For over two million years, many populations have utilized manipulation as a mode of therapy. The earliest influence was the Eastern ways of healing, which relied heavily on manipulation (1). In fact, some of the earliest forms of mobilization were practiced in China and India (1). For example, in India, bath attendants used joint manipulation not as a therapeutic modality, but rather for personal purity. This practice was so embedded in hygienic standards that bath attendants would not surrender until they adjusted the spine (1). Furthermore, in China mobilizations were used as early as 2700BC, where they emphasized massage and exercise along with manipulations (1).
The tradition of spinal manipulation is linked all the way back to Hippocrates, and marks the beginning of the Western world renaissance (1). It is during this period that Hippocrates shifted the chiropractic paradigm, emphasizing the importance of the spine and its relation to illness and health (1). Hippocrates used modalities such as succusion (gravity traction) as well as adjusting tables (1). For Hippocrates, these techniques were the foundation of healing and were on par with other medical treatments (1). Probably of most importance, is the stress he put on holistic health, which the reality of today.
The tradition of bone setting can be traced through text to as early as 1656, with Moulto (1). The nineteenth century is when the practice of bone setting became a well-recognized profession among the humble working class (1). Despite their honest work ethic, bone setters were denied the privilege of treating patients in hospitals for going against the medical norms (1). In reality, bone setters were still in high demand by the public who were suffering from neurological conditions such as sciatica, lumbago and rheumatism (1). As a result, in England, doctors began to incorporate the unorthodox techniques into their practices, eventually calling themselves osteopaths (1). Bone setters during this period began to divide into other professions that are recognized today: chiropractic, orthopedists as well as osteopath (1).
Manipulative therapies have been the common grounds for professions relating to physical therapy, such chiropractic and osteopathy alike (1). Originally, osteopathy had a strong foundation built on manipulation, but as the years passed, the profession steered toward a more medical base practice, focusing on surgeries and “material medica” (1). Despite this, manipulative therapies have become a specialty of the osteopaths nowadays. Over the past century, the profession of physical therapy has been an integral part of the movement that has aided in the revolution of manipulation and its therapy (1). It has actually been a part of the of physical therapist’s repertoire since the professions creation, yet it has only has been singled out as a specific treatment since the 1990s (1).
From the topics discussed above, is it clear that chiropractic has taken a very distinct path to become the practice it is today. From early primitive healing, to Western healing; chiropractic has developed from the each of these and the metaphysical dogma they represent. Throughout the timeline, this idea of an innate system that self heals when guided appropriate is recurrent. Metaphysics encompasses the philosophy that deals with the primary theory of a concept, or abstract thing (2). Health care in the past was very much focused on metaphysics, and believing in abstract modalities, yet the importance here is that the earlier ideas of chiropractic were explored critically (2). Thus, metaphysics has led to where we are today, having a sound evidence based understanding of those once abstract, and unorthodox medical practices (2).
1. Wiese G, Callender A. History of spinal manipulation. In: Haldeman S, editor. Principles and practice of chiropractic. 3rd ed. New York: McGraw-Hill, Medical; 2005.
2. Senzon S. Constructing a philosophy of chiropractic: evolving worldviews and premodern roots. Journal of Chiropractic Humanities. 2011:18(1):10-23