Each patient education article in this column details research documented in Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach, co-edited by Dr. Masarsky and Marion Todres-Masarsky, DC.
Charles Masarsky, DC. Previous articles, a "Talk Back" forum and a brief biography of the author are available online at [url=http://www.chiroweb.com/columnist/masarsky]http://www.chiroweb.com/columnist/masarsky[/url].
Sometimes a patient mentions a clinical problem almost apologetically, saying something like, "I guess this isn't in your field." For instance, the patient may assume that a bladder problem is the domain of the medical specialist in urology, and has nothing to do with chiropractic.
It is vital to get across the idea that even if we can't fix an internal organ's "machinery," we are very much involved in its "circuitry." The following patient education article should be useful in sending that message.
Most people understand that problems in the lumbar vertebrae (vertebrae in the low back) can irritate the nerves controlling the muscles of the low back. Anyone who has experienced shooting pain from the back into the buttocks, thighs and legs (sciatic pain) has probably figured out that these nerves also control the muscles of the lower limbs. Relatively few people are aware of how nerves from this same region of the spine help control the internal organs. In fact, it is possible for misalignment or restriction (subluxation) of the lumbar vertebrae to disrupt the circuitry of the lower abdominal organs without any low back pain at all. A 36-year-old woman with a history of bladder discomfort, diarrhea, pain during intercourse, and an inability to experience orgasm consulted with a doctor of chiropractic. Despite numerous pelvic surgeries and other medical interventions, her symptoms had continued for 18 years. Interestingly, the patient denied having any history of low back pain.
The chiropractor's examinations revealed evidence of a subluxation of the fifth lumbar vertebra, complicated by disc involvement. After four weeks of chiropractic adjustments, bowel and bladder function were normal. All pelvic pain was gone within eight weeks, and the patient was reportedly enjoying a normal sex life by the time her case was published in the literature.1
While this is a particularly striking case, it is just one of many examples in the chiropractic clinical literature of lumbar spine subluxation being related to pelvic pain and pelvic organic dysfunction.2 When there is no pathology in an organ - when the "machinery" is okay - it is time to check the "circuitry."
References
Charles Masarsky, DC
Vienna, Virginia
neurofitness@aol.com
Recent laws in New Jersey and California represent a disturbing trend that will negatively impact a practice’s ability to collect monies from patients, as well as expose them to significant penalties if the practice does not follow the mandatory guidelines to a T. Please be aware that a similar law may be coming to your state. The time to act is before the law is passed.
With estimates showing over 30 million Americans affected by peripheral neuropathy – and a significant portion underdiagnosed – it’s increasingly likely that chiropractors are already treating these patients. What’s missing is structured recognition, comprehensive management and targeted tools to slow progression, improve function and support systemic health.
Each year, ICD-10-CM is updated on Oct. 1. For 2026, there are 74,179 total codes, with 487 additions, 28 deletions and 38 revisions. Code changes are based on date of service, not the claim submission date. Services performed on/after Oct. 1 must use the new codes. While no changes affect the common spinal or extraspinal codes most frequently used by DCs, several updates may still affect your claims – particularly for comorbidities, referred pain, or trauma cases.
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