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If Not Bone Out of Place, Then What?

Learn ACA Survey Course Shows How Chiropractic Theory Has Changed and Where the Science Is Taking Us

Author: Robert Leach/Tuesday, October 30, 2018/Categories: Professional Development, Research

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By Robert Leach, DC, MS, CHES, FICC

Is it as simple as bone-out, pinched-nerve, cause dis-ease?

For more than a century, chiropractic science—at least as offered by many chiropractors—was frozen in late 19th century medical thought. Because the founders spoke of “tone” and the “safety-pin cycle,” it became almost a rallying cry for many of the followers. But has chiropractic science advanced since that time, and if so, will chiropractors embrace it? Many of you have read my theory textbooks through the years, but have you kept up with our modern science?

Busy clinicians don’t have time to fact check every claim, idea and hypothesis proposed by the founders and their subsequent adherents, but they should make time to listen to the growing cadre of scientists at our schools and institutions, speaking through biomedical and science journals. Instead, many of us spend valuable practice time evaluating short legs instead of pressure pain thresholds and OATS, discussing untested claims rather than effective lifestyle changes, focusing on selling supplements while leaving precious little time to advise a healthier Mediterranean-type diet, and devoting energy to “tell the chiropractic story” while skipping exercises for core strength or balance, injury prevention or smoking cessation. Moreover, the old story has many scientists laughing at what we say to our patients, as opposed to enhancing our position in this age of multimedia access.

There is a new story to tell. It’s not based on the science that was popular before man flew to the moon and became able to tweet with the president. The new story is based on solid science that dovetails nicely with science from related healthcare disciplines, and that places us squarely in the middle of interdisciplinary recommendations for conservative spine care and positions us as a substitute for old-school use of opioids and back surgery—instead of putting us out on a ledge, preaching against interdisciplinary care.

There is a new story to tell. It’s not based on the science that was popular before man flew to the moon and became able to tweet with the president. The new story is based on solid science that dovetails nicely with science from related healthcare disciplines, and that places us squarely in the middle of interdisciplinary recommendations for conservative spine care and positions us as a substitute for old-school use of opioids and back surgery—instead of putting us out on a ledge, preaching against interdisciplinary care.

The new story has evolved from words such as “subluxation” and “misalignment” and “philosophy” to embrace new concepts such as patient-centered care, and an option for either problem-focused or wellness-oriented practice. This new story accepts a role for inflammation, neuroplasticity and muscular facilitation within the larger framework of modern neurophysiology.  Moreover, instead of scientists laughing at what we say, they are now writing about it and attempting to replicate our research.

ACA and I have created a short six-hour survey course, available in the new Learn ACA online learning management system, to help both new and older doctors understand how chiropractic theory has changed over time and why our practice guidelines are changing, where our science is leading us today, and most importantly, how understanding our current research can help you be a better doctor Monday morning.

So, you can always re-read a green book this weekend (and I too love history). Or instead, join me in reviewing new, cool stuff about the modern science of chiropractic: hear about happy anti-inflammatory chemicals like interleukin 10 released when we give our adjustments, and learn how neuroplastic changes after chiropractic may spare the amygdala, prefrontal cortex and other brain centers from shrinkage because of previously chronic pain. Unlike our preaching the old “bone-out, pinched-nerve, cause dis-ease” model that makes all the Quack Watch websites vibrate with enthusiasm, talking about our new science should leave them, well, speechless.

Dr. Leach is an author, clinician, and scientist/practitioner. He is also the Mississippi Delegate to the American Chiropractic Association House of Delegates and serves on the ACA Public Health Advisory Board.

To register for Dr. Leach’s online course, “Theory-Driven and Evidence-Informed Chiropractic: A 6-Hour Survey," visit Learn ACA and click “Courses” (6 CE credits are available).

 

Learn ACA features a robust course catalog of education programs, presented by some of the profession’s most knowledgeable subject matter experts and respected thought leaders. Topics range from business management, evidence-based practice, coding, documentation, quality and safety, to diversity, nutrition, rehabilitation and more. There are also special programs focusing on information for the new practitioner as well as those who treat Medicare beneficiaries. With a single secure login, doctors can access the content they want and earn any available CE credits.

 

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1 comments on article "If Not Bone Out of Place, Then What?"

Derek Smith

11/1/2018 3:06 AM

This sounds like a great start to changing patient education, practitioner understanding and interdisciplinary communication, but this needs to be strongly incorporated into the chiropractic education and less emphasis placed on historical philosophy and theory. I'm sure that dental and med students don't spend time learning about misunderstandings of the past unless for entertainment or trivial purposes. I find it difficult to re-educate patients when they have been instilled with "bone out of place" or "short leg" concepts and passive mentality. This damages the perception of the profession and is a disservice to the patient..It is still taught in our profession and perpetuated through biased principles passed down through generations and still taught in CE. This change has to begin at schools and be tested on and become a basic framework for all chiropractors to build their education. If they want to learn about history that should be on their own time and not something tested on for national boards or state licensing. This may make one generation mad but will get us going in the right direction of reducing passive care and poor patient education and in a direction to become more unified and prominent in healthcare as a whole. Thanks for the work.

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