The Saga Continues: Chiro bash on

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lobelsteve

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Combined chiropractic interventions for low-back pain
Cochrane Reviews, 04/15/10



Walker BF et al. – For this review, chiropractic was defined as encompassing a combination of therapies such as spinal manipulation, massage, heat and cold therapies, electrotherapies, the use of mechanical devices, exercise programs, nutritional advice, orthotics, lifestyle modification and patient education. Non–specific low–back pain indicates that no specific cause is detectable, such as infection, cancer, osteoporosis, rheumatoid arthritis, fracture, inflammatory process or radicular syndrome (pain, tingling or numbness spreading down the leg). Twelve randomised trials (including 2887 participants) assessing various combinations of chiropractic care for low–back pain were included in this review, but only three of these studies were considered to have a low risk of bias. Combined chiropractic interventions slightly improved pain and disability in the short–term and pain in the medium–term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.

Sleep v Facet: Round 2, ding.

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Combined chiropractic interventions for low-back pain
Cochrane Reviews, 04/15/10



Walker BF et al. – For this review, chiropractic was defined as encompassing a combination of therapies such as spinal manipulation, massage, heat and cold therapies, electrotherapies, the use of mechanical devices, exercise programs, nutritional advice, orthotics, lifestyle modification and patient education. Non–specific low–back pain indicates that no specific cause is detectable, such as infection, cancer, osteoporosis, rheumatoid arthritis, fracture, inflammatory process or radicular syndrome (pain, tingling or numbness spreading down the leg). Twelve randomised trials (including 2887 participants) assessing various combinations of chiropractic care for low–back pain were included in this review, but only three of these studies were considered to have a low risk of bias. Combined chiropractic interventions slightly improved pain and disability in the short–term and pain in the medium–term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.

Sleep v Facet: Round 2, ding.

"When compared to other interventions". This has been my position all along. I've never said chiro treatment is some magical intervention that cures everyone in its path. I've simply said that it's no worse than anything else out there. Some patients never make it to my office because someone else helped them. Some patients don't respond as well as I'd like to my treatment, so they are referred elsewhere. But don't kid yourself: a lot of people DO respond to chiro treatment, and some of them do it after having failed other forms of treatment. So you can argue, "if chiro is no better than anything else, then why do we need it?". But that's just not a sound argument for the reasons just stated.

Nice try though.

P.S. It's nice to see that you are now reading chiro-related literature. Progress?
 
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"When compared to other interventions". This has been my position all along. I've never said chiro treatment is some magical intervention that cures everyone in its path. I've simply said that it's no worse than anything else out there. Some patients never make it to my office because someone else helped them. Some patients don't respond as well as I'd like to my treatment, so they are referred elsewhere. But don't kid yourself: a lot of people DO respond to chiro treatment, and some of them do it after having failed other forms of treatment. So you can argue, "if chiro is no better than anything else, then why do we need it?". But that's just not a sound argument for the reasons just stated.

Nice try though.

P.S. It's nice to see that you are now reading chiro-related literature. Progress?

It's Cochrane reviews. And I didn't read more than the abstract. Still a fan of Crislip's interpretation of chirocare at www.quackcast.com
 
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You mean facetguy, facets is my name, I'm thinking of changing my name to facet babe so we don't get confused anymore:laugh:
 
You mean facetguy, facets is my name, I'm thinking of changing my name to facet babe so we don't get confused anymore:laugh:

How about "zygapophysial" then we will know you are not a Chiro
 
Thats probably true, it has more than 5 letters:laugh:
 
Zygawhat?? Never heard of it.:rolleyes:

Why don't we all try the Pain Management approach: "Let's do the epidurals first. That'll work." (3 epidurals later..) "OK, that didn't help. So let's try some facet injections next. That'll do it." (Multiple sticks later...pause, scratch head) "Hmmm. Well then, it's on to the trigger point injections..." and on and on. Sound familiar?? And talk about cost to the system, not to mention risk to the patient. You guys don't have a whole lot of room to talk.:)
 
Wow
Amazed you got my practice pattern exactly right!

What else does your Crystal ball show you?
-where the most recent car accident was
-where the newest PI attorney set up shop(probably taught 1st semester in your training)
 
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Wow
Amazed you got my practice pattern exactly right!

What else does your Crystal ball show you?
-where the most recent car accident was
-where the newest PI attorney set up shop(probably taught 1st semester in your training)

C'mon. You know me by now. That was largely tongue-in-cheek. But the kernel of truth in there is that such a practice pattern does exist, and I see it quite a bit. You can't deny that. Nobody's perfect, especially when it comes to spine pain.
 
"When compared to other interventions". This has been my position all along. I've never said chiro treatment is some magical intervention that cures everyone in its path. I've simply said that it's no worse than anything else out there. Some patients never make it to my office because someone else helped them. Some patients don't respond as well as I'd like to my treatment, so they are referred elsewhere. But don't kid yourself: a lot of people DO respond to chiro treatment, and some of them do it after having failed other forms of treatment. So you can argue, "if chiro is no better than anything else, then why do we need it?". But that's just not a sound argument for the reasons just stated.

Nice try though.

P.S. It's nice to see that you are now reading chiro-related literature. Progress?
Chiropractic literature is fraught with GIGO, as is the case here. The "other interventions" referred to are some combination of "myofascial therapy, Back School, McKenzie therapy, an instructional booklet, ultrasound, cold pack, corset, transcutaneous muscle stimulation, and/or massage."

When you compare non-specific chiropractic treatment to heterogenous, non-specific therapies, they yield similar non-specific outcomes.

Not exactly a seminal article.
 
Chiropractic literature is fraught with GIGO, as is the case here. The "other interventions" referred to are some combination of "myofascial therapy, Back School, McKenzie therapy, an instructional booklet, ultrasound, cold pack, corset, transcutaneous muscle stimulation, and/or massage."

When you compare non-specific chiropractic treatment to heterogenous, non-specific therapies, they yield similar non-specific outcomes.

Not exactly a seminal article.

You forgot to say "Physical Therapy", to which you have no problem referring patients. Entrenched bias is one thing, but at least be straightforward about things.
 
You forgot to say "Physical Therapy", to which you have no problem referring patients. Entrenched bias is one thing, but at least be straightforward about things.
The article cited by the original poster breaks out the therapies chiropractic is being compared with in the articles under review.

If you are uncertain regarding the specifics of the review, I invite you to read the article (as I did).

I did not mention physical therapy, but rather the specific treatments mentioned in the review. In case you are unaware, myofascial therapy, Back School, McKenzie therapy, ultrasound, cold packs, and transcutaneous muscle stimulation are all modalities used by physical therapists
 
I did not mention physical therapy, but rather the specific treatments mentioned in the review. In case you are unaware, myofascial therapy, Back School, McKenzie therapy, ultrasound, cold packs, and transcutaneous muscle stimulation are all modalities used by physical therapists

Physical therapists also utilize manipulation or grade 5 mobilization if you speak Maitland.
 
Physical therapists also utilize manipulation or grade 5 mobilization if you speak Maitland.
That was not a modality being compared to chiropractic in the Cochrane Review article in question (please see the citation below)
 
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