Reflections on the “type O” disorder

The organisation of the stress response, and its relevance to chiropractors: a commentary

“…The literature supports the existence of somatovisceral and viscerosomatic reflexes [ 98 - 100 ], but there is little or no evidence to support the notion that the spinal derangements (often referred to as subluxations by chiropractors) can cause prolonged aberrant discharge of these reflexes. Equally unsupported in the literature is the notion that the prolonged activation of these reflexes will manifest into pathological state of tissues, and most relevantly, that the application of spinal manipulative therapy can alter the prolonged reflex discharge or be associated with a reversal of the pathological degeneration of the affected reflexes or tissues [ 101 , 102 ]. The evidence that has been amassed is largely anecdotal or case report based [ 102 - 104 ] and it has attracted much intra disciplinary debate [ 102 , 105 , 106 ] because of its frequent association with certain approaches to management (largely described as being traditional or "philosophical" in nature).…”

“…Despite prolonged debate, very little consideration has been given to other potential mechanisms (and solutions) for the presence (and resolution) of the "type O" condition. A recent review has detailed that the somatovisceral reflex is a short term effect (millisecond to seconds in duration) when compared to supraspinal influences on the spinal cord which can be weeks to months in duration [ 102 ]. The review reasoned that the chiropractic profession should consider supraspinal factors in the generation and management of chronic pain states [ 102 ].…”

“…A recent review has detailed that the somatovisceral reflex is a short term effect (millisecond to seconds in duration) when compared to supraspinal influences on the spinal cord which can be weeks to months in duration [ 102 ]. The review reasoned that the chiropractic profession should consider supraspinal factors in the generation and management of chronic pain states [ 102 ]. This conclusion is particularly pertinent on the now known association of psychosocial variables in chronic pain and disease [ 102 ], and the fact that many of the conditions treated by chiropractors whether type O or M are of a chronic nature [ 95 ].…”

“…The review reasoned that the chiropractic profession should consider supraspinal factors in the generation and management of chronic pain states [ 102 ]. This conclusion is particularly pertinent on the now known association of psychosocial variables in chronic pain and disease [ 102 ], and the fact that many of the conditions treated by chiropractors whether type O or M are of a chronic nature [ 95 ]. However, the call to look at non-spinal non mechanical aspects of management has not been well received by the profession to date as evidenced by the continued predominantly mechanistic approach to management.…”