Answers to Questions about Chiropractic:
Should a Physical Therapist Go to
Chiropractic School to Learn Manipulation?

Samuel Homola, D.C.

Question

I am a physical therapist with a master's degree. I have recently been considering going back to school to learn chiropractic. However, after reading much of your site, I am quite dismayed about what you report. I am only interested in the chiropractic approach to treating musculoskeletal problems, so that I can combine the two professions and perhaps offer my patients a wider variety of techniques.

I have taken a few osteopathic-based courses on muscle-energy techniques for the spine. Even there, however, I find people diagnosing everyone with sacral torsion, rotated innominate, or rotated vertebrae. And it appears that inter- and intra-examiner reliability, even among experienced practitioners, is poor.

Do you think it wise to pursue a degree in chiropractic? If not, do you have any ideas where I can get further training in back injuries and manipulative techniques?

Thank you so much for your time and your tenacity in sticking with a scientific medical approach.

Answer

Have you considered going back to a university-based school of physical therapy for a Doctor of Physical Therapy (D.P.T.) degree? This would allow more direct access to your services in private practice where you could use any type of physical treatment method, including manipulation. Many physical therapy schools teach manipulation as well as with mobilization. I have also read about postgraduate classes in manipulation taught by physical therapists.

I agree that it would be a good idea to combine use of spinal manipulation with mobilization and other physical therapy modalities. The spinal manipulation taught in chiropractic schools could certainly be useful. But I would not recommend that you attend a chiropractic college unless postgraduate training in manipulation, offered by physical therapists, is not available. The practice of chiropractic has so long been associated with quackery and cultism that it raises an element of suspicion. Furthermore, the "spinal adjustment" used by chiropractors to correct "subluxations" as a method of "restoring and maintaining health," based on the scientifically rejected vertebral subluxation theory, is not the same as spinal manipulation used to restore normal movement in the spine.

Only a few of the chiropractic colleges offer adequate training in the treatment of musculoskeletal problems. Most train their students to adjust the spine to correct alleged subluxations. Some even lack training in physical therapy modalities, rejecting any treatment method other than spinal adjustments.

Some properly-limited, science-based chiropractors do a good job treating back pain. Most of them include use of physical therapy modalities. Such chiropractors disagree with chiropractic colleagues who claim that spinal adjustments are effective in treating a host of organic ailments, including such things as asthma and ear infection.

I strongly recommend hat you avoid the controversy surrounding the practice of chiropractic. Most chiropractors still cling to the theory that vertebral subluxations cause disease or ill health. The stigma of being associated with such practitioners can be disconcerting and counterproductive. It would be much better for you to obtain a D.P.T. degree and then take postgraduate training in manipulation taught by physical therapists.

Before you make a decision, read some of the articles on Chirobase, particularly my article "How Chiropractic Subluxation Theory Threatens Public Health."

_________________

Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on June 9, 2003.