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Scope of Chiropractic Practice in California

Doctors of chiropractic are trained to diagnose all conditions. They are trained in history taking and physical exam techniques, and are licensed to order all appropriate laboratory tests and imaging studies such as MRI and x-ray. Doctors of chiropractic are educated, trained and licensed by the state of California to treat all conditions, diseases, and injuries in a manner consistent with chiropractic methods and techniques. Doctors of chiropractic are not licensed to prescribe drugs nor perform surgery. - for more information see the California Chiropractic Association

The Vertebral Subluxation

Throughout the 20th century there was much questioning, from both inside and outside the chiropractic profession, as to whether the subluxation was primarily a lesion of malposition, as Dr. Palmer had originally theorized. Many, if not most, chiropractic clinicians and researchers have now concluded that the subluxation is a lesion primarily characterized by loss of joint mobility. Nonetheless, today, many doctors of chiropractic (DCs) continue to believe, and to educate patients to believe that spinal dysfunction is primarily a result of bones of the spine being “out of place”. These same DCs routinely speak of a need to align the vertebra of the spine.

The question of whether a subluxation is primarily a lesion of position or of motion is easily answered and explained to the public or to healthcare professionals as follows: the inherent functional capacity of vertebrae is such that they are able to flex, extend, laterally bend, and rotate in relation to the vertebrae above and below them. Therefore, a vertebra has no single place, nor spatial relationship with its adjacent vertebrae, to which it can be returned through spinal adjustment or any other means. It has an infinite number of possible positions/spatial relationships between itself and the adjacent segment. Additionally, the functional state of a vertebral motor unit (two adjacent vertebrae and their contiguous and functionally associated tissues) includes free movement between the two segments. In a state of free, adaptive movement, each vertebra would have the ability to find a dynamic balance and functional relationship to its neighbor. This balance has historically been inappropriately referred to, and confused with “alignment”.

If it is believed that spinal dysfunction is due primarily to bones of the spine being “out of place”, and needing to be aligned, then patients find themselves in the predicament of having only one remedy for their condition; alignment of the spine by a DC or other spinal manipulator. If, on the other hand, it is understood that the central functional loss of spinal dysfunction is that of mobility, then, patients can, with their doctor’s assistance, consider the likely causes and restore mobility through spinal adjustment, elimination of offending foods, flexibility exercises, increased physical activity, nutritional supplementation, dealing with emotional issues, etc...

As evidence grew that the tissues (connective, muscle, nerve, lymph, vascular) of the vertebral motor unit were all involved in the lesion, the term “subluxation complex” was added to the lexicon of the chiropractic profession to denote the broader understanding of the anatomical and physiologic scope of the lesion.

With improved understanding of the lesion itself, greater attention began to be directed toward the causes of subluxations. Historically, subluxations were treated primarily as the result of physical displacement of vertebrae. It is now understood that the causes of subluxations include, but are not limited to, physical trauma, food allergies and intolerances, physical inactivity, environmental toxicity, emotional stress, nutrient insufficiencies, and disease or imbalance in specific organs.

Effects of the Vertebral Subluxation

It is theorized, and appears to be the case from the vantage of tens of thousands of chiropractors over the last 100 years, that subluxation can be causative and/or aggravate both musculoskeletal and visceral conditions. Low back pain, neck pain, and headache are the most common musculoskeletal complaints that appear to have direct relationship to the subluxation. Some visceral and non-musculoskeletal conditions that appear, in some cases, to be caused by, or associated with subluxation are; vertigo, otitis media, dysmennorhea, constipation, migraine, asthma, bedwetting, and infertility.