Do chiropractic ‘facts’ change? The mystery of chiropractic research studies and the science revealed

Do you ever get frustrated when scientific facts seem to change from day to day? Instead of getting frustrated, here is a way to reframe how we look at chiropractic research studies and science.

Early in my career, I thought that research could answer all of my questions once and for all. However, I was wrong.

That is not really how “research and science” works. Research is not a search for a final answer, but a means to find greater truths. And research is a process we must engage in so that our profession may continue to grow.

Chiropractic research studies: a cyclical process

So how should we look at chiropractic research studies and science? One way is to think of it as a continuous quality improvement cycle, which is a concept that comes naturally to most chiropractors. This cyclical process allows us to ask questions, gain new information, then incorporate that new information to improve our theories and models.

Research is about asking questions and testing our hypotheses, not closing our minds once we have found out just one answer, since there may be several correct answers to one question. Thus, the facts are supposed to change and improve as we gain new knowledge. And as we explore chiropractic, we know that chiropractic care can be very powerful, so keeping our minds open to the possibilities is important.

Through the wonderful and fluid processes of research and science, we can drill down to the minute details or we can go really big with analyses and models. Research is a tool that provides us with a way to better understand what we are doing and how we can do it better. This process means that we may continue to grow as individuals and as a professional community.

Strengthening chiropractic

Through research and science, we also have the opportunity to strengthen the foundations of our clinical practices and our profession.

When asked about the Journal of Manipulative and Physiological Therapeutics (JMPT), Journal of Chiropractic Medicine, and the Journal of Chiropractic Humanities, President Emeritus James Winterstein, DC, DACBR, replied, “The bottom line is that without peer-reviewed and indexed scientific journals, the academic and clinical reputation of our industry as a whole would suffer. These journals give relevance and significance to our practice because they represent the science that undergirds what chiropractic physicians do. Their presence has both promoted and published research, which in turn has given stature to our researchers who can, because of them, publish in other scientific journals.”

Thus, our chiropractic journals help to provide opportunities for our researchers and contribute to strengthening the chiropractic body of scientific knowledge, which helps to secure our future.

Whether a chiropractor reads one or many different journals, scientific journals are important for the health and security of our profession. Building our science reservoir means that we are building a library of information so that it is ready when it is needed. We cannot rely solely on other professions to build our library for us; we have the responsibility to do this for ourselves. Thus, our chiropractic journals are essential. The information that we incorporate into chiropractic research and science fortifies the foundation of the chiropractic profession, therefore it is our duty as chiropractors to support our research and science, and to support our chiropractic journals.

For example, the JMPT was established at a time when no other scientific peer-reviewed journal of its kind existed. In the 1960s and 1970s, which was a tumultuous time in chiropractic history, Dr. Joseph Janse witnessed the oppression imposed by the established medical scientific community and how they influenced legislation and the practice of chiropractic. In 1978, he took a leap of faith knowing that there had been prior failed attempts at establishing a respected indexed journal, however he knew that a scientific chiropractic journal was desperately needed by the profession.  After a few years, the JMPT became the first chiropractic journal to be listed in MEDLINE and continues to lead the way in chiropractic scientific publications. Since that time, the JMPT has published thousands of papers and has helped our chiropractic researchers establish a scientific track record so that they can continue their research and publish in a wide variety of journals. And the articles from the JMPT has helped practitioners in many ways to establish the legitimate science of chiropractic and to show that there is evidence for what we do.

I sometimes hear, “I am a practicing chiropractor, not a researcher. How can I participate in research and science?”  My response is this. One does not need to be a professional artist to appreciate and support art. Thus, one does not need to do research to appreciate and support chiropractic research.

If you find value and see the importance of research and science for the chiropractic profession, then you are in good company. The Practice Analysis of Chiropractic 2020 reported that the majority of chiropractors in the United States value research and science. In their analysis, 96.2% of chiropractors report reading peer-reviewed research and 90.3% report using research-based treatments. This is fabulous news when we consider that knowledge is a critical component in order to be invited to sit at the decision-making table, which ultimately determines what happens with the chiropractic profession.  

Chiropractors read journals to attain, maintain, and improve their competence and to stay current with health care trends. Reading scientific journals is an efficient method of increasing awareness about evidence-based approaches to health care. So, the bottom line is that:

• information is expected to change and improve over time, and;
• research and science are participatory.

It is our responsibility as chiropractic practitioners to know what is being done and published within and about our profession. And it is also our duty to support the journals that support chiropractic to make sure that they continue to serve chiropractic far into the future.

Many great thinkers in our profession have demonstrated their love for knowledge and that one is never too old to learn new facts or propose new hypotheses. By continuing to ask questions, measuring the facts, appraising them if they are worthy of considering, then applying what was found to practice, we continue to improve. And being able to speak and understand the language of science gives us a voice so we may be included at the table when important decisions are being made, both locally and nationally, about chiropractic.

Additional research needed

There is still much to be explored in the world of chiropractic research studies. In 2021, although we have a good start on our body of scientific knowledge, we only know a small fraction about what chiropractic can do and its full potential to impact the health of our patients. There is much to be explored about the mechanisms of chiropractic care, not only on the cellular and systems level, but on the level of the whole patient and its impact on the community.

As chiropractic research moves forward, we will need additional research related to pragmatic clinical applications and ways that practicing chiropractors can engage and give input into this process. Our research and science will help guide chiropractic into the future and each of us has the responsibility to be a participant.

CLAIRE JOHNSON is a professor at the National University of Health Sciences, editor of JMPT, JCM and JCH, and has served as the peer review chair of many scientific chiropractic conferences. She is the administrator of the Research and Science Society (RASS), which is a membership-based, online forum for chiropractic practitioners who are interested in better understanding and applying research and science. This society engages stakeholder participation by encouraging members to learn, apply, and impact research and science. Learn more by visiting ResearchScienceSociety.org.