Many experts have pointed out that the subluxation myth (which is at the core of chiropractic history, theory and practice) lacks sufficient evidence to even reach the level of a theoretical construct. In fact, it is no more than pseudoscientific dogma. I have discussed the issue repeatedly, for instance here, here and here.
The myth continues to generate fierce debate within and outside the chiropractic profession. This survey sought to determine how many chiropractic institutions worldwide still use the term in their curricula.
Forty-six chiropractic programs (18 from US and 28 non-US) were identified from the World Federation of Chiropractic Educational Institutions list. Websites were searched for curricular information September 2016– September 2017. Some data were not available on line, so email requests were made for additional information. Two institutions provided additional information. The total number of mentions of subluxation in course titles, technique course (Tech) descriptions, principles and practice (PP) descriptions, and other course descriptions were reported separately for US and non-US institutions. Means for each category were calculated. The number of course titles and descriptions using subluxation was divided by the total number of courses for each institution and reported as percentages.
Means for use of subluxation by US institutions were: total course titles = .44; Tech = 3.83; PP = 1.50; other = 1.16. For non-US institutions, means were: total course titles = .07; Tech = .27; PP = .44; other = 0. The mean total number of mentions was 6.94 in US vs. 0.83 in non-US institutions. Similarly, the mean course descriptions was 6.50 in US vs. 0.72 in non-US intuitions. The term subluxation was found in all but two US course catalogues. The use of subluxation in US courses rose from a mean of 5.53 in 2011 to 6.50 in 2017. US institutions use the term significantly more frequently than non-US.
The authors comment that unscientific terms and concepts should have no place in modern education, except perhaps in historical context. Unless these outdated concepts are rejected, the chiropractic profession and individual chiropractors will likely continue to face difficulties integrating with established health care systems and attaining cultural authority as experts in conservative neuro-musculoskeletal health care.
This paper prompted a comment in ‘The Chronicle of Chiropractic‘. It is full with ad hominem attacks against the authors. In the comments section of this blog, we have ample evidence that this is one thing in which chiropractors often excel. Here are a few quotes:
While one should be aware of Fake News these days, chiropractors should be aware of Fake Research by the likes of Mirtz and Perle and anything published by this journal tool of the subluxation deniers club…
Among other things, Perle believes the subluxation construct is “scientifically unsubstantiated” and that those focusing on subluxation are practicing a “pseudo-religion”…
It is another great case study in the use of logical fallacies – particularly the straw man fallacy, and the liberal use of unreferenced opinions presented as facts…
END OF QUOTES
For once, I do sympathise with chiropractors; they clearly are in a pickle:
- Abandoning subluxation is scientifically necessary, as otherwise chiropractors will become the laughing stock of the healthcare community (to a degree, this has already happened; so, there is not much time!).
- Abandoning subluxation would quickly lead to the end of chiropractic, as it would ‘degrade’ chiropractors to some sort of inferior physiotherapist and thus threaten their right to exist.
Dammed if they do, and dammed if they don’t!