MisunderstoodA chiropractic doctor is probably one of the most misunderstood healthcare practitioners in the medical profession. Through the years they have been looked at askance by doubters who are full of suspicion. In times past, they have been called quacks, or worse. This is due, in part, to the public's narrow and limited view of medical treatment - being that solely of administering prescription drugs and performing surgery. It's unfortunate that the majority of people believe this is all there is to health care. There truth is there is more to health care than drugs and surgery! A great deal more!Sad to say, but even some chiropractic patients haven't a real clear understanding of what chiropractic is. And for those who have never been to a chiropractor, most are totally misinformed as to the make up of the profession. The fact is chiropractic is the largest drug-free form of health care and the third largest form of any health care in North America. What is Chiropractic?The word "chiropractic" is a blending of the Greek words cheir (hand) and praxis (action) and means "done by hand." Chiropractic is an alternative medical system in that the practitioner takes a different approach from conventional medicine in diagnosing, classifying, and treating medical problems.Essentially, chiropractic focuses on the relationship between the body's structure - primarily that of the spine - and the body's function. Doctors of chiropractic use hands-on therapy called manipulation (or adjustment) as their core procedure.Comparable to an MD? So is the training of a chiropractor as rigorous as that of a medical doctor? The answer is a resounding, yes. Today's doctor of chiropractic receives an extensive educational background beginning with three years of pre-chiropractic study. From there they advance into a four-year course of study. A student of chiropractic spends as many hours in the study of human physiology as that of a medical doctor. Chiropractic programs require a minimum of 4,200 hours of combined classroom, laboratory, and clinical experience.The difference between the education of an MD and that of a chiropractor lies in the fact that an MD trains in pharmacology and surgical procedures and chiropractor trains in the care of the spine.Worth the Cost?Some will assert that it costs too much to go to the chiropractor. However, the opposite is true. The fact is that oftentimes when a person is treated by a chiropractic doctor for one certain symptom, the adjustments (treatments) result in a higher level of overall health and well being. This leads to cutting back on prescription drugs, preventing the need for surgery, and slowing down the aging process. Those who benefit from chiropractic treatments look at it as an important part of their ongoing health maintenance, similar to that of regular exercise or visiting their local health spa. They now know the difference - how they felt before chiropractic treatments and how much better they feel now. A survey of patients of chiropractors in an independent physicians' association found that, when asked if they would recommend their Doctor of Chiropractic to others, 95.5% of the patients said "yes." 1A chiropractor is a whole health practitioner who is concerned not just about your symptoms, but your overall state of well being. What your doctor of chiropractic can offer, no other doctor can. Have no doubt that a chiropractor is well trained to assist you reach your own personal optimal health. 1 http://www.neffchiro.com/research.htm CLA Insight
Chiropractic Fraud - Could Perception Be Reality?
CLA Insight Perception: Large numbers of consumers and investigators alike believe that fraudulent activity in the Chiropractic profession is pervasive, and, unfortunately, may use a broad-brush to paint all chiropractors as deviant actors.Why is the foregoing impression so prevalent today?Is this perception the result of historical context, viz., that the foundational premise of Chiropractic was the Chiropractic-subluxation, a condition neither objectively identifiable nor proven to exist?The subluxation may have something to do with the prevailing perception of Chiropractic. However, based on more than twenty years of experience investigating chiropractic fraud and assisting chiropractors with compliance, I suspect the following activity by some chiropractors may form the actual basis of such a perception:-Do you want what I have?: Employ practice activity advocated by practice building consultants who boast of having large bank-accounts, expensive cars, pricey clothing, luxurious vacations... and the keys to practice success. Large numbers of chiropractors are recruited directly from chiropractic colleges.-Recipe for Wealth: Employ practice activity, often at the instruction of practice building consultants, to increase practice revenues without establishing the compliance of said activity with applicable laws & rules, including, but not limited to: marketing campaigns to recruit new patients; generation of referrals from attorneys and MDs; convert/retain patients; treatment protocols for all; administer new or re-packaged health care services; provider services rendered by unlicensed staff; use computer-generated noting systems; billing codes to enhance reimbursement; and collection mechanisms to maximize income.-Explode your practice: Create multidiscipline and/or specialty practices, operating in conjunction with existing chiropractic practices, to avoid limited chiropractic coverage and access more health care dollars - including those payable by federal health care programs.-We are conveniently located: Operate multiple clinics where scripts and protocols are the norm - instruct clinic doctor and staff on what to do, how to do it, what to bill...-We provide a good service: Provide the same services at similar intervals for all patients regardless of individual needs. Services involve little actual hands-on treatment by a chiropractor who uses new "state-of-the-art" treatment equipment or has unlicensed staff administer the bulk of patient care.-We treat the cause not the symptom: Report the treatment of the cause of health care ailments and abnormalities with adjustment of the spine to allow the body's innate intelligence to heal, not masking the symptoms with medication or surgery. -Benefit design: Provide services not based on established, individual patient needs but on philosophical beliefs - everyone needs chiropractic care, no actual health care complaint required (found if needed for insurance purposes), chiropractic adjustments result in optimal health, same adjustment on all patients (upper cervical, full-spine) and modalities help the adjustment last.-Wallet Biopsy: Identify available insurance or a willingness to commit to payments on potential patients, even those who are asymptomatic - if an existing revenue stream is found potential patients are told they have medical conditions requiring chiropractic treatment.-Do you believe: Saying and doing almost anything to generate income from those who indicate they "believe" in chiropractic - purporting to treat acne, allergies, anxiety, bed wetting, cancer, colic, depression...-You could be hurt and not know it: Provide checkups, under the guise of public service, to identify health conditions that need treatment. Often such checkups, administered on asymptomatic individuals, include use of testing devices not clinically or scientifically recognized for purposes of generating reports that purportedly show medical conditions and a need for treatment outlined in scripted presentations.-Winner, winner, free chicken dinner: Free or donated services promised in aggressive marketing campaigns - mailers, telemarketing, screenings, dinner talks, etc. - designed to get as many people in the clinic as possible for patient conversion regardless of actual medical need.-Let's make a deal: Charge insured patients more for services than cash patients receiving similar services. Agreements with insured patients to accept what insurance pays and forego collection of deductibles, co-pays and non-covered services. Varying deals with cash patients regarding what they will pay.-See you in Court: Use the court system to file lawsuits to challenge payor reimbursement decisions and practices for purposes of eroding resistance to questionable activity - making it the norm and acceptable.-You are picking on us: Profess to be a victim when held to account for improper practice activity - even when such activity is known by reasonable thinking persons to be inconsistent with the laws & rules governing health care.Reality: The Chiropractic profession, for the most part, has grown far beyond the limitations espoused by its founder, and is seen today as a bona-fide health care discipline that offers valuable health care services to patients.Reality: Not all chiropractors engage in fraud. Not all attorneys are shysters. Not all insurers refuse to pay legitimate claims. Not all investigators are out to get chiropractors!Reality: There is a Chiropractic fraud problem present in every geographic area of the United States, with deviant chiropractors propagating their schemes with impunity and contempt.Reality: The crime-scene for investigations of health care provider fraud, regardless of the providers' discipline, is the provider's clinical and billing records. And, if you know what you are looking for when evaluating chiropractic records, you can identify the fraud. Investigators view the following as 'red-flags':- Promised free/discounted services to induce patients to clinic - Extensive exams, tests and treatment on subjective complaints of injury or on asymptomatic patients - Use testing devices that are not recognized clinically or scientifically to convince patients they have a condition and need treatment - Scripts & protocols - same services on similar schedule, even when better - Services for conditions not found in presenting complaints - Services based on available insurance or for legal reasons - not actual need - Provider services administered to patients by non-providers - Patients direct treatment or treat themselves - Excessive amounts billed for services - Goal is to bill certain amounts per visit - Billing codes reported based on what results in the best reimbursement, not on actual conditions or what was done - 'Quick-codes' automatically bill for all services insurance covers, regardless of need or if actually provided - Conditions reported only when required to get paid (Subluxations - Medicare) - Clinical notes appear same on all patients, prepared to support payment - not health care rendered, - Clinical notes prepared only when requested by payers - more extensive for liability carriersReality: Large numbers of chiropractors see what others see and try to fight for change and accountability, often fighting from an island and dodging bullets of attack from their peers and payors.Reality: Many otherwise honest and ethical chiropractors succumb to the temptation of fraudulent activity as they see deviant chiropractors getting rich off insurance payments without ill-effects (e.g., consumers turning away, claims denied, government audits, and fraud investigations).Reality: The Chiropractic fraud problem must be addressed by Chiropractic educators, Chiropractic leaders, consumers, legislators, insurers, regulators and law enforcers if effective measures are to be taken - especially those problems that are already well-known and visible. Reality: Observe this inexorable recipe that could result in an unimaginable disaster for the Chiropractic profession:- More access to health care dollars by chiropractors - Neither substantial- nor quantitative-steps to address widely-known fraud problems - Failure to take steps to prevent bad-actors from ruining reimbursement advancements for those health care professionals who follow the laws & rules while delivering quality care to patients, is a recipe for disaster that could result in the fraud reaching unimaginable levels.According to James Edwards, D.C., past Chairman of the American Chiropractic Association, ("News Flash: Obama Victory Could Result in Full-Scope Chiropractic," Dynamic Chiropractic, 1/15/09), the election of President Obama, as well as the fact that Democrats control both houses of Congress, most of whom are pushing for "universal health care," the Chiropractic profession has its best chance to achieve the long-desired goal of a full-scope of practice on a national level (with full-reimbursement access).Further, Dr. Edwards reports that should a full-scope of practice become a reality, the Chiropractic profession should thank ACA leadership for their courage to file a lawsuit against a national health insurer, an insurer that administered federal health care programs, as well as the countless contributors to the ACA's Legal Action fund who made the lawsuit possible.Could greater governmental-control over our individual-choices and freedoms, combined with Universal health care, provide any long-lasting positive results? The last time the Democrats had such leverage we got the Health Insurance Portability and Accountability Act.Could giving chiropractors full-physician status, as well as full-access to reimbursement for services they perform, be an answer to the chiropractic fraud problem?Could treating chiropractors as other physicians are treated result in a significant drop in the nonsense in which some chiropractors engage? Would treating chiropractors as other physicians preclude having those chiropractors engage in practice-activity that is either objectionable or fraudulent? What impact, if any, did such treatment have on the Osteopathic profession?We've all heard stories about someone who was crippled or even killed by a Chiropractor. Sometimes we're even warned by our family doctor not to let our Chiropractor adjust us as it may cause a stroke. Even the L.A. Times recently called the safety of manipulation into question. Just how safe is chiropractic treatment? What are the facts?1. Due to the extreme rarity of injuries caused by Chiropractic treatment and its unequaled safety record, chiropractic doctors pay only a fraction (i.e. 1/10 to 1/50) the malpractice rates compared to medical physicians. (1)2. Only 19 deaths have been attributed to Chiropractic treatment worldwide over the latest 65 years studied (1934-1999). In fact, the risk of "serious injury" from anti-inflammatory medication including Aspirin and Advil is 400 times greater than from manipulation. (2)In other words, it's much safer to have a chiropractic treatment for your neck pain or headache then taking medicine (over the counter or prescribed).3. Nearly 10,000 studies have been performed on manipulation (making it the most thoroughly studied form of treatment for back pain) and the great majority have found the following when compared to medical treatment:a. Increased patient satisfaction.b. Shortened time to return to activities or work. c. Less permanent disability.d. Less costly.The governments of several countries, including the United States (A.H.C.P.R.) and Canada (Manga), have found manipulation to be the most effective form of treatment for back pain. In fact, the Canadian report suggested that Chiropractors be the "gate keepers" for back pain saying that it would save Canada hundreds of millions of dollars if their citizens saw Chiropractor's first. After reviewing all published studies, it was determined that there were "no medical procedures that were as safe as Chiropractic treatment."The British Medical Journal and the U.S. Department of Health and Human Services found similar results. In fact, the U.S. government reported that physical therapy and acupuncture were not "cost effective" and that surgery was useful in only 1% of cases.Further, the report was emphatic that they should be employed only after conservative approaches (like manipulation) were first exhausted.So why are there still news reports of the dangers of Chiropractic? Lets take a look at the last article that was reported by the journal, "Neurology", and reported in the L.A. Times.The study found that seven out of the 51 people questioned who had a stroke were adjusted by a Chiropractor in the previous month. This compared to two of those in the control group. So an association was drawn between manipulation and strokes. The problem with making such an opinion is that headaches and neck pain are the early symptoms of this type of stroke. So of course more people with neck pain and headaches sought chiropractic care versus those who were in the control group who were pain free.This illustrates the problem with association-type studies. They don't show the cause only association. For example, the following is a common example taught in research courses that warn against making conclusions from such studies.Since there are more churches in violent neighborhoods, churches lead to violence. Actually, establishing churches are a reaction to people living in a violent neighborhood, not a cause.In fact, another study published by the same journal, "Neurology," found fewer people having strokes if they were adjusted than the control group that wasn't. Unfortunately, that never made the newspapers nor did most of the other studies which showed chiropractic treatment far safer than all other medical treatments.Why the media prints inflammatory stories while ignoring others that would put your mind at ease is beyond the scope of this paper. But it is unfortunate that people are being scared away from a treatment that is absolutely safer and more effective and by default being directed to one that has significantly greater risks. Personally, between Dr. Murray and myself, we have practiced about 40 years and have never injured anyone (more than some temporary soreness as part of the treatment). The real danger comes from having musculoskeletal problems that are covered-up with drugs and surgery. Since the cause is not addressed this way, the patients often get worse, more discouraged and depressed and there are often side effects.We use only the safest of all procedures and specifically screen for all risk factors that make manipulation unsafe. I'm sure you have already noted how thorough we are. This is the only way that you should be treated by any of your doctors. If you ever have questions about the risks or benefits of any procedure, always feel free to speak to us directly.(1) Malpractice Statistics from the National Chiropractic Mutual Insurance Company, West Des Moines, Iowa.(2) Terrett, A, Current Concepts in Vertebrobasilar Complications, NCMIC Group, Inc., 2001, p 199.
What is Subluxation & Treatment for Back Pain
CLA Insight Before I begin, let me give you a little insight to where my perspective on the healing comes from. By training, I'm a scientist. I am really good at looking at issues critically and deciphering facts and problems based on factual evidence and sound theories. At the same time, I always had an interest in alternative medicine and while I lived in Seattle for 5 years, I had the chance to experience directly and learn various healing modalities such as naturopathic physician care, acupuncture, homeopathy, Nambudripad's Allergy Elimination Techniques (NAET). Some of my knowledge comes from being the inquisitive patient, some comes from discussions with students of Bastyr College of Naturopathic medicine who I befriended while in Seattle. While in Seattle I also took several classes on Reiki, and became a Reiki Master/Teacher and hence I have the insiders perspective on how energy healing works and what it can and can't do.I am a strong advocate of alternative therapies in conjunction with or sometimes instead of traditional medicine. However, recently, I have been really bothered by practices of chiropractors (some not all) and I feel that there are many out there that take advantage of the general lack of understanding of how the human body works in patients to keep their businesses going. I write this article with the goal to educate moms on the good, the bad, and the ugly associated with chiropractic care, especially as many chiropractors now advocate for 'maintenance care' not only for adults but also for children.As you will see below, I do believe that chiropractic adjustments can be very useful, especially when they are performed as part of the whole body healing, but unfortunately, when done in isolation, chiropractic adjustments often only set you up on a path of going, and going, and going back to your chiropractor for more treatments, rather than getting well.The work of a chiropractor is to manipulate the spine to remove misalignments. Misalignments in the spine are often referred to as subluxations. Traditional chiropractic philosophy is based on the belief that misalignments in the spine are the root cause of illness. Hence they remove the misalignments in the spine with the hope that the illness will go away as well. The idea behind this theory is that all body organs are connected to the spine through nerves. If there is misalignment in the spine, it will cause a problem with the nerves and then other organs connected to them. If you consider long term chiropractic care for yourself or your family, be sure that this theory of all illness originating from spine misalignments resonates with you. It doesn't with me. Here is why.The spine connects to joints, then to muscles and ligaments that support the spine and its structure. If there is a problem within the spine, the muscles in the close proximity to the spine misalignment (and often not only in that region) will also be affected. Typically some muscles will become overly tight and some will become weak, as muscles work in pairs. This is what's commonly referred to a muscle imbalance. In addition to the musculoskeletal system in your body, there is a biochemical system, and an emotional system. The biochemical system includes your blood chemistry, hormones, vitamins, minerals, and hence this system is vital to your well-being. Emotions, including moods and attitudes have also been shown to contribute to and to aid illnesses. The musculoskeletal, the biochemical, and the emotional systems within our body are very intimately connected to create our well-being or sickness. If we become ill, all of these systems will be affected and disease will manifest in all. I think it's naive to believe that all disease starts from the spine. For example, if you never go out in the sun and eventually become Vitamin D deficient, it is likely that you will develop problems in your spine since Vitamin D deficiency leads to muscles weakness. This in turn will likely lead to spine misalignments. Similarly, severe emotional trauma, never addressed properly, over time may lead to sickness which will likely cause some spine misalignment. I believe that it's correct to say that most illness will manifest itself in the spine, but that is not the same as saying that all illness originates in the spine. One thing to keep in mind is that the somewhat simplistic philosophy behind chiropractic and illness was developed at time when people had no choice but to eat minimally processed foods from local sources, before there were any chemicals in the environment, and at a time before drugs, vaccinations, and other environmental factors were impacting our health. In our modern society, there are other factors that contribute to creating illness, which must be addressed. In my opinion, removing the cause of the illness is the best approach for curing it. Finding the cause of the illness is often the tricky part. This is where a doctor with a broad range of expertise and education is most helpful. Ideally, the physician you pick as your doctor is familiar with how disease manifests itself in the musculoskeletal system, as well as in the biochemical and emotional system. Such a physician can best determine how to get all these systems back into balance.Chiropractic treatments have the best chance of curing problems most directly related to disturbances in the musculoskeletal system of the body. Many joint, and muscle pains can be aided by chiropractic manipulation. The question is, whether the pain will stay away. If the treatment is for an injury such as back pain due to someone lifting a heavy object in awkward manner, one to several chiropractic adjustments will usually get rid of the pain for good. The reason is that the cause of the pain was the spinal misalignment, and once removed, the patient is usually pain free.What about chronic pain though? Moms often develop neck and shoulder pain from nursing and carrying their children. Lower back pain and sciatica are also quite common. All chiropractors happily address these conditions, but how they are addressed varies greatly between chiropractors.It is a very common chiropractic practice to manipulate the spine to try to get it back to its proper alignment, and ask the patient to come back multiple times in a week, often for long periods of time. The reason for the multiple return visits is not addressing the cause of the spine misalignment. If the cause of the problem is not removed, few hours to a few days after the adjustment, the spine slowly returns to its previous state.Why? Because the muscles that are tight are pulling it in the direction of previous misalignment and the weak muscles can't support the corrected structure. So the patient goes back to the chiropractor, and the process is repeated. 5, 10, 20, 40, sometimes 60 times, usually 1 to 3 times a week over a course of weeks. Then once a week, then once a month. After all those adjustments, it is possible that the muscles over time slowly adapt into the new corrected shape from the repeated adjustments, but typically if treatment is stopped, the spine will go back to the misalignment as the cause of the problem was never addressed by the chiropractic practitioner. Many moms I know have chronic neck or lower back pain, and all feel better after visiting a chiropractor. The problem is that they need to keep seeing the chiropractor in order to feel better.The underlying reason for chronic pain is often postural patterns (such as forward rounded shoulders from computer use) and muscle imbalances (strong quadriceps and weak hamstrings in runners or after pregnancy). That's only part of the picture though. Spine misalignment can also be caused by and exacerbated by a food allergy, such as dairy intolerance, or vitamin deficiency. The misalignments due to these factors can be as severe as from chronic postural patterns. Chiropractic adjustments will keep making the patient feel better after every adjustment, however if the cause is never addressed, the problem will keep coming back. In these examples, it would make most sense to address the cause of the illness (vitamin D deficiency or dairy intolerance) rather than the symptom (spine misalignment).A good chiropractor should be able to determine what the cause of the muscle imbalance and/or spine misalignment is, whether it is purely structural or whether there is an underlying problem such as a nutrient deficiency, a food sensitivity, a toxic overload, or a hormonal imbalance. This takes not only a good chiropractor but an inquisitive mind set as well as good doctoring skills. These are not taught in all chiropractic schools, and the good chiropractors have usually had lots of other training, for example in applied kinesiology.Hence in my view, chiropractic adjustments are useful to address some musculoskeletal issues. For sure, for acute injuries to the system. When it comes to chronic pain though, the key to getting rid of the issue is addressing the cause. A practitioner who understands how the body works will use a combination of spinal manipulation with physical therapy to address tight and weak muscles, and offer a plan on removing the cause of the ailment (postural habits, etc). This would be similar to the work of a physical therapist skilled in spinal manipulation. Often however even that is not enough. A chiropractor with a firm belief that removing spine misalignments is all that is needed to treat a person will likely keep a person with a vitamin deficiency or a food allergy in treatment for months (and be unsuccessful). I think that is plain ignorant. To treat a person, all aspects of the body have to be considered and for that a holistic practitioner acknowledging the whole body approach to healing is needed. A good chiropractor will recognize the limitation of his or her work and will refer a patient to someone else if spinal manipulation is not producing lasting results. Long term Chiropractic CareMany chiropractors think that regular spinal manipulations are necessary to stay healthy. After all, in their minds, all disease originates in the spine, and hence small misalignments should be frequently removed for optimal health. It is not clear to me whether these chiropractors actually believe this or whether they simply understand that they will have clients for life, as long as the client believes that he or she should see the chiropractor once a month for optimal health. Of course, services are not limited to adults. Many chiropractors now offer a family package and start adjusting children from infancy; For maintenance: once a month for the rest of their lives.Maintenance may be a good idea a couple times a year or after accidents to prevent the problem of "as the twig is bent, so grows the tree". However, there is more to good maintenance healthcare than adjusting. The biochemical and emotional systems also need maintenance, and typically people with more balanced chemical and emotional systems will need less adjustments to stay feeling good. A good alternative to using a chiropractor for health maintenance is using a practitioner who can address the full spectrum of healthcare and preventive maintenance, such as a Naturopathic Doctor also trained in physical medicine.In summary:The good: chiropractic manipulation can be extremely helpful in reducing or removing pain, often chronic.The bad: Typical chiropractors address only the structural component of the problem. Some will often guidance on how to stretch and strengthen affected muscle groups to help the spine in alignment. Most do not tackle the chemical/hormonal aspect of the problem which are often the hidden cause of spinal misalignments. There is also an emotional aspect of spinal alignments which is rarely addressed.The ugly: Chiropractors often set up their practice with the intention of keeping the clients coming and coming and coming. It's not uncommon to see packages of 60 to 80 visits sold upfront: not only for you - but for your entire family, whether they are ill or not!Optimal Solution: Finding a practitioner who understands the relationship between the musculoskeletal, biochemical, and emotional systems in your body, and can get to the cause of your problem. This can be a holistic chiropractor, naturopathic doctor trained in spinal manipulation, or perhaps a chiropractor who's also an acupuncturist.What truly differentiates doctors of chiropractic from any other healthcare professionals is the fact that chiropractors are the only professionals who are trained to diagnose and treat what are called spinal subluxations. The word "subluxation" comes from the Latin words meaning "somewhat or slight" (sub) and "to dislocate" (luxate). So the term 'vertebral subluxation' literally means a slight dislocation or misalignment of the bones in the spine.When a subluxation occurs, a chiropractor can correct the misaligned bone and allow it to return to its proper position. This procedure is appropriately called an adjustment, and the adjustment enables the body to heal. The chiropractic adjustment is a quick thrust applied to a vertebra for the purpose of correcting its position, movement or both. Adjustments are often accompanied by an audible release of gas that sounds like a "crack." The sound sometimes shocks people a little bit the first couple times they get adjusted, but the sensation is usually relieving. Occasionally, minor discomfort is experienced, especially if the surrounding muscles are in spasm or the patient tenses up during the chiropractic procedure. There are times when the audible "cracking" does not occur. This is often due to either significant muscle tightness or that the patient may be having a hard time relaxing during their adjustments. However, the chiropractic adjustment is still important. The leak is fixed. The wiring is fixed. Information is flowing again. To keep the wiring fixed and the information flowing, several adjustments over a course of time may be necessary, in addition to massage, physical therapy, stretching exercises, or strengthening exercises. In the chiropractic world, keeping the problem fixed and preventing its reoccurence is just as important as the initial remedy.There are actually five components that contribute to the vertebral subluxation complex (VSC).Bone Component-where the vertebra is either out of position, not moving properly, or are undergoing degeneration. This frequently leads to a narrowin of the spaces between the bones through which the nerves pass; often resulting in irritation or impingement of the nerve itself. Nervous Component-is the disruption of the normal flow of energy along the nerve fibers, causing the messages traveling along the nerves to become distorted. The result is that all of the tissues that are fed by those nerves receive distorted signals from the brain and, consequently, are not able to function normally. Over time, this can lead to a whole host of conditions, such as peptic ulcers, constipation and other organ system dysfunction.Muscular Component-since nerves control the muscles that help hold the vertebrae in place, muscles have to be considered to be an integral part of the vertebral subluxation complex. In fact, muscles both affect, and are affected by the VSC. A subluxation can irritate a nerve, the irritated nerve can cause a muscle to spasm, the spasmed muscle pulls the attached vertebrae further out of place, which then further irritates the nerve and you have a vicious cycle. It is no wonder that very few subluxations just go away by themselves.Soft Tissue Component-the VSC will also affect the surrounding tendons, ligaments, blood supply, and other tissues as the misaligned vertebrae tug and squeeze the connective tissue with tremendous force. Over time, the soft tissues can become stretched out or scarred, leaving the spine with either a permanent instability or restriction. Chemical Component-is the change in the chemistry of the body due to the VSC. Most often, the chemical changes, such as the release of a class of chemicals called "kinins," are pro-inflammatory; meaning that they increase inflammation in the affected area.These changes get progressively worse over time if they are not treated correctly, leading to chronic pain, inflammation, arthritis, muscle trigger points, the formation of bone spurs, loss of movement, as well as muscle weakness and spasm. Chiropractors have known the dangers of the vertebral subluxation complex ever since the birth of the profession. More and more scientific research is demonstrating the tremendous detrimental impact that subluxation have on the tissue of the body. In order to be truly healthy, it is vital that your nervous system be functioning free of interference from subluxations. Chiropractors are the only health professionals trained in the detection, location, and correction of the vertebral subluxation complex through chiropractic care.