Reflections on The Type “O” Disorder
Pollard H.
Journal of Manipulative and Physiological Therapeutics 2005; 28: 547.e1-547.e9.


Chiropractic is at a crossroad in its development in many ways. The New Zealand Royal Commission into Chiropractic defined a type O disorder as management of viscerosomatic conditions with chiropractic methods, and the type M disorder as the standard musculoskeletal condition. They concluded that the profession attempts to manage both conditions, but there is little evidence to support the management of type O conditions. This paper suggests that evidence of such management in both chiropractic and medicine is evolving but the evidence is limited. Rather than the profession developing an almost dualistic support for the type O/type M vitalistic/mechanistic approaches to management, there exists an acceptable model to act as a bridge between the collective treatment impasse. The embrace of the supraspinal influences inherent in the biopsychosocial model may serve us well when investigating the enigma that is evidence-based practice.

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