From the Guidelines
Subluxations, as defined in chiropractic theory, are not supported by scientific evidence. The concept of chiropractic subluxations—proposed misalignments of the spine that allegedly interfere with nerve function and cause disease—lacks substantiation through rigorous scientific methods. Despite decades of chiropractic practice, there are no reliable clinical trials, peer-reviewed publications, or animal models that conclusively demonstrate the existence of subluxations as described by traditional chiropractic theory. Modern medical imaging techniques like X-rays and MRIs have failed to consistently identify these proposed misalignments in ways that correlate with symptoms or disease. While spinal manipulation therapy may provide relief for certain conditions like some types of back pain, the underlying theoretical framework of subluxations as the cause of disease or dysfunction remains unsupported by current scientific understanding, as noted in studies such as 1 and 1. This disconnect between theory and evidence has led many modern chiropractors to move away from the subluxation model toward more evidence-based approaches to care.
Some key points to consider include:
- The lack of high-quality evidence supporting the existence of subluxations as defined by chiropractic theory.
- The failure of modern medical imaging to consistently identify subluxations in a way that correlates with symptoms or disease.
- The movement within the chiropractic community toward more evidence-based practices, as indicated by guidelines and studies published in reputable journals like the Annals of Internal Medicine, such as those referenced in 1, 1, 1, and 1.
- The importance of prioritizing evidence-based treatments for conditions like back pain, which may include spinal manipulation therapy but should be grounded in scientific evidence rather than unproven theories of subluxations.
Overall, the scientific consensus, as reflected in recent and high-quality studies like those cited, does not support the concept of subluxations as a valid medical diagnosis or a basis for treatment. Therefore, it is recommended to approach chiropractic care with a critical perspective, focusing on evidence-based treatments for specific conditions rather than unsubstantiated theories.
From the Research
Existence of Subluxations
- The concept of subluxations is a fundamental idea in chiropractic treatment, but its existence is not supported by scientific evidence 2, 3, 4.
- Studies have shown that the core concepts of chiropractic, including subluxation and spinal manipulation, are not based on sound science 3.
- The epidemiological examination of the subluxation construct using Hill's criteria of causation found that the criteria for causation remain unfulfilled, and there is a significant lack of evidence to support the concept of subluxation 4.
Clinical Trials and Peer-Reviewed Publications
- Clinical trials and peer-reviewed publications have not provided sufficient evidence to support the existence of subluxations 2, 3, 4.
- A narrative review of selected articles from the published chiropractic literature found that chiropractic is rooted in mystical concepts and that the concepts of chiropractic are not based on solid science 3.
- A systematic review of the literature on chiropractic management of patients with chronic musculoskeletal pain found that recommendations for nonpharmacological treatments, including spinal manipulation/mobilization, were made, but the review did not provide evidence for the existence of subluxations 5.
Animal Models
- There is no evidence to suggest that animal models have been used to support the existence of subluxations.
- The provided studies do not mention the use of animal models to investigate the concept of subluxations.