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Myths busted: Is your spine “Out of Alignment?”

So many time clients with spine issues tell me the following:

“I’ve had this in the past and my spine was out, so it had to be put back in place”.
Usually, they refer to a manual therapist or chiropractor that did that for them.

I believe this needs to be addressed since it’s simply not true and it can create problems which I’ll explain.

But first let me point out that the spine is a very strong and robust structure. It cannot simply be pushed into and out of alignment by quick thrust. If that would be the case, Rugby players and MMA fighters would be in serious trouble after nearly every match.
Also, in Australia, recently some students tried to take apart an SI joint. It took them more than an hour, 2 students, a hammer and lots of sweat to do it. There’s a small chance that if that’s the case, a microsecond and a quick thrust will provide any structural change.

As a matter of fact :

“No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal, this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.” 

Why is this misconception a problem?

Saying that a client’s spine “is out” creates two problems in my opinion:

  1. dependency on the practitioner or technique used to “correct” the problem.  It’s the practitioners duty to inform the client correctly and in my opinion, and provide information and/tools to empower the client to take manage or restore their own bodies’ function. We as health professionals can and should help this process but dependency on us should be avoided.
  2. False beliefs about a structural “dysfunction” of the spine. Saying something is “out of place” and “needs to be adjusted” creates the idea that there is something wrong with the spine. The next time a client deals with pain, a logical consequence would be to think “my spine is out again”, which will result in thinking that manipulation is needed to fix the problem.

Both of these issues can be avoided simply by not using these terms anymore. Spinal manipulations definitely have clinical value but we should aim to provide information that is accurate and beneficial to the clients beliefs, aside from just treating them.

The Epidemiology of low back pain. (Hoy D1Brooks PBlyth FBuchbinder R.)

 

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