The chiropractic (from ancient Greek χείρ cheir , hand 'and πρᾶξις practice , activity') is an alternative medical treatment with the aim of malfunctions serving on the movement and support of the human body body parts to find particularly the spine, and eliminate them. Both the disturbed joint play and the displacement (see subluxation ) are taken into account. The effectiveness and scientific nature of the method are controversial.
Originally, in the 19th century by Daniel David Palmer founded chiropractic the thesis was advocated that various, also non- orthopedic diseases are caused by a misalignment of the vertebral joints and can accordingly be cured by a manipulative correction ( manipulation ) of the misalignment. This view contradicts modern knowledge of the anatomy, physiology and pathology of the human organism. ChiroSuisse , the Swiss Society of Chiropractors, now focuses chiropractic only on the treatment of "functional, reversible disorders of the musculoskeletal system".
The manual medicine is based, inter alia, methods of chiropractic.
Already in antiquity ( Hippocrates and Galenus ) practices were described to bring about therapeutic effects with the bare hand. The founder of today's chiropractic was Daniel David Palmer (1845–1913). He was believed to have been trained in this treatment by Jim Atkinson of Davenport, Iowa. In order to be able to market them himself, he invented the name “Chiropractic”. Its founding legend, on the other hand, reads: “Harvey Lillard, the porter of the Rayan block house where I had my practice, was hard of hearing. He no longer heard the clatter of a horse-drawn cart in the street or the ticking of his alarm clock. I wanted to know where this 'numbness' came from, so he told me that he had lifted something heavy in a cramped, hunched position. He would have had the feeling that something had been pulled on his back, and immediately afterwards he would have gone deaf. The examination showed that one vertebra had been pushed out of its normal position. I figured if the vertebra were properly seated again, the man's hearing would have to work again. With this goal in mind, I tried - in a half-hour conversation - to convince Mr. Lillard that he should allow the re-placement. I set the vertebra in its correct position using the vertebra's spinous process as a lever, and shortly afterwards the man could hear as before. There was nothing accidental about it, it was the completion of a conscious goal, and the result lived up to expectations. "
DD Palmer explained what was supposedly new about his treatment method as follows: “The basic principles and the principles of chiropractic that have developed from them are not new. Nevertheless, I claim to be the first to use a displaced vertebra using the spinous and transverse processes (Proc. Spin. U. Trans.) As levers, whereby the dislocated vertebra returns to its normal position. Proceeding from this basic fact, a science was created which is intended to revolutionize the theory and practice of the healing arts . "(Translations: D. Oesch)
Chiropractic (as well as osteopathy ) came to Germany through Pastor Gustav A. Zimmer, who was born on December 22nd, 1869 in Krachen / Silesia and lived temporarily in the USA. After his return in 1927, he ran a training center for chiropractic and osteopathy in Dresden which was mainly attended by naturopaths. Zimmer ended his professional activity in 1938 and died on December 17, 1939. Three of the books published by Zimmer were on the "List of harmful and undesirable literature" and were banned by the National Socialists. After the Second World War and the legalization of a revised version of the Heilpraktikergesetz of February 17, 1939, the Nuremberg naturopath Willi Schmidt resumed the professional training he had started in 1938, including in chiropractic from 1951 onwards. In 1959 Schmidt took over the management of the working group for chiropractic and osteopathy in the DH with working groups in all regional associations, an annual central specialist training congress in Bad Homburg and the publication of a total of 92 editions of the training sheets of the working group of German chiropractors and osteopaths in the DH , which were published by Published 1959 to 1971. In 1952 the Hamburg naturopath Werner Peper DC, a graduate of the American Palmer School of Chiropractic, published the book Technique of Chiropractic .
1. Adjustment : This adjustment is achieved through specially learned hand movements. You have the goal of eliminating "subluxations" on the spine (on the zygapophysial joints) and thus relieving the pressure on the spinal nerves (lateral) or the spinal cord (medial). If this succeeds, then the pain disappears in a short time, e.g. B. in sciatica (sciatic irritation).
2. Traction : In traction, the joint partners are separated from each other by pulling. Among other things, this leads to pressure reduction, relief and pain relief. In addition, the stretching of the ligaments and the joint capsule improves mobility.
3. Translational sliding, also called mobilization : In order to restore the lost joint play, and thus also the mobility, the joint parts are moved parallel to each other.
4. Soft tissue treatment : Using stretching and relaxation techniques, the muscles should be lengthened so that they adapt to the newly acquired joint play.
5. Reflex techniques : Using nerve reflexes, the tension of the muscles and the perception of pain should be influenced. Reflex therapies can also be used to act on the central nervous system , e.g. B. on the vegetative nervous system and also on cognitive areas.
Chiropractic in Germany
In Germany there are no special regulations for exercising the profession of “chiropractor”. To practice the profession of chiropractor or chiropractic therapy, you have to be either a doctor or an alternative practitioner (see Alternative Practitioners Act, 1st Implementing Ordinance). Chiropractors qualified abroad must therefore obtain a naturopathic license in order to practice in Germany. In practice, however, authorities have regularly requested a comprehensive knowledge test. In the recent past, some administrative courts have objected to this and ruled that training abroad should be recognized.
The first graduate of an American chiropractic school, the Palmer School of Chiropractic, opened a practice in Frankfurt / Main in 1924. In the early 1950s, Werner Pepper, also a Palmer School graduate, wanted to open a branch of the Palmer School in Germany. This was rejected by the school management.
Chiropractic in Switzerland
In Switzerland the chiropractor is a recognized medical professional who diagnoses and treats functional disorders and painful conditions of the spine and the musculoskeletal system on his own responsibility. The five medical professions in Switzerland include the chiropractor, human medicine, dentist, veterinarian and pharmacist. The following federal laws and the corresponding ordinances regulate the training and activities of chiropractors as well as the mandatory assumption of costs for chiropractic services: Medical Professions Act (MedBG), Health Insurance Act (KVG), Accident Insurance Act (UVG), Military Insurance Act (MVG), Radiation Protection Act (StSG).
The services of chiropractors were legally recognized as compulsory services by medical professionals when the Health and Accident Insurance Act (KUVG) of 1911 was partially revised in 1964. Since then, chiropractic services have been covered by the compulsory basic health insurance. The chiropractor is the only legally regulated first contact for the patient next to the human medicine.
In Switzerland, only trained medical professionals are allowed to offer chiropractic care. 300 chiropractors are organized in ChiroSuisse , the association of Swiss chiropractors.
Basic, advanced and advanced training
In Switzerland, chiropractic studies have been offered at the medical faculty of the University of Zurich since autumn 2008. It lasts twelve semesters plus hospital internships and leads through the bachelor's degree in medicine (B Med) to the master's degree (M med. Chiro), optionally further to the chiropractic doctorate (Dr. med. Chiro). The Swiss Academy for Chiropractic, which is accredited by the Federal Office of Public Health , is responsible for the further training of chiropractors. She is also responsible for conducting the examination to become a specialist chiropractor.
The chiropractors, like all medical professionals, are obliged to undertake further training of 80 hours per year within a statutory framework.
Contraindications and undesirable effects
In general, it is necessary to clarify certain damage to the spine (e.g. metastases , tumors ). In the case of low back pain, the anamnesis (collection of the medical history) and the examination are sufficient. Imaging is not required.
Science and effectiveness
In a review article on chiropractic from May 2008, the head of the Department of Naturopathy at the University of Exeter in England , Edzard Ernst , came to the conclusion that chiropractic was based on "mystical concepts" after reviewing scientific articles on the subject. In addition, the basic concepts of chiropractic such as subluxation and spinal manipulation were not based on "solid science" (= "sound science").
More recent studies also show that there seems to be no connection between the disease and subluxation of vertebrae due to an unfavorable influence on the allegedly affected nerves.
According to the retired Swiss professor for orthopedic surgery Max Geiser, neither chiropractic nor “so-called manual medicine ” has provided evidence to date that “serious, non-spontaneously remitting disorders of the musculoskeletal system can be eliminated and that they can do more than all other sham treatments of the alternative and complementary medicine ”.
A systematic review of the Cochrane Collaboration of 2003, the treatment of low back pain had means of spinal manipulation on the subject, showed no advantages over other, non-contraindicated treatments as general medical treatment, painkillers , physical therapy , physiotherapy or back exercises . The authors believed that spinal manipulation might be superior to placebo treatment. In a review from 2011, no clinically relevant differences between spinal manipulative therapy and other established therapies were found with regard to pain reduction and functional improvement in patients with chronic low back pain. Serious complications could not be observed in this analysis either. It remained unclear whether spinal manipulation was superior to placebo, because only a few studies, typically with a high risk of bias, deal with this aspect. Even in acute low back pain, spinal manipulative therapy did not show any advantages over a (recommended) standard treatment, a placebo treatment or as an addition to another treatment.
After the outbreak of COVID-19, false reports increased on social media such as Twitter about an alleged increase or "boost" of the immune system mediated by spinal manipulative therapy . However, there is no reliable evidence that it could have such an impact on the immune system.
- Duden | Chiropractic | Spelling, meaning, definition. Retrieved December 23, 2017 .
- Chirotherapy: Meta-analysis sees limited effect on low back pain Arezteblatt.de from April 12, 2017
- Max Geiser: The Return to Reason in Health Care in the 21st Century (via Wayback Machine) ( Memento from October 16, 2014 in the Internet Archive ) (PDF; 190 kB) In: Schweizerische Ärztezeitung 2007, page 758, accessed on October 23, 2011
- Renate Wagner: Chiropractic, Chirotherapy. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 250.
- A detailed family biography of Zimmer (with numerous historical images) can be found at http://www.struckmeyer-family.com/histories/gustav_zimmer.htm , in which his profession as “Doctor of Chiropractic / Osteopathy” is documented. Zimmer also published a number of self-published books in Germany, including chiropractic or The human backbone as a carrier and cause of health and disease. Based on the best American sources, as shown on the basis of our own experience (Dresden 1934) and edited the text Das ist Chiropraktik! from JS Riley with the following recommendation, including his Dresden address: “Healthy, sick and nervous sufferers - with a friendly 'Grüß Gott!' - Presented by Gustav A. Zimmer - American chiropractor and osteopath - In Dresden = A.24, Nürnberger Straße 40 ”. This brochure was later published by Hedwig Zimmer's publishing house for chiropractic and unmedicated healing methods, Dresden. a. with the imprint “Presented by Alfred Singler (alternative practitioner, chiropractor and osteopath)”.
- http://www.berlin.de/rubrik/hauptstadt/verbanned_buecher/suche.php?orderby=autor_nachname&order=desc&s_ort=Dresden . The titles of the books were: The Shortest Path to Health (1933), Chiropractic or The Human Spine as Carrier and Cause of Health and Disease (1934) and Chiropractic (1935)
- All of the specialist articles published in these advanced training sheets are published in the book by Willi Schmitdt: Die Kunst der Chiropraktik und Osteopathie - Essays and lectures on theory and experience of manual holistic therapy , Marczell-Verlag Munich 1984, ISBN 3-88015-093-1 , das the professional association of German Heilpraktiker Landesverband Bayern e. V. (today Heilpraktikerverband Bayern e.V. ) published on the tenth anniversary of Willi Schmidt's death. This includes a biographical article by the naturopath Norbert Seidl (a student of Willi Schmidt) under the title Der Heilpraktiker Willi Schmidt on the 10th anniversary of his death .
- Karl F. Haug Verlag, Saulgau / Wttbg., Review in Naturheilpraxis 1952, p. 223
- Chiropractic in Europe - An illustrated History p. 83 ff .; Matador publishing house
- Organization on chirosuisse.ch
- Studies at the University of Zurich
- Michael M. Cooking, Eva Blozik, Martin Scherer, Jean-François Chenot: Imaging for low-back pain . In: Lancet (London, England) . tape 373 , no. 9662 , February 7, 2009, ISSN 1474-547X , p. 436-437 , PMID 19200903 .
- Stephen Barrett , MD, " Chiropractic's Dirty Secret: Neck Manipulation and Strokes "
- David Colquhoun . " Doctor Who? Inappropriate use of titles by some alternative“ medicine ”practitioners ( Memento of the original from June 15, 2009 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and remove then this notice. ", The New Zealand Medical Journal , 25-July-2008, Vol 121 No 1278
- Edzard Ernst : Deaths after chiropractic: a review of published cases . In: Int J Clinical Practice . 64, No. 8, 2010, pp. 1162-1165. doi : 10.1111 / j.1742-1241.2010.02352.x . PMID 20642715 .
- Edzard Ernst , Chiropractic: A critical evaluation. In: J. Pain Symptom Manage. May 2008, 35 (5): 544-62. PMID 18280103
- Summary of a recent study
- Assendelft WJJ, Morton SC, Yu Emily I, Suttorp MJ, Shekelle PG: Spinal manipulative therapy for low-back pain. A Meta-Analysis of Effectiveness Relative to Other Therapies. In: Annals of Internal Medicine 2003 Jun 3; 138 (11): 871-81. doi : 10.1002 / 14651858.CD000447.pub2 PMID 12779297
- Sidney M. Rubinstein et al .: Spinal manipulative therapy for chronic low-back pain . In: The Cochrane Database of Systematic Reviews . No. 2 , February 16, 2011, p. CD008112 , doi : 10.1002 / 14651858.CD008112.pub2 , PMID 21328304 .
- Sidney M. Rubinstein et al .: Spinal manipulative therapy for acute low-back pain . In: The Cochrane Database of Systematic Reviews . No. 9 , September 12, 2012, p. CD008880 , doi : 10.1002 / 14651858.CD008880.pub2 , PMID 22972127 .
- Greg Kawchuk et al .: Misinformation about spinal manipulation and boosting immunity: an analysis of Twitter activity during the COVID-19 crisis . In: Chiropractic & Manual Therapies . tape 28 , no. 1 , June 9, 2020, p. 34 , doi : 10.1186 / s12998-020-00319-4 , PMID 32517803 , PMC 7281697 (free full text).