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Posted on 08-24-2010

What is a Chiropractic Neurologist?

Within the Chiropractic profession, there are specialists in radiology, orthopedics, neurology, and physical rehabilitation. A Chiropractic Neurologist is a licensed chiropractor who has completed an additional 3-year course of study in neurology, including coursework and residency-based clinical training, and has passed a comprehensive certification examination administered by the American Chiropractic Neurology Board. There are currently only about 400 board-certified chiropractic neurologists in the world.

A Chiropractic Neurologist is qualified to diagnose and treat a range of nervous system disorders, just as is a regular medical neurologist. An important difference between the two is that the therapies a Chiropractic Neurologist prescribes do not include drugs or surgery. Typical dysfunctions treated by a Chiropractic Neurologist include a variety of movement disorders, including the painful involuntary muscle contractions known as dystonia, stroke, hemispheric brain lesions, and radiculopathy, commonly known as a "pinched nerve." In addition to providing therapies and treatments, a Chiropractic Neurologist can provide counseling about diagnostic dilemmas and offer advice about the appropriateness of care a patient may already be receiving.

What therapeutic perspective does a Chiropractic Neurologist offer?

There's an old-fashioned belief that brain development takes place early in childhood and then stops by the time we reach maturity. In fact, recent research has shown that the brain never stops changing in response to input from the environment. Sensory information gathered by receptors in the muscles and joints, for example, can alter the function of brain systems, which in turn affect the function of those receptors. The Chiropractic Neurologist is a specialist in "brain-based" therapy modalities, that is, therapies informed by an understanding of the brain's role in joint and muscle dysfunction.

Humans have many kinds of sense receptors, which we use to gather information about the world around us and within our own bodies. You've probably heard, for example, about the rods and cones in the eye's retina, which we use for detecting color, shape, and movement. You may not know about mechanoreceptors, receptor cells sensitive to mechanical stimulation such as touch, pressure, and tension. We have mechanoreceptors not just in our skin (for the sense we think of as touch), but also in our muscles and joints for a less-well-known sense called proprioception. Proprioception is the largely unconscious sense that allows your brain to know at all times where your body parts are and what they're doing, even if you're not looking or paying attention. If you close your eyes and touch your finger to your nose, your sense of proprioception is at work.

All of the sense receptors connect to nerves that in turn connect to the spine and brain. As sensory input is routed through the nervous system, it alters the function and structure of the brain on an ongoing basis. The brain in turn uses sensory input to regulate the body that houses it, constantly sending information and instructions back to all body parts, including the receptor cells that gathered the sensory information in the first place.

All of the sense receptors, joints, muscles, and nerves, together with the spine and brain, form a single, integrated system in constant communication with itself. Even such a seemingly simple act as walking requires a complex exchange of information among all parts of the system. As you step forward, mechanoreceptors send information to your brain about the position and movement of your joints, which your brain then uses to perform precise calculations, formulating commands to send back to your legs. At exactly the right moment, some muscles contract while others relax, and your weight is shifted in just the right way to let you take another step without falling. You're never conscious of the information your mechanoreceptors are sending to your brain or the calculations your brain is performing to send the right instructions back to your muscles. All of those instructions depend ultimately on the position and movement of your joints, which are thus integral to your nervous system.

In this integrated system, a change in one part can't help but affect all the others. For example, the biomechanics of a joint can be altered by injury, poor posture, or repetitive stress, resulting in a condition known as Subluxation. When that happens, a cascade of harmful structural and physiological consequences may follow:

(1) Decreased mechanoreceptor stimulation in and around the joint results in inadequate information sent to relay centers in the brain, which leads to poor control of the muscles. That in turn can lead to weakness in muscle groups such as postural muscles, due not to lack of exercise but to inadequate activation of the nervous system. Given that the brain adjusts itself constantly in response to environmental input, decreased stimulation by the mechanoreceptors can actually result in degeneration of the brain's relay centers. (2) Lack of movement of a joint results in atrophy of surrounding muscles. The deep layer of muscles around a joint can be activated only when the joint moves. If those muscles become too weak, the joint itself becomes less stable, perpetuating a vicious cycle. (3) In an attempt to compensate for deep-muscle atrophy, muscles closer to the surface tighten and are liable to spasm painfully.

The Chiropractic Neurologist specializes in assessing the health of every part of this loop connecting the joints, muscles, and nervous system, and in identifying imbalances in each part that can lead to problems with the others.

What kinds of treatment does a Chiropractic Neurologist prescribe?

Depending on the location of dysfunction, the Chiropractic Neurologist may work directly on the muscles, joints, or nervous system. Treatments may include chiropractic adjustments, neuromuscular re-education exercises, deep tissue treatments, rehabilitation exercises or stimulation of the auditory, visual, vestibular (balance), or other sensory systems.

What special skills does the chiropractic neurologist bring to the art of joint manipulation?

Many physical medicine practitioners -- including physiatrists, osteopaths, physical therapists, and massage therapists -- have become aware of the benefits of joint manipulation or mobilization. What does a Chiropractic Neurologist have to offer that the others don't? M

Any practitioner should have a comprehensive understanding of the patient's condition before performing joint manipulation. Of all the practitioners just mentioned, only chiropractors receive four years of formal training in both the art of joint manipulation and the science of the biomechanics of joints. In addition, only Chiropractic Neurologists have specialized advanced training in the neurological systems interacting with

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