Neurologically Based Chiropractic

Hi Dr. D’Ambrosio,

I loved your response, especially the fact that you consider yourself to be a Principled Chiropractor, as it represents the bright side of our profession.  What I find is that I’m getting the same response from the medically modeled side as well. So perhaps, as is my hope, we can use this direction to bring both sides to the middle and reunite the profession.

I understand that the profession continues to exist on the results achieved through chiropractic care and that we can get away with the “magic 7” just because the innate intelligence of the body has the ability to make the best of resetting the Allostatic balance through sensory stimulation. In this however lies the answer to the dilemma of the profession. Since the beginning in 1895, we have been lacking in supportive science and have had to rely on our philosophy to explain why the adjustment had a positive effect. Our support of the vertebral subluxation theory has remained the single limiting factor in acceptance of chiropractic in the scientific world (please note, not just medical). This has been challenged even further by the rejection of the philosophy of chiropractic at our educational institutes. While all of this has been going on, neuroscience has been progressing at a tremendous rate with knowledge that actually supports what we have been doing in our practices.

That said, in my mind I feel that we have a greater responsibility to the profession and the public to be able to support chiropractic through today’s technology and knowledge. This will not only move the profession out of the restrictive scope of spinal pain management, and mechanical based care, but will also offer the opportunity to improve the quality of care through a better understanding of the neurophysiology based on today’s neuroscience.

It is just too easy for us to take the stand of, “results is all that matters” or “Chiropractic works” and disregard the unseen potential of exploring “why it works” and “therefore how can we improve what we do”.

One of the most common questions we get asked is, “What do I have to change in my practice?” and I have to admit that I do feel some frustration with this question. The reason for this frustration is that I interpret this as a level of laziness within the profession. Growth lies in change and not in stagnation. Enough of that lecture. I agree that it is easy to keep on adjusting and chiropractic will get results but what a terrible shame we are now facing with about 50% (or more) of the profession moving in the mechanical model direction in order to be included in billing codes and medical acceptance. This movement is because we have not been able to establish chiropractic with a neuroscience foundation that will allow us to reach out of the pain model of care and demonstrate the role of Chiropractic in improved neurological management.

So I think the real question here is how this approach can improve your practice, which is not only fair but a critical issue. One of the main factors of success in practice is not just enthusiasm but confidence. When we know we can objectively show what we “say”, the confidence grows from DC to patient.  With the development of instrumentation such as the NeuroInfiniti we can now move past the spinal theory and show that your care not only makes changes but that your care actually changes central nervous system function.  This changes the intent of your care. Along with this comes the ability to offer neural reintegration via patient participation in bio/neurofeedback.  Your Patient Visit Average will grow and you can offer the patient the opportunity to decide to continue care based on obtaining some level beyond pain relief. When patients make the choice, the compliance goes up. I can tell you this based on the experience of not only my practice (180 PVA) but our clients who are using the NBC concepts and the NeuroInfiniti.

Some examples of how this can improve clinical practice:

1. No longer do we talk about Chiropractic as a bone or spinal practice. The “Neurological Based Chiropractic” (NBC) practice deals directly with the level of neurological efficiency, so it is not “Check my spine” but rather “Check my nervous system function”.

2. Because we are talking directly about neurological activity, the scope of practice goes far beyond back pain, neck pain, headaches or trauma injury (moves the practice out of the pain complaint reason for seeking your services).

3. The different techniques of chiropractic now play a role in their application; meaning that we can now, based on the patient’s neurological needs, determine which type of technique is more appropriate.

4. Both the DC and the patient can have the opportunity to see if the neurological response is moving toward better neurological balance with the care. (Or not moving in the right direction which offers the reason to change techniques, frequency or duration of care)

5. The chiropractic premise of “Our primary focus of care is the nervous system” is totally supported by our office dialog and examination with acceptable objective measurements.

6. This level of objective outcomes moves the profession out of the theory and myth group in the healing arts and provides the opportunity to reach out to a broader audience.

7. The NBC approach expands the concept of “Wellness Care” to a specific “Peak Performance Care” so that ongoing care addresses a measurable improvement. (Such as the ability of the patient to improve Skin Conductance [SC] or neuromuscular reintegration scoliosis training).

The simplest way to explain this to a patient – Ask them the question, “Do you want care that relieves your symptoms and leaves the cause of your problem or do you want care that deals with the cause of your challenge?” When they say “The Cause!”, you best be prepared to further the conversation and offer examinations that support your new position. This is one of the simple steps that we use in moving patients into the real value of Neurologically Based Chiropractic care.

Your last paragraph really sums up what I have been writing about and the need for NBC and objective measurement. I agree with everything you have written – great statement, now prove it!

We have lost credibility as a profession over the years, just because of this type of response. It is a grand, impressive statement that rings in my heart but without any proof other than results, it becomes hyperbole in that it lacks any form of supporting evidence as to “how” or “why”. You deserve the support of science for the great work you do – so does this profession.

Thanks for your response and working together we can grow this profession that we love into the respect that we know it deserves

Subject: Law of Hormesis

Hi,

I would like to watch the rest of the Law of Hormesis video.

Also, I enjoyed Richard’s article in Chiropractic Economics (and the full article online) and had a few questions regarding it.  I can see where he is going with this and it makes a lot of sense, but in reality, how does this change what is being done in an office?  I had the 5-Tech Subluxation Station and it told me about nerve interference on all levels, heart rate variability, etc, but it was always the same: someone came in with lots of colors, I adjusted them based on my technique findings, I’d re-scan them and there would be improvement.  In reality, as great a tool as the sub station was, it was useless with the exception of showing clients what they and I already knew – their nervous systems were not functioning optimally and it was affecting all aspects of their health.  So, I sold the unit and practice very happily without it.

Now, with the model Richard is proposing, the reasons behind what chiropractic does and what a subluxation is may be altered, but does it in reality affect how chiropractic is being practiced?  Everybody benefits from chiropractic adjustments, whether or not their symptoms improve or not.  I already knew this and the scans I did in the past showed this to me as well.  There are plenty of old school chiropractors seeing hundreds of people a week, some doing the “flying seven” and people are benefiting tremendously.  If you want to base it on symptoms, which these chiropractors don’t as they don’t treat symptoms, you can see the huge successes in the symptomatic and non-symptomatic improvements in health and well-being in the majority of their clients. That being said, how does the proposed model he is espousing alter what happens in an office?  Granted, the explanation may be different, but isn’t that, in most cases, where it ends? 

Since I mentioned the explanation, how can one take what was very well written in the article and then translate it into terms that make it easier to understand to a lay person so they get “the big picture”?  I’d love to be able to use what was said, but when I attempt to turn it into everyday language, the story comes out to be the same as it was before.  I have always stated that chemical, physical and emotional stress affect the way the body operates which in turns negatively affects the nervous system.  My job is to find where there is interference within the nervous system so that I can remove that interference in a way most honoring to the body, so the body can then better communicate with itself and process stress more efficiently so all systems, including the immune system, can function optimally.  The adjustment positively alters nerve patterning, which can be negatively affected under stress which can result in serious health problems down the road.  What I do is allow the body to heal itself by opening up the communication between the brain and the rest of the body so the trillions of cells and hundreds of trillions of chemical reactions taking place can work together in an organized manner and in unison. I’m not moving a bone into place, but in reality introducing a 3 dimensional vibratory force which the body then transforms and uses to correct itself.

Is what I’m saying that far off from what was being offered in the article?  Maybe it is so any insight would be greatly appreciated!

Thanks in advance and have a great night!

Yours in optimum health,

John C. D’Ambrosio

Principled Chiropractor

The latest issue of Scientific American has an article titled “Faulty Circuits”. They are found in the brain and have a relationship to mental disorders.  The article starts with a statement about doctors historically trying to glean something about the underlying cause of a patient’s illness before they figure out a treatment to address the source of the problem. Really? Great statement and what a difference if it were true!  This includes chiropractors as well as medical professionals. This statement implies that we need to use our intelligence, training, and experience to gather data and, God forbid, THINK!

Today we have managed to let computers do our thinking for us. Fill in the data and it comes up with a diagnosis! That way we get paid at least, which solves the source of one problem, income. Applications such as: tissue resistant testing to determine the area of restricted motion and therefore vertebral subluxation; to crazy instruments that can tell you which vertebra to adjust based on Galvanic Skin Response (along with which heavy metals are in your system as well as personality traits) are coming out of the woodwork. 

While at Chiropractic events, I’ve seen everything from distraction tables that would be enough to scare me out of a DC’s office, to weird Frankenstein like “gizmos” with electric arcing, that are supposed to do something (other than affect the northern lights) , all for sale to Chiropractors.  Some of these “wonder” instruments claim to have some level of registration with the FTC while others have a story about it not being needed. Be careful out there in “Wonderland” folks!  This profession deserves our respect and attention when it comes to the image we portray and instrumentation we use.

With the direction in the profession fixed on spinal structure and joint mechanics, it is easy to see why we attract the mechanical model support vendors such as: mattress sales, various muscle testing devises, orthotics sales, exercise equipment, x-ray equipment and others. Next we have the add-on sales that, while they have value, are more about adding on to income than actual Chiropractic application. Products such as: pillow, supplements, herbal therapy, food processors, various sprays, tapping, and hot and cold packs.

There are some discerning organizations out there who restrict their vendor list to meet a level of credibility and hats off to them. The Master Circle is one that I know is doing this. 

Before I get too far off track, let me make my point!  It seems that as Chiropractic lost its direction of improving neurological function, we started to gather these other applications around us as they found a market place willing to grab at anything that will sell under the guise of Chiropractic.

In the meantime we have neuroscience talking about neuroimmunology, stress influences on neurological function, brain innate, and faulty circuits as the cause of illness and disease.

So we are still fortunate enough to have a choice about our future direction but the time is fast running out. Will we be smart enough to seize the opportunity to regain the concepts of Chiropractors being “Functional Neurologists” or will we continue to struggle as symptom relief caregivers with limited responses? Not much of a choice especially when you look at the company we are keeping at our events.  Want a direction for the future – visit the www.neuroinfiniti.com web site and start learning about Neurologically Based Chiropractic!

Stunning revelations are coming from the world of neuroscience research these days. Information on the ability of the brain to keep itself organized during its quiet times supports the Chiropractic theories of innate intelligence.  The chiropractic profession has suggested that the body is a self maintaining, self healing organism and that this ability is centered within the nervous system. However, mainly because the Chiropractic profession has mostly abandoned many of its basic theories while pursuing the Musculo-skeletal, mechanical model, the latest developments in neuroscience will bypass Chiropractic completely.

The article titled, “The Brain’s Dark Energy” (Scientific American, March 2010: pages 44-49) presents key concepts which include:

. “Neuroscientists have long thought that the brain’s circuits are turned off when a person is at rest.

. Imaging experiments however, have shown that there is a persistent level of background activity.

. This “default mode network” (DMN) as it is called may be critical in planning future actions.

. Miswiring of brain regions involved in the default mode may lead to disorders ranging from Alzheimer’s to schizophrenia.”

The Default Mode Network involves multiple areas of the brain with the Medial Prefrontal Cortex, in both hemispheres, being the largest.  This organization within the brain is not surprising as stated in the article, “the brain is not a free-for-all among independent systems but a federation of interdependent components.”  While there is a hierarchy within this federation, there are times when the outside environment stressors will override it so that the brain faces a challenge between planned responses and immediate needs.

If there is a heavy level of immediate needs (alert responses or threats) and/or restricted downtimes, the DMN cannot function and the brain becomes over loaded. Researchers were able to identify when a subject was about to commit an error in a computer test because the DMN took control during focused concentration.

The current understanding suggests that the DMN plays a very important role in illnesses such as Alzheimer’s, depression, and schizophrenia. Research is now looking into the DMN role to provide deeper insights into the cause of disease and treatment strategies.

So what does all this mean? It means the chiropractic theories regarding Innate’s ability to self organize were correct. It also means that we are about to lose ground once again in the healing arts because we have abandoned the very concepts that were our unique positioning.  In so doing we have basically sold our “souls” in order to get reimbursed by insurance companies. Short term gain – long term loss!

There is more to be said  here as the April Issue of Scientific American contains an article on the brain’s faulty wiring or what Neurologically Based Chiropractic calls “subluxation”.

My first question is, “What are you reading, books on spinal mechanics or disc decompression?” My next question is, “What do you think is really the cause of those problems?”

Time to catch up with neuroscience!

What a wondrous world in which we live! From D. D. and B.J. Palmer’s first constructs of the Philosophy of Chiropractic came the term “Innate Intelligence” and with it much of the bitterness that has divided the profession.

The first level of division involves the claiming of the term “Innate” and was part of the ongoing battle between father and son in the Palmer family. History clearly shows that D.D. Palmer, the father, won this battle having published a definition of “Innate” in his book titled “The Science of Chiropractic” in 1906 (page 109).

Clearing up who created the term does not help the larger challenge within the profession over the use of the term “Innate”.

D.D. Palmer stated; “Innate is that vital principle, the heretofore unknown intelligence which, associated with matter, controls the manifestations and properties of organized bodies, thereby distinguishing organized from inorganic matter.” He goes on to say, “Innate retains its education acquired in past ages.”

B.J. had a slightly different view. He saw “Innate” as “God in Man” and referred to it as “WE”. The problem arose with the term as used by B.J. Palmer. He developed his entire philosophy of Chiropractic around the concepts of Innate, the fellow within, as God’s director of life.

As the science of its day could not offer any support for the Chiropractic concepts, B.J. continued to develop its philosophical foundations. He poured himself into whatever science was available and applied it to chiropractic research. His research was relentless and his development of the electroencephaloneuromentimpograph demonstrated how far ahead of the science of his day he was.

Today we have the ability not only to understand the “education of the past” concepts of “Innate”, found in DNA, but also to recognize the inborn ability of the body to organize itself into a healthy state. We continually see and hear the term “Innate” being used in medical and neuroscience. How soon we forget! A short 50 years ago Chiropractors were being condemned by other health professionals and some of their own profession for even suggesting there was such a thing.

Times have indeed changed! The March edition of Scientific American headline article is titled “The Brain’s Dark Energy”. It is about the fact that science has had the wrong idea about resting brain function for years. Hans Berger, the inventor of the electroencephalogram (EEG) which records electrical activity of the brain stated, “we have to assume that the central nervous system is always, and not only during wakefulness, in a state of considerable activity.” His work was ignored – now we find that he was correct. Sounds familiar!

During resting and/or physically inactive times, this “dark energy” in the brain increases. We note that Sensory Motor Rhythm (SRM) activity increases and until now there was no explanation for this. These activities are the times that the innate intelligence of the brain reorganizes itself. A house cleaning, so to speak! We even know the primary areas and patterns of the brain in charge of this activity which is called the default mode network (DMN). The importance of any interference to the default mode network’s ability to reorganize brain function is stated clearly in the article. “Such patterns may not only serve as biological markers for diagnosis but may also provide deeper insights into causes of the disease and treatment strategies.”

Welcome to “Innate” and thank you D.D. and B.J. Sounds as if you were both right after all.