spinal alignment

Chiropractor In Amarillo Talks About Back Alignment: Useful Terminology?

Amarillo chiropractor, Dr. Jeff Williams discusses the use of the terminology. 


I need to start this blog entry by saying that there is a great divide in the chiropractic profession. There are really 3 factions in the chiropractic profession. While I’m not particularly fond of labels, it is useful to make a distinction between the three. We will call one of them the philosophical camp, one the agnostics, and the other we will call the evidence-based camp.

Let us now discuss the differences.

Philosophical Faction:

Roughly 20% of the chiropractic profession consists of chiropractors holding the belief/opinion that most, if not all, of the diseases are caused by 'subluxations' in the body. When chiropractors talk about subluxations, it is quite different than when a medical doctor speaks of a subluxation. According to the medical profession, a subluxation is something less than a dislocation and is commonly used when discussing a shoulder injury or something of that nature. For example, the head of the shoulder comes out of socket and then comes back into the socket. It can hurt like crazy but it is less than a full dislocation. It is termed a subluxation. Which is a medical term and has been far before the chiropractic profession was ever originated. 

When the faith/philosophical/subluxation theory chiropractors speak about subluxation, they’re talking about something entirely different. They base their entire practices on the term and the theory. The basic theory is that there is a misalignment of vertebral bones causing pressure on the nerves exiting the spinal cord at that level. This pressure causes dysfunction in the tissue the nerve then runs to. Basically, they say the back is 'out of alignment'. This is where that ‘back alignment’ terminology comes from.

If they are able to ‘align’ the back alignment and keep pressure removed from the nerves exiting the spinal cord, they’ll be able to heal almost any malady within the body. They believe regular adjustments even keep you from needing any vaccinations. They believe you can cure just about anything this way. Through proper back alignment.

This is a good spot in our discussion to point out that this theory has never been proven through any sort of peer-reviewed, randomized controlled trial, systematic review, or....really any kind of reputable research at all. 

Evidence-based Faction:

Roughly 80% of the chiropractic profession tend to consider themselves evidence-based practitioners or, at the very least, evidence-informed. This means the vast majority of the profession does not use the terms ‘subluxation’ or ‘back alignment’ or any of the associated theories to health and disease at all. As mentioned, evidence-based chiropractors do not feel there is any high-level research supporting using the terminology.

Many, if not most, evidence-based chiropractors look to integrate patient treatment with other practitioners in the healthcare field. Rather than treating the patient 50-100 times in a year, evidence-based practitioners are seeking to find the most efficient, quickest ways to obtain a successful outcome for their patients and they are quick to refer their patients out to other specialists when the case is clearly out of their expertise. They tend to have a good feel for when back alignment is ineffective.

There are excellent guidelines for the chiropractic profession and very high level, randomized-controlled trials showing significant effectiveness for chiropractic care. Chiropractic care has proven its worth time and time again in the research literature. Certainly when combined with exercise/rehab protocols and appropriate physiotherapeutics.


I call them Agnostics because there is a group of chiropractors that do not know any of the available research, they are not up on current guidelines or thinking, yet are not subluxation theorists either. They are somewhere in the middle basically just going to work every day and surviving. They are not ineffective for their patients. After all, they graduated with a Doctor of Chiropractic degree. However, they are not as effective as they could be with current, up-to-date training and thinking. 

The Difference

The difference is that evidence-based practitioners, according to research, are treating movement dysfunction and movement disorders in the spine. That’s a simplification for sure but, essentially, the frame (skeleton) isn’t working correctly and evidence-based chiropractors are tasked with making the proper corrections.

Sometimes that is mobilizing joints. Sometimes it’s strengthening them and leaving mobilization out of the equation completely. Are you seeing why the term ‘back alignment’ has seen better days? Our bodies are built very strongly and the idea of taking a bone from one position and shoving it into another may be a little outdated.

Simply put, spinal pain is typically caused by certain bones in the spine not moving well with each other. That movement type of pain typically responds better to movement-related treatments like chiropractic and exercise than it will respond to chemical treatment like shots or even surgery. 


Healthcare evolves as the knowledge base expands. Just like the medical field no longer commonly performs lobotomies, blood-letting, or uses leeches, the chiropractic field has long since moved beyond the initial ill-informed ideas of the founders from the late 1800’s and early 1900’s.

Evidence-based chiropractors are now biomechanical experts and have been shown to be much less expensive and more effective than not only physical therapists but usual medical care as well. Chiropractic has also been proven to be as effective or more effective for our bodies than many NSAID medications.

The Question

The question should not be whether you want to treat with a chiropractor for your issue. The main thing is deciding which kind of chiropractor you want to visit. If you visit their websites and see verbiage having to do with anti-vaccine ideas, blog articles on ear infections, allergies, or curing cancer, you need to run.

If you go to a chiropractor and they have you sign a contract for your healthcare and schedule, turn around and run. There should be no contracts in my opinion for chiropractic care.

If there is a presentation of x-rays showing you a decreased curvature in your neck and a discussion of it taking 38+ visits to correct this curvature issue, turn around and run.

These ideas are not supported by the research and would never be recommended by an evidence-based chiropractor.

On the other hand, if you are told about your condition, are recommended a very reasonable and responsible trial treatment schedule, and have exercise/rehab protocols mixed into the treatment with the proper outcome assessments and goals to achieve, well….you may have found yourself a good evidence-based chiropractor.



Dr. Jeff Williams, DC, FIANM is a Fellowship-trained Neuromusculoskeletal specialist and chiropractor in Amarillo, TX. As an Amarillo chiropractor, Dr. Williams treats chronic pain, disc pain, low back pain, neck pain, whiplash injuries, and more. Dr. Williams is also the host of The Chiropractic Forward Podcast. Through the podcast, Dr. Williams teaches fellow chiropractors and advocates weekly for evidence-based, patient-centered practice through current and relevant research. If you have any questions for Dr. Williams, feel free to email at [email protected]

Learn more about Dr. Williams and his practice at https://www.amarillochiropractor.com. Dr. Williams's full-time Amarillo chiropractic practice is Creek Stone Integrated Care at 3501 SW 45th St., Ste. T, Amarillo, TX 79109

Jeff S Williams, DC, FIANM, DABFP

Jeff S Williams, DC, FIANM, DABFP


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