Chiropractic care offers a holistic approach to health by addressing subluxation and nervous system interference.
The chiropractic profession’s now lengthy history of progression has always hovered, if not centered, around the neurobiology of the spine. That said, a practice can be built directly around neurology, whereas others have succeeded while making little to no mention of nerve interference in their messaging. We all know how the song goes, “The hip bone is connected to the backbone,” and many people identify with structural faults even when functional issues such as alignment and fixation are indicators of nervous system compromise. At the core of chiropractic is the idea that subluxation involves degrees of nerve interference and nervous system disruption. Over the years, various neurobiological mechanisms have been used to describe this functional interference, but for patients, it remains an advanced concept. Over time, largely through imaging and instrumentation, we have worked to demonstrate to patients what we can easily observe with our hands and eyes. The ability to convey subluxation as a health concept and not just an obscure chiropractic diagnosis is the bridge to helping people realize that most body systems depend on the nervous system platform as the integrator for all health information.
The reality is there are many ways to describe chiropractic, as seen through our collection of techniques, each defining the relationship of neuromuscular and skeletal structures to nervous system function. With so many options, why fret over the acknowledgment or utilization of neurology in our lexicon? For starters, neuroscience has progressed dramatically in the past 25 years, and along the way, new opportunities to update and strengthen our model have opened in places you might not have expected. It is important to recognize that the garden hose theory of nerve root compression is the most common analogy used to educate patients. While this approach has clinical relevance, it has two problems:
Most of the subluxation-based nervous system interference we observe in chiropractic patients was not detected by objective neurological testing like NCV/EMG.
This simplified version of our science gives the public a limited vision of when to seek chiropractic care. On the other hand, there is a recent trend in peer-reviewed research, where the explanation of nerve interference centered around proprioception is gaining acceptance in the research community.
The idea that the deficiencies of balance and movement associated with nerve interference from subluxation correlate with the function of proprioceptors, the sensory receptors that receive stimuli from within the body, especially one that responds to position and movement, is becoming more relatable for people. The fact that proprioceptors are concentrated in the spine and feet helps make another vital connection to the most common adjustments we perform around the spine and extremities. The nervous system integrates balance, breathing and other spine-related functions through its communication platform to maintain homeostasis. The chiropractic perspective on nervous system function is critical to viewing a complete picture of health.
Gaps in applying neurology have also slowed our understanding of brain health, contributing to the task at hand. Not long ago, MRI brain imaging had limited functional value in our most severe brain-injury and degenerative brain cases, due in part to imaging resolutions too low to pick up evidence of micro-vessel ischemia. When magnet strength increased from 3-Tesla, the resolution for these structures improved vastly, enabling radiologists to see the damage associated with neurovascular incidents, validating what our clinical team already knew. DCs have used highly accessible indicators, such as range of motion and symmetry of the spine and whole body to describe subluxation; yet even today, there are commonly used metrics in neurology that fail to capture subluxation. Nerve conduction and EMG studies may have value when neurological compromise reaches a critical mass; however, everyday nerve interference picked up by our hands and eyes may go unrecognized by the neurologist.
Further progression of 3T MRI toward fMRI continues a trend toward understanding what DCs have known since the beginning. With fMRI, instead of looking purely at anatomy, they started to look at the movement of blood, following the trail of oxygenation, which offers a unique picture of brain function previously seen only with QEEG. Functional brain testing sensitive enough to tell the difference between a person with their eyes open versus eyes closed better reflects the level of neurological function needed to appreciate what a DC feels and sees.
The idea is not that explaining how the body works through the nervous system is suddenly easier; it’s that people can learn so much about their health, and we can explain it to them confidently in our language. No, we are not just going to look for nerve root compression; our physical examination and imaging allow us to see dysfunction from your head to your toes. Yes, the alignment of your spine works similarly to an antenna, so when it is just a little off balance, this poor internal reception may compromise your other functions. We look at muscles, but we pay special attention to how the undercurrent or circulation of blood, spinal fluid and lymph could be affected. We can even find the causes of spinal subluxation, like foot overpronation that destabilizes the hips and spine so that we know to address it and protect your adjustments with functional orthotics and the right exercises., The nervous system is tracking everything, and when we learn to speak its language, we can form the right habits.
Technology more committed to intelligence than the average human
Our culture has become predominantly dependent on digital communication platforms, most if not all of which have commercialized the utilization of artificial intelligence (AI). Recent studies have shown AI outperforming humans in creative tasks, an area thought to be uniquely human. Despite this humbling reality around human cognition, or thinking and understanding, human health still depends on conative processing, or what we do. So, will people skip over understanding their own bodies and innate intelligence? Will people learn about the value of our internal communication and the ability to adapt to make the most of every situation? Neuroscience will continue to develop functional brain testing, and there are versions of the work where chiropractic principles are embedded in that thought process. What will people do when they discover breathing and balance and posture-based functions around the spine are the behaviors they need to learn for both physical integrity and performance? With our knowledge, especially backed up by neuroscience, we can follow our indicators for adjusting and remain curious about just how well a person can function when they reset their spine and mind.
Final thoughts: Improve awareness of subluxation through education
Chiropractic offers an efficient way to influence physical balance and overall homeostasis. Whether I’m complementing spinal adjusting with adjustment of the extremities and cranium, functional orthotics or home exercise programs, my mindset is to build resilience through the spine. Neurology is the most inclusive biological mechanism I have found that captures this story and when reported to patients they can receive full disclosure and empowerment for making additional lifestyle improvements. While we all have been given great placeholders, like the garden hose theory, to fully complement the body and reach the potential that the subluxation concept has to offer, we must embrace the theory of garden hoses and bring more awareness to the two-way communication between the brain and body that is as vitalistic to our survival as any other body function. If the DC’s perspective on neurology were applied to healthcare, the likely result would be more posture-based care and patient education.
ANISH BAJAJ, DC, is a 2000 graduate of Life University in Atlanta, Georgia, and the owner of Bajaj Chiropractic in New York, New York. Bajaj serves on the executive board of the New York Chiropractic Council and was the recipient of their Chiropractor of the Year Award in 2022. As a member of the Foot Levelers Speakers Bureau, he travels extensively, sharing his chiropractic knowledge and expertise with audiences around the US.
