Talk:Vertebral subluxation

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 18 August 2020 and 12 December 2020. Further details are available on the course page. Peer reviewers: Plutoandcosmo.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 12:20, 17 January 2022 (UTC)[reply]

Chiropractors and Vaccination: A Historical Perspective

I just restored reference to this source, as it appears to be on-topic, used appropriately, and reliable to the topic at hand. Is there any reason why this assessment is in error? - 2/0 (cont.) 22:49, 23 September 2009 (UTC)[reply]

Deletion of legitimate EL

Please stop deleting the Chirobase link. You have no legitimate reason for doing so. If you're going to do that, you should delete the other links as well, according to your arguments on other pages. This is total BS and nonsensical. I'm really beginning to wonder if you haven't lent your account to Levine2112, as this behavior is more like his than your usual behavior. I expect better from you. -- Brangifer (talk) 23:00, 3 December 2009 (UTC)[reply]

I agree that the other external links should probably be removed. DigitalC (talk) 14:01, 4 December 2009 (UTC)[reply]

Now my suspicions of you letting Levine2112 use your account are strengthened. This is exactly his tactic. He would do anything, including ripping valuable pro-chiropractic content out of articles, if it achieved the end of removing even a small bit of criticism. No, that tactic won't work. -- Brangifer (talk) 21:53, 4 December 2009 (UTC)[reply]

I'm sure that you're both carefully watching the clock and counting your reverts, but you could still be smacked for violating the intent if not the letter of 3RR. (With a little AGF on the side.) Is there a particular page that sums up the pro/con arguments for that EL? AndroidCat (talk) 15:10, 5 December 2009 (UTC)[reply]

A very late reply here, but Lancet recommends Chirobase as "an excellent resource":

"One may not agree with the spirit of the site, but it is still an excellent resource on this controversial discipline." Click of the week: Closing in on chiropractic. The Lancet, Volume 355, Issue 9213, Page 1471, 22 April 2000.

That's a pretty good recommendation. -- Brangifer (talk) 05:58, 17 February 2010 (UTC)[reply]

Another late response. Chirobase is basically the blog of Dr. Stephen Barrett. We don't typically use blogs in external links. DigitalC (talk) 15:09, 21 February 2010 (UTC)[reply]

??? I suspect you're searching for some other word to describe it, because it hasn't the slightest resemblance to a blog. It's the internet's largest database of chiropractic material from a skeptical angle (but with lots of neutral and positive material), whether it's scientific research, original articles, reprints of articles, government reports, historical sources, etc.. It, like all of his websites devoted to special topics, is built up in the same manner as Quackwatch, which isn't a blog either. He simply doesn't have a blog of any kind. He wouldn't have any interest in or patience for maintaining a blog. He's not that kind of person. Numerous individuals help him maintain and develop it. Even if it were a blog, when it comes with such a recommendation it would become usable in more situations than a blog without such a recommendation, but that's a moot point here. It's simply not anything like a blog.

The current chiropractic editor is second-generation chiropractor Samuel Homola, DC. Previously it was third-generation chiropractor Charles E. Duvall, Jr, DC, a co-founder of the National Association for Chiropractic Medicine (NACM). In 2002, when the mixed DVA committee was considering whether to give chiropractors access to VA hospitals, he is credited with thwarting the attempts by the WCA and ICA to force a straight-only form of access to VA hospitals. Here's one source that very briefly mentions his role. At the time I actually wrote to the secretary for the committee and she sent me a huge packet of material which they were using. It was very interesting to follow along in the process. He successfully presented a relatively unknown scientific face of the profession to the DVA committee, and thus changed opinion in favor of allowing chiropractors to gain access to the VA hospital system. At the time (2002), mainstream medicine only saw the straight face, since straights did (and still do) dominate the profession (by influence, not numbers).

Interestingly, Daryl Wills, the president of the ACA, was alarmed [1] that Duvall had been appointed to the DVA committee, and named him, the ICA, the WCA, and the Federation of Straight Chiropractors, as divisive influences, but it turned out that without Duvall, chiropractic would likely have completely failed to gain any access at all. The MD, DO, and PT members of the committee could understand him, while the straights used their esoteric (understood only by chiropractors) language and terminology, with their odd ideas of fictional anatomy. They turned off the committee, but Duvall revealed that there was a legitimate way to use spinal manipulation that wasn't related to a belief in fictional "vertebral subluxations". He used scientific terminology and showed that at least some chiropractors could be trusted to practice in an ethical manner. That broke down their resistance and the bill was passed.

Chirobase, Barrett, and the NACM have always supported the use of scientifically validated forms of chiropractic care. Their opposition has always been focused on unethical, unscientific, "deviant and questionable chiropractic practices", not the chiropractors who practice in a scientific and ethical manner. They are the best friends of the profession. Without such critics the profession would still be an exclusively straight profession, without a drop of credibility in the scientific and medical community. -- Brangifer (talk) 15:36, 21 February 2010 (UTC)[reply]

Even if it were a blog (which it isn't, it's a RS) it would still pass muster as a expert's blog. Verbal chat 15:00, 24 February 2010 (UTC)[reply]

Study pans chiropractic's "subluxation" concept

Four scholarly chiropractors have concluded that epidemiologic evidence does not support chiropractic's most fundamental theory. Since its inception, the vast majority of chiropractors have postulated that "subluxations" (misalignments) are the cause or underlying cause of ill health and can be corrected with spinal "adjustments."

After searching the scientific literature, the chiropractic authors concluded:

"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." - Mirtz TA et al. An epidemiological examination of the subluxation construct using Hill's criteria of causation." Chiropractic & Osteopathy 2009, 17:13, 2009

This new source may well provide some interesting content. It is also evidence that modern reform chiropractors are making their mark in the chiropractic literature. Brangifer (talk) 06:16, 12 December 2009 (UTC)[reply]

First, to label these four authors as four "scholarly chiropractors" - is absolutley false. Not only are they not scholarly, their research falls under "Integrity and Misconduct in Academic Research", a crime if found guilty. They are nothing but what Academic Scholars would call "Straw Men Fallacy" - a few people, 4 in this case, form a biased opinion, and then make themselves expert on this topic. The people that respect these four DCs, are themselves just like them, biased people ignorant of the facts. Their articles falls under what D. G. Altman calls "Scandal Of Poor Medical Research". BMJ. 1994 January 29; 308(6924): 283–284.

In addition, I will just site one article, and can furnish at least ten per vertebral segment, Believers in the VSC, and Chiropractic Philosophy - as well as Innate Intelligence, do not waste time trying to defend the lies from the pitts of Hell from Homola, Barrett, Mertz, Seaman and the remaing lunatics like them. I have a 60 Slide FREE powerpoint that cite over 120 Studies from Scientific Journals for every single Vertbral Subluxation and Corresponding Visceral Disease. These four authors know about them, and purposely exclude citing these studies. That's academically called Scandal of Poor Medical Research. In addition, they cite only supporting articles from one another. Stephen Barrett should be living in a Insane Assylum and not writing against Chiropractic. Chiropractic Adjusting cant help him, because Adjusting enhances brain function, he evidently doesnt have one. Below is one of 24 Articles you can get for from from [email protected] - the other 23, just like this one, for each vertebra. The Authors are David C. Parish, MD, MPH, Jerrold A. Clark, MD, Steven M. Liebowitz, MD and W. Claire Hicks, MD Sudden Death In RA From Vertical Subluxation Of The Odontoid Process, JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 82, NO. 4

A second article is Kauppi M, Sakaguchi M, Konttinen YT, et al. Pathogenetic mechanism and prevalence of the stable atlantoaxial subluxation in rheumatoid arthritis. J Rheumatol 1996; 23:831. (I can supply 100 top articles for this point alone)

These 4 authors are either a plant from the AMA to write these false, erroneous, misleading, untrue articles, or their head was buried in sand when the read this literature. At a talk I gave for one hour, at Palmer South in FLA in Jan, 2009, I said this from the podium about these four authors, one of them was in the audience, and the next week I got a letter from the College President, banning me from speaking these truths against these four authors.

Homola, surrender your DC degree back to the school you got it from. You are not worthy of the initials DC anywhere in print where your name appears. You are a disgrace to the Chiropractic Profession, an enemy of truth. — Preceding unsigned comment added by 64.134.225.84 (talk) 22:48, 22 October 2012 (UTC)[reply]

UK Governing Body axes subluxation

The article needs substantial revision:

"Claims of Subluxation Causing Disease Prohibited in Great Britain" "The General Chiropractic Council (GCC), a UK-wide statutory body with regulatory powers, has published a new position related to subluxation and the claims made by Doctors of Chiropractic." http://www.chiroaccess.com/News/Claims-of-Subluxation-Causing-Disease-Prohibited-in-Great-Britain.aspx?id=0000165 Dogweather (talk) 08:33, 6 June 2010 (UTC)[reply]

This certainly needs to be incorporated into the article (and presumably also into the main chiropractic article). Brunton (talk) 12:28, 10 June 2010 (UTC)[reply]

I've added it to the "Definitions and current official status" section. The last paragraph of the lead probably also needs amendment to take it into account. Brunton (talk) 06:55, 12 June 2010 (UTC)[reply]

Real orthopaedic subluxations versus imaginary chiropractic subluxations

An interesting article from Focus on Alternative and Complementary Therapies, an official journal of the Royal Pharmaceutical Society:

Homola, S. "Real orthopaedic subluxations versus imaginary chiropractic subluxations". Focus on Alternative and Complementary Therapies, Volume 15, Issue 4, pages 284–287, December 2010. Article first published online: 25 NOV 2010. DOI: 10.1111/j.2042-7166.2010.01053.x Royal Pharmaceutical Society

Brangifer (talk) 16:24, 29 May 2011 (UTC)[reply]

Reverts without concise justification

2 editors have recently reverted my edits to subluxation and deleted peer-reviewed research that written in a NPOV manner. Please discuss what edits you specifically have a problem with as the edits as I written were factual and cited. DVMt (talk) 08:00, 19 November 2011 (UTC).[reply]

The issue DVMt, is that you have completely overhauled the text of a highly controversial article without any discussion first. My recommendation would be to discuss changes, one source/sentence in the article at a time. This is how all prgress at the chiropractic article has been made, with slow and meaningful discussion over the value and accuracy of the proposed changes. I can tell you that at fist glance, I would also have reverted changes to the text until there had been thorough discussion. As a single example: you changed

"Subluxation is a term used by some chiropractors..." to "subluxation, or joint dysfunction, is a term used by chiropractors..."

I am a chiropractor, I know lots of chiropractors (in Canada), very few of us use the term subluxation, and it certainly is not the same a simple biomechanical joint dysfuntion. Subluxation is joint dysfunction with the addition of a vitalistic/metaphysical belief system. Thus, I would also want to see a discussion of this proposed change. Moreover, your changes here have removed some reputable sources. Usually, to avoid this kind of edit war, good sources and text can be added with limited discussion, but removal of existing sources, which usually required extensive discussion in the first place to include, is asking for trouble unless you have outlined very clearly in the talk page first and it is not controversial.

Please consider discussion of your proposed changes if you think they can add value to the article. All changes must be supported by secondary sources....primary sources have value, but until they are put in the context of a systematic review it is too easy to cherry-pick those sources that support one single perspective. Secondary sources 'help' us avoid this. Puhlaa (talk) 13:20, 19 November 2011 (UTC)[reply]

I was not aware that the changes were controversial. My first edit made over a week ago was not challenged. The source I used supports the material. Looking briefly at your national association, the term subluxation was also (http://www.chiropracticcanada.ca/en-us/FactsFAQs.aspx#984) in a manner which is congruent with the added text ("Subluxation" is a term used to describe a problem with a spinal joint. The World Health Organization defines a "subluxation" as a functional problem related to a joint and the structures associated with the joint such as the muscles, tendons and nerves. Dysfunction can present itself in various ways such as pain, inflammation and restricted movement of the joint. Some types of dysfunction, such as sprain, will not appear on an x-ray. Chiropractors are trained to identify dysfunction that does not appear on imaging through the use of manual examination and non-imaging diagnostic tests.). I do not believe I deleted sources, but if that's the case, we can review them and make sure that have not been supplanted with more recent research. I have read WPMEDRS and if secondary or tertiary sources are available I will most definitely use them. However, PS are justified if secondary and tert are not available which was the case. I look forward to collaborating with you in improving Wikipedia. DVMt (talk) 16:00, 19 November 2011 (UTC)[reply]

Two points:

1. Your use of the WHO is a bit careless by failing to account for the fact that the WHO definition of a medical subluxation (in contrast to a chiropractic vertebral subluxation) is the same as other definitions, and only relates to the position of the joint, whereas the chiropractic definition describes other things, often irregardless of the position of the joint (often the joint is in a totally normal position):

Footnote 1 on Page 4: "This [chiropractic] definition is different from the current medical definition, in which subluxation is a significant structural displacement, and therefore visible on static imaging studies." http://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf

The WHO glossary provides chiropractic terminology and understandings, some of which are disputed by mainstream medicine. They are thus the opinion of chiropractic and nothing more.

2. You misunderstand our policy about using primary sources. We are not allowed to just use them when other sources are lacking. On the contrary. To do so is OR.

This relates (in principle) to a problem with recentism. By using primary sources ("recent", compared to secondary sources) which are not directly mentioned in secondary sources, we are violating the spirit of no original research. Yes, primary sources are occasionally allowed (especially in biographies), but not very often in biomedical subjects, and they should already be mentioned in secondary sources, and for MEDRS matters those sources should be literature reviews, not single studies. Wikipedia is not supposed to be the first place that mentions a study. That makes Wikipedia the publisher of OR and a secondary source, and that's not okay at all. We're not supposed to do that. If a primary study is mentioned in a secondary MEDRS, then we can ALSO include the primary study. Until then recentism should be avoided, since the large majority of primary studies often don't pan out well in the future anyway. (They are usually shown to be unimportant, poor research quality, outright wrong, or even fraudulent, as with the Andrew Wakefield scandal.) Only those that are good enough and accurate enough to stand the test of time (not "recent") should be mentioned here, and whether they pass that test is proven by whether they are mentioned in secondary sources. -- Brangifer (talk) 18:53, 20 November 2011 (UTC)[reply]

Changes to Lead Discussion

Bullrangifer and ALf have reverted my previous changes to the lead on VS. Here is my proposed lead

Subluxation or "joint dysfunction" is a term used by chiropractors to describe biomechanically restricted/fixated of the joints of the spine and extremities. It is this "manipulable lesion" that is the target of their main clinical intervention, spinal manipulation. Chiropractic medicine defines joint dysfunction/subluxation as a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.[1]

Cardinal biomechanical features of chiropractic joint dysfunction/subluxation is fixation/restriction and misalignment[2]

Chiropractic uniquely asserts that joint subluxation/dysfunction disrupts proper neurological function and that joint manipulation can restore proper biomechanical and neurological integrity[3]

Chiropractic's theory subluxation/joint dysfunction and it's putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895 due its vitalistic and metaphysical origins which used vitalistic terminology that was not amenable to scientific investigation. Far reaching claims and lack of scientific evidence supporting spinal joint dysfunction as a cause of disease has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum disorders that are not related to the neuromusculoskeletal system.[4]

Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction/subluxation[5] the manipulable lesion remains inextricably linked to the profession as the rationale behind their approach to[manual therapy and health care.

What specific statements, wording or sources do the editors disagree with? DVMt (talk) 16:04, 19 November 2011 (UTC)[reply]

I'm happy to discuss these changes individually, but there are two points of procedure I would like to suggest: (1) the lead should reflect the article contents, so if you're going to want to change around the article contents also, I think we should start there and change the lead to reflect the contents as new contents are added, and (2) could you please put the references in your suggested changes so that everyone can look at them? I'm assuming that they're the same ones used before, but I don't know for sure, and it's a lot of work to go picking through the history to find them, even assuming that they are. The easiest way to do this and still have useful material to paste in is to put a colon in the first <:ref> tag for each one, e.g.<:ref>blah, blah, blah, example</ref> and then we don't need a reflist template but we can see where the information comes from.

I have some thoughts on your lead, but I can't say anything specific about it until I see the refs, except for the fact that the sentence that begins "Cardinal biomechanical..." doesn't make any sense to me whatsoever, and the numbers of the verbs don't match the nouns, and when I looked last night at what it was cited to, I didn't see anything resembling it in there. But enough of that, can we see the references you want to source these statements to?— alf.laylah.wa.laylah (talk) 16:52, 19 November 2011 (UTC)[reply]

Thank you for your reply. I am learning WP procedure, so you'll have to excuse me if I make an honest mistake like that. I'm having a bit of problems with proper reference formatting, a little help would go a long way in this regard. Feel free to instruct to discuss with me on my TALK page if necessary. Here is the text I had written are the references I provided. I attempted to find secondary and tertiary sources, but with more recent evidence, reviews or textbooks aren't always available. The source are however from peer-reviewed journals and are verifiable. I also believe that I accurately summarized the sources and used NPOV language. Your feedback is appreciated.

Subluxation or "joint dysfunction" is a term used by chiropractors to describe biomechanically restricted/fixated of the joints of the spine and extremities. It is this "manipulable lesion" that is the target of their main clinical intervention, spinal manipulation. Chiropractic medicine defines joint dysfunction/subluxation as a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.<:ref name="WHO_guidelines"/> Cardinal biomechanical features of chiropractic joint dysfunction/subluxation is fixation/restriction and misalignment<:ref name=Introducing the external link model for studying spine fixation and misalignment: part 2, Biomechanical features.>Henderson CN, Cramer GD, Zhang Q, DeVocht JW, Fournier JT. http://www.ncbi.nlm.nih.gov/pubmed/17509437</ref> Chiropractic uniquely asserts that joint subluxation/dysfunction disrupts proper neurological function and that joint manipulation can restore proper biomechanical and neurological integrity<:ref>http://www.chirocolleges.org/paradigm_scope_practice.html</ref> Chiropractic's theory subluxation/joint dysfunction and it's putative role in non-musculoskeletal disease has been a source of controversy since its inception in 1895 due its vitalistic and metaphysical origins which used vitalistic terminology that was not amenable to scientific investigation. Far reaching claims and lack of scientific evidence supporting spinal joint dysfunction as a cause of disease has led to a critical evaluation of a central tenet of chiropractic and the appropriateness of the profession's role in treating a broad spectrum disorders that are not related to the neuromusculoskeletal system.<:ref name=How can chiropractic become a respected mainstream profession? The example of podiatry.> Murphy DR, Schneider MJ, Seaman DR, Perle SM, Nelson CF.http://www.ncbi.nlm.nih.gov/pubmed/18759966</ref> Although there is external and internal debate within the chiropractic profession regarding the clinical significance of joint dysfunction/subluxation<:ref name=The prevalence of the term subluxation in North American English-Language Doctor of chiropractic programs.>Mirtz TA, Perle SM.http://www.ncbi.nlm.nih.gov/pubmed/21682859</ref> the manipulable lesion remains inextricably linked to the profession as the rationale behind their approach to[manual therapy and health care.

DVMt (talk) 17:33, 19 November 2011 (UTC)[reply]

OK, thanks. I changed the formatting of the refs here so that they're visible; this is my own system for doing this, but I think it's useful. Please feel free to revert if you don't agree. I'll look at them later today in detail. Have you thought about what I said about saving discussion on the lead until after discussions of changes to the body of the article? I think that that'll save time in the long run.— alf.laylah.wa.laylah (talk) 17:47, 19 November 2011 (UTC)[reply]

Oh, PS: I really appreciate the fact that you're sticking around to learn the culture of WP and to discuss things. It takes a while, but it really does work. Welcome to the project!— alf.laylah.wa.laylah (talk) 17:48, 19 November 2011 (UTC)[reply]

DVMt, are these all the same references that were used previously? When I make changes in controversial articles, I like to outline everything easy for other editors to review;

For example:

Proposed change #1

Original text (or original source): "Vertebral subluxation is a term that is commonly used by some chiropractors (specifically, "straight chiropractors") to describe signs and symptoms of the spinal column. Those chiropractors who assert this concept also add a visceral component to the definition. Chiropractors maintain that a vertebral subluxation complex is a dysfunctional biomechanical spinal segment (lesion) the same as medical doctors do, but additionally assert that the dysfunction actively alters neurological function, which in turn, is believed to lead to neuromusculoskeletal and visceral disorders. The WHO acknowledges this difference between the medical and chiropractic definitions of a subluxation. Medical doctors only refer to "significant structural displacements" as subluxations, whereas chiropractors suggest that a dysfunctional segment, whether displaced significantly or not, should be referred to as a subluxation.^[1]

Proposed new text (or proposed new source): "'Subluxation or "joint dysfunction"' is a term used by chiropractors to describe biomechanically restricted/fixated of the joints of the spine and extremities. It is this "manipulable lesion" that is the target of their main clinical intervention, spinal manipulation. Chiropractic medicine defines joint dysfunction/subluxation as a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.^[1]"

Reasons why proposed text is more appropriate than original text: (list policies, accuracy of text, quality of source, etc)

Puhlaa (talk) 17:58, 19 November 2011 (UTC)[reply]

I think that this is an excellent system. Thanks for suggesting it.— alf.laylah.wa.laylah (talk) 18:08, 19 November 2011 (UTC)[reply]

I agree I like this system and will use it in future edits. Puhlaa, the references are the same, the wording had slightly changed. Please look at my revision and let me know what wording you think could be improved and I'm sure we can come up with something in the middle. DVMt (talk) 18:50, 19 November 2011 (UTC)[reply]

EXCELLENT discussion! This is how things are supposed to be, and thanks to DVMt for sticking around. We would love to work with you. The main problems in the beginning related more to edit warring and violation of BRD. When someone reverts you, work it out on the talk page.

Now to the main thing that's relevant now.....this discussion should wait since changes to the article body content must precede changes to the lead, unless small tweaks in the lead can be justified based on current content. That happens sometimes, but the changes are usually small and should be discussed in detail.

Keep in mind that each word and phrase in the lead may be the consensus version arrived at after long battles. Sometimes changing a single word takes six months and thousands of bytes of talk page discussion involving dozens of editors and the use of RfCs and dispute resolution. Sometimes it has involved the blocking and banning of editors! So even changing one word of a consensus version can be a serious matter that offends the editors who worked for those changes. There must be VERY good reasons for making such changes.

So let's stop this thread and only take it up again when it's warranted. When we're ready for it again, then start in a new thread further down. That will keep the talk page chronological. -- Brangifer (talk) 18:21, 20 November 2011 (UTC)[reply]

Thanks for your comments and input BullRangifer and your suggestion was duly noted. The body of the article does in fact contain the same sources, and I simply added the Cramer study which I will insert into the body. We already have two other editors including myself who are going to look at the revisions and see what specific problems they might have with the content or wording. Alf explained his rationale behind his reversions with specific commentary and we wanted to see the sources that were used. I believe Puhlaa will also be given it a careful eye. Before doing any more reversion to the article itself I would like to first see what those 2 editors have in mind for my lead revision which accurately reflects the source and content of the body. DVMt (talk) 18:54, 20 November 2011 (UTC)[reply]

Proposed LEAD revision

Proposed change #1

"Subluxation or "joint dysfunction" is a term used by chiropractors to describe biomechanically restricted/fixated of the joints of the spine and extremities. It is this "manipulable lesion" that is the target of their main clinical intervention, spinal manipulation<:ref>Chiropractic Technique, Principles and Procedures, 3rd ed. 2011, Au: Bergmann and Peterson, Publisher=Elsevier"<:/ref> Chiropractic medicine defines joint dysfunction/subluxation as a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.<:ref name="WHO_guidelines"/>"

"'Original Lead sentence"'

"Vertebral subluxation is a term that is commonly used by some chiropractors (specifically, "straight chiropractors") to describe signs and symptoms of the spinal column. <no ref>Those chiropractors who assert this concept also add a visceral component to the definition <no ref>. Chiropractors maintain that a vertebral subluxation complex is a dysfunctional biomechanical spinal segment (lesion) the same as medical doctors do, but additionally assert that the dysfunction actively alters neurological function, which in turn, is believed to lead to neuromusculoskeletal and visceral disorders<no ref>. The WHO acknowledges this difference between the medical and chiropractic definitions of a subluxation. Medical doctors only refer to "significant structural displacements" as subluxations, whereas chiropractors suggest that a dysfunctional segment, whether displaced significantly or not, should be referred to as a subluxation.^[1]

The reason that the text has been changed is because the lead sentence is not referenced, nor is only specific to straight chiropractors. Also, the biomechanics characteristics of subluxation/joint dysfunction are worth mentioning in the lead as well as other terms that are used by chiropractors such as fixation and restriction but are synonymous with subluxation. I reworded and clarified the text a bit because the term "manipulable lesion" and "joint dysfunction" is used interchangeably in the chiropractic tests are are synonymous with subluxation. if I could add a reference to that statement it would be "Chiropractic Technique, Principles and Procedures, 3rd ed. 2011, Au: Bergmann and Peterson, Publisher=Elsevier" I then used the same WHO reference to to specifically state what the international definition of subluxation is. Hope that gets the ball rolling, looking forward to working with you on this project! DVMt (talk) 19:15, 20 November 2011 (UTC)[reply]

A few points to consider:

1. The lead sentence doesn't need a ref because the referenced content is in the body of the article. That's where the refs are located. Do you feel that it misrepresents the body of the article? The very reason this article exists and isn't covered by the subluxation article is because of the difference between the two. It is this difference that is the main subject matter here.

2. The "visceral component" part is most notably held by straight chiropractors. In fact, without this element, there is no chiropractic "vertebral subluxation". That's an essential difference between a medical subluxation and a chiropractic subluxation, and the major bone of contention between the chiropractic profession and all other mainstream health professions. It is unproven and a number of chiropractic leaders and researchers have repeatedly called for dropping the concept and wording entirely. Many chiropractic websites and journals are now scrubbed of the words. You will rarely find the word subluxation used in them, but straight chiropractors still use the concept and wording.

3. Your initial wording violates the rules for WP:LEAD, but you probably didn't know that. The wording in the title must appear in bold in the lead sentence in some way or other. That's easy to fix.

Throughout the whole article it's important to maintain the distinction between the subjectively-defined chiropractic VS belief/concept (treated with "adjustments") and the objectively-verifiable mainstream anatomic definition of subluxation (sometimes treated by "manipulation" and "mobilization"). The differences in philosophy and practice are embodied in spinal adjustment (only performed by chiropractors, because they are the only ones who believe in the existence of VS) and spinal manipulation (performed by MDs, DOs, and PTs).

4. The WHO needs to be cited correctly. You're being careless there. That's easy to fix.

Brangifer (talk) 21:11, 20 November 2011 (UTC)[reply]

Thank you for your reply. The difference indeed between a medical subluxation and the chiropractic subluxation is that the medical subluxation is a partial dislocation of a joint, viewable on X-rays. The chiropractic subluxation is a dysfunction of joint. The concept of joint dysfunction applies to any synovial articular structure and not simply the spinal vertebrae. Do we agree on this point? It was not my intent to confuse a medical subluxation and a chiropractic subluxation. The term subluxation is still the preferred term in the profession and it is synonymous with joint dysfunction. One only has to look at the WHO document which defines subluxation as "A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity." The visceral component, technically, is what separate a subluxation from the subluxation "complex". This is noted in the article as well. Your assertion that there is "no chiropractic vertebral subluxation without a visceral component" is not reflected in the cited source the WHO document. It is my understanding that straight chiropractors use subluxation in a metaphysical way, using classic terminology like innate intelligence, nerve impulses, and such language. Also, there is a philosophy regarding "subluxation" but that is not what my revision was about. It was looking at a mainstream, international definition of subluxation which is what the WHO document presents. The biomechanical features of joint dysfunction/subluxation has been demonstrated by basic science research. The sequalae of joint dysfunction/subluxation, in an animal model, is covered nicely by Cramer and Henderson, one of the sources I added. Chiropractic adjustment and spinal manipulation are synonymous. Both are HVLA thrusts. The terminology of adjustment and manipulation is used interchangeably by the mainstream of chiropractic. Thus, your argument that "spinal manipulation" is not practiced by chiropractors is not factual. Please see the following links http://www.mayoclinic.com/health/chiropractic-adjustment/MY01107. As well as well Medicare does not make the distinction that you claim as it specifically states "Medicare Part B covers manipulation of the spine if medically necessary to correct a subluxation (when one or more of the bones of your spine move out of position) when provided by a chiropractor or other qualified provider." http://www.medicare.gov/Publications/Pubs/pdf/10116.pdf. Other "qualified providers" implies that those health professions who have spinal manipulation as part of their scope of practice can use manipulation to correct a subluxation (which is synonymous with joint dysfunction, as I had proven earlier). Also the ACA itself uses the term "spinal manipulation" and equates the term "subluxation" with "biomechanics dysfunction". http://www.acatoday.org/pdf/spinal_manipulation_policy.pdf — Preceding unsigned comment added by DVMt (talk • contribs) 04:00, 21 November 2011 (UTC)[reply]

If there isn't any significant opposition I will re-insert the lead as written with the modification proposed by ALF who suggested changing the phrasing of cardinal biomechanics features to something else. DVMt (talk) 04:22, 23 November 2011 (UTC)[reply]

Finally getting back to this! Since you had significant additions which were reverted (not rejected), most likely because it was too much at one time, and thus not necessary a "rejection" of the content, it's worth getting back to this and working on the changes you wish to make to the body of the article, and do it a little at a time. Since the article is a controversial one (plenty of history on that!), it would be wisest to propose each change on this talk page, and then we can look at it and determine if it's an improvement. It might well be!

I'd like to clear up a misunderstanding. I didn't say that ""spinal manipulation" is not practiced by chiropractors". I said: "spinal adjustment (only performed by chiropractors, because they are the only ones who believe in the existence of VS) and spinal manipulation (performed by MDs, DOs, and PTs)." There is a difference. The term "spinal manipulation" is used by all the professions involved, but chiropractors have a special relationship to spinal manipulation/adjustment. Since those are different articles than this one, we needn't dwell on that here. I just wanted to clear that up.

This one deals with the unique chiropractic understanding of subluxation, IOW as something that occasionally includes the medical definition (limited to actual, visible change of position), but also includes dysfunction and a whole host of other ideas, many rooted in chiropractic history and philosophy.

The WHO deals with the chiropractic understanding of subluxation (often termed VS or VSC), and does not mention the mainstream medical definition, except in a footnote where it makes it clear there is a difference. That's why the main subluxation article is so short, and this one so long. (IOW, if it relates to dysfunction, it belongs here, not there, especially if found in chiropractic literature.) All the myriad signs and symptoms that MDs, DOs, and PTs relate to joint dysfunctions are often described by them using many different terminologies and specific diagnoses.

Chiropractors choose to group these myriad things under one diagnostic umbrella - "vertebral subluxation", and they nearly always treat them all with one form of treatment - manipulations/adjustments. Straights, like the Palmers and Sid Williams of Life University, believed in "one cause, one cure". MDs, DOs, and PTs don't subscribe to that belief, and non-straight DCs don't usually either, yet DCs still use the one treatment form to treat nearly all the conditions they see in their offices (the ACA document mentions that).

It's interesting that some prominent chiropractic researchers and leaders have called for the profession to drop the word "subluxation" entirely from their vocabulary, at least in the traditional way it has been (mis)used. Many websites and journals have done this now. It's interesting to compare archived versions of websites with newer versions. They have just used different words to replace that one word! I checked dozens of prominent chiropractic websites while writing my book. Unfortunately they didn't change their way of thinking or practice methods to bring them into line with modern scientific understandings. They just changed the wording to avoid getting into trouble or to avoid criticism. -- Brangifer (talk) 04:18, 25 November 2011 (UTC)[reply]

BR, let's discuss the SMT/SA at the SMT page to avoid confusion. I am happy you did show up, getting lonely here waiting for suggestions! There are a few factual clarifications that we should discuss first however. You state "Straights, like the Palmers and Sid Williams of Life University, believed in "one cause, one cure". MDs, DOs, and PTs don't subscribe to that belief, and non-straight DCs don't usually either, yet DCs still use the one treatment form to treat nearly all the conditions they see in their offices.

1) The 2011 source specifically states "Although the profession today emphasizes the important relationship between health and the structure and function of the neuromusculoskeletal system, it does not promote a monocausal concept of subluxation induced disease” (Chiropractic Technique: Principles and Procedures, 3rd ed, 2011)." It does not state that "straight" DCs still endorse the one cause one cure VS as you suggest. Further,research stated that the majority of DCs practiced in a multi-modal way i.e. used manual therapy but also exercise, nutritional counselling, patient education, physiological modalities, etc. This is in disagreement with your statement " yet DCs still use the one treatment form to treat nearly all the conditions they see in their offices". I'm going to let the lead sit until we discuss it some more but will restore the history section as it is not controversial and has all the original sources. DVMt (talk) 04:48, 25 November 2011 (UTC)[reply]

Regarding your first paragraph immediately above, yes, that's what I said. This isn't the place to discuss it. I just wanted to clear up a misunderstanding.

I agree with the 2011 statement. It is not in conflict with anything I believe. The profession has definitely moved away from its monocausal origins, and mixers do use other methods than "chiropractic spinal manipulation/adjustment", but the ACA document states that they still use it most of the time. Keep in mind that one 2011 source doesn't describe the entire reality of every corner of the profession, and our articles are supposed to do that.

As far as straight DCs goes, either they are straight or they aren't. That's how they are defined, among other things. Straights still have a tendency toward monocausal thinking. Maybe not as openly as before, but in practice....well, their practice doesn't show any change in their thinking! They still claim that regular, life long, adjustments improve resistance to dis-ease (including visceral and contagious), and that failure to do so has dire consequences. Straights haven't died out yet.

As far as your changes, it's hard to really see what changes you made because you made such a large amount at one time. As I suggested above, it would be best to start here on the talk page. Revert what you did and start a new section below. Then show what you're planning to do. Right now it's too tempting to just revert you because I can't figure out exactly what changes you made and why. Such a revert isn't necessarily a "rejection", but is the most convenient way to start over again. I'd rather you did it. This is called collaborative editing. On controversial articles (all alternative medicine subjects) it's the safest way to proceed. The chiropractic article grew immensely through the efforts of a great chiropractor (Dematt) because he worked that way. Before that it was a battlefield. I miss him. The two of us wrote the spinal disc herniation article. -- Brangifer (talk) 05:27, 25 November 2011 (UTC)[reply]

BR, a few points of clarification are needed

what is the specific ACA document you are citing?
do you have a source that says straights still have a tendency towards monocausal thinking? It's important that we back up our claims with evidence.
do you have evidence that straights promote regular life long adjustments to improve resistance to dis'ease'?
I agree that there are still a minority of subluxation based chiropractors but we need some current evidence that tells us definitely whether or not they practice according to your claim or if they've themselves "straightened out" (haha, terrible pun it's late)
Rather than reverting me, I had posted the content up for talk for nearly a week without any specific discussion on the edits. Look at the history section in particular and let me know if any wording or sourcing is a problem. Then we can work towards the lead. I deliberately left out the revised lead because you had asked me to wait. But I need specifics from you since I'm the only one making a draft with no alternative being presented. DVMt (talk) 07:17, 25 November 2011 (UTC)[reply]

The one you provided above: http://www.acatoday.org/pdf/spinal_manipulation_policy.pdf
Discussion here doesn't need sourcing, only if we're going to include it. It happens to be in the definition of what a straight chiropractor is, and I think the main chiropractic article discusses it. Have you read it in detail yet? You really should. You're mentioning things that are mentioned there. I don't think the last straight chiropractor (that would include all those educated at Life University!) has died yet, so there really is nothing to speculate about. It's a simple fact.
You've never read that? One of the more prominent promoters was Joseph Flesia, who had a huge influence on the profession and practice building. Here's one quote: "My position is that the 81% of society into wellness today are ALL prospective subluxation-based, vitalistic/innate intelligence chiropractic wellness patients. With their entire families, children and parents -- for a lifetime, of course. Renaissance Seminars has been teaching and maturing this very same message for 21 years." - Joseph Flesia, DC. (More about him here and here. While researching my book I found many chiros who promoted getting adjustments regularly, even in the absence of symptoms. This is unsurprising since straight chiros believe everyone is born with subluxations and needs regular adjustments to keep them in check. Of course this is all salesmanship developed by B.J. Palmer, and he was a master salesman and conman who learned hypnotism in the circus where he worked in his young days. In fact he was still very young when he more less stole his father's school from him, paying him only a pittance and banning him from the campus.
There are still plenty of straight chiros out there. Just do a Google search, or better yet, create a Google Alert for terms like "subluxation". Nearly 100% are from chiros. If you get them sent to you weekly you'll be able to keep up with what's happening in the profession and on websites.
Let's do it all here to begin with. Using the article just clutters up the history. It also avoids someone else coming along and interferring, and it also prevents edit wars. -- Brangifer (talk) 07:57, 25 November 2011 (UTC)[reply]

Discussion of new additions

Per BRD and the suggestion above, I have restored sourced content and removed the new additions so we can develop a consensus version. Now lets discuss any new additions here, taking it a little bit at a time. -- Brangifer (talk) 23:00, 25 November 2011 (UTC)[reply]

Please, a very little bit at a time, and can we make a new section, or maybe subsection, for each bit? A good way to break it up might be by sentences cited to a single instance of a reference. First I was going to suggest one sentence at a time, but that seemed like it might destroy context. So each subsection could be to discuss like Blah blah blah. Blah blah. Blah.<:ref>....</ref> and then we have another section for the next such piece? I find most of the above discussion impossible to follow, and the changes impossible to keep track of.— alf laylah wa laylah (talk) 23:06, 25 November 2011 (UTC)[reply]

I am awaiting specific suggestions or specific problems with the revised history content I put in. DVMt (talk) 04:35, 28 November 2011 (UTC)[reply]

Okay, the way we usually do this (I shouldn't have assumed you'd know....sorry about that) is that you start a new section and suggest an edit. Show what it looks like, along with the references. Tell why you'd like to make the edit. Then we can discuss it. If it's good, you'll get help to make sure it's formatted properly, etc.. If it's not good, you'll likely get some criticism and suggestions as to whether it has potential or not.

The history shows that the content has been reverted back to what it was on 05:24, November 7, 2011‎. All your edits were reverted, so take a small part of it (nothing related to the lede, we'll deal with that last) and we can work on it. So start a section below where we can work on developing content. -- Brangifer (talk) 07:41, 28 November 2011 (UTC)[reply]

Old version

DO not see consensus for this new version thus restored back per discussion at WT:MED. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:39, 11 February 2013 (UTC)[reply]

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8 colleges' open statement

I just removed:

In 2015, 8 internationally accredited chiropractic colleges: AECC, WIOC, IFEC-Paris, IFEC-Toulouse, USD-Odense, UZ-Zurich, UJ-Johannesburg and Durban University of Technology made an open statement which included: "The teaching of the vertebral subluxation complex as a vitalistic construct that claims that it is the cause of disease is unsupported by evidence. Its inclusion in a modern chiropractic curriculum in anything other than an historic context is therefore inappropriate and unnecessary".^{[citation needed]}

I searched for a primary source and found none. Especially since this datum is being presented as coming from these specific entities, we need a reliable source. (Heroeswithmetaphors) talk 15:23, 2 June 2017 (UTC)[reply]

Here is the link for the original document: [2] — Preceding unsigned comment added by 75.152.109.249 (talk) 17:20, 2 June 2017 (UTC)[reply]

Thanks for finding that source! I marked it up as a proper footnote and added a Internet Archive link to it too so it is future-proofed against link rot. --Krelnik (talk) 15:08, 3 June 2017 (UTC)[reply]

Trimmed lead

Have just radically trimmed the lead/intro to a more reasonable length. Most of the trimmed material either was already in the body, or properly belongs there. The intro should be a short summary of the body. - Snori (talk) 04:52, 7 June 2018 (UTC)[reply]

Ummm....no, that's not how it works. The important points of the article should be duplicated in the lead. -- BullRangifer (talk) PingMe 06:55, 7 June 2018 (UTC)[reply]

OK, granted I was a little hasty. However it seems very evident to me that the current lead is very poor. Perhaps the best example is the "A 2009 review performed by chiropractors concluded..." quote, which is a large duplicate section of the body text. Is it reasonable to discuss some trimming of that? - Snori (talk) 09:24, 7 June 2018 (UTC)[reply]

Snori, lead improvement is always welcome, but my initial reaction was to seek more discussion before going forward, so thanks for your willingness to pursue that path. When I look at the concerns in that quote and compare it to what we have in the body, I think you have a point; we're covering those same concerns with the next paragraph, so we could dispense with that 2009 quote in the lead. Go for it. -- BullRangifer (talk) PingMe 14:38, 7 June 2018 (UTC)[reply]

Done. I've gone ahead and done it before I forget this discussion. I hope that's better. -- BullRangifer (talk) PingMe 03:47, 8 June 2018 (UTC)[reply]

Actually that one change makes a big difference. I'm happy to leave it as it is. - Snori (talk) 08:32, 8 June 2018 (UTC)[reply]

The prevalence of the term subluxation in chiropractic degree program curricula throughout the world

^[2]

References

^ ^a ^b ^c Cite error: The named reference WHO_guidelines was invoked but never defined (see the help page).
^ Funk, Matthew F.; Frisina-Deyo, Aric J.; Mirtz, Timothy A.; Perle, Stephen M. (July 2, 2018). "The prevalence of the term subluxation in chiropractic degree program curricula throughout the world". Chiropractic & Manual Therapies. 26 (1). Springer Nature. doi:10.1186/s12998-018-0191-1. ISSN 2045-709X.{{cite journal}}: CS1 maint: unflagged free DOI (link)

BullRangifer (talk) PingMe 23:36, 3 July 2018 (UTC)[reply]

Components section has the wrong reference

I read the reference listed and it does not mention anything about the five components. I read the rest of the journal and spent 10 minutes looking around the interent and could not find a RS. I will remove the ref and replace with citation needed.

Spinal Kinesiopathology
Neuropathophysiology/Neuropathology
Myopathology
Histopathology
Pathophysiology/Pathology

^[1] --Akrasia25 (talk) 01:38, 8 January 2019 (UTC)[reply]

Sources
^ Keating, Joseph, Jr. (March 2003). "Evaluating the quality of clinical practice guidelines". Journal of Manipulative and Physiological Therapeutics. 26 (3): 209–11. doi:10.1016/S0161-4754(02)54104-X.`{{cite journal}}`: CS1 maint: multiple names: authors list (link)

Moving text to different sections

I am trying to group similar selections of text in the same sections so that this reads as an article. For example, there are definitions scattered throughout the text along with critiques and procedures. I have not deleted anything and will first group the selections together so that it is clear that nothing has been deleted. I am leaving edit summaries along the way and going step by step rather than a full rewrite so others can see the revision change rather than one wide ranging rewrite.--Akrasia25 (talk) 23:24, 8 January 2019 (UTC)[reply]

That sounds like a wise procedure. -- BullRangifer (talk) PingMe 00:18, 9 January 2019 (UTC)[reply]

NPOV

This article is a mess. It contains around 20 very long quotes. Nearly all of them should be removed. If there is important information in those quotes and if they are from reliable sources then that information should be incorporated into the article. Some of the quotes don't seem to add much to the article and some are from unreliable sources. On Wikipedia, facts should be reported as facts and opinions as opinions. Polygnotus (talk) 23:46, 6 May 2024 (UTC)[reply]

[WHO_guidelines-1] Cite error: The named reference WHO_guidelines was invoked but never defined (see the help page).

[Funk_Frisina-Deyo_Mirtz_Perle_7/2/2018-2] Funk, Matthew F.; Frisina-Deyo, Aric J.; Mirtz, Timothy A.; Perle, Stephen M. (July 2, 2018). "The prevalence of the term subluxation in chiropractic degree program curricula throughout the world". Chiropractic & Manual Therapies. 26 (1). Springer Nature. doi:10.1186/s12998-018-0191-1. ISSN 2045-709X.{{cite journal}}: CS1 maint: unflagged free DOI (link)

[3] Keating, Joseph, Jr. (March 2003). "Evaluating the quality of clinical practice guidelines". Journal of Manipulative and Physiological Therapeutics. 26 (3): 209–11. doi:10.1016/S0161-4754(02)54104-X.{{cite journal}}: CS1 maint: multiple names: authors list (link)

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