January 2006

Discovering the global burden of subluxation

by Dr. Terry A. Rondberg

What impact does vertebral subluxation have on the world? Does it affect human health and well‑being? How does it alter the mortality and morbidity rate in various population groups? Can it be a factor in combating pandemics or raising the wellness level in developing nations?

These are some of the questions we, as a profession, must answer if we are to secure a position for chiropractic in the 21st century health paradigm.

To arrive at the answers, we'll need to approach the challenge with a massive information‑gathering effort that can combine the most credible research protocols with the power of electronic data collection technology.

In many ways, we have to model the effort on the World Health Organization's "Global Burden of Disease (GBD) project," which was started in 1993.

Although we always assume there's a mountain of research to support the medical approach, that isn't the case. According to the Harvard School of Public Health, "Historically, there has existed no reliable epidemiological data‑set sweeping enough to identify priorities for health services and research." The GBD project ‑‑ sponsored by WHO and the World Bank ‑‑ was launched as a worldwide collaboration of about 100 researchers.

Based on the data those 100 or so researchers compile, the project "series comprehensively quantifies the burdens of 486 sequelae of 108 major causes of death and disability, disaggregated by eight geographic regions and ten age‑sex groups; risk factors are evaluated and projections to the year 2020 are made."

Thanks to this ambitious project, we know more than ever about the state of human health throughout the world. Scientists have quantified the health impact of factors as diverse as climate change, obesity and clinical depression and have even been able to estimate how many years each factor takes off our life. These "Disability Adjusted Life Years," or DALYs as they're called, combine the time lived with disability and the time lost due to premature mortality. One DALY can be thought of as one lost year of 'healthy' life, WHO explains.

What if the GBD project included vertebral subluxation as one the criteria it studied? How many DALYs would subluxations be responsible for? How many more years of healthy life would be added if we were a subluxation‑free world?

Not surprisingly, the GBD project did not include subluxations. After all, many of our own researchers and leaders continue to remind the world there's little proof that subluxations even exist, let alone have an impact on health.

For instance, an article written by Donald R. Murphy, DC, and nine of his colleagues in the Sept. 1, 2005 issue of Dynamic Chiropractic, noted that "the scientific literature has failed to demonstrate the very existence of the subluxation."

Likewise, in the January 2004 issue of the "Journal of Manipulative and Physiological Therapeutics (JMPT) Joseph Keating, PhD stated: "I cannot recall ever reading a randomized controlled clinical trial in which putative segmental indicators of subluxation were monitored alongside clinical outcomes variables such that correlation between subluxation correction and improved clinical outcomes could be demonstrated."

Sadly, they are at least partially correct. (I do dispute their claim that there is no proof of the subluxation's existence or impact on health. There have been a number of excellent research papers in the Journal of Vertebral Subluxation Research and other chiropractic journals that provide a firm foundation of evidence.)

Still, they are correct to say that we lack the kind of research data that would allow us to quantify the global burden of subluxation and be accepted by the world's medical and scientific communities.

But we are closer to that goal than ever before, thanks to RCS (Research & Clinical Science), the private‑sector project that is engaging in a global data gathering effort to identify and quantify various factors relating to subluxation and health.

It's hard to believe that the chiropractic profession could conduct research on the scale of the World Health Organization or Harvard. Yet, while the GBD included only about 100 researchers, RCS is prepared to train and equip thousands of chiropractic doctors as field researchers, collecting data from hundreds of thousands ‑‑ and perhaps even millions ‑‑ of people around the world.

Naturally, RCS doesn't have funding from the World Bank and can't rely on government grants. If we wait for that to happen, we'll never get the research we need. Instead, each doctor involved in the program is asked to pay a fee (as low as $149/month) to become an Authorized RCS Clinical Investigator. Many doctors have chosen to become RCS members solely to be part of this monumental research effort rather than because their practices could grow significantly as a result.

It's hard to understand why some chiropractic researchers haven't enthusiastically jumped on board this project. They say we need the hard, scientific proof that subluxations have a negative impact on health and that chiropractic care can provide specific benefits. Yet, they continue trying to keep all meaningful research restricted to their own little exclusive domain, to maintain their elevated position above the rabble of mere practitioners in the field.

Despite their initial skepticism, they can no longer have doubts about RCS's legitimacy. Not only has it earned approval by an independent Institutional Review Board, but it makes sure every doctor who participates in the program is approved as well. No other chiropractic research project ever conducted has been as scrupulous.

Nor can they have failed to be impressed by the composition of the RCS International Scientific Advisory Panel, a multi‑disciplinary group of world‑class scientists with extraordinary credentials and expertise. As a group, their research papers have been published in hundreds of major scientific journals through the world, including:

It's clear that RCS has the scientific research expertise and scope to carry out chiropractic's "Global Burden of Subluxation" project. Thanks to doctors around the world who are bold enough and dedicated enough to become RCS Authorized Clinical Investigators, we will finally be able to answer the important questions about chiropractic and provide the "proof" that chiropractic is a key element in health, longevity and well‑being.

Whether you're motivated by the desire to help prove chiropractic works, expand your practice, or raise the level of your profession's credibility in your community, you should consider joining your colleagues as a member of RCS.

To learn more, call RCS at 800‑909‑1354 or 480‑303‑1694, or visit the RCS website at www.rcsprogram.com. Log on to the special limited‑access area of the site by using the username DC1 and password RESEARCH.