Dynamic Chiropractic

This article presents evidence that Chiropractic Spinal Adjustments (CSAs) yield positive neurophysiological outcomes related to anxiety and depression, emphasizing that the underlying mechanisms are critical. Anxiety and depression are linked to decreased alpha wave activity in the brain. Studies by Haavik, et al. (2024), demonstrated that post-CSA assessments revealed a significant increase in alpha bands, a pattern associated with reduced anxiety and improved relaxation, which persisted when retested four weeks later.

A key distinction is drawn between a CSA—a high-velocity, low-amplitude thrust directed at an identified dysfunctional vertebral motion segment—and generic spinal manipulation. Only CSAs reliably generate Central Segmental Motor Control (CSMC) changes, which are central nervous system changes affecting motor function. Research confirms that CSAs induce measurable neuroplastic changes in cortical regions (including the primary motor and somatosensory cortices), enhance maximum voluntary contractions, and increase neurological feedback (H-reflex and V-wave). Given the known risks and common long-term side effects of anxiety and depression medications, such as SSRIs and benzodiazepines, including emotional blunting and sexual dysfunction, and confirming the safety profile of chiropractic care (an extremely low adverse event rate of 0.00021%), the literature supports using chiropractic as a safe, first-line treatment for managing these mood disorders.

This article presents a proactive, five-part strategy for "squaring the geriatric curve"—the goal of maintaining a healthy, engaged life until a rapid decline at the very end, effectively adding "life to your years" (livegevity) rather than merely extending life. This holistic approach hinges on five synergistic components.

The first is Adjustments (CMT), which maintain normal joint mechanics, reduce degenerative changes, and must be paired with postural correction to reduce the negative effects of gravity. The second is Diet/Nutrition, emphasizing an anti-inflammatory diet high in omega-3s and low on the glycemic index, which helps mitigate systemic inflammation linked to most chronic diseases. Adequate protein intake (at least 0.75g/kg body weight for those over 55) is vital to combat sarcopenia. The third component is Rest/Sleep, which necessitates proper recovery from activity (active or passive) and maintaining sleep hygiene, including calming the brain through meditation or reading. Fourth is Mental Agility, requiring continuous engagement through learning new skills or staying socially active, especially since Alzheimer’s has been linked to inflammation. Finally, Exercise must include aerobic activity (minimum 120 minutes/week), resistance training to preserve muscle and bone mass, and flexibility training, all performed while grooving sagittal- and frontal-plane alignment. Chiropractic care is highlighted as the front-line defense, based on a vitalistic mechanism of healing, that enables patients to achieve this livegevity.

The Letter to the Editor discusses the crucial issue of recognizing and responding to potential strokes in chiropractic practice, particularly focusing on vertebral artery dissection (VAD). The authors affirm that while chiropractors are not expected to diagnose strokes, they must refer patients for urgent evaluation if symptoms diverge from typical musculoskeletal presentations. The article acknowledges that VAD is rare and most patients recover well when referred appropriately. Although there is no convincing evidence that cervical spinal manipulation (CSM) directly causes VAD, the authors emphasize the plausible risk that performing CSM in the presence of an existing, underlying dissection could worsen the condition or precipitate an immediate thromboembolic stroke. Given that vascular screening tests for VAD lack reliability, clinical reasoning and vigilance in history-taking are deemed essential preventative measures. The letter strongly urges all chiropractors to become familiar with published research detailing structured risk-benefit clinical assessment strategies designed to exclude VAD prior to performing CSM. Adopting this framework is crucial for recognizing atypical presentations, preventing avoidable strokes, and reducing significant patient harm and malpractice liability exposure.

This segment compiles several updates relevant to the chiropractic community. The Foundation for Chiropractic Progress (F4CP) celebrated the launch of Adjusted Reality: Supercharge Your Whole-Being for Optimal Living and Longevity, authored by F4CP President Dr. Sherry McAllister, with a successful launch party in New York City. The event, attended by thought leaders and influencers, focused on igniting a movement centered on whole-being health and emphasizing chiropractic’s role at the forefront of that change. In an important professional advocacy effort, the Chiropractic Future Reimbursement Workgroup is seeking confidential input from DCs to document and report real-world reimbursement challenges. This collection of specific data is vital for proving systemic abuse, quantifying harm, and ultimately driving change within the financial landscape of the profession. Lastly, Palmer College of Chiropractic announced its second annual Alumni Awards. Honorees included Louis Sportelli, DC (Distinguished Achievement Award), Paul Hetrick, DC (Distinguished Service Award), Charles “Chuck” Gibson, DC (Entrepreneurship Award), and ten newer alumni who were recognized with the 10-Under-10 Award for reflecting the global impact of the Palmer alumni community.

Part 2 of this series tackles the systemic administrative and financial hardships faced by Doctors of Chiropractic (DCs), suggesting that hostile tactics similar to historical attempts to "contain and eliminate" the profession persist through contemporary business practices. While DCs provide convenient, evidence-based care, intermediary DC networks function to convert this care into a commodity, aiming for the lowest possible cost through utilization controls and suppressed reimbursement. These networks contract DCs individually (via NPI), effectively eliminating the ability to negotiate contract terms and imposing "all or none" bundles. Crucially, fee schedule data required by the 2022 Transparency in Coverage rule show that commercial DC reimbursement is typically well below CMS (Medicare) rates, while other specialties receive 130% or more of those rates. This low, unchanging reimbursement, combined with high patient copays, often leaves patients functionally uninsured, electing to pay cash rather than use their benefits. DCs are further burdened by excessive Prior Authorization (PA) requirements and network profiling based on arbitrary utilization thresholds. Ultimately, the result is that chiropractic care is a profit center for intermediaries who siphon revenue away from the DCs, pushing practices toward the edge of economic viability, causing patients to suffer.

This clinical case report illustrates the application of the evidence-based, patient-centered model of care, emphasizing the necessary integration of the best available literature, clinical expertise, and respect for the patient’s wants and needs. The patient was a 44-year-old female presenting with chronic neck pain and cervicogenic vertigo (dizziness upon head movement), symptoms that began 15 years after a whiplash injury. Objective findings included reduced and painful cervical range of motion, radiating pain upon compression, and somatosensory signs. Based on clinical expertise and the chronicity of the injury, the assessment included suspected cervical cord compression and cervical degenerative changes, justifying orders for a Davis series and MRI to rule out instability. The critical moment arose when the patient explicitly stated she was afraid of and did not want her neck adjusted due to a negative past experience. The author highlights that even if clinical findings supported high-velocity, low-amplitude manipulation, the absence of informed consent—which requires explaining procedures, diagnoses, and outcomes—precludes such treatment. Therefore, the recommended treatment was gentle cervical distraction and soft-tissue work to align with the patient-centered paradigm.

The article examines gaze stabilization—the complex system that ensures crisp vision and stable balance during head movement—and its critical relevance for Doctors of Chiropractic (DCs) in fall prevention. Proper stabilization relies on the sophisticated interaction of three key reflexes: the vestibulo-ocular reflex (VOR), the cervico-ocular reflex (COR), and saccadic eye movements (SEMs). The COR is strongly influenced by the suboccipital muscles, which contain up to 10 times the average density of muscle spindles, providing highly detailed position-sense information about head movements. A failure in this system, often caused by advancing age, vestibular disorders, or neck pain, results in impaired balance, blurred vision, and a greatly increased risk of falling. Specifically, researchers have demonstrated that age-related decreases in SEM speed strongly correlate with impaired dynamic balance and reduced walking speed in older adults. DCs can screen for impairment using a simple, cost-effective dynamic visual acuity test. Crucially, simple, home-based gaze stabilization exercises have been proven to improve postural stability, balance confidence, and even cognitive function in both healthy older adults and those with mild cognitive impairment. Integrating these exercises into conventional balance rehabilitation significantly reduces fall rates.

This article stresses the criticality of accurate charting in chiropractic risk management, particularly focusing on the clinical discussion that links findings to recommended treatment. The author advises that while Electronic Health Record (EHR) templates are useful for recording factual exam findings, the DC’s professional opinion and ethical obligations should be documented in a separate, dedicated, non-templated section labeled "Discussion". This addresses risks identified by the U.S. Office of Inspector General (OIG), such as inaccuracies arising from improper copy-pasting or auto-population in EHR systems. A detailed medicolegal case study of a 44-year-old delivery carrier is presented, suffering from chronic lower extremity pain attributed to work injury, along with plantar fasciitis history. The examination revealed specific issues like an antalgic limp, a proprioceptive disorder (inability to single-leg stance without assistance), and pain inconsistent with a simple lumbar dermatomal pattern. The clinical discussion identified a potential Baxter’s nerve entrapment—a key differential diagnosis often misdiagnosed as plantar fasciitis. The proper documentation justifies chiropractic manipulation to break up adhesions alongside essential referrals for potential surgical consult, MRI (to evaluate nerve entrapment), and ankle X-rays (to measure degenerative joint disease), thereby supporting medical necessity and mitigating legal risk.

Southern California University of Health Sciences (SCU) has made a major step in its mission to become the nation's first Integrative, Whole Health University by announcing an agreement with Pacific College of Health and Science (PCHS). Pending regulatory approval, PCHS’ San Diego and Chicago campuses—including all students, faculty, staff, and academic programs—will officially join SCU in May 2026. PCHS, founded in 1986 as Pacific College of Oriental Medicine, is the largest acupuncture and herbal medicine school in the U.S., also offering curricula in holistic nursing and massage therapy. According to Dr. John Scaringe, President and CEO of SCU, this agreement not only creates a "national hub for TCM education, innovation, and advocacy" but also significantly expands SCU’s influence on whole-person care and healthcare transformation. As part of the merger, SCU will also acquire the Pacific Center for Lifelong Learning, the PCHS cosmetic acupuncture program, and the annual Pacific Symposium conference. This move signifies a cohesive strategy among health education institutions to meet the growing demand for comprehensive, integrative healthcare practitioners. PCHS will retain its New York campus, as it is excluded from this agreement.

The article highlights BAC-PAC (Better Access to Chiropractic PAC) as a critical initiative designed to address chiropractic’s long-standing lag in political influence, which has historically restricted patient access and limited reimbursement in Washington, D.C.. BAC-PAC is the profession’s first and only federal super PAC, dedicated to electing and supporting pro-chiropractic members of Congress. Unlike traditional political action committees, a super PAC can raise and spend unlimited funds independently, allowing the profession to act with speed and scale in key elections—a powerful new tool to influence outcomes. Born from the Chiropractic Future Strategic Plan, BAC-PAC represents a shift toward "playing offense" politically, matching the profession’s strategy to the scope of its clinical contributions. The success of the organization was demonstrated in 2024 when a targeted 30-second ad helped re-elect Congresswoman Jen Kiggans, proving that strategic political investment can yield measurable results. Crucially, BAC-PAC operates non-partisanship, supporting candidates—Democrat, Republican, or Independent—who support chiropractic’s place in modern healthcare. The future success of this effort, which relies entirely on contributions and commitment, will shape whether the profession succeeds or merely survives.