Why You NEED to Care About Your Spine

Центральная нервная система-Central nervous system
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The following is deep and steeped with big words. However, the words also include definitions, so don’t let it stop you from reading. It’s written by a mentor of mine and I wanted you to get a much fuller and deeper understanding of what chiropractic is and why you NEED to know!

If you have any questions go to www.nevadachiro.com or call 565-7474.

A Four-Dimensional Model of Vertebral Subluxation

By Christopher Kent, DC, Esq.

Vertebral subluxation represents the heart and soul of chiropractic, yet to many chiropractors, it remains a clinical conundrum. I believe that the controversy and confusion surrounding the chiropractic concept of vertebral subluxation is due, in part, to the lack of an operational definition compatible with most techniques.

A review of models of vertebral subluxation has been published elsewhere.1 However, regardless of the elegance of a theoretical model, it must be capable of being operationalized if it is to be used to develop clinical strategies. The four-dimensional model was developed as an initial step in the operational definition of vertebral subluxation. It incorporates traditional chiropractic constructs and serves as a bridge to contemporary technology.

The First Dimension

The traditional safety-pin cycle (SPC) consists of the transmission of afferent information from the tissue cell (periphery) to the brain cell (epiphery) on one side, and on the efferent side, from brain cell to tissue cell.2 In the 4-D model, the first dimension is dysafferentation, representing the afferent portion of the SPC. Aberrant afferent input to the CNS may result in qualitatively and/or quantitatively inappropriate responses to changes in the internal or external environment.1 In the contemporary jargon of the computer industry, there is “garbage in – garbage out.” Dr. Fred Barge, in his book One Cause, One Cure, stated that the cause of disease is “The body’s inability to comprehend itself and/or its environment.”3 Such “comprehension” is dependent upon interference-free afferent input.

Dye4 quoted remarks, attributed to B.J. Palmer in August 1935, which express this concept, noting the result of an adjustment: “[T]he restoration of the normal transmission of mental impulse supply from its point of origin within the brain to its point of expression in the diseased part of the body, or vice versa, that the Innate Intelligence within the brain may receive correct, accurate, exact messages as to the external conditions existing at the periphery so that it may direct either the necessary reparative forces or the necessary cooperative forces from that the tissues may be repaired or that the organ or structure may be properly directed that it may perform the normal functioning desired and indicated by the incoming message from me part without.”

The authors of the remarkable book Segmental Neuropathy, published by Canadian Memorial Chiropractic College, proposed the concept of a “neural image,” dependent upon the integrity of neural receptors and afferent pathways. This “neural image” is a representation of the organism’s perception of the external and internal environment. If afferent input is compromised, efferent response may be qualitatively and quantitatively compromised.5

The clinical implications of aberrant or suboptimal afferent go beyond short-term homeostatic regulation. Dysafferentation may result in anatomical and functional changes in the brain itself. Merzenich6 noted, “The brain was constructed to change.” This challenge to the conventional world view that the mature adult brain is stable and unchanging, the only exception being the death of brain cells, has profound implications for the chiropractor.

Gage7 stated, “Researchers first demonstrated that the central nervous systems of mammals contain some innate regenerative properties in the 1960s and 1970s, when several groups showed that axons, or main branches, of neurons in the adult brain and spinal cord can regrow to some extent after injury.” The ability of the brain to change both anatomically and functionally is known as neuroplasticity. Three types have been described:8

  • Experience-independent plasticity refers to changes which are not the result of environmental changes or influence.
  • Experience-expectant plasticity occurs when the brain uses input from the external environment to effect normal developmental changes in its structure.
  • Experience-dependent plasticity is when a modification to the internal or external environment produces change in a feature of the brain.

Holloway6 explained how the brain reconfigures itself and the implications of doing so: “Change the input, be it a behavior, a mental exercise … or a physical skill and the brain changes accordingly. Magnetic resonance imaging machines reveal the new map: different regions light up … [T]he brain can be extensively remodeled throughout the course of one’s life, without drugs, without surgery. Regions of the brain can be taught to do different tasks if need be … This sort of thing will be a part of normal future life … healing plasticity can be driven by behavior.”

The 2nd-4th Dimensions

The remaining three dimensions represent the efferent portion of the safety-pin cycle. Each component may be reliably measured. These measurements provide objective evidence concerning manifestations of vertebral subluxation. The three components are:

  • Dyskinesia. Dyskinesia refers to distortion or impairment of voluntary movement.9 Spinal motion may be reliably measured using inclinometry.10 Alterations in regional ranges of motion are associated with vertebral subluxation.11
  • Dysponesis. Dysponesis is abnormal involuntary muscle activity. Dysponesis refers to a reversible physiopathologic state, consisting of errors in energy expenditure which are capable of producing functional disorders. Dysponesis consists mainly of covert errors in action potential output from the motor and premotor areas of the cortex and the consequences of that output. These neurophysiological reactions may result from responses to environmental events, bodily sensations, and emotions. The resulting aberrant muscle activity may be evaluated using surface electrode techniques.12 Typically, static surface electromyography (SMEG) with axial loading is used to evaluate innate responses to gravitational stress.13
  • Dysautronomia. The autonomic nervous system regulates the actions of organs, glands, and blood vessels. Acquired dysautonomia may be associated with a broad array of functional abnormalities.14-19 Autonomic dystonia may be evaluated by measuring skin temperature differentials.20 Uematsu, et al., determined normative values for skin temperature differences based upon asymptomatic “normal” individuals. The authors stated, “These values can be used as a standard in assessment of sympathetic nerve function, and the degree of asymmetry is a quantifiable indicator of dysfunction … Deviations from the normal values will allow suspicion of neurological pathology to be quantitated and therefore can improve assessment and lead to proper clinical management.”21 Skin temperature differentials are associated with vertebral subluxation.22 Autonomic tone and balance may also be evaluated by measuring heart rate variability.23

This four-dimensional model may be used with any technique which has, as its objective, the detection, management or correction of vertebral subluxation. Correction or reduction of vertebral subluxation facilitates the restoration of proper tone throughout the nervous system. Alterations in the tone of the somatic system may be objectively evaluated using surface EMG. Altered autonomic tone may be evaluated using skin temperature measurements. Changes in ranges of motion may be measured to assess dyskinesia. Such objective assessments have the potential to make chiropractic the dominant strategy of 21st century health care.


  1. Kent C. Models of vertebral subluxation: a review. Journal of Vertebral Subluxation Research, 1996;1(1):11.
  2. Stephenson RW. Chiropractic Textbook. The Palmer School of Chiropractic: Davenport, IA. 1948 edition, page 9.
  3. Barge FH. One Cause, One Cure. LaCrosse, WI, 1990.
  4. Dye AA. The Evolution of Chiropractic. Published by A.A. Dye, DC: Philadelphia, 1939, page 266.
  5. Segmental Neuropathy. Canadian Memorial Chiropractic College. Toronto, Ontario. No date. Presumed to be written in the 1960s primarily by H.M. Himes and A. Peterson.
  6. Holloway M. “The Mutable Brain.” Scientific American, 2002;289(3):79.
  7. Gage FH. “Brain, Repair Yourself.” Scientific American, 2002;289(3):47.Neuroplasticity. PowerPoint lecture. www.snl.salk.edu/~nikoosh/Lecture_5.ppt
  8. Dorland’s Pocket Medical Dictionary., 25th Edition. WB Saunders Company, 1995.
  9. Saur PM, Ensink FB, Frese K, et al. Lumbar range of motion: reliability and validity of the inclinometer technique in the clinical measurement of trunk flexibility. Spine, 1996;21(11):1332.
  10. Blunt KL, Gatterman MI, Bereznick DE. Kinesiology: An Essential Approach Toward Understanding the Chiropractic Subluxation. Chapter 11 in Gatterman MI (ed): Foundations of Chiropractic Subluxation. Mosby: St. Louis, MO, 1995.
  11. Whatmore GB, Kohi DR. Dysponesis: a neurophysiologic factor in functional disorders. Behav Sci, 1968;13(2):102.
  12. Kent C. Surface electromyography in the assessment of changes in paraspinal muscle activity associated with vertebral subluxation: a review. Journal of Vertebral Subluxation Research, 1997;1(3):15.
  13. Backonja M-M. Reflex sympathetic dystrophy/sympathetically mediated pain/causalgia: the syndrome of neuropathic pain with dysautonomia. Seminars in Neurology, 1994;14(3):263.
  14. Goldstein DS, Holmes C, Cannon III RO, et al. Sympathetic cardioneuropathy in dysautonomias. New Engl J Med, 1997;336(10):696.
  15. Vassallo M, Camilleri M, Caron BL, Low PA. Gastrointestinal motor dysfunction in acquired selective cholinergic dysautonomia associated with infectious mononucleosis. Gastroenterology, 1991;100(1):252.
  16. Baron R, Engler F. Postganglionic cholinergic dysautonomia with incomplete recovery: a clinical, neurophysiological and immunological case study. J Neurol, 1996;243:18.
  17. Soares JLD. Disautonomias. Acta Medica Portuguesa, 1995;8(7- 8):425. Written in Portuguese. English abstract.
  18. Stryes KS. The phenomenon of dysautonomia and mitral valve prolapse. J Am Acad Nurse Practitioners, 1994;6(1):11.
  19. Korr IM. The Collected Papers of Irvin M. Korr. American Academy of Osteopathy: Indianapolis, IN, 1979.
  20. Uematsu S, Edwin DH, Jankel ER, et al. Quantification of thermal asymmetry. J Neurosurg, 1988;69:552.
  21. Kent C, Gentempo P. “Instrumentation and Imaging in Chiropractic: A Centennial Retrospective.” Today’s Chiropractic, 1995;24(1):32.
  22. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Circulation, 1996;93:1043-1065.
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Solutions for Back and Leg Pain

Stages of Spinal Disc Herniation
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Back and Leg Pain (Lumbar Radiculopathy)  as a Result of Disc Herniation and the Long Term Effect of Chiropractic Care


The term “herniated disc” has been called many things from a slipped disc to a bulging disc. For a doctor who specializes in disc problems, the term is critical because it tells him/her how to create a prognosis and subsequent treatment plan for a patient. To clarify the disc issue, a herniated disc is where a disc tears and the internal material of the disc, called the nucleus pulposis, extends through that tear. It is always results from trauma or an accident. A bulging disc is a degenerative “wear and tear” phenomenon where the internal material or nucleus pulposis does not extend through the disc because there has been no tear, but the walls of the disc have been thinned from degeneration and the internal disc material creates pressure with thinned external walls. The disc itself “spreads out” or bulges.

There are various forms and degrees of disc issues, but the biggest concern of the specialist is whether nerves are being affected that can cause significant pain or other problems. The problem exists when the disc, as a result of a herniation or bulge, is touching or compressing those neurological elements, which is comprised of either the spinal cord, the nerve root (a nerve the extends from the spinal cord) or the covering of the nerves, called the thecal sac.

With regard to the structure that we have just discussed, the doctor must wonder what the herniation of the neurological element has caused. In this scenario, there are 2 possible problems, the spinal cord and nerve root. If the disc has compromised the spinal cord, it is called a myelopathy (my-e-lo-pathy). You have a compression of the spinal cord and problems with your arms or legs. An immediate visit to the neurosurgeon is warranted for a surgical consultation. The second problem is when the disc is effecting the spinal nerve root, called a radiculopathy. It is a very common problem. A doctor of chiropractic experienced in treating radiculopathy has to determine if there is enough room between the disc and the nerve in order to determine if a surgical consultation is warranted or if he/she can safely treat you. This is done by a thorough clinical examination and in many cases, an MRI is required to make a final diagnosis. Most patients do not need a surgical consultation and can be safely treated by an experienced chiropractor.

While herniations can occur anywhere, it was reported in the US Chiropractic Directory in 2010 that 95% occur in the lower back, who stated “The highest prevalence of herniated lumbar discs is among people aged 30–50 years, with a male to female ratio of 2:1. In people aged 25–55 years, about 95% of herniated discs occur at the lower lumbar spine (L4/5 and L5/S1 level); disc herniation above this level is more common in people aged over 55 years.”

It was reported by Aspegren et al. (2009) that 80% of the chiropractic patients studied with both neck and low back (cervical and lumbar) disc herniations had a good clinical outcome with post-care visual analog scores under 2 [0 to 10 with 0 being no pain and 10 being the worst pain imaginable] and resolution of abnormal clinical examination findings. Anatomically, after repeat MRI scans, 63% of the patients studied revealed a reduced size or completely resorbed disc herniation. A study by Murphy, Hurwitz, and McGovern (2009) focused only on low back (lumbar) disc herniations and concluded that, “Nearly 90% of patients reported their outcome to be either ‘excellent’ or ‘good’…clinically meaningful improvement in pain intensity was seen in 74% of patients (p. 729).” The researchers also concluded that the improvements from chiropractic care was maintained for 14 1/2 months, the length of the study, indicating this isn’t a temporary, but a long-term solution. It was reported by BenEliyahu (1996) that 78% percent of the low back-lumbar disc herniation patients were able to return to work in their pre-disability occupations, which is the result of the 90% of all low back-lumbar disc herniation patients getting better with chiropractic care as discussed above.

These are the reasons that chiropractic has been, and needs to be, considered for the primary care for low back-lumbar disc herniations with resultant pain in the back or legs. This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for herniated discs and low back or leg pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.


1. http://www.uschirodirectory.com/index.php/patient-information/item/242-cervical-and-lumbar-disc-herniations-and-chiropractic-care
2. Aspegren, D., Enebo, B. A., Miller, M., White, L., Akuthota, V., Hyde, T. E., & Cox, J. M. (2009). Functional scores and subjective responses of injured workers with back or neck pain treated with chiropractic care in an integrative program: A retrospective analysis of 100 cases. Journal Manipulative Physiological Therapy 32(9), 765-771.
3. BenEliyahu, D. J. (1996). Magnetic resonance imaging and clinical follow-up: Study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. Journal Manipulative Physiological Therapy, 19(9), 597-606.
4. Murphy, D. R., Hurwitz, E. L., & McGovern, E. E. (2009). A nonsurgical approach to the management of patients with lumbar radiculopathy secondary to herniated disk: A prospective observational cohort study with follow-up. Journal Manipulative Physiological Therapy, (32)9, 723-733.

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Forward Head Posture Facts

spinal cord.
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As a continuation of forward head posture theme, I wanted to share a couple of other vital research tibits you need to be aware of:

1. “For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.” (Kapandji, Physiology of the Joints, Volume 3)

2. “Loss of the cervical curve stretches the spinal cord 5-7 cm and causes disease.” (Dr. Alf Breig, neurosurgeon and Nobel Prize recipient)

I regularly see patients come in the door with 3-4 inches of forward head posture and they don’t even realize it. They are walking around carrying an average of 30-40lbs of additional head weight.

Equally disturbing is that 5-7cm equals 2-3 inches. Imagine stretching the spinal cord 2 inches. It is devastating situation. The impact of that stretch primarily occurs at C1, which has a control effect on the entire body.

That is how a seemingly simply thing such as forward head posture can have an effect on your entire health.

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Forward Head Posture…The Missing Link to Health!

Many people are unaware of the consequences from neglecting the spine. It requires attention. If you lack the proper spinal care, you will pay the price.

Look at just a few of the things that forward head posture creates:

According to Rene Cailliet MD, director of the Department of Physical Medicine and Rehabilitation at the University of Southern California, forward head posture can add up to 30 pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. FHP results in loss of vital capacity of the lungs by as much as 30 percent. This shortness of breath can lead to heart and blood vascular disease. The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP.

It causes an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body’s pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production.

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Do You Know the Importance of Spinal Alignment

Many people are completely unaware of the importance of spinal alignment. As a result, alignment problems affect what would normally be thought of as unrelated problems. But there is so much more to the story.

Did you know this vital point? 90% of the stimulation and nutrition to the brain is generated by the movement of the spine,” says Dr. Roger Sperry, Nobel Prize recipient for brain research.

Dr. Sperry demonstrated that 90 percent of the energy output of the brain is used in relating the physical body to gravity. Only 10 percent has to do with thinking, metabolism, and healing, so when you have forward head posture, your brain will rob energy from your thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing.

So what is normal spinal alignment? When you look at the front of a person there shoulders and hips should be level. There should be a lordotic (to the front) curve in the neck and low back. If these are present forward head posture will be present and problems will develop.

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