Vertebral Subluxation Complex - Details

Neurologic Component

While the original Chiropractic concept, that irritation to the Nervous System will produce abnormal functioning, has some basic support from the literature, there is still much to be learned about this connection. In a future Module, the Nervous System will be presented from an anatomic point of view. Suffice to say, the human Nervous System is the body's Telephone Communication System.

From a practical, clinical point of view, the portion of the Nervous System most evident to the patient (and thus, usually the most important aspect from the patient's point of view) is Pain. However, pain is a Subjective Symptom. In similar situations, pain may or may not be perceived by a particular patient. (Compare this to an objective finding, such as taking someone's temperature.) This subjectiveness adds a level of difficulty to determining the cause of patient's problem.

Other factors which are determined via the Nervous System, in addition to pain, would include a patient's Motor Function, i.e., their ability to produce coordinated muscular movement; proper Reflex actions and Sensation through the senses. Any damage to a particular region of the Nervous System could cause compromise to any of these areas, thus creating the potential for abnormal functioning in the patient. As an example, think of someone who has been burned in a fire, damage to the skin and subsequently the Nervous System, has produced altered sensations/feelings.

One of the important regions of the Nervous System is that of the nerves emanating from the Spinal Cord, the Spinal Nerves. A specific portion of these Spinal Nerves is known as Dorsal Root Ganglia (DRG). The DRG lie in close proximity to the vertebral joints. When the DRG becomes irritated, they tend to be more excitable than other regions of the Nervous System, including the spinal nerves themselves. Once irritated, the DRG have been found to produce spontaneous neural discharges, which over time, could lead to "clinical and pathologic signs and symptoms". (#1 - p. 156).

One of the proposed theories surrounding the Chiropractic treatment, is directed toward the role which manipulation plays in causing the treated joints to produce their own neural discharges. It appears that when a joint's Mechanoreceptors (that portion of a joint which is capable of transmitting/relaying information) are stimulated, perceptual effects, reflex effects and pain suppression may be produced. As research into this area proceeds in the upcoming years, more pieces of the Chiropractic puzzle will be solved.

Mentioned earlier, Pain is probably the primary motivating factor for patients seeking and subsequently receiving treatment. Further, understanding that the Nervous System is the body's Telephone Communication System allows one to comprehend the notion of Referred Pain. Relationships between the various organs (Heart, Lungs, Liver, etc.) and the rest of the body (Viscerosomatic Relationships) are widely recognized as patterns of Referred Pain. Think for a moment of the pain one may feel in their left shoulder and arm during a heart attack. Whether the opposite is true, from a scientific point of view, i.e., whether pain/abnormalities in the Viscera can be an indicator for problems with the joints (Subluxation) appears to be at the heart of the Chiropractic Controversy.

There is evidence that this opposite relationship, a SomatoVisceral Relationship, may exist. For example, it has been demonstrated, in a randomized, controlled trial, that Chiropractic adjustments (Manipulations) were effective in reducing blood pressure in humans.

Other proposed ideas, such as a Neurodystrophic Hypothesis, suggest that when neural (nerve) dysfunction is present, it is stressful to the viscera (organs) and other body structures and leads to lowered tissue resistance. This, in turn, may lead to impaired Immune System functioning. If proven through the established scientific methods, it would validate Chiropractic's clinical evidence gathered over the years, for successful treatment of more general conditions, such as pulmonary (lung) diseases, gynecological conditions, such as Dysmenorrhea and hypertension. (#1 p. 157). In animal studies, there is evidence that interference of a portion of the Nervous System known as the Sympathetic Nervous System can compromise the body's immune system.

As a side note, this author has seen successful outcomes clinically in cases of Tachycardia and Epileptic seizures.

"The most dramatic effects of adjustive procedures are related to the reduction or elimination of back pain. Decreased pain appears to be associated with increased Range of Motion (ROM), supporting the dynamic focus of the Vertebral Subluxation Complex." (#1 p. 158)