Paradigm Shifts in Chiropractic – Part 2

Posted On: May 31, 2012

I am Dr. David Johnson and I am both a chiropractic physician and a physical therapist. I have been practicing since 1988 and I have been witness to a lot of changes in the chiropractic profession.

In my last blog I wrote about the shift in the chiropractic paradigm from the bone out of place subluxation model to the joint restriction or fixation model that most chiropractors believe today.

In this blog I am going to blog about the early shift to evidence based medicine which I witnessed while I was a student at the Logan College of Chiropractic in the mid to late 1980’s. While at Logan I got exposed to many different techniques including the Logan basic technique, the Gonstead technique and what is called diversified chiropractic adjusting. We also could take electives and I chose to take the Cox flexion distraction technique as one of mine.

The reason I chose the Cox technique was because I went to see Dr. Cox at a seminar and I was very impressed with his command of radiology, diagnostics and the patho-mechanics of lower back pain. Dr. Cox had published a text book titled: Lowe Back Pain: Mechanism, Diagnosis and Treatment and had developed his own treatments for a number of different conditions that cause lower back pain.

This was the first time that I had ever run into such a well-read and well-referenced chiropractic physician. Like many a young chiropractor I was searching for validation and Dr. Cox appeared to have the answer.

I read his book and learned his technique and applied the technique to many of my early patients and got good results in helping them to recover. Surely this was the answer that I had been seeking.

Alas Dr. Cox was not the answer to all of my patient’s lower back problems. He indeed had identified a useful tool but even though there wasn’t as much referenced literature for the other techniques, many of them have good studies to now back them up. There also was the growing body of evidence for the McKenzie technique, which was originally championed by physical therapists.

What I didn’t realize back in the late 1980’s that having a theory and scouring the references for evidence that supports your theory is the lowest level of evidence. It is not until the theory has been tested in randomized controlled trials and it holds up does the theory have real weight. Fortunately for Dr. Cox his theories are starting to be tested and in the early trials and case series they have been shown to be clinically effective.

His however is not the only effective technique and other approaches like chiropractic manipulation and the McKenzie technique are gaining their share of good results as well. In my next blog I will discuss how all of the techniques fit together to help North Shore Spinal & Sports Rehab better serve it’s patients.

To learn more about our practice visit us at To schedule an appointment, please call our Lake Forest, Lake Bluff office at 847.295.0920, or our Highland Park office at 847.432.4077. You may also use our online Request an Appointment form.

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