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Guest Essay

Chiropractic Adjustment or Spinal Manipulation?
It’s Not Just Semantics


By Dr. James Gregg

It is my opinion that chiropractors for too long have not spoken out on our philosophical approach to health and disease. Beleaguered as chiropractic has been by orthodox medicine, we have strived to prove our value by defending the practice of our science and proving it’s clinical validity for the treatment of musculo-skeletal disorders. Essentially we have won the battle of acceptance, but have we fought so long that we have forgotten what the battle was for?

To emphasize the importance of bringing forth our philosophy, I quote, in part, Dr. E. Philo, Simon Fraser University, British Columbia, “The present threat to chiropractic, as I see it, is cultural not social.” Dr. Philo notes in his writings, that the term spinal manipulation in a public mind has become synonymous with chiropractic. He points out that at present, chiropractors are losing their exclusive claim to the practice of spinal manipulation, because of the increasing use of this technique by allopathic medicine (M.D., D.O.) and physiotherapists.

How did we as a profession allow this to happen, that the technique of spinal manipulation would become synonymous in the public mind with chiropractic? What gives us the right to try and lay claim to a technique that has been used by many long before our profession was even discovered? Many years prior to the introduction of our profession to the world by Dr. D.D. Palmer, Dr. A. T. still introduced the profession of osteopathy and the term spinal manipulation. The use of this technique can also be traced back to many ancient civilizations. What then would give us the right to lay exclusive claim to the technique?

What can we lay exclusive claim to? What must we lay exclusive claim to? What is it that makes our profession uniquely different from all others? The answer, the philosophy of chiropractic, and within that philosophy the teaching of the disastrous affect of the vertebral subluxation on the function of the human body and most especially, the correction of that subluxation with a chiropractic adjustment. It is this philosophy that is exclusively ours. We can and must lay claim to this.

Many in our profession would argue that this is just semantics; that the chiropractic adjustment and spinal manipulation are one in the same. Someone may even make the point that we are classified by the federal government under the heading of spinal manipulation and under the sub heading of grade 5 mobilization. In all my chiropractic education, never once was I taught that a chiropractic adjustment and spinal manipulation were one in the same. It was presented very clearly to me that spinal manipulation was a technique of mobilizing joints of the human body to increase fluid flow and improve range of motion. Whereas the chiropractic adjustment was a technique that delivered a controlled force to a specific vertebra to correct vertebral subluxations and eliminate nerve interference. It is this teaching that is uniquely chiropractic and allows us to exist as a separate and distinct healing discipline.

Why, then, in the public mind has the term spinal manipulation become synonymous with chiropractic instead of the term chiropractic adjustment? I believe it is entirely our own doing. We have been sold a bill of goods by many in our profession who continue to tell us that in order to gain acceptance we must become more mainstream in our thinking and in our terminology. Since the term spinal manipulation is a more mainstream term, why not just use it instead of imposing upon mainstream medicine and the public a new term—chiropractic adjustment. Whether it be our old enemy or the enemy within, that wishes to change the practice of chiropractic, what a simple way to do it. Rather than fight to pass liberal chiropractic legislation, why not just change the terms that its practitioners use to describe what they do? More and more as I talk to chiropractic students, read chiropractic journals, or talk to chiropractors across this country, I find the terminology of this become clearer to me than when I began to fight for the rights of chiropractors to have hospital privileges. Numerous times when speaking to hospitals across the country, the question was posed “Why do we need you? We already have doctors on staff that provide spinal manipulation.”

In a time when the buzz word in the health industry is cost containment, they were very concerned about duplication of service. Once the difference between spinal manipulation and the chiropractic adjustment was explained to them, they became much more receptive. If anyone should be concerned about the duplication of the service issue, it should be the chiropractor. Ask yourself, why would an insurance company want you to be apart of their health programs if they already have two doctors (M.D. & D.O.) performing the same service? This is exactly what has kept many chiropractors out of PPOs and HMOs across the country.

One more reason my concern continues to grow, is that if we are to be an alternate health system and within that system a primary health care provider, we must protect and preserve our uniqueness by using terminology that specifically describes our approach to health care. I truly believe that rather than choose, we were chosen to be chiropractors. We were given a great responsibility to take the chiropractic principle and the hope contained within that principle to the sick and suffering people of this world. Lest us not forsake our mission for mainstream acceptance.

Dr. James Gregg, D.C., has practiced in Garden City, Mich., for 30 years. During his career he has held many offices within the Michigan Chiropractic Council and served as a chiropractic consultant to Medicaid, the Department of Social Services, the state of Michigan and many other organizations.


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