Chiropractic
Chiropractic is a form of alternative medicine mostly concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine.[1][2] Some proponents, especially those in the field’s early history, have claimed that such disorders affect general health via the nervous system,[2] through vertebral subluxation, claims which are not based on scientific evidence. The main chiropractic treatment technique involves manual therapy, especially spinal manipulation therapy (SMT), manipulations of other joints and soft tissues.[3] Its foundation is at odds with mainstream medicine, and chiropractic is sustained by pseudoscientific ideas such as subluxation and “innate intelligence” that reject science.[4][5][6][7][8] Chiropractors are not medical doctors.[9]
Numerous controlled clinical studies of treatments used by chiropractors have been conducted, with conflicting results.[4] Systematic reviews of this research have not found evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.[4] A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition.[10] Spinal manipulation may be cost-effective for sub-acute or chronic low back pain but the results for acute low back pain were insufficient.[11] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[12] There is not sufficient data to establish the safety of chiropractic manipulations.[13] It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.[14] There is controversy regarding the degree of risk of vertebral artery dissection, which can lead to stroke and death, from cervical manipulation.[15] Several deaths have been associated with this technique[14] and it has been suggested that the relationship is causative,[16][17] a claim which is disputed by many chiropractors.[17]
Chiropractic is well established in the United States, Canada, and Australia.[18] It overlaps with other manual-therapy professions such as osteopathy and physical therapy.[19] Most who seek chiropractic care do so for low back pain.[20] Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues.[4] Many chiropractors describe themselves as primary careproviders,[4][21] but the chiropractic clinical training does not support the requirements to be considered primary care providers,[2] so their role on primary care is limited and disputed.[2][21] Chiropractic has two main groups: “straights”, now the minority, emphasize vitalism, “innate intelligence”, and consider vertebral subluxations to be the cause of all disease; “mixers”, the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[22]
D. D. Palmer founded chiropractic in the 1890s,[23] after saying he received it from “the other world”,[24] and his son B. J. Palmer helped to expand it in the early 20th century.[23] Throughout its history, chiropractic has been controversial.[25][26] Despite the overwhelming evidence that vaccination is an effective public health intervention, among chiropractors there are significant disagreements over the subject,[27] which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.[28] The American Medical Association called chiropractic an “unscientific cult” in 1966[29] and boycotted it until losing an antitrust case in 1987.[21] Chiropractic has had a strong political base and sustained demand for services; in recent decades, it has gained more legitimacy and greater acceptance among conventional physicians and health plans in the United States.[21]
San Diego
San Diego (/ˌsæn diːˈeɪɡoʊ/, Spanish for “Saint Didacus“; Spanish: [san ˈdje.ɣo]) is a major city in California, United States. It is in San Diego County, on the coast of the Pacific Ocean in Southern California, approximately 120 miles (190 km) south of Los Angeles and immediately adjacent to the border with Mexico.
With an estimated population of 1,394,928 as of July 1, 2015,[9] San Diego is the eighth-largest city in the United States andsecond-largest in California. It is part of the San Diego–Tijuana conurbation, the second-largest transborder agglomerationbetween the US and a bordering country after Detroit–Windsor, with a population of 4,922,723 people.[11] San Diego has been called “the birthplace of California”.[12] It is known for its mild year-round climate, natural deep-water harbor, extensive beaches, long association with the United States Navy, and recent emergence as a healthcare and biotechnology development center.
Historically home to the Kumeyaay people, San Diego was the first site visited by Europeans on what is now the West Coast of the United States. Upon landing in San Diego Bay in 1542, Juan Rodríguez Cabrillo claimed the area for Spain, forming the basis for the settlement of Alta California 200 years later. The Presidio and Mission San Diego de Alcalá, founded in 1769, formed the first European settlement in what is now California. In 1821, San Diego became part of the newly independent Mexico, which reformed as the First Mexican Republic two years later. In 1850, California became part of the United States following the Mexican–American War and the admission of California to the union.
The city is the seat of San Diego County and is the economic center of the region as well as the San Diego–Tijuanametropolitan area. San Diego’s main economic engines are military and defense-related activities, tourism, international trade, and manufacturing. The presence of the University of California, San Diego (UCSD), with the affiliated UCSD Medical Center, has helped make the area a center of research in biotechnology.