First I would like to thank you for taking the time to reading and responding to this question.  Also this is by no means an attack on you or the profession, but rather an inquiry just to trigger free thought.  Please try to keep a open mind.

In a subluxation complex, what is the diagnosis criteria?  Are they visible on a X-ray?  I asked a Professor of radiology at N.C.C. who has 20 years of clinical experience, his response is no.  I was also told that the most full proof diagnostic criteria is palpation.

My first inquiry is this, if the subluxation complex is not a significant enough of a displacement of the vetebral body,  so that it could be viewed on normal radiographic analysis, and this subluxation complex is also significant enough to compromise the integrity of the contents of the inner vetebral foramen,  than wouldn't normal movement (when examined under radiographic analysis any movement;  rotation, flexion or extension shows much greater vetebral body displacement than a subluxation complex) be a potential health risk?  Would America be a healthier place if everyone just stayed in bed?  For a moment lets assume that a  subluxation complex is significant enough to cause an interruption in the action potentials of the nervous system at the I.V.F. Then, would the patient have a health risk?  What little innervation of the normal function (not sympathetic and parasympathetic function) the brain provides to the viscera is via the Vagal Nerve, CN X.  This nerve never even passes through an IVF, it courses through the jugular foramen in the posterior cranial fossa, and sees its way all throughout the body.  The innervation provided by the nerves which pass through the IVF are primarily of a parasympathetic and sympathetic nature.  If these nerves were unable to fire an action potential then a person would not be at a health risk, but rather he/she not be able to get excited or relax.  The example that really got me thinking was a paraplegic.  Some of these people are paralyzed from upper cervical segments down, yet they have an immune response, and all their organs work normally.  This is because the nature of visceral activity is primarily due to chemical mediators which travel through the blood stream and regulate activity (positive and negative feedback loops), not through the mixed spinal nerves which travel through the IVF.  For instance the human heart will beat even outside of the body if it is in the presence of glucose 1-phosphate.

If you are still reading this I commend you on your open mindedness, hopefully I have not offended you but rather stimulated you to question authority.

Rather than suggest to a patient that a subluxation complex can affect the normal activity of  the viscera, why not consider the discussing the implications of immobilization of the vetebral bodies, or any joint in the body for that matter.

 JMPT  Vol. 20(9) 634-644 has a wonderful journal entry on the effects of immobilization on the  joints of the human body.  For after all we do know that joint complex dysfunction’s (subluxations)  do exist, and that there are health risks involved with them.

The ultimate question lies in personal ethics, every day you chose to inform a patient about a bodily function that you assume is impaired rather than can confirm is unpaired, you are behaving in a unethical manner.  Currently NCC is preparing to research the effects of joint complex dysfunction's (subluxations) on nerve function and their potential health risks.  If this or other studies can prove or disprove this, than it would be ethical to market your practice this way.  But the current trend is unethical, just as it would be unethical for me to say on national television that subluxation complex can not be a potential cause of "dis-ease", it is equally unethical to say that it is.

I certainly hope you took the time to read this.  Again I thank you for your open mind, and I hope I have not offended you in any way.

I know that chiropractic manipulation is beneficial, that is why I am here at NCC,  I know that our profession does play a major role in health care delivery, and that it and many other no invasive techniques are the future of health care delivery.  Yet the reason our profession faces so much adversity is due to marketing  unknown claims.  Someday scientists  will have figured out all of the benefits of chiropractic manipulation, but until they do wouldn't it make you feel better if you told patients what you knew rather than what you thought?

Please respond via. My email.

Sincerely,
Xxxxx X. Xxxxx B.S.E.
xxxxxxxxxx@xxxxxxx.com

Reply:
Dear Xxxxx Xxxxx,
Thank you for your interest and questions.  I will do my best to answer your questions. Unfortunately, there is limited research and scientific data available on subluxation (vertebral subluxation complex or VSC) that I am aware of, therefore, my answers are somewhat opinionated and based more on personal experience.  Scientific research is going to require money.  I will rejoice the day it is here, but in the mean time, I will continue to enjoy the results I see in practice.  Also, thank you for the courtesy expressed.  I am by no means offended.  Your questions are well thought out and logical.

Sometimes subluxations can be "seen" on Xray.  But static Xray is by no means sufficient for diagnosis.  Motion x-rays, however, will reveal vertebral level dysfunction and are more diagnostic.  But in general, they are usually not seen on static Xray.  I sometimes use motion x-rays but rarely use Xray to help locate subluxations.  Sometimes appearingly misaligned vertebrae on Xray are fully functioning and fully mobile segments.  I do not believe a fully functional and mobile segment should be "adjusted".

I use generally accepted definitions on my web page that are easy for the lay person to understand.  However, I believe subluxation has more to do with a mal-function of normal vertebral motion than misalignment (though mal-alignment is involved).  I believe IVF encroachment plays a much smaller role than is emphasized, but certainly it plays a role.  I do wonder if nerve impingement might take place as a result of inflamed tissues in or near the IVF.  This would account for the fact that displacement by itself, such as that which occurs with everyday motion, does not impinge a nerve.  I believe increased motion equals increased proprioception.  More afferent nerve signals makes more efferent signals and likely contributes to health (greater input equals greater output).  This model probably contributes to the results seen with the adjustment.  I also believe motion bathes the nerves and discs contributing to their health.  Therefore, staying in bed would lead to less health, whereas more activity should contribute to greater health.

There are many subluxation models, and many probably contribute to the results.  I don't care which models account for the results, I'm just glad it works.

Regarding your thoughts on interruption in action potentials at the I.V.F., consider sympathetic nerves coming from the lateral horns of the upper thoracic levels of the cord that form the upper cervical ganglion with postganglionic fibers ascending to supply, among other things, blood vessels of the brain.  Now, with spinal nerves impinged affecting the brain, (and hence, vagal
nerve) the results from the adjustment are limitless.  I am not saying this is why it works... I'm not sure why it works.  I just know it does.

But what about the paraplegic?  I also have considered this and say it is a great point.  I don't know if there are studies on this but I wonder if the life expectancy of a paraplegic is the same as that of the general population (78 years according to recent W.H.O. stats for the average American).  I have talked with people that have severed or damaged (bruised) spinal cords and their health is deteriorating.  Organs are functional, but, I don't think they are at 100%.  I believe research with this population would contribute tremendously to the study and understanding of chiropractic.

You are right when you say visceral activity is primarily due to chemical mediators which travel through the blood stream and regulate activity (positive and negative feedback loops).  But  chemical mediators are under the control of the CNS.  Consider the hypothalamus and its control of the endocrine system.  The role of the nervous system is spelled out in Gray's Anatomy on page 5 of the 30th edition:  "The nervous system controls and coordinates all the other organs and structures and relates the individual to his environment".

And when it comes to ethics, I will do my best to help my patients.  I do not care about money, I have sufficient.  I tell people I can help them for them, not for me.  I have no problem telling a patient I may be able to help them when I believe I can.  I have uncovered visceral problems and informed patients "you will likely see fast results".  I have seen impotency of 10 years healed in 1 adjustment.  constipation difficulty of 10 years healed in 1 adjustment.  Insomnia of several years healed in 1 adjustment.

A patient was fine most of his life (viscerally) till getting hit on the head with a surf board a few years back.  Immediately following the accident, he has vertigo and constipation.  He finally comes in 3 years later for neck pain.  1 adjustment later, he is completely healed.  Subluxation or chance? (true case).

And, Xxxxx, what if we are all wrong in this CNS theory and jargon?  What if we are actually only mobilizing fixations and giving spinal manipulation therapy, though we think we are correcting subluxations?  I know this is not the case,  But what if?  Even spinal manipulation therapy has been proven in its effectiveness in low back treatment.  It is proven we can relieve pain, and hence, stress.  Wouldn't less stress make for better health?  Would it not make someone's heart more joyful?  In Proverbs 17:22 we read: "A joyful heart promoteth healing; but a broken spirit drieth up the bones."  Again, I don't care how it works, I'm just glad it does.

I don't at all mean to sound "all knowing".  I am not.  I love what I do and love to talk and share with others the joy of practice.  Your questions are well thought out.  You have obviously pondered the differing opinions for some time.  Continue to do so till you choose what is right for you, but don't struggle with it.  You will do fine treating back pain, but find out what else your patients are suffering from and watch them get healed.  The visceral symptoms often disappear long before the pain symptoms.  The results will blow your mind.

I hope you find my reply helpful.  Please share and discuss the information.  Agree or disagree, I am glad to provide you with my response.  God Bless You.

Yours in Health,
Michael A. Haley, D.C.