Question
Dear Dr. Healey,

I am new to using Chiropractic services and went to my 1st consultation last week. The Doctor completed an x-ray. I have stage 2 spodiolathesis (spelling?)(5th lumber, I think), and a significant curvature of my spine both to the side & to the front. In addition, my pelvis was tilted on the X-ray. Guess this explains the pain I've had in my lower back for the past 15+ years!

He has suggested a treatment plan involving 48 ajustments over a 2-year period of time, and at a total cost of $2060.

Having no experience with this field - I have no idea if this is reasonable. Can you give me any guidence? - Thanks you - Denise Castellano

Answer
Dear Denise Castellano,

Thank you for your question.  Yours is a question similar to those I have heard from others who are investigating chiropractic and scheduling and fees are often critical in whether someone will choose to accept a recommendation.  Unfortunately, though, your question is based on some misconceptions.  In order to answer it properly, I'll first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not the same as the findings mentioned in your question, but they may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as accidental trauma, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  You say in your message that you guess that your x-ray findings explain why you have lower back pain.  Even if that were true, that is a question outside the realm of non-therapeutic straight chiropractic and, unfortunately, when it comes to determining if there is a vertebral subluxation present, pain is not a valid or reliable measuring stick.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  In order to know if someone has a vertebral subluxation, it is necessary to have that person's spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible using a procedure known as 揳djustment.?br>
Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

Now, that you have more information about the body and vertebral subluxation, how do you make use of it?  Well, first understand that this is not an explanation of why you have the problems you list or whether any of them relate to vertebral subluxation.  Are there reasons for what you're experiencing?  Even though they may be beyond our ability to identify, yes, there are; but it is not relevant to the matter of whether you will benefit from being free of vertebral subluxations.  Vertebral subluxation is, in and of itself, detrimental to your life.  It is not valid or reliable to try to connect it to any organ or tissue conditions.  A key question to ask for your purposes, then, would be, Is someone with lower back pain better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  It's not that you should see a non-therapeutic straight chiropractor FOR your lower back pain and other symptoms ?you should visit one in an effort to be free of vertebral subluxations, even WITH those complaints.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating this or any other medical condition.  It is entirely separate in its goal.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  It seems likely that the chiropractor you visited was offering therapeutic mixed chiropractic.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What information I give you must not be interpreted from the mixed viewpoint.  

Non-therapeutic straight chiropractic is not about the treatment of pain at all ?whether in 48 visits or any other proposed regimen.  The theories that are proposed to demonstrate the validity of spinal manipulation for ailment treatment certainly are topics of great debate and are clearly different from what would be proper non-therapeutic straight chiropractic procedures or principles.  

In your question, you use the term 揳djustment,?but it is necessary to point out that it is not being used correctly.  In your question, they are akin to a scheduled treatment for your backache.  This is inconsistent with proper non-therapeutic straight chiropractic practices.  From the non-therapeutic standpoint, an adjustment is not a process that requires a series of visits; it is a procedure that is accomplished immediately.  Repeat adjustments are made if and when a subluxation is detected ?and only then.  It would require prophetic powers to know with any certainty when and where someone would be subluxated in the future, even though the causes are very common and, therefore, being subluxated is certainly a likely event.  In fact, when a vertebral subluxation has existed for a period of time, certain changes occur in the body, perhaps both structurally and physiologically, that make it even more likely.  Understandably, then, it is not uncommon for a chiropractor to help in planning with you a schedule of visits so that you will be checked for vertebral subluxation often enough for them to be corrected when they occur without letting them exist for long periods again.  This is why at first the visits may be typically closer together than they are later on.  Ultimately, the goal is to 損romote?you to the point where you are being checked regularly, but perhaps only once per week - the typical seven-day cycle of stress-events that are opportunities for vertebral subluxation!  Naturally, it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor on an ongoing basis if it is your desire to have an opportunity to realize your full potential.  

It is impossible for me to answer the question of exactly what your schedule should be.  We've never even met!  It is the responsibility of the non-therapeutic straight chiropractor to make such a determination based on your individual needs.  In a sense, it is impossible to over-utilize non-therapeutic straight chiropractic when done properly because when no vertebral subluxations are detected no adjustment procedures are done!  It's as simple as that!  However, if bones were moved regardless of the presence of vertebral subluxations, then that is not an adjustment.  In such a case, the service was not proper non-therapeutic straight chiropractic.  In a non-therapeutic straight chiropractic office, it would make perfect sense that the chiropractor would recommend that you be checked regularly.  It would only make sense, though, that you be adjusted when a vertebral subluxation was found.  You may not need to receive an adjustment on each occasion of being checked.  Celebrate those visits, because it means you are functioning with all the nerve channels open!  

Certainly, as I said earlier, it would be wise to have your spine checked for vertebral subluxations by a non-therapeutic straight chiropractor, even if you still elect to have therapeutic attention for your other concerns or wish to continue with a therapeutic mixing chiropractor to do so.  Remember, the two objectives are not the same.  This is not a comment on the cost at the office you visited, for there are possibly as many ways of exchange for services as there are different offices.  Only you can know whether $42+ is within your budget or reasonable.  Most non-therapeutic straight chiropractors, though, typically have fee systems that make regular lifetime visits possible for all people of many different financial circumstances.  If such is not the case, then one might question the chiropractor's commitment to and belief in the value of all individuals living free of subluxation!  I can not tell you whether this chiropractor is right for you, but hopefully you now have enough information at hand to make that decision with greater confidence.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  You may also visit www.gschiro.com, a site that represents non-therapeutic straight chiropractic organizations on a state level.

Denise, I wish you the best in sorting out the sometimes confusing world of chiropractic.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.