Notice that I wrote that the BOOP subluxation model fails; nothing was said about failure of the adjustment to be beneficial to the body. BOOP subluxationists become angry and defensive when the BOOP model of subluxation is criticized. Not surprisingly, I received several letters riddled with ad hominem attacks - most unsigned - after my last three articles on the subluxation complex.
The reactionary nature of certain BOOP subluxationists is to accuse those who don't buy into the BOOP model of being anti-chiropractic - an astonishing leap of ignorance, to say the least. Furthermore, anyone who does not buy into the model is trying to "medicalize chiropractic" - another example of low-IQ thinking. And if tears do not well up in your eyes when you hear the phrase, "The power that made the body, heals the body," you are accused of having no passion for chiropractic - still another example of depressed, frontal-lobe activity. Even worse, if you don't buy into every bizarre, New Age, tree-hugging notion that comes down the pike and is circularly attached to subluxation, you will be accused of being an atheist - an excellent example of the need for psychiatrists and the drugs they prescribe.
Not all BOOP subluxationists fit the psychotype described in the previous paragraph. The more rational chiropractors who embrace the BOOP model feel that it keeps us from being characterized solely as "back pain specialists," and I agree with this concern. In other words, I don't think we should be locked in a low-back-pain box, and the evidence clearly suggests that patients suffer with numerous vertebrogenic symptoms besides back pain.3-5 That being said, it is important to also state that mechanisms associated with visceral symptom generation do not occur because of BOOP subluxation and nerve interference; visceral symptoms occur because of dysafferentation,3-5 which is why the BOOP model needs to be upgraded.
Even though their theory is absolutely invalid, the criticisms levied by BOOP practitioners against mechanical low back pain (MLBP) are completely valid. MLBP is probably the most limiting and ridiculous term ever tagged to back dysfunction, not to mention that it probably does not occur. In other words, MLBP is as invalid as BOOP, and both should be described only in the context of history.
The human body is not a mechanical machine; it is a bio-psycho-mechanical machine, at the least, and many would argue that it is a bio-psycho-spiritual-mechanical machine. So, to varying degrees, we are likely to suffer from bio-psycho-spiritual-mechanical low back pain. To see that this statement is being increasingly accepted, all one needs do is read the first chapter in the 1999 (4th) edition of Managing Low Back Pain, which is devoted to the psycho-spiritual aspects of back pain.6
Since we chiropractors are trained in the biological sciences, and because we are not trained in psychology or theology, it seems most appropriate that we focus on the biological component of the back pain problem. In fact, it also seems that altered biochemistry precedes and promotes the expression of altered biomechanics. Consider, for example, that chondrocytes are able to generate a hydrogen peroxide free radical that can damage joint cartilage proteoglycans, hyaluronic acid, and collagen, and it is thought that this can contribute to articular cartilage degeneration and arthritis.7 It is well-known that we can protect ourselves against free-radical damage by ingesting antioxidant-rich fruits and vegetables and by taking supplements.
Dietary fatty acids also significantly influence joint structures. For example, normal cartilage has low levels of pro-inflammatory n6 fatty acids, but as we age, concentrations steadily increase; this trend is especially pronounced in osteoarthritic cartilage. In fact, lipid accumulation in chondrocytes generally precedes local tissue degeneration in several models of degenerative arthritis. Researchers have found that histological severity of osteoarthritis may be related to accumulation of arachidonic acid, an omega-6 fatty.8 So, by focusing our diets on grains, seeds, packaged goods, and vegetable oils (corn, safflower, and sunflower), we literally biochemically program our joint tissues to express dysfunction - foolishly called a "BOOP subluxation" by some and "mechanical low back pain" by others.
- Seaman DR. Subluxation complex and nerve interference, part I. Dynamic Chiropractic March 11, 2004;22(6):23,32. www.chiroweb.com/archives/22/06/19.html.
- Seaman DR. Subluxation complex and nerve interference, part II: Research efforts into nerve interference. Dynamic Chiropractic April 22, 2004;22(9):33-34. www.chiroweb.com/archives/22/09/21.html.
- Nansel D, Szlazak M. Somatic dysfunction and the phenomenon of visceral disease simulation: a probable explanation for the apparent effectiveness of somatic therapy in patients presumed to be suffering from true visceral disease. J Manipulative Physiol Ther 1995;18:379-97.
- Seaman DR, Winterstein JF. Dysafferentation, a novel term to describe the neuropathophysiological effects of joint complex dysfunction: A look at likely mechanisms of symptom generation. J Manip Physiol Ther 1998; 21:267-80.
- Seaman DR, Faye LJ. The subluxation complex. In Gatterman MI. Foundations of Chiropractic: subluxation. 2nd ed. (in press).
- Kirkaldy-Willis WH, Bernard TN. A new look at an old problem. In: Kirkaldy-Willis WH, Bernard TN, eds. Managing Low Back Pain, 4th ed. Churchill Livingstone: New York; 1999: p.3-9.
- Tiku ML, Liesch JB, Robertson FM. Production of hydrogen peroxide by rabbit articular chondrocytes: enhancement by cytokines. J Immunol 1990;145:690-96.
- Tiku ML, Shah R, Allison GT. Evidence links chondrocyte lipid peroxidation to cartilage matrix protein degradation: possible role in cartilage aging and the pathogenesis of osteoarthritis. J Biol Chem 2000;275:20069-76.
David Seaman, DC, MS,DABCN
Port Orange, Florida
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