From the Guidelines
There is no scientific evidence that chiropractic subluxations cause degenerative changes. The concept of chiropractic subluxations—theorized misalignments of the spine that allegedly interfere with nerve function—lacks substantial scientific support in modern medicine, as noted in studies such as 1 and 2. Major medical and scientific organizations do not recognize subluxations as a cause of disease or degeneration. While some patients report temporary pain relief from chiropractic adjustments, this is likely due to joint mobilization effects rather than correction of nerve interference, as suggested by the findings of 1 and 2. Normal age-related spinal degeneration occurs due to factors like genetics, wear and tear, activity levels, and injury history. If you're experiencing back or neck pain, consider evidence-based approaches including:
- Appropriate exercise
- Physical therapy
- Maintaining a healthy weight
- Proper ergonomics
- Medical evaluation when necessary These approaches address the actual biomechanical and physiological factors that contribute to spinal health rather than focusing on an unproven concept like subluxations. The most recent and highest quality studies, such as those published in the Annals of Internal Medicine 1, 2, support the use of evidence-based treatments for low back pain, rather than relying on unproven concepts like chiropractic subluxations. In clinical practice, it is essential to prioritize treatments that have a strong evidence base, in order to minimize morbidity, mortality, and improve quality of life for patients with back or neck pain.
From the Research
Chiropractic Subluxations and Degenerative Changes
- The relationship between chiropractic subluxations and degenerative changes is not clearly established in the provided studies.
- Some studies suggest that chiropractic subluxation theory lacks biological plausibility and validity 3.
- A study published in 2011 proposed a theoretical basis for maintenance spinal manipulative therapy, hypothesizing that routine manipulation of asymptomatic patients may retard the progression of joint degeneration 4.
- However, another study published in 2009 found no compelling evidence to indicate that chiropractic maintenance therapy effectively prevents symptoms or diseases, and associated spinal manipulation with considerable harm 5.
- A 2012 study discussed the putative mechanical features of the subluxation and three theories that form the foundation for much of chiropractic practice, but did not provide direct evidence for the relationship between subluxations and degenerative changes 6.
- A 2016 study criticized the chiropractic subluxation theory and considered any attempt to manipulate the immature spine of a neonate or a small child to correct a putative chiropractic subluxation as dangerous and unnecessary 7.
- A 2018 systematic review found no evidence that spinal manipulations/chiropractic care can be used in primary prevention or early secondary prevention in diseases other than musculoskeletal conditions 3.