The new patient was already a fan of chiropractic. "I liked the guy a lot," he said of the previous DC he had consulted. "But he is on the other side of town, and I just can't get there after work. So he sent me to you, since you're his buddy."
"OK … he spoke so fast, I didn't get it all. I've had this low back pain for a long time, but he seemed have it spot on. He said I had a joint suffocation in my back, or maybe a subrogation, salutation, I don't know. Anyway, it's been pinching my psychiatric nerve and now I've got an exasperation!"
I didn't see any reason to tell the patient he had it wrong. I'm sure he heard the doctor say, "a subluxation pressing on the sciatic nerve," but that's not what he remembered. What he heard was a word from the 19th century that the public does not recognize or understand, and consequently does not believe has any clinical relevance in their lives. They can quickly understand the concept, but not the word.
Most will not put the word subluxation on par with words like cancer, heart disease, or even gingivitis or onychomycosis, for that matter. No one says, "He lost his battle with the subluxation." No one is referred to as a "subluxation survivor." No one goes to a Home for the Chronically Subluxated. It is a word that has caused more misunderstandings, emotional diatribes and just plain frustration than even the word chiropractic.
Now, before nasty e-mails and letters to the editor start being written, I want to be clear: This article is not about the neurological concept often known as the vertebral subluxation complex. It is not about what we do every day. As the accomplished chiropractic educator, the late Joseph Janse, DC, said, "The concept is a biological classic!"
It's about the word. The S word. It has annoyed me almost forever. I know there is some evidence that many chiropractors use this word to educate their patients, but I don't think it works for most of us. The stubborn persistence many in our profession have for using this word to represent a "mechanically challenged spot" may be a reason that only about 7-15 percent of the population visits chiropractors (according to various sources).
The chiropractic profession has argued over the definition of the subluxation since the beginning of chiropractic itself. The Association of Chiropractic Colleges says that the subluxation is a "complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health." That's a lot of "and/or's," but it is the first time any chiropractic group with authority has been able to agree on a definition. I won't jump into the fray, but I can identify with the Supreme Court justice who couldn't define pornography, but knew it when he saw it. I can't define subluxation, but I know it when I feel one.
If the word subluxation is so sacrosanct, why don't more chiropractors use it in their advertisements? Why aren't there more clinics named "Subluxation Solutions," "Subluxed Nation," "Subluxation Envy" or "Subluxations Gone Wild"? A few years ago, in New Orleans, I attended the annual Research Agenda Conference and the gathering of the Association of Chiropractic Colleges (ACC-RAC). One of the DC speakers from Canada reported that a regional chiropractic association paid for an advertising campaign, using billboards and such, trying to educate the public on the topic of the subluxation. The speaker said that it resulted in people going to their medical doctors, asking them whether this public health issue of "subluxation" was important or not. Apparently the campaign failed to direct traffic to chiropractic offices. I didn't know whether to be amused or dejected.
The word has been an anchor hung around the neck of the profession for too long. It should be cut off and left to slowly sink to the bottom of the sea of antiqued health jargon, along with words like lumbago or rheumatism. Continuing to use this confusing S word is endangering the essence of the "biological classic concept" that holds true in our day-to-day chiropractic effort to help suffering humanity.
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