There have been a number of algorithms published over the years. The Mercy Guidelines were published in the early 1990s:My distorted view remains that you have yet to illucidate specific treatment algorithms for disc, facet, and based low back pain, leaving me to conclude that all low back pain is evaluated radiographically (if the patient's insurance will pay for it), random line-drawing on said x-rays (www.ncbi.nlm.nih.gov/pubmed/14970809), discussion about the terrible findings on said x-rays, and then treated indefinitely with the same adjustments, discussion of good posture, and conversation regarding nutrition.
You are probably interested in "Section VIII: Frequency and Duration of Care".
Additional algorithms and guidelines have been published since then, most recently I think by the Council on Chiropractic Guidelines and Practice Parameters (CCGPP). These things also show up in various textbooks. Of course guidelines exist.
As to the random line drawing on xrays, there have been over the years a number of so-called assessment methods that some chiros have promoted, so I can't really argue much there. I don't know how much of this still goes on, but as I said long ago, we as a profession are improving all the time. The lines I learned in school are the standards that anyone would use, e.g., George's line, Cobb Angle, canal-body ratio, etc.
I don't see anything wrong with a discussion about good posture. And I don't see much wrong with giving a patient some diet advice (gee, Americans don't need any of that, do they?). So, we are in agreement there.
Back in the day, there was no literature available regarding chiropractic care of anything. So, little by little, researchers began to do this study. But you know as well as I that it is more feasible to design a study with a narrow focus so as to avoid any number of errors. It's not surprising, then, that it was spinal manipulation that got looked at the most; it's something virtually all chiropractors do, and it lends itself to specific study. That's why so many of these references are for "spinal manipulation" and not "chiropractic care". Some of them don't involve chiropractors, so that's another reason for the generic label of "spinal manipulation". (This isn't really that hard to understand)No, I want to you prove to me that what YOU DO (chiropractic care, not spinal manipulation, which includes what D.O.s do) works better that a placebo (not PT, or massage, just a placebo) in a prospective, double-blind, placebo-controlled trial for specific indications (not non-specific chronic low back pain). Until your field can measure up to the same demands we in medicine hold ourselves to, then yes, I will indeed consider it voodoo. Not because of any medicine vs chiropractic dialectic, but rather because that is the standard all of medicine is held to.
But when you expand the parameters out to "chiropractic care", now it gets tougher to say exactly what that included. There are many ways to manipulate a body, and many ways to utilize modalities, and many ways to exercise a patient. So, for study purposes, it gets a little hazy. But, nonetheless, there are some studies that examined "chiropractic treatment" specifically:
That second study does address a specific source of low back pain, so you might like that one. But, as I've said several times now, most of the literature has examined "low back pain" or "neck pain". That's because in many cases, the true source of the patients pain is never 100% confirmed. But they get better, so everyone should be happy. SleepIsGood wants all chiropractors to use fluoro on their patients before and during treatment; sounds real practical to me. You guys do the fluoro stuff; we don't. It's widely known throughout healthcare that the true source of neck and back pain is elusive sometimes. And most times, a working dx after history and exam leads us in the right direction and we get the patient better.
Off the deep end again here. And, since it is your position that chiropractors routinely practice medicine without a license, why aren't we all getting sued and losing our licenses? There are lots of lawyers out there, so why are chiropractors still able to endanger patients' lives with such reckless abandon, as you would contend?Yup, I will wonder what disease entities you might have missed, and look forward to the day a judge in a malpractice suit holds you to the standard of an ordinary and reasonable physician when your attempts to practice medicine go awry.