McTimony is a form of chiropractic therapy. Chiropractic is a treatment where a practitioner called a chiropractor uses their hands to help relieve problems with the bones, muscles and joints. A description of this therapy includes ‘a high velocity low amplitude spinal manipulation therapy, produces profound but transient attenuation of motor neurone activity’. In the NHS it is considered a type of complementary and alternative medicine (CAM); which means it’s not a conventional medical treatment.
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Historic mechanism of action
So, how does it work?
History of Chiropractic
Historically, chiropractors defined their action on misalignment of bones, usually in the spine, a Vertebral Subluxation (VS), leading to interruption in the flow of “innate intelligence”. This was an unproven force responsible for normal health. This force was acknowledged in a quote about magnetic healing when it was written that, “chiropractic was not evolved from medicine or any other method, except that of magnetic.”
‘Magnetic’ derived from Anton Mesmer’s (1734-1815) investigations into the supposed curative effects of animal magnetism, practitioners of magnetic healing identified the unimpeded flow of energy with health and defined illness as obstruction.
Modern Chiropractic
Of course, no scientific evaluation of such a force is possible. And to gain the appearance of scientific legitimacy, most chiropractors gradually moved away from this concept and argued that the misalignments in the body damaged health by impinging on nerves.
Many practitioners have a great knowledge of anatomy, and aim to work by manipulation, predominantly of the spine, to alleviate pain related conditions.
What is chiropractic for animals?
For the most part, the principles and practices of animal chiropractic are extrapolated and adapted from those applied to humans. On occasion, when evidence is lacking, we do have to cautiously extrapolate human data or from other animal models. Concerns come from the fact that principles are extrapolated from humans despite the obvious biomechanical and anatomic differences between bipedal hominids and quadrupedal veterinary patients.
Does chiropractic work?
In humans, there is some reasonable evidence that spinal manipulations such as practiced by chiropractors may benefit humans with back pain. However, Cochrane review (a Cochrane Review is a systematic review of research in health care and health policy) of spinal manipulation and general chiropractic therapy for lower back pain finds small effects and research has a high risk of bias. It was concluded by one reviewer that ‘There is no good reason to believe chiropractic is useful for any other complaint in humans [other than lower back pain].’
Is McTimoney different to chiropractic?
McTimoney Method states that it is distinguished by its whole-body approach to Chiropractic care. It claims that McTimoney Chiropractors approach the body as a whole, functioning system rather than treating only specific areas that may be presenting with symptoms. The approach is based on the view that discomfort and pain in one part of the body may be manifestations of problems elsewhere in the musculo-skeletal system. And that, for optimal health, the whole musculo-skeletal system needs to work harmoniously together. It was stated that a McTimoney Chiropractor will aim to find the misalignment underlying the symptom that clients are experiencing.
Looking specifically at McTimoney, one study in horses found positive evidence that McTimoney chiropractic treatment (and when combined with Pulsed electromagnetic field therapy treatment) show a significant reduction in sensitivity to musculoskeletal tenderness (increased Mechanical nociceptive thresholds) over the time period compared with no treatment. Another study supported a hypothesis that (McTimoney) chiropractic treatment may improve the symmetry of tarsus and carpus range of motion of horses, and another found that there was some evidence that McTimoney treatment influences stride length and speed (forwardness) of the horse during trot.
The bottom line
Though there is no reliable data yet in companion animals, chiropractic therapy as a popular modality for treatment for humans appears to occasionally be translating into animal treatment. There are also no controlled evidence identifying the risks of chiropractic therapy of animals, so we can only speculate about the safety of this intervention. In humans the one review found that of 138 cases of serious complications due to chiropractic, more than 8 of 10 were from cervical manipulation. Other serious adverse incidents from neck rotation have included vertebrobasilar accidents with consequences such as cutting off bloodflow to the brainstem or cerebellum (or both), Wallenberg syndrome, and locked-in syndrome. Problems such as spinal cord compression, vertebral fracture, tracheal rupture, diaphragm paralysis, and internal carotid haematoma and the rate of serious complications is still debatable and unknown.
The historic theories of chiropractic are fundamentally flawed and should not be the basis of any treatment. The more modern theories and practices of animal chiropractic are copied or extrapolated from those employed in treating humans, despite there being little strong, reliable scientific evidence to show any benefit from veterinary chiropractic treatment. However, we have emerging evidence that the modern theories of chiropractic could be beneficial to our patients, and we await more research in companion animals before drawing strong conclusions as to its efficacy.
This is not to say that it does not work – manipulative therapies definitely can influence musculoskeletal function. However, it does mean we should be cautious and, ideally, gather more information and evidence. “One animal got better” is not evidence. “Nine animals got better and one got worse” is weak evidence. “Nine hundred animals got better and one hundred got worse when compared to a matched and randomly assigned control group” is strong and reliable evidence. As yet, we have a lot of the former and none of the latter! – Editor.
Concerns raised
One of the biggest concerns cited was that chiropractic therapy for animals is often associated with opposition to conventional medical care and with other unproven or clearly ineffective alternative therapies. It was believed that this combination presents extra risks to patients seeking ‘care’ from animal chiropractors who sometimes spread further misinformation due to their unregulated nature.
Discussion