by Mark Studin DC, FPSC, FASBE(C), DAAPM

Citation: Studin M. Biomechanical Pathology Is Vertebral Subluxation. Dynamic Chiropractic, December 2023;41(12).

• As wonderful as it is, chiropractic has been mired in a cycle between 7% and 10% utilization of the population.
• In large part, it is because we continually use the word subluxation, which is unique to the chiropractic profession, and is great for intra-professional communication, but creates a significant disconnect with those treating 99% of the population; the rest of the healthcare community.
• When I started talking in terms of biomechanical pathology, the entire posture of every collaboratve or referral-based conversation changed and I started being taken seriously as a peer.
• Additionally, biomechanical pathology has its own ICD-10 codes, and is considered usual and customary in the health care community.

The central nervous system is being affected by a biomechanical pathology, also known as vertebral subluxation. As a profession, we must discuss nomenclature, branding, and utilization. This article is based on my observation and feedback on a national basis from those in the medical and legal communities. It has nothing to do with any faction within our profession, either political or philosophical.

As wonderful as it is, chiropractic has been mired in a cycle between 7% and 10% utilization of the population. This has been widely reported in the literature, and no matter what the results or new research findings, we seem to be stuck in this cycle. Over the last 20 years, I have focused on intense market research on why we are stuck, regarging utilization as a profession. In large part, it is because we continually use the word subluxation, which is unique to the chiropractic profession, but creates a significant disconnect with those treating 99% of the population. My observational conclusion after speaking with hundreds of medical doctors at the primary and specialty levels is that based on the disconnect of the word “subluxation,” where they privately think we are clueless in relation to spine care.

When I started talking in terms of biomechanical pathology the entire posture of every conversation changed and I started being taken seriously as a peer, along with my other credentials versus a therapist somewhere in between a massage therapist and physical therapist. When market testing this strategy nationally, the end result was hundreds of thousands of referrals in part because of this. Additionally, biomechanical pathology has its own ICD 10 codes and is considered usual and customary in the healthcare community. Because medicine understands this is a problem and is poorly trained on mechanical spine issues it positions our profession as being the leaders in treating these patients, which is the core of the misnomer “nonspecific back pain.”

• M99.81 Other biomechanical lesions Cervical region
• M99.82 Other biomechanical lesions Thoracic region
• M99.83 Other biomechanical lesions Lumbar region
• M99.84 Other biomechanical lesions Sacral region
• M99.85 Other biomechanical lesions Pelvic region

With biomechanical pathology, there is central nervous system negative sequella, through the mechanoreceptors, proprioceptors, along with autonomic dysfunction function. There is also neurogenic inflammation and significant affarent and bombardment of the CNS through impulses traveling up the spinal thalamic tracts through the periaqueductal gray area, hitting the thalamus and distributing it to different areas in the brain.[1] These are the same effects that have been historically assigned to the vertebral subluxation complex, although not termed as such in the literature.

With persistent biomechanical pathology, Wolff's law also comes into play when the bone remodels through the piezoelectric effect. This has been previously termed “subluxation degeneration.”

Our profession has chosen to rename what is already usual and customary in the healthcare and scientific communities. If we as a profession choose to evolve without giving up our identity by offering a unique chiropractic adjustment, we will be doomed to the same cycle of 7% to 10% utilization, leaving so many people to suffer devoid of our services.

[1] Haavik, Heidi, et al. "The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function." European Journal of Applied Physiology 121.10 (2021): 2675-2720