When did we as a profession move away from chiropractic functional neurology?
The chiropractic profession is based on neurology. The main goal for the care of our patients is to enhance and or restore the performance of their neurological systems.
“Neuro performance” is a term to describe optimal functioning of a patient’s nervous system during their normal activities of daily living. So, how does this relate to chiropractic care and what is the impact of chiropractic functional neurology?
Brain research
Research now demonstrates that chiropractic manipulation lights up certain areas of the brain. The early chiropractors knew that their treatments were more far-reaching than just segments of the spine being put back into place. They saw conditions such as tuberculosis, influenza, respiratory ailments, bedwetting, and many more problems responsding to chiropractic adjustments. These were not miracles, but chiropractic functional neurology working as it should, treating both the peripheral nervous and autonomic nervous systems.
Somewhere along the line we forgot what made our profession so special. The vast majority of practicing chiropractors have not been treating autonomic nervous system imbalances. For example, what if a patient presented in a sympathetic dominant state or in constant fight or flight? How would you document this in the subjective section of your daily note, and what would be your objective findings be?
Chiropractic functional neurology treating stress, sleep and the brain
These are the patients who come into your office saying they had a very stressful day, and have the upper trapezius tightness to prove it. They look tired and if you were to shake their hands, they would be cold and clammy. If questioned on how they are sleeping, they would say, “I cannot seem to turn my brain off at night, causing me to toss and turn.” You adjust them and they walk out only to return a few minutes later saying, “It’s out again.”
What you treated was a musculoskeletal condition, but the causation of their symptoms was an imbalance of their autonomic nervous system — specifically the sympathetic and parasympathetic nervous systems.
Over the years, the vertebral subluxation complex became the focal point of what we treat, and the working model was a “bone out of place pinching a nerve.” We started narrowing our scope to musculoskeletal conditions.
A disturbing trend
Medicare’s own medical necessity statement indicates a patient must have a neuromusculoskeletal condition to receive chiropractic care. All other third-party payers follow this simple statement for their medical necessity requirements as well.
After reviewing thousands of chiropractic files over the years as a compliance consultant, I have seen a disturbing trend: We are forgetting the neurological aspect of the medical necessity requirements. We are pigeonholing the conditions and procedures we treat and use, based on what insurance will reimburse. We have taken the brain totally out of the equation, and yet that is what we affect the most with chiropractic manipulations. If you don’t believe it, take a refresher course on the spinal tracts, as they all end up in the cortex of the brain.
Case study: concussion treatment
Last November, I had a high school football player present to the office with a concussion from a helmet-to-helmet hit in a playoff game. The impact was so violent he was knocked unconscious and was transported by ambulance to emergency room. He was evaluated and a CT scan performed and was deemed negative for any vascular insult. He was instructed to go home and get some rest.
His mother had heard that our office had been successful in treating athletes with concussions and brought him in for a consultation. His eyes still had a glazed and distant look, his balance was extremely poor, and he had difficulty concentrating. We initiated specific gentle chiropractic manipulations to the occiput and C1 areas. We also began brain wellness guided meditation recordings and balance training rehabilitation exercises. In just under 90-days, he was symptom free and his mother stated we gave her son back to her. She also stated she didn’t know where else to turn and was so happy she was referred to the clinic.
I tell this story because there are over 2.5 million cases of reported traumatic brain injuries (TBIs) every year in the United States. Many of these patients are trying to wait out the symptoms because they were instructed it would take time. What is very worrisome, these are the reported cases, how many more thousands of people are suffering that did not report the injury?
If concussed patients do not receive the appropriate care then imbalances in their autonomic nervous system become an ingrained neurological pattern. The result is anxiety, depression, insomnia and a whole slew of symptoms that right now are being treated with medications.
We can help these people regain their lives by treating their brains with chiropractic functional neurology. The amazing aspect is you do not need to become a diplomat in functional neurology (I do have the highest respect for these doctors) — you already have the training, and with acquiring some new tools and equipment, can begin making a difference in these people’s lives. Research by Heidi Haavik, DC, has validated what we have known all along — we are neurologically based, in that we affect the brain.
Providing chiropractic brain-based treatments
Chiropractors do very well treating peripheral nervous system symptoms and musculoskeletal conditions. But let’s face it, there exist stiff competition in this market. We have pain doctors, physical therapists, and primary care physicians all in this game.
But no other health care discipline is trained and ready to provide brain-based treatments with chiropractic neurology. The floodgates of new patients with challenging but interesting cases can and should be coming into chiropractic offices every day. It is time for a paradigm shift away from the “bone out of place” theory, and into brain wellness through chiropractic.
We are should strive to bring out that functional neurologist in all of us and get back to our roots as the neurological profession. This is what B.J. Palmer knew along with the rest of the pioneers in the profession. Everything old should be neuro again.
TED A. ARKFELD, DC, MS, CPC, is the clinical education director of the neurological performance program at Haven Medical. He can be reached via email at ted@haven-medical.com or call 989-448-8065.
