Autonomic Nervous System Assessment - A Key to Chiropractic Care

Although chiropractors have existed for more than 100 years in their specific health care field, there are different opinions regarding to where this professional field belong to - whether traditional or alternative fields of health care. Are chiropractors just providers of spinal care or are they providers of treatments for a variety of non-spinal conditions? What kind of scientific assessment methods may help them to position themselves as providing care of a broader scope in accordance with postulates made by the founder of modern chiropractic school Dr. D. Palmer?

Main dilemma of chiropractic care.

It is widely known that most chiropractors deal with patients who have back or neck pain. Approximately, one out of five people experience such symptoms at some point in their life. In this situation, the main objective of a chiropractor is to help the patient to get rid of the pain. However, according to multiple publications, the objective of the chiropractor extends to not only to relieve the patient of back or neck pain, but to also to improve the overall health of the individual. This is based on the assumption that various structural and mechanical changes in the spinal cord often negatively influence the autonomic nervous system of a human being. Being under such influence the autonomic nervous system is not able to provide adequate innervations of various internal organs of the human body, which will lead to the individual being more susceptible to various illnesses. It, therefore, becomes very crucial to fix these structural and mechanical changes as soon as possible, in order to prevent further damage to the overall health of the person, as well as provide possible treatment of his/her current illnesses.

Such approach to chiropractic care comes from the philosophy of Dr. D. Palmer, who was the founder of modern Chiropractic Medicine. At the end of the 19th century, he suggested that "a subluxated vertebra... is the cause of 95 percent of all diseases. The other five percent is caused by displaced joints other than those of the vertebral column."

However Dr. Palmer's opponents state that he made this conclusion based on a single clinical case, trying to explain why patient's deafness was cured by spinal manipulation. The opponents state that there is not enough scientific evidence to originate a conclusive statement that treatment of back or neck pain is related to the cure of other health issues.

Thus one of the big issues which chiropractors have to resolve is positioning of their specific profession. Whether they primarily treat spinal or neck problems causing pain or they treat much wider range of health disorders. One possible reason for the latter argument is that chiropractors do not widely use special instrumentation that could objectively test their patients' to find out if their treatment causes positive effects.

What method can help chiropractors to assess effects of their treatment?

One of the possible ways to solve this problem is to assess the body's Autonomic Nervous System activity. The Autonomic Nervous System (ANS) is a mechanism which controls all of the body's processes. Depending on the performance of the ANS, the body either functions normally, or experiences some abnormalities. At their early stages, many sicknesses can be linked to a disruption in performance of the ANS.

As of today, some chiropractors are trying to test the effectiveness of their treatment procedures by evaluating their effects on the sympathetic nervous system. For example, they try to measure the decrease in blood pressure, increase in skin temperature, as well as increase in blood flow. However, there is a much more effective method to determine the status of autonomic nervous system (ANS) activity based on analysis of a person's heart rate variability (HRV).

It is well-known that a decrease in heart rate variability is a leading sign of a disruption of the ANS function. There were several clinical studies showing that proper chiropractic treatment procedures led to the increase in HRV. E.g. Dr. Zhang et al. from Logan College of Chiropractics showed that both single and long-term chiropractic adjustment care eliminated bodily pain and also resulted in increased patient's heart rate variability. Therefore HRV assessment is the most appropriate method of testing patient's autonomic function during chiropractic treatment procedures.

Autonomic nervous system assessment tools available.

One of the most appropriate and affordable tools available for this purpose is the Heart Rhythm Scanner developed by Biocom Technologies. It gives an assessment of the autonomic nervous system function within just 5 minutes. Upon completion of the testing procedure it generates a detailed report, which includes interpretations of the state of balance between the sympathetic and parasympathetic systems, along with the level of their function.

Here are some useful tips on how to use the Heart Rhythm Scanner in chiropractic care during the treatment of patients with various back and neck problems:

1. Assess the autonomic balance before and after the treatment procedure.


2. If the results of post-treatment testing show improvement of the autonomic balance, the treatment not only cured the patient of neck/back pain but also had a positive effect on the autonomic function so other body organs benefited from it.


3. If the results of post-treatment testing show worsening of the autonomic balance, the treatment procedure caused a negative impact on the autonomic function and it is extremely important to review the treatment option in greater details to find out what may have caused a negative effect on the autonomic function.


4. If the results of both pre- and post-treatment testing showed an abnormal autonomic balance, it is likely that patient has problems with autonomous regulation. The patient would then have to undergo more in-depth examination, in order to figure out the reason(s) behind these problems. In such a case, multiple testing of the autonomic function during the course of treatment may allow for assessing its effectiveness.


5. If the results of both pre- and post-treatment testing showed a normal autonomic balance and did not change much, this means that the autonomic function is fine and the focus should be shifted towards just fixing the main complaints which brought the patient to the doctor.