D.D. Palmer was on to something when he first used skin temperature to pinpoint subluxations.¹ By using the dorsal side of his hand, he was able to locate what he called “hot boxes” and adjust accordingly. Today, skin temperature plays a key role in the diagnostic tool known as thermography, wherein minute temperature differences are turned into images that can be viewed by you and your patient.

Body heat as a diagnostic tool
Used in clinical settings since the 1960s, thermography, also known as infrared imaging, uses a device that senses different body temperatures, indicating places where heat is released by creating patterns for interpretation. The result is a rainbow of images and figures that represents an exact temperature level. Like a “heat” photograph, an image is created from infrared scanning of the body’s surface, and offers up data ranges that include the patient’s autonomic nervous system and its control of surface body temperature, as well as the evaluation of the physiological status of a patient’s sympathetic nervous system.

As the only non-invasive technique for body imaging, thermography does not pass energy into or through the body. This makes it painless and risk-free for your patients, while revealing vertebral subluxations, as well as other areas of concern such as nerve entrapment, conditions of the facet joints and discs, and myofascial conditions. Migraines, tension headaches, and injuries of the bones and joints can also be assessed with thermography.

A particularly valuable diagnostic tool
According to the American Chiropractic Association, high-resolution infrared imaging is valuable when used to diagnostically evaluate patients if clinical history suggests the presence of one of the following situations²:

• Early diagnosis and monitoring of reflex sympathetic dystrophy syndromes

• Evaluation of spinal nerve root fiber irritation and distal peripheral nerve fiber pathology for detection of sensory/autonomic dysfunction

• Evaluation and monitoring of soft tissue injuries, including segmental dysfunction/subluxation, sprain and myofascial conditions (strains and myofascial pain syndromes) not responding to clinical treatment

• Evaluation of the physiological significance of equivocal or minor anatomical findings seen on myelogram, computed tomography (CT) and/or magnetic resonance imaging (MRI)

• Evaluation of feigned disorders

The guidelines³ of the International Chiropractors Association (ICA) also supports the use of thermographic scanning in the chiropractic practice, upholding it as a valid diagnostic modality.

Training and credentials
As thermography can play a valuable role in the

chiropractic practice, it is recommended that you thoroughly train in its use. A good place to start is with an organization such as the International Academy of Clinical Thermology, which offers a Certified Paraspinal Thermologist Program. While there are other organizations that also provide comprehensive thermographic training, it is good to do your research first as to which will help you achieve your desired level of competency. You may also consult with the association that oversees the board certification of those who use thermography – the American Chiropractic College of Infrared Imaging (ACCII).

The ACCII is a subdivision of the Council on Diagnostic Imaging (CDI) of the American Chiropractic Association (ACA). Acting as the official ACA spokesperson on the topic of infrared imaging, the ACCII is also responsible for the recommendation of criteria for certification, ethics, and professional competency, as well as to promote and advance the specialty of infrared imaging in the chiropractic profession.

To become a member of the ACCII, you must be a member of the ACA and the ACA Council on Diagnostic Imaging, as well as Board Certified by the American Chiropractic Board of Infrared Imaging (ACBII). Having the board certification ensures competency, and that you know how to properly use the diagnostic tool. According to the ACCII website at www.accii.org, “only licensed chiropractors holding such credentials can claim sufficient competence to make valid judgments or comments regarding appropriateness, necessity, or accuracy of infrared imaging studies, and their relevance to chiropractic case management.”

Where is thermography today?
Thermography has come a long way since the days of the flower child. Unfortunately, it became the black sheep of reimbursement in the 1980s, with practices overbilling insurance companies for the diagnostic test. Additionally, the allopathic medical community at large generally does not approve of the use of thermography. However, many medical practitioners do recognize the value in using this diagnostic tool for particular conditions, and your patients will appreciate the tangible evidence that thermography provides to help you help them find relief from pain.

1. J. Christiansen, G. Gerow Thermography 1990 1(1):4. Williams & Wilkins.
2. Council on Chiropractic Practice.  Clinical Practice Guideline Number 1: Vertebral Subluxation in Chiropractic Practice.  1998 (updated 2003).  www.ccp-guidelines.org/guideline-2003  (Verified 05/12/08).
3. Recommended Clinical Protocols and Guidelines for the Practice of Chiropractic. International Chiropractor's Association. Arlington, VA 2000.