Chiropractic critical in the UK. Could USA be next?

cdmguy

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I read a comment by Michael Moore that the UK media has better analysis than US newspapers which are dumbed down. Perhaps this more objective analytical ability crosses over to affect the tolerance to alt-med quackery. Both the UK and USA have scopes of practice for chiropractors that are based totally on quackery. Recently a scandal where the British Chiropractic association tried to silence a critic led to a huge public backlash and the disbanding of chiropractic in the UK is being talked about. This is pretty big.

http://chirotalk.proboards.com/index.cgi?action=display&board=summaries&thread=4474&page=1

"Panicking chiropractors order slash-and-burn of their own websites"

Here in the USA MDs have been cowed into submission after losing the Wilk v. AMA lawsuit despite the fact that state scope of practice for chiropractors are likewise based on 100 year old subluxation dogma that has no relation to evidence based health care.

One thing I haven't seen discussed here is the observation by Chirotalk that chiropractic biomechanics is bogus and they can't restore spinal stabilization because they have no way to strengthen ligament laxity. Read FAQs 1 & 2 for an interesting summary (especially considering how lightly musculoskeletal treatment is covered in med school ).

FAQ 1
FAQ 2

Can anyone see a scenario where the american public "gets it" and demands delicensing like what is happening in the UK? Given that chiropractic is pretty hopeless is there anything MDs can do to better inform patients without being on the receiving end of another anti-trust lawsuit?

Has anyone seen the endemic corruption of these guys? False advertising by colleges, feeding fake information to career summaries, brainwashing. Anything goes. The nutjobs you see on the forum aren't the exception, they are the norm.

I am really getting tired of chiropractors crowing about how great they are at primary care diagnosis and then reading that more patients were stroked out due to unnecessary cervical manipulations or that another kid went deaf because a DC thought manipulation was a fine treatment for otitis media and delayed the referral. It has to stop. Don't MDs have a responsibility to clarify the problems and make an objective recommendation? Just because there are insurance parity laws doesn't mean people have to refer to quacks when evidence based providers are available.
 
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gettheleadout

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I hope the public "gets it" someday.
 

ILikeDrugs

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You seem a bit tense. Perhaps you should make an appointment with a chiropractor to loosen you up. :thumbup:
 

tabascosauce

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CunningCaregivr

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I think this is a classic case of taking a few bits of information and using them to fit your assumptions. Have you been to a chiropractor? Certainly some have overstepped their boundaries, but the majority understand their niche, and make a difference in the lives of their patients.

If you look around, you'll see that chiropractors are very successful in the US, and I believe that while their practice is not comprehensive and based on the purest science, it cannot be 100% BS.

In general, being critical is a good thing, but you sound like a Sarah Palin when you make such unchecked blanket statements.
 

Charles_Carmichael

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I agree with Ivy. Can you cite randomized, prospective trials that show chiropractry to be equivalent/superior to medical solutions? Not just phase I/II, I'm asking for phase III trials. If not, I would be hard pressed to say chiropractry works as well, or better, than "Western" medicine.
 

jadealer

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I do to a chiropractor and have done so for many years and gotten help for problems when traditional medical approaches did nothing to help my pain.

Also, I have an equine chiropractor work on my horses twice yearly. It truly has helped them, especially when my horse who had a really horrible fall and was performing subpar for several months despite seeing the two different vets and being on anti-inflammatory drugs. The day after his first session, his time in barrel racing improved by a full 1.5 seconds.. which is a huge amount when thousandths of a second can mean the difference between a win and loss.
 
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apumic

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I do to a chiropractor and have done so for many years and gotten help for problems when traditional medical approaches did nothing to help my pain.
Most likely any placebo would have worked here.
Also, I have an equine chiropractor work on my horses twice yearly. It truly has helped them, especially when my horse who had a really horrible fall and was performing subpar for several months despite seeing the two different vets and being on anti-inflammatory drugs. The day after his first session, his time in barrel racing improved by a full 1.5 seconds.. which is a huge amount when thousandths of a second can mean the difference between a win and loss. Oh and btw, there was a study in Europe about the ability of chiropractic, massage, and anti-inflammatory drugs to relieve back pain in equine athletes. It was shown that chiropractic yielded the most long term benefit with the fewest side effects. I will have to look to find the paper because i read it a few months ago.
IF chiros have any place in healthcare, it is w/ musculoskeletal issues. This would make sense then for your horse's injury.

When you find that paper, ensure they have compared efficacy, at minimum, in 4 conditions: control (no Tx), placebo, chiro, medicine. Missing any of those especially placebo and control is a major red flag. d-values are easily inflated when there is no way to compare Tx1 vs. placebo to Tx1 vs. control and placebo vs. control.
 

jadealer

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When you find that paper, ensure they have compared efficacy, at minimum, in 4 conditions: control (no Tx), placebo, chiro, medicine. Missing any of those especially placebo and control is a major red flag. d-values are easily inflated when there is no way to compare Tx1 vs. placebo to Tx1 vs. control and placebo vs. control.
Here was the article. My mistake though as it was done at Colorado state University is the #2 vet school in the country not in Europe
Reducing Back Sensitivity

by: Christy West, Digital Editor/Producer
March 30 2008, Article # 11573

Back pain is often suspected in horses, but most treatments haven't been researched much or at all. Results of a study designed to measure the effects of massage, chiropractic, and phenylbutazone (Bute) on back sensitivity were presented at the 2007 American Association of Equine Practitioners Convention, held Dec. 1-5 in Orlando, Fla. Kevin Haussler, DVM, DC, PhD, assistant professor within the Department of Clinical Sciences at Colorado State University, reported on the study. Researchers used pressure algometry (a spring-loaded device with a rubber-tipped plunger that measures applied pressure on a gauge readout) to measure mechanical nociceptive threshold (MNT)--the pressure at which a horse reacts painfully--at several locations along the spine. This method of objective pain assessment is also used in humans to evaluate pain due to fibromyalgia, osteoarthritis, and other conditions. A higher MNT means more pressure is required to elicit a response, so the horse is less sensitive or painful.
Researchers theorized that subclinical back pain is present in all ridden horses, so therapy should lessen that pain and raise MNTs. Thirty-eight healthy adult horses with no history of back pain from four farms were used for this study, which aimed to see which treatment modality raised MNTs the most over the course of a week. The horses were treated as follows:


  • Seven horses received Bute (1 g/500 pounds orally every 12 hours) for a week.
  • Eight received one chiropractic treatment using a spring-loaded mechanical force instrument at localized regions of joint stiffness, abnormally high muscle tension, or pain (this mechanism ensured a consistent force/velocity of the treatment).
  • Eight received one directed massage by a certified massage therapist.
  • Seven received no treatment, but continued to be ridden (active controls).
  • Eight received no treatment, but were turned out and rested (inactive controls).
  • All horses' MNTs were evaluated on Day 0 (before treatment) and at Days 1, 3, and 7 post-treatment.
The results of MNT evaluation on different sites on each horse were pooled for evaluation, and the numbers were somewhat surprising, said Haussler.

  • The Bute group actually had a negative response, with 9% and 8% lower MNTs on Days 1 and 3 compared to Day 0. On Day 7, this group had an 8% higher MNT. Bute is much more effective if given when active inflammation is present, noted Haussler.
  • Massage was beneficial throughout the study period, with an 8% higher MNT on Day 1, 9% higher on Day 3, and 12% on Day 7.
  • Chiropractic resulted in a slight (1%) decrease in MNT on Day 1, an 11% increase on Day 3, and a 27% increase on Day 7 on average.
  • Both active and inactive controls' MNTs fluctuated by about 1% across all days.
"We hypothesized that low-grade back pain or inflammation was present in ridden horses, and we found this to be true; otherwise the MNTs would not have increased in all three treatment groups relative to the two control groups," said Haussler. "Massage was beneficial throughout the study; Bute had negative effects for 3 days, then it had a positive effect; and chiropractic had a negative effect on the first day, but then it had the most positive effects.
"Pressure algometry provides an objective tool to evaluate commonly used, but unproven, treatment modalities for the treatment of back pain," he concluded. "Future studies need to evaluate combined treatment effects and long-term MNT changes in horses with documented back pain."

http://www.thehorse.com/ViewArticle.aspx?ID=11573
 

apumic

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Here was the article. My mistake though as it was done at Colorado state University is the #2 vet school in the country not in Europe
Reducing Back Sensitivity

by: Christy West, Digital Editor/Producer
March 30 2008, Article # 11573

Back pain is often suspected in horses, but most treatments haven't been researched much or at all. Results of a study designed to measure the effects of massage, chiropractic, and phenylbutazone (Bute) on back sensitivity were presented at the 2007 American Association of Equine Practitioners Convention, held Dec. 1-5 in Orlando, Fla. Kevin Haussler, DVM, DC, PhD, assistant professor within the Department of Clinical Sciences at Colorado State University, reported on the study. Researchers used pressure algometry (a spring-loaded device with a rubber-tipped plunger that measures applied pressure on a gauge readout) to measure mechanical nociceptive threshold (MNT)--the pressure at which a horse reacts painfully--at several locations along the spine. This method of objective pain assessment is also used in humans to evaluate pain due to fibromyalgia, osteoarthritis, and other conditions. A higher MNT means more pressure is required to elicit a response, so the horse is less sensitive or painful.
Researchers theorized that subclinical back pain is present in all ridden horses, so therapy should lessen that pain and raise MNTs. Thirty-eight healthy adult horses with no history of back pain from four farms were used for this study, which aimed to see which treatment modality raised MNTs the most over the course of a week. The horses were treated as follows:


  • Seven horses received Bute (1 g/500 pounds orally every 12 hours) for a week.
  • Eight received one chiropractic treatment using a spring-loaded mechanical force instrument at localized regions of joint stiffness, abnormally high muscle tension, or pain (this mechanism ensured a consistent force/velocity of the treatment).
  • Eight received one directed massage by a certified massage therapist.
  • Seven received no treatment, but continued to be ridden (active controls).
  • Eight received no treatment, but were turned out and rested (inactive controls).
  • All horses' MNTs were evaluated on Day 0 (before treatment) and at Days 1, 3, and 7 post-treatment.
The results of MNT evaluation on different sites on each horse were pooled for evaluation, and the numbers were somewhat surprising, said Haussler.

  • The Bute group actually had a negative response, with 9% and 8% lower MNTs on Days 1 and 3 compared to Day 0. On Day 7, this group had an 8% higher MNT. Bute is much more effective if given when active inflammation is present, noted Haussler.
  • Massage was beneficial throughout the study period, with an 8% higher MNT on Day 1, 9% higher on Day 3, and 12% on Day 7.
  • Chiropractic resulted in a slight (1%) decrease in MNT on Day 1, an 11% increase on Day 3, and a 27% increase on Day 7 on average.
  • Both active and inactive controls' MNTs fluctuated by about 1% across all days.
"We hypothesized that low-grade back pain or inflammation was present in ridden horses, and we found this to be true; otherwise the MNTs would not have increased in all three treatment groups relative to the two control groups," said Haussler. "Massage was beneficial throughout the study; Bute had negative effects for 3 days, then it had a positive effect; and chiropractic had a negative effect on the first day, but then it had the most positive effects.
"Pressure algometry provides an objective tool to evaluate commonly used, but unproven, treatment modalities for the treatment of back pain," he concluded. "Future studies need to evaluate combined treatment effects and long-term MNT changes in horses with documented back pain."

http://www.thehorse.com/ViewArticle.aspx?ID=11573
Effect sizes? p-values? Method of statistical analysis used? Research methods used? Possible confounds and controls for confounds? Supporting literature upon which this experiment was based? Replications of this research? Potential conflicts of interest? Expertise of experimenters?

With such a small sample size, it is unlikely the p-values found were significant. Further, tests of pain, while clinically useful, are often quite dubious as research tools.

Do keep in mind that generally Placebo and Nocebo effects have more research supporting their efficacy in pn mgmt than does Chiro.... Perhaps we need to come up w/ the D.Pl (Doctor of Placebo Therapy)....
 
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I do to a chiropractor and have done so for many years and gotten help for problems when traditional medical approaches did nothing to help my pain.

Also, I have an equine chiropractor work on my horses twice yearly. It truly has helped them, especially when my horse who had a really horrible fall and was performing subpar for several months despite seeing the two different vets and being on anti-inflammatory drugs. The day after his first session, his time in barrel racing improved by a full 1.5 seconds.. which is a huge amount when thousandths of a second can mean the difference between a win and loss.
Anecdotes.

It's literally not possible to be more irrelevant.
 
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cdmguy

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No I am not cherry picking information.

Be careful here, just because manipulation (done by any provider-PTs etc not just DCs) helps acute injuries recover faster doesn't mean that it justifies lifetime care or is effective at stabilizing degenerated spines. It's a trap to assign chiropractors credibility based on anecdotes that gives blanket sanction for quackery just because the quackery is a form of manipulation.

Fine distinction.

And yes I have been to chiropractors and they are very nice as they rip you off. I especially like the Sesame Street anti-vaccination posters and nerve charts they use to get you to treat any disease with manipulation.

http://www.clinicalcharts.com/categories/Chiropractic-Posters-and-Supplies/Charts-and-Posters/
http://www.chiropractic-books.com/posters.html
https://www.backtalksystems.com/posters.html



Know how much experience the average DC has diagnosing and treating otitis media? About as much as the pre-meds on this forum. Read their accreditation standard. there is no requirement to see a minimum number of kids with it).

March 18, 1993. The Wall Street Journal ("Chiropractors Seeking to Expand Practices Take Aim at Children," by Timothy K. Smith p. A4) reports on a chiropractor who had treated a five-year-old boy and his four-year-old sister for mastoiditis. The boy's infection had invaded his skull; the girl's was so severe that part of her face was paralyzed and pus was pressing against her brain. The children's parents were using a chiropractor as their primary care doctor. The doctor of chiropractic correctly diagnosed the ear infections and tried to cure the children by manipulating the bones of their spines. Because they were not treated with antibiotics, the girl is now deaf in one ear and the boy is still under observation for neurological damage. The author reports on the systematic efforts of chiropractors to recruit children as patients. One company, Peter Pan Potential, holds seminars for chiropractors to teach them how to get more children as patients. Their advertisements for chiropractors in trade magazines tell the chiropractors to "Do your part to change the perception of chiropractic with patients who aren't negative or skeptical--they're children!"
http://www.skepdic.com/refuge/funk1.html

The only chiropractic pediatrics certification (ICPA) is through the International Chiropractors Association, a group that is against differential diagnosis.

Straight chiropractors adhere to the philosophical principles set forth by D.D. and B.J. Palmer, and retain metaphysical definitions and vitalistic qualities. Straight chiropractors believe that vertebral subluxation leads to interference with an "innate intelligence" exerted via the human nervous system and is a primary underlying risk factor for many diseases. Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary for chiropractic treatment. Thus, straight chiropractors are concerned primarily with the detection and correction of vertebral subluxation via adjustment and do not "mix" other types of therapies.[33] Their philosophy and explanations are metaphysical in nature and they prefer to use traditional chiropractic lexicon terminology (i.e. perform spinal analysis, detect subluxation, correct with adjustment, etc.). They prefer to remain separate and distinct from mainstream health care.
http://en.wikipedia.org/wiki/Chiropractic#Straights_and_mixers

Strong skepticism of diagnosis and science
+ rabid anti-medical mentality
+ indoctrinated overestimation of the value of manipulation and nutrition
+ otitis media
= deaf Kid

By the way, that chiropractor only received a $1,000 fine and a few hours of continuing education from the pro-straight SC chiropractic licensing board for causing the deafness. grrrrrrrrrr

SC chiropractic license statute:
SECTION 40-9-10. Definitions.
As used in this chapter:

(a) "Chiropractic" is defined as that science and art which utilizes the inherent recuperative powers of the body and deals with the relationship between the nervous system and the spinal column, including its immediate articulations and the role of this relationship in the restoration and maintenance of health.

(b) "Chiropractic practice" is defined as the spinal analysis of any interference with normal nerve transmission and expression, and by adjustment to the articulations of the vertebral column and its immediate articulations for the restoration and maintenance of health and the normal regimen and rehabilitation of the patient without the use of drugs or surgery.
http://www.scstatehouse.gov/code/t40c009.htm

Really, judging from this statute did the DC do anything wrong? He deemed the kid to be subluxated using quacky analysis and had the right to treat him to improve his health which he believed would take care of the infection. According to this statute perhaps the only problem was not co-managing care by making a referral but no doubt he was either afraid an MD would tell the patient to discontinue care or so indoctrinated that he believed medicine would do no good or harm the kid.

Let's join some DCs and get a first hand peek into their indoctrination at an official seminar. Here's some hard core mind control use in action at the Sherman College of Straight Chiropractic's annual Lyceum in South Carolina from this year (note the emphasis on thought stopping criticism by isolating around supporters only and black & white thinking). This is recognized as continuing education for chiropractors! (note the mix of students and DCs). Folks this is Jonestown with an accredited degree.

[YOUTUBE=http://www.youtube.com/watch?v=fq7qGveqXto]2010 Lyceum Indoctrination[/YOUTUBE]

Cunning, if you're awarding continuing education credits to teach indoctrination propaganda then a "blanket statement" is warranted. Honestly, it's annoying that your reflex action to my first post was apparently not to read and understand the issue but to come out and defend it with unsupported statements. Rather than using personal bias to hope for the best a more realistic view is that quacks are the norm because practice management organizations and chiropractic schools indoctrinate them that way and science based DCs are the exception.

But read the FAQ links above, even mixer chiropractors who accept differential diagnosis can't solve patient problems so no matter what happens the chiropractic scope is inadequate to prevent patient dependency.
 
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phltz

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Can anyone see a scenario where the american public "gets it"
Nope. Just to choose one example of the American public definitively not getting it: in a 2008 Gallup poll, 44% of Americans said they thought the Earth was less than 10,000 years old.
 

startswithb

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It's annoying to drive around town and see shingles for "DDS; MD; or DPM" and then a group of "Dr.s" I mean, just using the Dr. to me seems like a blatant attempt at deception.

I think the only chriopractors that have a real shot at a successful business are those that market themselves as alternative medicine solutions. They often combine accupunture and massage therapy. Then it's more of a "feel better" thing than a "cure." Meh.
 
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I go to a chiro, but I'm not illusioned into thinking he can save me from anything other than acute misalignment from some odd movement of mine.
I've tried the pain-killer/muscle relaxant route with no avail, one pop from the DC and I was fine.

Now, if I had an ear infection, no I would not call up Dr. DC. I'd call Dr. MD/DO for their assistance.

The point is knowing your use and limitations. Being a DC does not make you superman, just able to make a cool popping noise that feels pretty darn good.

On a side note, as startswithb mentioned, my chiro's office has a person on their door (Dr. Some Lady) that I'm not sure what makes her a doctor...I've been wondering what her "doctor" is in...but she never has tried to manipulate my spine, just my DC. And they are more of a holistic type place, herbs and all that jazz.
 
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I am a college athlete. I have had hip and back problems for most of my life. Pain killers/ muscle relaxers/ anti-inflammatories do nothing for my pain. In high school I saw a chiropractor for it and it helped me get through my workouts. I do believe I would not have been able to get through them without him. In college, our athletic department hires a OMM specialist. That helped me even more.

Don't talk about delicensing chiropractors when they obviously help people. I agree with the person above me that If I have an ear infection, I am going to the doctor. But for sports related pain, I can assure you that this works.
 
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Be careful here, just because manipulation (done by any provider-PTs etc not just DCs) helps acute injuries recover faster doesn't mean that it justifies lifetime care or is effective at stabilizing degenerated spines. It's a trap to assign chiropractors credibility based on anecdotes that gives blanket sanction for quackery just because the quackery is a form of manipulation.

Fine distinction.
The biggest danger of the pseudo-medical practices - be it chiropractic, OMM, homeopathy, naturopathy, etc etc - is that patients can put false faith into their (ineffective) treatment and fail to get proper medical care.

While I wouldn't do it, I'm fine with someone going to a chiropractor to get a back rub to relieve pain. Me, I'd prefer to go to a PT. So long as these pseudo medical practitioners insist on the efficacy of their unprovable quackery, they deserve the pressure and scrutiny they get.
 

Suenya

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Anecdotes.

It's literally not possible to be more irrelevant.
Incorrect. Although I agree with you to a point, anecdotes (often more formalized as case studies) have helped pave the way for real advances in understanding, and they are used commonly in medical literature as a starting place before moving on to deeper levels of investigation. They are far from irrelevant. They may end up being incorrect when ascribing causality, but that is far different from irrelevance.

But you just want to be a condescending ass, so I guess it works easier that way. I'm sure you probably realize that there are even less relevant sources of information, but it would cut in on your "cleverness" or whatever it is you were going for with this post.
 

Suenya

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Hey...better outcomes at day seven with a study with n=8.



In horses.


Color me convinced.
Although I'd normally not care, since you seem like you're going for major snarky attitude in this thread, I feel the need to be almost as much of an ass as you, and point out that that study looks like it has a far bigger n than 8, but it has groups with an n ~=8. Not a study, study groups.

Especially with so many groups, it's not going to be a huge difference, but even if it were just two groups of 8 being compared, that is already a huge difference, doubling the group size.
 
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cdmguy

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Trop & Muscle,

I certainly am not disputing that manipulation is an effective tool of therapists for acute musculoskeletal trauma. Research shows it offers good pain relief and speeds healing. However we aren't talking about this. Rather chiropractors do a bait and switch. They get you in the door usually under the premise that they are acting as responsible musculoskeletal therapists for credibility then start with the patient indoctrination (subluxation, lifetime care, etc). But my biggest problem is that if we accept that chiropractic is the provider for treating unstabilized spines then we are stuck because this profession doesn't have the scope or science orientation to accomplish its mission. So it impedes progress by pretending to serve the niche when it really doesn't. I have the same concern with physical therapists because of their lack of scope. So instead of DCs or PTs I see DOs doing a much better job at it because they have the scope to give prolotherapy to tighten up the weak ligaments and they lack the quackery. Do you see my point?
 
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coldweatherblue

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..placebo is an amazing thing..

when determining the indications for chiropractic care, just remember: it may be as effective as acetaminophen for low back pain..
 
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Trop & Muscle,

I certainly am not disputing that manpulation is an effective tool of therapists for acute musculoskeletal trauma. Research shows it offers good pain relief and speeds healing. However we aren't talking about this. Rather chiropractors do a bait and switch. They get you in the door usually under the premise that they are acting as responsible musculoskeletal therapists for credibility then start with the patient indoctrination (subluxation, lifetime care, etc). But my biggest problem is that if we accept that chiropractic is the provider for treating unstabilized spines then we are stuck because this profession doesn't have the scope or science orientation to accomplish it's mission. So it impedes progress by pretending to serve the niche when it really doesn't. I have the same concern with physical therapists because of their lack of scope. So instead of DCs or PTs I see DOs doing a much better job at it because they have the scope to give prolotherapy to tighten up the weak ligaments and they lack the quackery. Do you see my point?
I see your point but don't agree. I see both chiropractors and practitioners of osteopathy as quacks, I think they do more harm than good.
 
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cdmguy

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Muscle,

Granted DO's aren't there yet and I find fault with their manipulation methods as well but the point is they have the potential to get better where the DCs don't without a radical science-research attitude shift and legislation changes in 50 states which isn't likely to happen.

But I admit the DO Upledger craniopathy sillyness is disturbing.

Coldweather,

Manipulation works better than placebo. It basically stimulates hypoactive spinal prioprioceptive input from posterior facet capsules. It's a temporary nerve tonic, palliative but useful for breaking pain cycles as some here have already attested to.
 

Rendar5

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sigh, wish people would stop using EBM to boast smarter-than-thou attitudes. Most things in medicine wouldn't be seen as scientifically true if we really did require such rigid guidelines to all research done.

Hell, we wouldn't treat most ear infections or strep throat cases either.

If proper studies aren't done and are lacking in an area, it doesn't mean that something is false, it means that there is no data to establish one position or another. so quit the "i'm right because you can't prove yourself because yoru papers i lacking X Y and Z" when you're not providing a different paper with X, Y, and Z"

And no, I don't see a chiropracter, believe in their practice, or encourage my patients to see them.
 
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Not a big chiropractic supporter.

I went to one for about 4 months because on the first appointment he told me he could make my back problems go away within 3 months. Turn out I had a pinched nerve and he made it a lot worse.

He was either an idiot, which isn't unlikely from how the guy acted, or he was quite the swindler.
 

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I am a college athlete. I have had hip and back problems for most of my life. Pain killers/ muscle relaxers/ anti-inflammatories do nothing for my pain. In high school I saw a chiropractor for it and it helped me get through my workouts. I do believe I would not have been able to get through them without him. In college, our athletic department hires a OMM specialist. That helped me even more.

Don't talk about delicensing chiropractors when they obviously help people. I agree with the person above me that If I have an ear infection, I am going to the doctor. But for sports related pain, I can assure you that this works.
OMM is not chiropractory. They may seem similar on the surface but the theory behind it and even the techniques are different. At least there have been attempts to study OMM over the years - the same can't be said about chiropractors. Their basic tenets are very different. One can make more parallels to PT with OMM than chiorpractory.
 

CunningCaregivr

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... Can you cite randomized, prospective trials that show chiropractry to be equivalent/superior to medical solutions? Not just phase I/II, I'm asking for phase III trials. If not, I would be hard pressed to say chiropractry works as well, or better, than "Western" medicine.
This debate should not be so polarizing. Most practitioners, including chiropractors themselves would agree that chiropractic treatment is an alternative form of treatment. Sure, pharmaceutical treatments have clinical trials behind them, but depending on the condition, it makes sense to compliment chemical treatment with mechanical. This mechanical treatment that is such "quackery" is utilized by 22 million people per year (WebMD).

Bottom line for a patient: 1) More options = better. 2) These options will not be considered through p-values or methodology of the latest research, but likely anecdotes -- whether from family, friends, or physician. 3) Mainstream resources such as WebMD or MayoClinic are very clear that chiropractic treatments are alternative/complimentary.

No one is claiming that chiropractic treatments trump Western Medicine, only that they currently are, and should be considered in a patient's options.
 
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cdmguy

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sigh, wish people would stop using EBM to boast smarter-than-thou attitudes. Most things in medicine wouldn't be seen as scientifically true if we really did require such rigid guidelines to all research done.

Hell, we wouldn't treat most ear infections or strep throat cases either.

If proper studies aren't done and are lacking in an area, it doesn't mean that something is false, it means that there is no data to establish one position or another.
Ren,
Agreed but the research has been done. The problem is that biomechanics is largely not covered in detail except at the orthopedic residency level so you haven't covered it yet. Chiropractic techniques have been known to be biomechanically false for over a decade. They lack translation and only cover axis rotations. Moreover, they don't account for the impossibility of z axis rotation due to torque through the skin to the underlying bone (Harrison, DD. Torque: an appraisal of misuse of terminology in chiropractic literature and technique. J Manipulative Physiol Ther. 1996 Sep;19(7):454-62. 8890026.) Another common problem in the most popular technique analysis (Diversified and Gonstead) is the lack of accurate 3D positional analysis from distorted 2D xrays.

Know what? They still teach and test on the invalid biomechanical listings.

This debate should not be so polarizing. Most practitioners, including chiropractors themselves would agree that chiropractic treatment is an alternative form of treatment. Sure, pharmaceutical treatments have clinical trials behind them, but depending on the condition, it makes sense to compliment chemical treatment with mechanical. This mechanical treatment that is such "quackery" is utilized by 22 million people per year (WebMD).

Bottom line for a patient: 1) More options = better. 2) These options will not be considered through p-values or methodology of the latest research, but likely anecdotes -- whether from family, friends, or physician. 3) Mainstream resources such as WebMD or MayoClinic are very clear that chiropractic treatments are alternative/complimentary.

No one is claiming that chiropractic treatments trump Western Medicine, only that they currently are, and should be considered in a patient's options.
Cunning, I vehemently disagree. Chiropractors do not have the right to use false and misleading ads to sell disproven quackery to patients. They do not have the right to indoctrinate students. I can't believe you agree with their methods after having posted the kind of sleazy methods that I linked to above. This is not better, patients are getting seriously injured and the system is getting ripped off. This is a serious public health issue and frankly it concerns me that you aren't evaluating the evidence I presented.

I am not against off label prescription and innovative treatment but when something is known to not work it should be banned and quacks using it who harm patients should be disciplined in the most severe manner possible to discourage the practices. What if it happened to your son or daughter and they were stroked out by some quack doing an unnecessary cervical adjustment? I'm sure you would change your tune very quickly.
 
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Trop & Muscle,

I certainly am not disputing that manipulation is an effective tool of therapists for acute musculoskeletal trauma. Research shows it offers good pain relief and speeds healing. However we aren't talking about this. Rather chiropractors do a bait and switch. They get you in the door usually under the premise that they are acting as responsible musculoskeletal therapists for credibility then start with the patient indoctrination (subluxation, lifetime care, etc). But my biggest problem is that if we accept that chiropractic is the provider for treating unstabilized spines then we are stuck because this profession doesn't have the scope or science orientation to accomplish its mission. So it impedes progress by pretending to serve the niche when it really doesn't. I have the same concern with physical therapists because of their lack of scope. So instead of DCs or PTs I see DOs doing a much better job at it because they have the scope to give prolotherapy to tighten up the weak ligaments and they lack the quackery. Do you see my point?
I get the point, but that it is not the case for all. The DC I go to has worked with me for the issues I face - that's why I go there. The first place I went to did precisely what you mentioned: "I want to see you 5 more times" and gave no explanation as to why. I ditched that fool quickly and found this guy. He's given me exercises to help strengthen muscles in the part of my back that pops out of alignment easily so I have less frequent problems. (Plus, he worked for the local baseball team, so I know he knows something) He never tries to give me information beyond what he knows, he'll refer me to others if I have a question he can't answer.

Not all DCs are doing the bait and switch. The same can be said with MDs/DOs who try to treat beyond their abilities.

Perhaps a better solution instead of removal of the profession would be tighter regulation on the practices and keeping the work within that which it is able to do?
 
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cdmguy

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Not all DCs are doing the bait and switch. The same can be said with MDs/DOs who try to treat beyond their abilities.

Perhaps a better solution instead of removal of the profession would be tighter regulation on the practices and keeping the work within that which it is able to do?
Trop,

Bait and switch is used by most DCs (known as straights). You can tell it from the emphasis on subluxation which is accepted by every chiropractic national association (see Edwards, James. "The Four Biggest Lies in Chiropractic. Dynamic Chiropractic – December 1, 1999, Vol. 17, Issue 25). The one you visit is in the minority. They usually attend "mixer" programs and practice similar to orthopedic physical therapists (functional rehabilitation). Interestingly rehabilitation isn't even a subject that is tested on by their National Board exams (however passive modalities like ultrasound and tens are in an optional exam called physiological therapeutics) so understand that it isn't even formally chiropractic.

Tighter regulation by who? The chiropractors themselves run their regulation in the majority of states with no medical oversight. Their national organizations refuse to open scope and limited scope is the rule in every state except Oregon and New Mexico. Several MD organizations have gone on record (Georgia) to formally oppose increased DC scope and even try to prohibit them from diagnosing by opposing diagnostic lab testing. Chiropractic regulators and national organizations refuse to disavow debunked methods and theories; all of the methods tested on by their national boards are biomechanically false. Every reform movement which tried reform failed (orthopractic & the now defunct National Association for Chiropractic Medicine).

Here are some links:


Judging from the results of the past two efforts, reform isn't going to happen and there is a serious public health threat to patients now that is being hidden not addressed. If we ignore it we will be complicit in harming these patients. I will not have that on my conscience.
 
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It's sad that the guy I see isn't more common. I know they have information about it, but he never brings it up. Or maybe I just don't pay attention to stuff beyond what I want to- like trying to ignore the religious music playing. Next time I'm in, I'll look around more to see what kind of propaganda they have up in support of your position.

Thanks for the links, when I get a little more time this evening I'll check them out more fully.
 
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cdmguy

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You're welcome Trop. I'm glad to see you getting more educated about it.

I'm sure the DC doesn't mention it because anything that casts a shadow over chiropractic professional legitimacy is a threat. Also the fact that the less quacky chiropractors don't have the ability to reform the field because they are vastly outnumbered. Before the internet all of these things would have been hidden and the chiropractic profession was growing like crazy despite MDs knowing there were serious problems with patient outcomes and false advertising. The largest program, Life University in Georgia, actually lost accreditation in 2001 for refusing to teach differential diagnosis (they substituted a boiler plate treat everyone system) as part of a scheme to get around medical necessity requirements by flooding the field with DCs trained to commit fraud. This now affects around 20% of all DCs and explains why insurance companies are so leery of chiropractic claims. No public statement was ever issued about the threat of having supposed primary care prividers who can't diagnose accurately and no remediation was every required to fix the problem. Instead it was covered up and individual DCs are scapegoated and disciplined as they injure patients on a case by case basis. Sickening. It makes me pity the naive DCs caught in that mess.

 
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startswithb

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Does anyone become a chiro for any other reason than money and wanting to be called Dr.? Or do they "believe" in this stuff prior to school?
 
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cdmguy

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Does anyone become a chiro for any other reason than money and wanting to be called Dr.? Or do they "believe" in this stuff prior to school?
I'd say most believe it. The schools position chiropractic as a desireable primary care profession with numerous false statements in their admissions materials and in the Occupational Outlook Handbook from data that originates from industry sources but is not screened for vested interests and accuracy. The distortions include:

  • Exagerating the plausability of the subluxation theory of disease and manipulation as an effective treatment
  • Misrepresention of chiropractic as a growing field with increasing acceptance using old data
  • Failuring to mention the huge number of chiropractors who quit practice (two surveys yielded similar figures, around 50% in 5 years)
  • Under representing student loan defaults (the official cohort default rate only counts defaults in the first two years)

This false marketing combined with the appeal of easy entrance and fast graduation gives it a convincing appearance of legitimacy for those unmotivated or unable to seek out and evaluate critical information.

Many students have experiences as chiropractic patients where they are led to conclude that the palliating effects of manipulation they experience prove that chiropractic's irrational theories of health and disease are correct. So the students are the victims here and the professional organizations and schools are the guilty parties.

But chiropractic associations and schools aren't the only guilty parties, since the 1980s the US Department of Education has been rubber stamping whatever an accreditation agency decides so there is no real regulation. For example, astrology is an accredited subject. Despite the caveat emptor (buyer beware) attitude of the DOE, their official website misleads students by exaggerating the significance of accreditation with the end result being the generation of huge amounts of nondischargeable student loans (and extra fees in defaults) for lenders.

"The goal of accreditation is to ensure that education provided by institutions of higher education meets acceptable levels of quality" -US DOE website

Acceptable to who? The accreditor representing the schools (who have members seated on its board) and the banks lending the money of course. Students are not represented at all and the agency takes little notice of student complaints except to see that they are properly covered up.

Chiropractic is rotten at the core and professionally has no ethics save maintaining some semblance of legitimacy. They always scapegoat individual chiropractors rather than admit and address problems systemically.

If you ever want to get input directly from the horses mouth per se visit Chirotalk: The Skeptical Chiropractic Discussion Forum and post any questions. The forum has many outspoken DCs, PTs, orthotists and MDs. It adheres to a skeptical science based point of view and is a valuable source of information about chiropractic.

(Warning Chirotalk is addictive!)

But returning to the original question, what can MDs do collectively and individually to protect patients from these problems while swaying public opinion to hasten chiropractic's demise? Any ideas?

Here are a few I've seen:

  • Anesthesiologist J. William Kinsinger initiated the Neck911.com website and gives lectures about the dangers of chiropractic care
  • Read and share Chirotalk and Chirobase.org with others
  • Support advertising and chiropractic victims groups including:
    Victims of Chiropractic Abuse

Ultimately I'd like to see a political action group started to delicense chiropractic in all 50 states and clean up the US Department of Education.
 
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vanbamm

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I am in my last year of chiropractic school- my institution is evidence based and we are not taught to be primary care providers or heal everything by manipulation- what we are taught is a thorough understanding of pathology and who qualities for adjustments and who does not-we are not taught to run mills and make money- we are not taught to lie or base things in theory that Palmer created 100 years ago- everything is evidence based; treatment protocols, modalities etc.

We also have good working relationships with MD/DO's as we rotate through the hospital here and do rounds with the MD students outside of our clinical rotations- all in effect to see a wider range of patholgies because most in the clinic are not serious or life threatening but you will see those few rare cases, and you should not miss them-

we do more than fix a subluxation- which is, if anyone is wondering, a minor dislocation of the vertebrae in relation to another- there is no secret about it- but it reaches beyond that- diagnosing or spotting for further eval. via CT/MRI spinal pathology( stenosis, degeneration, protrusions, extrusions, sequestrations, lesions, radiculopathy, fractures, tumors, metabolic disorders, vascular disorders, infections, suspect imaging etc.) - we also do extremity adjusting, rehabilitation, nutrition counseling, exercise prescription...we are taught alot, and given a solid foundation as to how to practice and help patients in those aspects of their life-

1.chiropractic is not a cure all- nothing is
2. chiropractic needs to be science based at ALL institutions- beware those that are not- and they often do not have a full encompassing program
3. do not go to chiropractors that talk about spirit, or life fields, or life energy or anything along those lines
4. if you have questions- ask them- and form your own opinions- some people hate medicine and drugs- some people hate chiropractic- both without proper education and understanding first- not all MD's are the same, not all DC's are the same
 
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cdmguy

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I am in my last year of chiropractic school- my institution is evidence based and we are not taught to be primary care providers or heal everything by manipulation
I have two problems with this. First, because the entire profession is quackery based then your assertion that you are evidence based is very suspect. That would make your school a maverick and jeopardize its accreditation.

Likewise chiropractors are defined by their accreditor, the Council on Chiropractic Education, to be primary care providers. There is also extensive state case law on this. It is necessary to accurately diagnose. The idea that chiropractors are portal of entry providers is one pushed by the straight organizations (International Chiropractors Association) to get a foothold into treating all patients by claiming to be portal of entry providers for subluxation care, which I have already debunked.

Which school do you attend?

Any position by a chiropractor or student is suspect because they often don't have the knowledge base to understand what real primary care is due to intense indoctrination and lack of exposure to the real thing (which is counterfeited in DC programs). Even the core textbook on differential diagnosis for chiropractic programs, "Differential Diagnosis and Management for the Chiropractor" by Souza endorses false biomechanics and is based on the debunked Motion Palpation fixation model of subluxation.

As for your assertion that your treatment for subluxation is effective, please re-read my earlier posts and references which explain why it isn't. It should trouble you that you are attending a school which misled you to believe that it was.

1.chiropractic is not a cure all- nothing is
2. chiropractic needs to be science based at ALL institutions- beware those that are not- and they often do not have a full encompassing program
3. do not go to chiropractors that talk about spirit, or life fields, or life energy or anything along those lines
4. if you have questions- ask them- and form your own opinions- some people hate medicine and drugs- some people hate chiropractic- both without proper education and understanding first- not all MD's are the same, not all DC's are the same
Do you usually not read earlier posts when responding to threads or is there a problem with your reading comprehension? The earlier posts in this thread clearly show that chiropractic has some fatal institutional flaws which you have chosen to ignore and instead are creating the red herring of a fictional lack of understanding. There is no ignorance here, except for the chiropractic propaganda and refusal to clean up their own house-and a few short hospital rotations aren't going to do it.
 
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I read a few of the articles on the chirobase.org collection. I still have more of your articles to go through.

While I understand, and to some extent agree with, your position. I'd be very upset if I couldn't call up the DC to get popped back into place. That doesn't mean I am for the deception that is confronted in the articles and what you are saying, but for the mis-alignments, I like having them around (the good ones). It's a shame that there is a self-propagating cycle of denial instead of just an awakening to what a chiro is able to do. I definitely do not like the simple posting of Dr. X, with no qualifying degree after, which I see at the place I go to.

I looked at the curriculum of where "my" DC went to, which is considered a very good chiro school. (http://www.logan.edu/SubPages.aspx?pID=95&mhID=142&splpID=5) They definitely have medical type courses listed in their clinical phase, along with business classes. Yet, I do see the thorough coursework they have outlined for understanding anatomy and research.

Perhaps he has tried to indoctrinate me, or maybe not - as I explicitly stated what I wanted when I got there and I always asked for more information when he mentioned things. Basically, I've made sure I kept my "treatment" isolated to what I want and not what someone else tells me. That's the same way I treat my interactions with a physician as well. If you tell me I have a problem with X, you need to give me more info and I won't sign up for something until I've done my own research.

Maybe I'm too bullheaded to fall for his jedi mindtricks? Or too oblivious? Or I know enough to know that all he can really do is just put that pesky vertebrae back into spot after I pulled it out?

As with anything, patients need to educate themselves as well and not simply go off of what one person says. I dislike the automatic response of doctor knows everything. I b!tched at my bf for doing that and after I helped him get educated, he's been able to deal with his health issue (not a DC related one, btw).

Sorry for the long post. Thank you for sharing your position, but I hope that you can also see where there is some utility in the profession from those of us who have told you our stories.
 
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Trop,

No need to apologize and it really wasn't a long post. You have to write a bit to express yourself.

Frankly I don't like the sense of dependency that you have on this DC. It makes me feel like he's blackmailing you or something. A good orthopedic certified PT or DO can probably manipulate you just as well and you wouldn't have to worry about all the rest of the mumbo jumbo. After all, PTs are the ones who do the majority of research on manipulation after all. There is nothing unique to chiropractic.

I wonder if there was no surgical knee reconstruction whether people would visit chiropractors to have their knees popped into place indefinitely and be satisfied with that? It seems a pointless exercise to me. Likewise, being dependent on any manipulation whether by PT, DC or DO. We all deserve better and research should be moving us forward not maintaining us in a state of dependency.
 

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I remember my first stroke patient I ever saw was due to some chiropractic maneuver that dislodged a plaque in the carotids- patient stroked out right in the office and never had any workup done by the DC to make rule out any underlying contraindications. Guy was in Neuro ICU for over a week. Never had an opinion about chiro beforehand and mostly negative ones since then.
 
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I don't think I'm dependent upon his manipulations. I go when I need them. When they ask me if I will be back next week, I say, no and I will let them know when I needed service again. I only go to him for one problem, that I've already stated. Being "pushed" towards excess treatments is what made me ditch the guy I had seen prior, again I told the current DC this. Maybe he knows not to try more with me lest he lose all possible business with me (which Logan should have taught him haha). So I go every couple/few months when I've done something stupid, and I'm defending that option. Doesn't make me dependent. :)

I'm by no means advocating for continual therapy - I'm down for the acute needs. I think it's pretty simple, what's the point of going to someone that keeps pushing you back in place but not making it stay? That's where I agree with the PT/DO route so you can work on developing the things that you need for a condition that requires more continual intervention.
 

vanbamm

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You are a very negative person- which leads me to believe that is why you are not working with patients now- it doesnt matter what field you would have went into- id guess you would have let down many people-

im glad you dont practice- say what you want- im going to be a good DC- the generation of DC's coming out are smarter and more in tune with the reality of the healthcare system-

and yes, my program is young, about 7 years, and the first of it's kind in chiropractic to incorporate research so much- everything we do is research based- every test we take, every examine we do, we are questioned as to why we are doing it and what supports it- and if we dont know, we have to find out or we cant use it.-

your failures dictate your progress- move on and get better, or move over so the stronger people can take over for you.
 

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Ugh. Why do I reply to these things. Someday I'll learn to just ignore this drivel. But you guys make it tough sometimes. I must say, though, that reading through a thread like this is good for a few laughs. The best so far in this thread belongs to Longshanks, with this classic: "OMM is not chiropractory. They may seem similar on the surface but the theory behind it and even the techniques are different. At least there have been attempts to study OMM over the years - the same can't be said about chiropractors. Their basic tenets are very different. One can make more parallels to PT with OMM than chiorpractory." Gee, do you think someone who refers to chiropractic as "chiorpractory" has an expert grasp on the relevant literature?? Laughable.

Cdmguy, you at least seem to have done some reading on this. We can agree that nothing would be more aggravating than a chiro who tells a patient he can cure her lung cancer with 500 chiro treatments. However, out in the real world, there is one sure thing that prevents this kind of stuff: malpractice attorneys. Chiros can get sued for this kind of behavior and every chiro knows that. And I also agree that the "bait and switch" you refer to can be sleazy. BUT, I disagree that these practices are rampant in the chiro profession, and if anything the profession is moving further away from this kind of stuff. Consider getting your info from someone other than a bitter group of failed chiros on chirobase.

Now, cdmguy, to the thrust of your argument: chiropractic manipulation can't help spinal patients because spinal patients have instability because of lax ligaments, and manipulation can't do anything about that. Your solution is to have everyone see a DO for prolotherapy. Now, I'm not dead-set against prolotherapy, but for you to rail against chiros for lack of evidence and then turn around and claim that prolotherapy is the answer is ludicrous! The literature on prolo is spotty at best. You need a new solution my friend. Now more importantly, your assumption that spinal instability is due to lax ligaments is largely incorrect. Sure, in the case of a significant trauma, ligamentous damage and subsequent laxity can be an issue. But this accounts for a tiny fraction of the neck and back pain patients that show up in doctors' offices every day. If your knowledge ran deeper, you would understand that spinal instability is a much more dynamic process that relies more on muscular firing than passive ligamentous stability. You did at least touch upon your superficial grasp of mechanoreception, which is a step in the right direction. But altered mechanoreception does more than just create pain. It alters motor programs, which alters dynamic stability, which causes pain. Manipulation improves mechanoreceptor function, improving afferentation and subsequently improving pain levels and function. And pain isn't everything; we know that people who experience recurrent episodes of back pain (i.e., most people) will still have poor control of their stabilizing musculature even during pain-free between-episode periods, setting them up for future episodes. There's also a growing body of literature looking at the effects of manipulation that go beyond segmental issues and into cortical effects.

There's lots of research out there. You just have to look. It's one thing for someone to say he or she is not familiar with the literature that exists. It's another to make wild proclamations about chiropractic without having any understanding of the science that exists.

If I get time later, I'll address clinical outcomes studies as well as safety issues (including stroke), which is being blown way out of proportion here.
 
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cdmguy

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It's always cute when the chiropractors start getting defensive. I guess this thread is a threat because it exposes their litter box.

Facet,

I'll highlight your disconnects.

Cdmguy, you at least seem to have done some reading on this. We can agree that nothing would be more aggravating than a chiro who tells a patient he can cure her lung cancer with 500 chiro treatments. However, out in the real world, there is one sure thing that prevents this kind of stuff: malpractice attorneys. Chiros can get sued for this kind of behavior and every chiro knows that. And I also agree that the "bait and switch" you refer to can be sleazy. BUT, I disagree that these practices are rampant in the chiro profession, and if anything the profession is moving further away from this kind of stuff. Consider getting your info from someone other than a bitter group of failed chiros on chirobase.
This is very misleading. Subluxation care is perfectly legal and codified in most state scopes of practice. The only thing a chiropractor has to do is not promise an outcome and co-manage serious illnesses.

As for Chirobase, I'm not aware of any failed chiropractors (though I'm sure it's more convenient for you to personally disparage your critics with ad hominem attacks rather than accept their damning criticisms). It would be just as ludricous to say you can discount James Randi for exposing astrology scams because he isn't a successful astrologer as to shoot down criticism because someone wasn't the owner of a booming chiropractic practice (with the majority based around subluxation quackery). You are insinuating that they are making this stuff up when there is real evidence supporting them. I know the biographies for two of the authors, William Lattanze DC was an osteopathic school student and Sam Homola DC practiced evidence based chiropractic for decades. My main concern with Chirobase is that it follows the defunct NACM/orthopractic model which relies on debunked fixation theory. In this model chiropractors used manipulation to treat fixations ala Motion Palpation technique only when patients has musculoskeletal pain syndromes. It is biomechanically false but a little less abusive than traditional subluxation care.

Now, cdmguy, to the thrust of your argument: chiropractic manipulation can't help spinal patients because spinal patients have instability because of lax ligaments, and manipulation can't do anything about that. Your solution is to have everyone see a DO for prolotherapy. Now, I'm not dead-set against prolotherapy, but for you to rail against chiros for lack of evidence and then turn around and claim that prolotherapy is the answer is ludicrous! The literature on prolo is spotty at best. You need a new solution my friend.
You misunderstand but I'm glad you see the problem. There is no literature on prolotherapy for the application I am proposing. It has never been tried. Prolotherapists don't traction shortened ligaments to structurally rehabilitate spines and don' t use supportive bracing to hold a good neutral position. The research that exists shows that the sclerosing solutions thicken ligaments so it should work. If it doesn't then at least attention will be directed to discover and innovate a better solution. But to discount a research direction prematurely makes no sense.


Now more importantly, your assumption that spinal instability is due to lax ligaments is largely incorrect. Sure, in the case of a significant trauma, ligamentous damage and subsequent laxity can be an issue. But this accounts for a tiny fraction of the neck and back pain patients that show up in doctors' offices every day. If your knowledge ran deeper, you would understand that spinal instability is a much more dynamic process that relies more on muscular firing than passive ligamentous stability. You did at least touch upon your superficial grasp of mechanoreception, which is a step in the right direction. But altered mechanoreception does more than just create pain. It alters motor programs, which alters dynamic stability, which causes pain. Manipulation improves mechanoreceptor function, improving afferentation and subsequently improving pain levels and function. And pain isn't everything; we know that people who experience recurrent episodes of back pain (i.e., most people) will still have poor control of their stabilizing musculature even during pain-free between-episode periods, setting them up for future episodes. There's also a growing body of literature looking at the effects of manipulation that go beyond segmental issues and into cortical effects.
I don't buy this at all because of microtrauma. You don't have to have significant trauma to permanently deform ligaments. This is why sit-ups are now discouraged for abdominal strengthening, they cause repetitive microtrauma to the disks.

Please post research next time. Your points are very weak, misleading and contradict the literature.
 
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mmmcdowe

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You are a very negative person- which leads me to believe that is why you are not working with patients now- it doesnt matter what field you would have went into- id guess you would have let down many people-

im glad you dont practice- say what you want- im going to be a good DC- the generation of DC's coming out are smarter and more in tune with the reality of the healthcare system-

and yes, my program is young, about 7 years, and the first of it's kind in chiropractic to incorporate research so much- everything we do is research based- every test we take, every examine we do, we are questioned as to why we are doing it and what supports it- and if we dont know, we have to find out or we cant use it.-

your failures dictate your progress- move on and get better, or move over so the stronger people can take over for you.
http://www.smbc-theater.com/?id=227
 

facetguy

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It’s always cute when the chiropractors start getting defensive. I guess this thread is a threat because it exposes their litter box.
Don't flatter yourself. These anti-chiro threads are plentiful around here, and yours is nothing special.

This is very misleading. Subluxation care is perfectly legal and codified in most state scopes of practice. The only thing a chiropractor has to do is not promise an outcome and co-manage serious illnesses.
I've already stated that any unethical tactics are wrong.

As for Chirobase, I’m not aware of any failed chiropractors (though I’m sure it’s more convenient for you to personally disparage your critics with ad hominem attacks rather than accept their damning criticisms). It would be just as ludricous to say you can discount James Randi for exposing astrology scams because he isn't a successful astrologer as to shoot down criticism because someone wasn't the owner of a booming chiropractic practice (with the majority based around subluxation quackery). You are insinuating that they are making this stuff up when there is real evidence supporting them. I know the biographies for two of the authors, William Lattanze DC was an osteopathic school student and Sam Homola DC practiced evidence based chiropractic for decades. My main concern with Chirobase is that it follows the defunct NACM/orthopractic model which relies on debunked fixation theory. In this model chiropractors used manipulation to treat fixations ala Motion Palpation technique only when patients has musculoskeletal pain syndromes. It is biomechanically false but a little less abusive than traditional subluxation care.



You misunderstand but I’m glad you see the problem. There is no literature on prolotherapy for the application I am proposing. It has never been tried. Prolotherapists don’t traction shortened ligaments to structurally rehabilitate spines and don’ t use supportive bracing to hold a good neutral position. The research that exists shows that the sclerosing solutions thicken ligaments so it should work. If it doesn’t then at least attention will be directed to discover and innovate a better solution. But to discount a research direction prematurely makes no sense.
It just struck me as odd that after all the negatives you cast at chiropractic, you would propose a treatment that has next to zero evidence behind it. As I implied, I'm not against prolo as a candidate for future study and as such am not "discounting a research direction prematurely". Currently, prolo is a research direction at best.




I don’t buy this at all because of microtrauma. You don’t have to have significant trauma to permanently deform ligaments. This is why sit-ups are now discouraged for abdominal strengthening, they cause repetitive microtrauma to the disks.
You are entitled to your opinion regarding microtrauma. But current thought is moving toward ligament 'sub-failure'. See http://www.ncbi.nlm.nih.gov/pubmed/16047209 ; Panjabi is a giant in spine research, so you may want to take this into consideration. Also, look into the work of Solomonow's group for more on this.

Please post research next time. Your points are very weak, misleading and contradict the literature.
The knowledge base has been developing over the last couple of decades, involving dozens if not hundreds of studies. No shortcuts here; get crackin' (pun intended). The individual clinical outcomes trials are easier to cite, which I'll do when time permits. The literature supports my position.
 
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cdmguy

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I glanced at that study. What's your point? If the ligaments are weak then they need passive stabilization (ligaments). Of course muscle dysfunction follows ligament damage. Active stabilization (muscles) is a pain for patients to keep doing and can never be as effective. It isn't a fix and provides no security if a motion catches someone off guard (unlike passive stabilization) so they are predisposed to more injury.
 
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