Chiropractic Care Comes Of Age

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We interviewed Dr. Heidi Bockhold, board member of the American Veterinary Chiropractic Association, to learn more about the advances that chiropractic care has made for horses.

Dr. Sharon Willoughby, founder of the American Veterinary Chiropractic Association, defines chiropractic care as the art and science of diagnosis and correction of dysrelationships between the nervous system and the spinal column through manual spinal manipulation. In this interview, Dr. Bockhold further explains this as restoring the normal range of motion to a joint, with the goal of alleviating any nerve irritation that may result from the vertebrae not moving freely.

Chiropractic care is a form of ”manipulative therapy,” which also includes massage, myofascial release techniques and addressing the soft tissues of muscle, fascia and tendon. Osteopathic manipulative therapy techniques also address the spine but include the soft tissues as well. A licensed veterinarian trained in chiropractic care would be the most similar to a Doctor of Osteopathic Medicine (DO) in the United States, where a DO is also licensed to prescribe medication and do surgery.

While we know that chiropractic care has been applied to animals for quite some time, it seemed to undergo a tremendous surge in the 1980s, especially for horses. Can you tell our readers what was behind this'

In 1988 Sharon Willoughby DVM, DC, started a school in Port Byron, Ill., to teach both chiropractors and veterinarians to adjust animals. As the graduates began to practice and clients witnessed the benefits of chiropractic on their horses the demand for animal chiropractic began to grow.

Are chiropractic treatments truly alternatives (to be used in place of more mainstream approaches), or would complementary be a better description'

Options for animals refer to animal chiropractic as integrative care. We encourage our students to work with all health-care professionals for the health and well being of the horse.

We understand that the principle behind chiropractic medicine is that the nervous system influences all body organs and functions, and that spinal malalignments may interfere with nerve function. An example of that anyone can understand would be spinal arthritis and ”pinched nerve” pain, like sciatica, or a prolapsed disk that is actually putting pressure on the spinal cord. Chiropractic seems to be talking about much more subtle things sometimes though, e.g. that even areas appearing normal on an X-ray may need adjustments. Can you explain'

All of animal chiropractic diagnosis and treatment is performed within the joint’s normal range of motion. The motion of a joint is evaluated at the elastic barrier looking for decreased or aberrant motion. The lack of motion can cause edema, inflammation, and toxins in the area. All of these factors can cause irritation of the nerves entering the spine. In addition to the nerve irritation, if a joint is not moving enough the other joints in the spine have to increase their motion to compensate. Over a long period of time this leads to arthritis in the joints.

The word misalignment is often misunderstood to mean that one or more bones in the spine have moved out of their normal range of motion and that chiropractic returns these bones to the correct place. Because chiropractic only treats joints within their normal range of motion the joint can appear normal on x-ray.

Studies of the morphology and range of motion of the horse’s back have found many segments, particularly the most caudal areas, to be relatively inflexible and have raised the question about whether it is even physically possible to ”manipulate” these areas in a normal horse. How does this relate to chiropractic adjustments of those regions of the spine'

As previously stated chiropractic is performed within its normal range of motion. The motion of one joint in the spine may only have 3 to 5 mm of movement.

With training a practitioner is able to assess the elastic barrier and motion of a particular joint as well as introduce a specific thrust in a specific line of correct to a joint to restore the movement of that joint.

Is it ever dangerous to perform chiropractic maneuvers on a horse ??? for example, a wobbler or a horse with an acute sacroiliac problem' Are there times when chiropractic treatment is contraindicated'

There are contraindications to adjusting the spine. For example, fractures, dislocations, infections, severe soft tissue injuries to name a few. The students are trained to recognize and exercise the appropriate precautions when examining and treating an animal.

Lateral facet joint fusions are fairly common in the backs of horses that race or jump. Does that limit how much effect chiropractic treatments can have, or should try to have'

Pathology in a joint can change the effectiveness of an adjustment in that joint. However by maintaining the rest of the spine, chiropractic can slow the degenerative processes down in the other joints.

Can joints become out of alignment for reasons that are not simply related to conformation, that is, not simply how the horse is built' How does this happen' Does chiropractic medicine address this also'

There are many causes of joint fixation. A few examples are confinement, strenuous training, poor nutrition, stress from travel, slips, falls, repetitive micro trauma etc. In addition to adjusting the horse it is important for the animal chiropractor to educate the client to some of the causes of the vertebral subluxation complex and how they can help their horse have fewer problems.

Vertebral Subluxation complex is what animal chiropractors diagnosis and correct.

How do you go about determining if an area requires an adjustment'

The animal chiropractor evaluates the horses gait, posture, muscle tone, and then each joint in the spine and extremities are motioned to detect decreased motion or fixation of that joint. If there is aberrant motion then the joint is adjusted.

What exactly is an adjustment and how is it performed'

An adjustment is a high speed, high force, low amplitude thrust given in a specific line of correction according to the joints anatomy to restore the normal motion.

What techniques are not recommended'

There are over 200 different techniques in human chiropractic. Many have been adapted to animal chiropractic. There are several types of manipulation done on horses that are called chiropractic but aren’t chiropractic at all. Mallets and many of the hand held instrument can be dangerous to use on the bones of the spine.

Are other techniques used as well, such as massage, trigger point or acupuncture point stimulation'

Other modalities can be used to enhance the healing process. They are not considered chiropractic and are usually performed by other professionals that have expertise in those areas.

If combined modalities are used, how can you determine which actually might have had an effect'

If an animal is in need of concurrent care those modalities are often added in to the care plan one at a time so as not to over load the animals system. The progress is monitored in order to record improvement for one modality to the next.

Are chiropractic techniques really a legitimate treatment for things like lung disease or colic'

Remember the key is integrative care. Chiropractic care does enhance the body’s inborn ability to heal and archive homeostasis. By adjusting the spine and allowing the body to function at a more effective level, the immune system, the endocrine system, the digestive system, the respiratory system, etc. are improved. Should an animal chiropractor be the first one called when your horse begins to colic ' No, that horse needs immediate medical care. Once the horse is stabilized and out of danger, adjusting that horse can assist the horse is his recovery and possibly prevent another episode of colic.

What is the AVCA'

American Veterinary Chiropractic Association is the organization that was created by Dr. Willoughby to independently examine the graduates of the accredited schools.

What is involved in the AVCA certification program'

Both veterinarians and chiropractors are eligible to attend one of the AVCA-accredited schools. The program is 210 hours of study including, but not limited to, animal anatomy, pathology, animal handling, chiropractic history, motion palpation, adjusting laboratories, chiropractic philosophy, and theory. The students are required to pass several exams as well as a final written and practical exam. After completing the program they’re eligible to take the AVCA exam.

How are chiropractic practitioners regulated at the federal and state level'

There is no federal control as of yet. Each state’s veterinary and chiropractic licensing boards regulate their own. The laws vary from state to state.

Why is there such a shortage of published controlled studies or even case reports with respect to chiropractic care' Doesn’t this hinder its acceptance by veterinary professionals in general'

Funding for such projects is very limited. Also most of the practitioners are practicing and don’t take the time to write and submit their cases. I don’t think that this hinders the acceptance by veterinary professionals because they’re seeing the results in their patients that are receiving.