B.J. Palmer's early model of vertebral subluxation included the
component of pressure on
nerves and over the past several decades this
model has undergone some scrutiny. The "newer" models dealing
with dysafferentation and facilitation have, to some extent, pushed aside
the notion that direct mechanical pressure on the nerve roots is a major
grouping of subluxation.
Drs. Boone and Dobson point out in their series of articles in the Journal
of Vertebral Subluxation Research [1-3] that this shift away from the
early model was not based on research but was in fact the result of
political tweaking of the various definitions of subluxation.
Dr. Kent points out in his article on "Models of Vertebral
Subluxation" [4] that the nerve compression model is far from
obsolete.
Thanks to a review of the literature on the topic recently published in
the Journal of Vertebral Subluxation Research, this model now has further
evidence to support and strengthen it.
The paper, "The
Effects of Mild Compression on Spinal Nerve Roots With Implications for
Models of Vertebral Subluxation and the Clinical Effects of Chiropractic
Adjustment," was authored by Scott Alderson, D.C. and George Muhs
D.C., D.A.B.C.N., C.C.N.
It is a comprehensive review of the hard bone - soft nerve concept of
subluxation. [5]
The lead author graduated from the University of Bridgeport College of
Chiropractic in May, 2000. The paper was completed as part of his
requirements for graduation and is a testament to the talent residing in
our chiropractic college students when it comes to research and scholarly
activity.
Originally wanting to do another study dealing with children who have
been under chiropractic care since the first year of their life, Dr.
Alderson had to change the topic when his advisor would not approve the
survey questions.
According to Alderson "With 4 weeks to go before graduation and no
thesis in sight, I chose to do a literature review that could potentially
irritate as many faculty as possible. I originally called the paper 'Hard
Bone-Soft Nerve' after the colloquial terminology for subluxation. Since
most of the school was based on the joint complex dysfunction and pain
modulation concept I figured this to be a good poke at their dogma."
Alderson states that significant aspects of the review of literature
include evidence that mild to moderate pressures at the level of the nerve
root are significant and prevalent. "This review shows that the idea
that the nerve root is only affected under gross pathological conditions
like disc herniations is clearly wrong and secondly that learned postural
aberrations might possibly lead to detrimental situations for the nerve
root," he explains.
The paper also discusses the impact of the adjustment on subluxation
and nerve root compression. Alderson explained "on a more microscopic
level the subluxation produces somewhat of a mini-strain to the area. Scar
tissue is laid down and/or soft tissues swell, all leading to motion
restriction and subsequent nutritional problems in and around the
vertebral joints and related structures. Encroachment occurs, but the
adjustment increases segmental motion improving imbibition, decreasing
swelling, altering scar tissue and thus decreasing the pressure on the
nerve roots."
The authors feel that those who think the nerve root compression model
is obsolete need to take a better look at the research. They also state
that more research in this area needs to be done such as looking at the
thoracic segments.
He feels strongly that chiropractic researchers need to focus on whole
body health and wellness when researching chiropractic. "The public
is more than happy to pop a pill for their low back pain. Let's show the
public that their entire being can be improved through the detection and
correction of subluxation and solidify our future."
When asked for his advice to practitioners who want to get involved in
chiropractic research he replied, "Research is like hiking up a large
mountain. If you focus too much on the top, it appears too great a task.
First you choose the mountain. Then you prepare your equipment. Choose the
aim of the research and then arm yourself with the proper material for a
foundation. As the hike begins make sure the load you carry is not so
great as to wear you out before completion. Occasionally look to the top
to keep your bearings but mostly concentrate on the next step and don't
forget to watch the scenery along the way. It might also be beneficial to
have a friend or two along to divide up the load and socialize with along
the way."
Dr. Alderson and Muhs' paper can be found in the Vol. 4 # 2 issue of
the Journal of Vertebral Subluxation
Research.
References
[1] Boone WR., Dobson GJ. "A Proposed Vertebral Subluxation Model
Reflecting Traditional Concepts and Recent Advances in Health and
Science." Journal of Vertebral Subluxation Research. Vol. 1
No. 1
2. Boone WR., Dobson GJ. "A Proposed Vertebral Subluxation Model
Reflecting Traditional Concepts and Recent Advances in Health and
Science." Part II. Journal of Vertebral Subluxation Research.
Vol. 1 No. 2
3. Boone WR., Dobson GJ. "A Proposed Vertebral Subluxation Model
Reflecting Traditional Concepts and Recent Advances in Health and Science.
Part III." Journal of Vertebral Subluxation Research. Vol. 1
No. 3
4. Kent C. "Models of Vertebral Subluxation: A Review." Journal
of Vertebral Subluxation Research. Vol. 1 No. 1.
5. Alderson RS., Muhs GJ. "The Effects of Mild Compression on
Spinal Nerve Roots With Implications for Models of Vertebral Subluxation
and the Clinical Effects of Chiropractic Adjustment: A Review of the
Literature." Journal of Vertebral Subluxation Research. Vol. 4
No. 2. 2001.