one would choose a medical doctor. I believe there are a number of criteria that should be considered.

One of the most important questions that should be asked in choosing a chiropractor is “Does he or she fix things?” I know chiropractors that can fix problems in as little as one visit, but I know others who routinely recommend twelve to fourteen weekly adjustments followed by monthly maintenance visits thereafter. Look for someone who has a reputation of fixing things and fixing them quickly.

Secondly, does the chiropractor look for specific abnormalities, or does he or she do the same series of adjustments on each visit regardless of the situation? If a joint is locked or out of place it needs to be released or repositioned, but if it is working properly nothing is to be gained by adjusting it. Attempting to fix something that isn’t broken may, as in the case of my first chiropractic injury, result in loss of function rather than in healing.

Thirdly, does the doctor have a broad repertoire of techniques from which to choose, or is the same approach taken with every patient or each challenge encountered? There are times when a snap, crackle, pop, manipulation will be required to release a joint and restore its proper function, but there are many situations that will respond to use of gentle pressure or light tapping. Look for someone who tailors the approach to each situation rather than a person to uses a “one size fits all” method.

Finally, does the doctor recognize when a condition requires a non-chiropractic approach and make appropriate referrals? Many cases of upper abdominal pain can be corrected with a chiropractic manipulation, but if the pain is due to the blockage of the common bile duct by a gallstone, surgery may be lifesaving. Most chiropractors recognize the difference, but occasionally I hear of someone who believes that chiropractic can fix everything. If the doctor expresses that attitude it would be well to look to someone else for care.

The chiropractic profession is made up of a diverse group of individuals who are united by the philosophy that the body has the ability to heal itself if it is functioning properly. Some limit themselves almost exclusively to spinal manipulation, while others focus heavily on nutritional supports. Finding a chiropractic physician who takes a balanced approach is sometimes challenging, but it is well worth the effort.