What I learned from the Medical Resident

When the Family Practice Resident started in my office the first day, we sat and talked about 20 minute before the patients started.   In that conversation I learned there were 3 things that he was looking for, first he wanted to observe how chiropractors were trained to evaluate patients, secondly he wanted to see how we “find” what we are treating and thirdly he wanted to see how we fix it.  He mentioned that he was skeptical of chiropractic but was looking for drugless and non-surgical approaches for caring for his patients.  That was interesting to me, he was skeptical but the non-drug and non-surgical approach of chiropractic was the idea that made him consider this elective.  That should give us all something to think about.  While the debate rages on in the chiropractic community about whether to allow prescription rights maybe we need to consider the Family Practice Resident’s perspective in Buffalo NY. 

I brought up the Subluxation to him by asking him what he knew about it.  He had a confused look on his face and said he didn’t understand why we would treat an unstable joint with spinal manipulation (I made sure that we started using the word Adjustment instead of Manipulation).  When you are speaking with the MD community this is the #1 reason they don’t “get” what we do.  The misinterpretation of the chiropractic subluxation and our failure to properly report are the reasons we don’t get regular referrals from the medical community.   We discussed that the chiropractic subluxation is a “physiologic” lesion (with the medical subluxation being an “anatomical” lesion) consisting of joint fixation and inflammation which results in improper neurological and muscular function.  It is the biomechanical component of the Subluxation (joint fixation and aberrant motion) that is directly treated by the chiropractic Adjustment.  The difference between the Adjustment and Spinal Manipulation is the all about what we are trying to influence.  The Adjustment is designed to work in two areas, the peripheral system by restoring proper biomechanics to the Subluxated joint and also to the central nervous system through direct stimulation of the afferent nervous system. 

Conceptually, a Subluxated vertebrae is in-between these two parts of the nervous system.  Afferent is going from the environment to the cord/brain and the efferent (e = exit) is going from the brain/cord to the environment.  We discussed the chiropractic Subluxation and treatment actually has to do more with the central nervous system then the spinal nerve root.  He started to understand why segmental issues in the spine can cause misinterpretation of the environment by the brain and spinal cord.  I used a simple example of age related changes to the cord.  We all know that the dorsal columns of the spinal cord are one of the first areas to start to degenerate with age.  Those tracts carry vibration and joint position sense.  When an elderly person is walking that is why they have to look at their feet or they trip.  They are losing the ability for their brain to know where their feet are.  Same when they are driving, their feet are under the dashboard and they can see them.  Hitting the gas instead of the brake is common.  In my office, Adjustment and simple physioball exercises can fix that.  I could see the wheels turning in his head.  YOU CANT GET THAT EFFECT WITH DRUGS OR SURGERY.  

The cord is gaining more and more interest as a modulator of nervous system function more than ever before.  Think about what happens when the chicken gets it head cut off, it runs around right? If the spinal cord didn’t modulate function, once the brain was severed that would be it.   That is not true and in fact, the only reason the chicken falls over is because it ran out of blood.  I spoke with him about the chiropractic adjustment having a direct effect on the spinal cord by producing nervous system input, you have all been adjusted and you know how that feels.  If the Adjustment simply “took the pressure of the spinal nerve” you would have a specific regional response and that is it.  Nothing could be farther from the truth; this is what I wanted him to understand in this elective.  The chiropractic Adjustment is critical to nervous system health. 

By Friday of the week that he started with me, he asked to be Adjusted!  Now, if we could only do that as a profession on a national level, what would happen?