The Cause of the Cause

Posted by Bill Esteb on May 26th 2022

Because our culture confuses symptom treating with health care, most chiropractic patients show up as a last resort after the failure of medicine or the side effects of drug therapy have become unbearable.

The many chiropractors are quick to remind patients that one of the distinctions that makes chiropractic unique is that unlike medical treatment, chiropractic care addresses the underlying cause of a patient's problem.

This assertion is often accompanied by a subtle or not-so-subtle air of superiority.

But is it true? Does chiropractic address the cause?

I know it's a common mantra, but do repeated adjustments address the cause of a patient's health issue?

I ask because at a recent speaking gig I was called out by an audience member for making just such an assertion. It prompted me to explore my thinking on the subject. Perhaps my musings below will clarify your thinking as it did my own.

Better Than Fooling the Body

I believe that vertebral subluxation is the body's gorgeous, creative, resourceful response to accommodate physical, chemical or emotional stress. As such, vertebral subluxation is a good thing, increasing our ability to adapt and survive despite the countless stresses to which we are exposed. Being anti-subluxation is to be anti-adaptive.

Adjustments, to reset this survival mechanism, especially if the offending stressor has come and gone, is certainly superior to ingesting a drug to fool the body so it can't sense the pain.

But is improving spinal biomechanics, with the intent of reducing nervous system interference, addressing the cause?

I don't think so.

Are Patients Willing to Partner?

Since spinal bones are static structures that move when muscles contract, and muscles only contract when commanded by the nervous system, if you are intent on addressing the cause of the patient's health issue, you'll want to go deeper. You'd want to become mindful of what it is/was that prompted the body to manifest the defense mechanism we call vertebral subluxation.

It was D. D. Palmer who asserted that the three causes of vertebral subluxation are “trauma, toxins and thots,” the latter which he referred to as autosuggestion. Even back then it was recognized that thoughts are things. Still are.

His model of the vertebral subluxation acknowledged metaphysical causes, such as the patient's values, phobias, beliefs, wrongheaded ideas, ignorance and subconscious programming which influence nervous system tone responsible for producing vertebral subluxation without physical trauma.

This autosuggestion component may be more a common cause than trauma and why chiropractic care is often palliative.

The reduction of symptoms, which is what most patients seek, and by which many chiropractors judge the success of their intervention, rarely produce significant or lasting structural changes to the spine.

To do that, in addition to repeated adjustments, improved sleep, nutrition, hydration and all the rest, it requires extraordinary patient cooperation, involving traction and specific unilateral exercises or maneuvers. Something for which few patients have interest—especially after achieving symptomatic relief.

After all, few, if any, patients begin care by calling your practice with the hope that you'll restore their cervical lordosis or improve their posture!

Going Through or Around

Something happened prior to the moment when the nervous system commanded a particular vertebra to become malpositioned. It would be helpful to be mindful of this subluxation precursor.

If some type of trauma is the cause the cause it could look like this: rear end collision whiplash neck and low back pain. Reducing the relevant vertebral subluxation(s) obviously doesn't correct the root cause, especially since the trauma was an event from the past.

If a toxin is the root cause it might look like this: heavy metal exposure → atlas subluxation → headache. Reducing the relevant vertebral subluxation(s) won't eliminate the exposure to the toxin. In fact, if the toxin is still present, chiropractic care may appear “not to work.”

If thots are the cause of the cause: feeling unsupported → L4-L5 subluxation → sciatica. Reducing the relevant vertebral subluxation(s) obviously doesn't correct the cause of the cause. If the emotional stressor is still present in the patient's life, managing the patient's pain is more likely than correcting the cause.

I don't find many chiropractors interested in, much less capable of, addressing the cause of the cause. Bringing awareness to a problem for which one doesn't have a solution isn't usually part of the practice model.

And it's not just that insurance carriers won't reimburse for it. Getting to the cause of the cause of a patient's problem can be time-consuming and messy for which most chiropractors are untrained to pursue. Plus, many patients would rather not subject certain aspects of their life to the introspection required to make real change. Especially when such a suggestion is coming from someone they thought was going to merely help them with their back pain.

So, instead of going through, which is the pathway to healing, they continue to go around, compartmentalizing or suppressing their emotional, environmental or spiritual stress.

Where to From Here?

There's no shame in relieving the suffering of patients by addressing biomechanical tension to the nervous system. So please don't take any of this as judgment or condemnation. But rather a potential explanation for why chiropractic doesn't enjoy the 100% success rate so many wish it would. And why searching for one more technique that involves thrusting into the spine may not be the solution either.

However, if you're truly interested in going deeper with willing patients, you might want to acquire additional tools that are more tonal, emotional or energetic in nature. Or, if that sounds uninteresting, a more obvious option is to develop a network of trusted counselors, therapists, energy workers and other resources to which you could refer patients who want to address the cause of the cause of the cause.

If I've missed something here, let me know


I was almost uncomfortable reading your thots.

I can assure you we are on the same page and as a chiropracTOR I really see your view.
As you stated, it is harder in real practice to coach people into doing what will really help them. As a result most want "Patch Care."

I started my journey in chiropractic as a patient in 1964. I began practice in 1975. I am certain most people "in chiropractic" are just as you say, acting as an alternate to medicine--as opposed to finding cause!

Almost every week I'm checked by my chiropractor and I'm always happy when I do not require an adjustment.

Holding is health. Not holding is adaptation and should return us to normal function provided we can become free of interference either spontaneously or with a specific chiropractic adjustment or through correcting the other underlying causes or perhaps with a combination of them all.

This will have me checking closer.

Thank You,

Michael W. Shreeve, D.C., L.C.P, D.Ph.C.S.

You hit the nail on the head in your assessment. I have struggled with the philosophical aspect of "we treat THE cause" of a patients presenting problem...and came to the conclusion you eloquently stated.

So...thank you for putting it out there it helps me appreciate how I do what I do for those that choose my approach to chiropractic care. I do my best to interest them in using care for more than symptom relief, but keeping in mind that we are now more than ever faced with "mental stressors" that can impact the body and manifest in a physical way. So people latch on to that and some don't..."their body their choice". Thank you again!


David Foster, DC