NYSCB Practice Alerts: Peripheral Neuropathy and Treating Concussions

On behalf of the NY State Board for Chiropractic's Public Information Committee, we are disseminating the following Practice Alerts: 1) "The Treating Peripheral Neuropathy" and 2) "Treating Concussion Practice Alerts" have been posted as #12 and #13 on the Chiropractic Practice Alert webpage in the links below:

Practice of Treating Peripheral Neuropathy
Practice of Treating Concussion

Practice of Treating Peripheral Neuropathy

Chiropractors licensed in New York must practice within their chiropractic scope of practice as part of an overall treatment plan for a chiropractic patient. Under Education Law §6551(1), the practice of the profession of chiropractic is defined as detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column. 

According to the National Institutes of Health, peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body (https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet). The treatment of peripheral neuropathy does not fall within the scope of New York chiropractic practice. Comorbidities such as peripheral neuropathy do not necessarily exclude chiropractic treatment or treatment of concurrent conditions that fall within the profession’s scope. 

Thus, in New York, chiropractors who treat peripheral neuropathy unrelated to the spine are practicing beyond the chiropractic scope of practice. In this instance, the chiropractor may be subject to a charge of unprofessional conduct for practicing beyond their lawful scope (see Board of Regent Rules 29.1 (b) (9)). 

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Practice of Treating Concussion

Chiropractors licensed in New York must practice within their chiropractic scope of practice as part of an overall treatment plan for a chiropractic patient. Under Education Law §6551(1), the practice of the profession of chiropractic is defined as detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column. 

According to the Centers for Disease Control and Prevention, a concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth (https://www.cdc.gov/headsup/basics/concussion_whatis.html). The treatment of concussion does not fall within the scope of New York chiropractic practice. Comorbidities such as concussion do not necessarily exclude chiropractic treatment or treatment of other concurrent conditions that fall within the profession’s scope. 

When the history, examination and assessment of a patient leads to the working diagnosis of a concussion, the chiropractor is required to refer the patient to an appropriate medical provider. Chiropractors may not manage the diagnosis and treatment of a concussion patient. A chiropractor may treat the associated spinal and soft tissue injuries sustained during a concussive event concurrent with a medical provider overseeing the concussion treatment. 

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Reminder:

All practicing DC's should keep up-to-date with the Practice Alerts: http://www.op.nysed.gov/prof/chiro/chiroalerts.htm

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