Knowledge of the Spine

BY Skip Maloney

Have you been experiencing a loss of energy or vitality? It could be that your T5 vertebra housing the nerve functions of the liver stomach pancreas spleen kidneys and adrenals is out of whack.

All of the nerves in your body connect to the spinal cord and pass through the narrow
channel in the middle of your spine. It’s a little like the Internet in that way with vital information traveling back and forth to the brain through this channel which results in your ability to stand up sit down or run around the block.

In fact your nervous system controls and coordinates every one of your bodily functions. If for whatever reason any of your 24 moveable vertebrae those “building block” bones of the spine move out of their natural position they can lower the capacity of this system’s wiring to deliver messages accurately — like an email that ends up reaching some stranger in Timbuktu instead of Aunt Mary in Duluth — resulting in fatigue or pain.

“We tend to take for granted that our experience of life is dependent on the quality of nerve control from the brain and spinal cord ” says Dr. Brian Heer of Sito Chiropractic in Lumina Station. “That is until we fall victim to our symptoms.”

Here to stay

It took nearly 60 years for the practice of chiropractic medicine to be recognized as a legally valid method of health care in all 50 states — from North Dakota’s issuance of chiropractic licenses in 1915 to its one-time ban in Boston to the state of Louisiana’s signature on legislation in 1974. From 1905 to 1931 it’s been estimated that there were 15 000 prosecutions related to the practice of chiropractic even though in that era there were probably not more than 12 000 chiropractors.

Today according to the American Chiropractic Association (ACA) there are more than 60 000 chiropractic licenses in the U.S. Puerto Rico and the U.S. Virgin Islands including dozens and dozens of facilities and practitioners in and around Wilmington. Its recognition as a viable health care profession has come a long way thanks to glowing recommendations from patients who have been helped.

In April of 1994 while a student at UNCW Arian Kelley was in a mountain bike accident that fractured his collarbone. A program of rehabilitative medical care that included “popping pills to mask the pain” failed to relieve that pain. Time spent with a local chiropractor provided “relief like I’d never felt before ” says Kelley.

In the hope that he could do for others “half of what” his chiropractor had done for him Kelley changed courses at UNCW to prepare for a career in chiropractic medicine.

An initial interest in nutrition turned into a Bachelor of Science degree in Human Anatomy and was followed by a Doctor of Chiropractic degree from the Parker College of Chiropractic in Dallas. After remaining in Dallas for two years and Roanoke Virginia for three more Dr. Kelley returned to the southeast coast of North Carolina to set up shop as Choice Chiropractic in Landfall.

Where it all began

The actual profession of chiropractic as a distinct form of health care dates back to around 1895 although even the Greek physician Hippocrates (460-370 BC) known as the “father of medicine ” noted that one should “get knowledge of the spine for this is the requisite of many diseases.” Herodotus a contemporary of Hippocrates gained some fame with his use of therapeutic exercises to cure diseases. When a patient was unable to perform these exercises Herodotus would do the work with his hands manipulating the spine which reportedly led the philosopher Aristotle to register a criticism of his “tonic-free” approach that might well then and now have sent older men rushing to their nearest chiropractor.

“Herodotus ” Aristotle complained “made old men young and thus prolonged their lives too greatly.”

While there is little dispute over the fact that chiropractic’s modern incarnation was the brainchild of Daniel David Palmer — who set up a practice and later a school in Davenport Iowa at the end of the 19th century — there is some dispute about the circumstances surrounding the first known chiropractic adjustment.

According to some reports Palmer restored the hearing of a patient by applying his theory of spinal manipulation. That patient Harvey Lillard had reported hearing something ‘pop’ in his back just prior to losing his hearing.

Lillard’s daughter told a different story. In her version the punch line to a joke heard by Palmer and Lillard prompted Palmer to slap Lillard on the back with a book he’d been holding in his hand. When Lillard reported that his hearing had suddenly improved Palmer started to examine spinal manipulation as an expansion of his existing practice in what he called “magnetic healing.”

From the beginning chiropractic has had its share of skeptics; none more powerful than the American Medical Association (AMA) which as late as 1963 was describing it as “an unscientific cult whose practitioners lack the necessary training and background to diagnose and treat human disease.” In 1987 a U.S. district court judge put a stop to what the court described as a “systematic successful illegal boycott against chiropractors” by the AMA.

Today chiropractors are finding a much broader base of support among members of the medical profession.

Dr. Robert Fibich for example who runs the Chiropractic Kinesiology Center of Wilmington has a mother who as a registered nurse wanted to know initially why her son wanted to become — in her words — a “quack.” These days not only is his registered-nurse mother a patient but so are many other relatives and neighbors.

“Between adjustments to Mom Grandma and the neighbors I’m busier when I go home for the holidays than I am here in a normal work week ” he says smiling. “Once they see what it can do their minds change pretty easily.”

Kathy Winkel a nurse at New Hanover Regional Medical Center (NHRMC) was searching for alternatives to the Imitrex she was taking to combat migraine headaches that virtually incapacitated her when they struck. She came upon Doctor Heer at a mall demonstration in which he was discussing migraine headaches.

Like many who approach spinal manipulation for the first time she was apprehensive.

“I remember my first visit. I was thinking ‘I hope this works ’ and ‘I hope he doesn’t paralyze me.’”

It did and he didn’t. “Dr. Heer keeps my migraines under control and I’m drug-free ” she said adding that her prescription for Imitrex ran out in 2003.

The case for chiropractic

There is a great amount of evidence-based research that supports what we do ” says Dr. Kelley. “The bread and butter of the principle is a specific deliberate adjustment of the spine or an adjacent joint to restore normal motion while removing noxious stimuli.”

According to the ACA educational requirements for doctors of chiropractic are among the most stringent of any health care profession. A document published on its Web site ( states that the typical applicant at a chiropractic college has already acquired nearly four years of pre-medical undergraduate college education including courses in biology inorganic and organic chemistry physics psychology and related lab work.

Once accepted into an accredited chiropractic college the requirements become even more demanding — four to five academic years of professional study are the standard. Because of the hands-on nature of chiropractic and the intricate adjusting techniques a significant portion of time is spent in clinical training.

“There is a large percentage of the population that is not optimally healthy and doesn’t know it ” says Dr. Heer. “People equate ‘symptom-free’ with ‘problem-free.’ The absence of symptoms is not necessarily evidence of optimal health.”

Chiropractic’s emphasis on problem prevention is as important as its ability to problem solve. It’s in the area of problem prevention that chiropractic continues to bear the burden of a questionable reputation. Chiropractic care almost by definition is a program of on-going maintenance that many people equate with some kind of insidious plot that chiropractors manufacture to encourage repeat visits. This puzzles many chiropractors.

“Would you ever approach dental care from the perspective of a single cavity?” asks Heer. “People often think that once they’ve solved a single issue they’re done. They think that the pinnacle is reaching the short-term goal.”

According to Dr. Kelley chiropractic is a “foundational health issue” that can be viewed in much the same way that you might choose to purchase a home.

“If you were set to purchase a home and a mandatory inspection of that home demonstrated a major problem with its foundation you wouldn’t buy that home ” Kelley says. “Our home is our body and too often we overlook the feet and the back until there’s a problem.”

A matter of maintenance

Not only does a chiropractor work with patients in dealing with specific issues or symptoms but he or she will also provide you with a series of “homework assignments” that place a portion of the burden for your overall health care on you the patient directly. In some ways a doctor of chiropractic is engaged in the process of eliminating you as a patient.

“Exactly ” says Irene Menendez a patient of Dr. Kelley. “He’s not saying ‘I’m the beginning and end.’ He’s saying ‘I’m going to help you but I’m also going to make you responsible for doing certain exercises.’ His plan is to not have you have to go to him.”

Megan Calabria a 35-year-old pre-school teacher at Wrightsville Beach Methodist School has been going to chiropractors since she was 16; initially to deal with headaches but today more as a form of maintenance. These days when she visits Dr. Heer she is as likely as not to be there with her 71-year-old mother Barbara Moretti and her own two daughters Francesca (8) and Giovanna (5).

“They never really had issues ” she explains of her children “except Francesca who had allergies that were initially being treated by a pediatrician with Claritin. The tablets started to bother her and she developed some stomach and digestive issues.”

According to Calabria chiropractic care resolved those issues and now Francesca is both drug-free and symptom-free from the allergies.

“My mother started at such an early age ” she adds “that her X-rays are actually better than mine. For her age she has a much better curvature of her spine and I wanted my girls to benefit from that as well.”

Anecdotal evidence like this aside there is a need for more public education about chiropractic health care — about all that it can do and arguably about what it can’t do.

Spinal decompression & brain-based therapies

Since chiropractic health care is uniquely associated with issues related to the spine it’s understandable that patients turn to chiropractors for relief of back and/or neck pain. In fact though chiropractic embraces a wide body of health care options and specialties that address an equally wide body of symptoms.

Like medical doctors that choose to specialize in a particular area or function of the body — neurology oncology dermatology — so too do chiropractors undergo specialized training that focuses attention on certain aspects of chiropractic care.

At Spinal Care of Wilmington for example in addition to general chiropractic treatment Dr. Aaron Richardet and his partner Dr. Jason Graf offer treatment in a procedure known as spinal decompression and a host of brain-based therapies designed to address neurological issues including children and adults with various forms of attention deficit disorders.

Spinal decompression is a non-surgical specialized method of treatment for chronic lower back and neck pain and thus within the parameters of what most people expect from chiropractic care. The brain-based therapies however some of which include use of a device known as the Interactive Metronome proceed from the assumption that the brain not the body is the issue.

“It’s about timing and rhythm ” says Richardet of the Interactive Metronome which as noted in a study published in the American Journal of Occupational Therapy in 2001 “appears to facilitate a number of capacities including attention motor control and selected academic skills in boys with Attention Deficit Hyperactivity Disorder (ADHD).”

“Something (in the brain) has turned off ” says Richardet “so you have to get that section of the brain working again.”

For Dr. Robert Fibich the specialty is applied kinesiology in which he forms a diagnosis using muscle testing as a primary feedback mechanism to determine how a person’s body is functioning.

“Applied kinesiology draws together core elements of many complimentary therapies ” said Fibich “so it provides an interdisciplinary and highly individualized approach to diagnosis and treatment.”