Matthew McCoy DC, MPH
The Subluxation is an Unscientifically Validated Construct?

“The spread of evil is the symptom of a vacuum. Whenever evil wins, it is only by default: by the moral failure of those who evade the fact that there can be no compromise on basic principles."

Ayn Rand

For over one hundred years chiropractors have been proclaiming the negative effects of vertebral subluxation as well as the positive benefits of subluxation reduction and correction. During those hundred years there were the factions from outside that labeled us as cultists for even suggesting that such an entity existed – never mind that we contended that its existence in a person had some deleterious effects on their health.

Over the years people within our own profession (even leadership) questioned its very existence and off and on there have been calls to do away with the term because one or another individual felt it was too ambiguous, politically charged or just simply unproven.

"We must differentiate ourselves from the Straights. We drop the term subluxation and use the term ‘Functional Articular Lesion.’”
James Winterstein – Chiropractic Medicine for Tomorrow. Presentation at New York Chiropractic College. 2/10/2005

Most leadership within the profession has taken a softer stance on attacking the term over the past several years especially following the signing of the ACC Paradigm Statement where the Presidents of all North American Chiropractic programs actually agreed upon a definition of subluxation – albeit a political definition- but an agreed upon definition just the same.  

While it might seem the subluxation has been saved once again from extinction within our vernacular the reality is that we are at more of a crossroads than ever. The fact is that what has been generally accepted is more of an orthopedic definition of sublxation – certainly one divorced from the Early Model of Subluxation which included an interference to the mental impulse as a necessary component.
“The chiropractic perspective on health and disease emphasizes two fundamental characteristics: (1) a testable principle suggesting that the structure and condition of the body influences how the body functions and heals and (2) an untestable metaphor that asserts that the mind-body relationship is instrumental in maintaining health and in healing processes.” 
Reed Phillips & Robert Mootz: Chiropractic in the US: Training, Practice & Research. AHCPR

So the powers that be within and outside the profession have stated: “Okay, we’ll give you that subluxations in one form or another actually exist – but so what?”  Then the barrage of questions begin:

• If subluxations exist - what evidence do you have that they have any clinical meaningfulness?
• If subluxations exist - what evidence do you have that their existence leads to adverse health outcomes?
• If subluxations exist and you have some evidence that their existence leads to adverse health outcomes – what evidence do you have that you can correct subluxations?
• And if you have evidence that you can correct them – what evidence do you have that correcting them leads to improved health outcomes?

And I could go on - but hopefully you get the point. Hopefully you also get the point that our days are shortly numbered in regards to vertebral subluxation and the claims we make about their alleged adverse effects, our contention that we have the ability to reduce them and whether or not positive health outcomes are tied to such correction.

One only need look at the CCGPP Best Practices (Mercy II) to get an example of what’s coming your way. If that’s not enough to scare the crap out of you then take a look at the Strategic Plan's of the managed care industry within the profession. While we all sit on our collective rear ends, argue amongst ourselves, support those who would destroy us and revel in some pre-apocalyptic delusion that everything is going to be okay – the Dark Side is progressively realizing its goals. And one of the tactics of the cartel is to portray the subluxation centered chiropractor as:

• A religious zealot
• A fundamentalist  
• Unscientific
• Non-evidence based

“If the formation of chiropractic groups opposed to improving educational standards,
advancing our scientific research accomplishments, discoursing intellectually with our colleagues in the various health professions, or accepting responsibility for patient care beyond what some may consider to be, are not myths, then at least the unscientifically validated constructs (ie, the subluxation) would represent, by Armstrong’s description, a chiropractic counterculture to the profession’s scientific and academic advancements.”
Reed Phillips, The Battle for Innate: A Perspective on Fundamentalism in Chiropractic. The Journal of Chiropractic Humanities. 2004.
“Unscientifically validated constructs (i.e. subluxation)” – got that?  

In order to address this effectively we have to be honest with ourselves and with each other. The rank and file and even some of the leaders in the subluxation centered community have acquieseced to the cartel within chiropractic that seeks to remake us in a more “modern” image. An image absent the vertebral subluxation.

Hopefully, the subluxation centered community will remember that it has a rich history and respect for science, research and evidence and this recollection will hopefully motivate it to do a few things immediately:

1.      Support subluxation centered research.
2.      Support subluxation centered educational institutions.
3.      Get involved politically at the state and national level.
4.      Stop supporting those groups, schools, organizations and individuals who seek to destroy you.

As always, I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic

McCoy Press