What is best for typical "back pain" probelms?

  • Chiropractor’s right, 3-5 visits/week for 10-20 weeks; plenty of maintenance for months after that.

    Votes: 4 5.1%
  • The OMM fellows are right with only 1-4 visits and only the occasional follow up after that.

    Votes: 54 69.2%
  • Manipulation isn't the answer, they need pain meds, muscle relaxers, and maybe steroid injections.

    Votes: 6 7.7%
  • Other, none of the above.

    Votes: 15 19.2%

  • Total voters
    78

Geronimo

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I'm a student who has decided on an allopathic school for several reasons, mostly financial and keeping my wife happy by keeping her close to family. :D It just so happens that my school has an informal/unofficial OMM elective. It is put on by DO residents at ETSU's family medicine residency program. So, I plan to take every advantage of this once a week class.

My purpose in this thread is to learn a little more about OMM. I've heard and read tons but have a specific instance where I felt things were unclear. While interviewing at DMU, we spoke at length to the OMM fellows. They spoke of how most "manipulations" are way overdone by chiropractics. In other words, a chiropractor would want to see a patient 3-5 times a week for 10-20 weeks in order to "fix" a curvature of the spine or "back pain." They explained that a DO would probably see the patient 1-4 times with OMM to fix/treat the problem. Maybe I am way over generalizing a "very complex" part of the human body but there seems to be a difference in philosophy when it comes to manipulation.

I have a good friend who is a chiropractor and he couldn't give me a good answer to my question because he is unfamiliar with the DOs and OMM.

Let's say you are dealing with severe scoliosis or a severe back injury, how does that change things?
 

jkhamlin

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Geronimo said:
I'm a student who has decided on an allopathic school for several reasons, mostly financial and keeping my wife happy by keeping her close to family. :D It just so happens that my school has an informal/unofficial OMM elective. It is put on by DO residents at ETSU's family medicine residency program. So, I plan to take every advantage of this once a week class.

My purpose in this thread is to learn a little more about OMM. I've heard and read tons but have a specific instance where I felt things were unclear. While interviewing at DMU, we spoke at length to the OMM fellows. They spoke of how most "manipulations" are way overdone by chiropractics. In other words, a chiropractor would want to see a patient 3-5 times a week for 10-20 weeks in order to "fix" a curvature of the spine or "back pain." They explained that a DO would probably see the patient 1-4 times with OMM to fix/treat the problem. Maybe I am way over generalizing a "very complex" part of the human body but there seems to be a difference in philosophy when it comes to manipulation.

I have a good friend who is a chiropractor and he couldn't give me a good answer to my question because he is unfamiliar with the DOs and OMM.

Let's say you are dealing with severe scoliosis or a severe back injury, how does that change things?
Are you aware that Chiropractic is an illegitimate derivitave of Osteopathy? Daniel David Palmer was a "magnetic healer" and a patient of Andrew Taylor Still, MD. He took what he could remember of the Osteopathic techniques Dr. Still used on him and applied them to his brand of snake oil to come up with Chiropractic.
 

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Geronimo said:
I'm a student who has decided on an allopathic school for several reasons, mostly financial and keeping my wife happy by keeping her close to family. :D It just so happens that my school has an informal/unofficial OMM elective. It is put on by DO residents at ETSU's family medicine residency program. So, I plan to take every advantage of this once a week class.

My purpose in this thread is to learn a little more about OMM. I've heard and read tons but have a specific instance where I felt things were unclear. While interviewing at DMU, we spoke at length to the OMM fellows. They spoke of how most "manipulations" are way overdone by chiropractics. In other words, a chiropractor would want to see a patient 3-5 times a week for 10-20 weeks in order to "fix" a curvature of the spine or "back pain." They explained that a DO would probably see the patient 1-4 times with OMM to fix/treat the problem. Maybe I am way over generalizing a "very complex" part of the human body but there seems to be a difference in philosophy when it comes to manipulation.

I have a good friend who is a chiropractor and he couldn't give me a good answer to my question because he is unfamiliar with the DOs and OMM.

Let's say you are dealing with severe scoliosis or a severe back injury, how does that change things?


Lets make sure you have your facts straight first-that poll misrepresents what you were told at DMU. If you interviewed since January 1 then I was one of the fellows you spoke with, if not then I know the fellows and we would never say that any patient can be fixed in 1-4 visits. There is no way to generalize how many visits someone might need-no way-period (someone can be overtreated-see below). Every patient if different and needs to be treated as such. In terms of OMM vs. chiro that could be an endless discussion. I have no beef with the chiro. profession-I do have a beef with any physician that puts monetary gain above proper pt. care and tries to treat problems that are beyond their scope. We hear a lot of stories from our patients that the chiro they saw treated them 2-3x.week w/ high velocity techniques which we feel is inappropriate regardless of dx. However, there are bad docs in every field and I personally know many chiros who are great people and great physicians.

The OMM course you describe sounds interesting-you will not be clinically proficient from a mini-course but you will likely gain an appreciation for what we do.

good luck with your endeavors

Please d/c above poll as it misrepresents osteopathy and chiropractic
 
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Geronimo

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Sorry about that on the poll. I checked with my wife and she remembers them that as well though. We were there in October actually. What they said, was they typically would see a patient around 4 visits (+ or -) a few if they complained of back pain with no serious complications or problems to speak of. I did throw in a disclaimer when I said "Maybe I am way over generalizing a "very complex" part of the human body" and I realize that. I'm just curious if I could better nail down the difference in how those such as yourself, an OMM fellow, would go about manipulation as opposed to a Chiro. I'll gladly change the poll but I'm not sure how.

The OMM course I was describing is like every Thursday night. I think that it is about 2 and half hours long. However, there isn't any testing or examination to my knowledge. I agree with the "not being" clinically proficient as I was told by several DO students they didn't feel clinically proficient even after a couple of years in OMM classes.
macman said:
Lets make sure you have your facts straight first-that poll misrepresents what you were told at DMU. If you interviewed since January 1 then I was one of the fellows you spoke with, if not then I know the fellows and we would never say that any patient can be fixed in 1-4 visits. There is no way to generalize how many visits someone might need-no way-period (someone can be overtreated-see below). Every patient if different and needs to be treated as such. In terms of OMM vs. chiro that could be an endless discussion. I have no beef with the chiro. profession-I do have a beef with any physician that puts monetary gain above proper pt. care and tries to treat problems that are beyond their scope. We hear a lot of stories from our patients that the chiro they saw treated them 2-3x.week w/ high velocity techniques which we feel is inappropriate regardless of dx. However, there are bad docs in every field and I personally know many chiros who are great people and great physicians.

The OMM course you describe sounds interesting-you will not be clinically proficient from a mini-course but you will likely gain an appreciation for what we do.

good luck with your endeavors

Please d/c above poll as it misrepresents osteopathy and chiropractic
 

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This is a misrepresentation of chiropractic practice. Typical the first week of care is 3X not 5X. On a few occasions, depending on the severity of the problem, a patient may be seen 5X the first week. Initial course of treatment is 3X week for 4 weeks and possibly 6 depending on problem. We do not treat patients for 10-20 weeks at 3-5 times per week. Where do you get your information? After that patients may elect to come in on a PRN basis or maintenance regimen. It's not required. I have patient's where I treat them maybe 1-4 visits and that is it. I can tell you, if you have a patient who has a spine riddled with 30 years of DJD; you are not going to be able to get them out of pain and functioning in 1-4 visits. If you claim you can, then I would like to know how you're doing it.
 

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BackTalk said:
I can tell you, if you have a patient who has a spine riddled with 30 years of DJD; you are not going to be able to get them out of pain and functioning in 1-4 visits. If you claim you can, then I would like to know how you're doing it.
Just out of curiosity, how do you fix 30 years of degenerative joint disease with chiropractic care? What do you do?
 

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macman

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BackTalk said:
This is a misrepresentation of chiropractic practice. Typical the first week of care is 3X not 5X. On a few occasions, depending on the severity of the problem, a patient may be seen 5X the first week. Initial course of treatment is 3X week for 4 weeks and possibly 6 depending on problem. We do not treat patients for 10-20 weeks at 3-5 times per week. Where do you get your information? After that patients may elect to come in on a PRN basis or maintenance regimen. It's not required. I have patient's where I treat them maybe 1-4 visits and that is it. I can tell you, if you have a patient who has a spine riddled with 30 years of DJD; you are not going to be able to get them out of pain and functioning in 1-4 visits. If you claim you can, then I would like to know how you're doing it.



I agree that generalizing about any profession is dangerous and unproductive. Unfortunately as a chiro you are likely very aware of the financial focus that many practictioners have and the similar bent of chiropractic of many seminars and colleges. That does not mean that a portion or a majority run that kind of practice. As I mentioned I know many D.C.'s (including my mother) and I have taken the activator course twice. I have two brother in laws and my best freind who are also D.C.'s. I have great respect for activator methods and use it regularly-the D.C.'s who run that group are world class. I think D.O's have our own skeletons such as the fact that the majority of practicing D.O.'s do zero spinal manip and do not really distinguish themselves as a member of a distinct field.

In terms of what has been said above-we at DMU do not claim to be able to treat complex conditions in 1-4 visits and if that was said (I was not on campus then) then you were misinformed.
 

macman

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Geronimo said:
Sorry about that on the poll. I checked with my wife and she remembers them that as well though. We were there in October actually. What they said, was they typically would see a patient around 4 visits (+ or -) a few if they complained of back pain with no serious complications or problems to speak of. I did throw in a disclaimer when I said "Maybe I am way over generalizing a "very complex" part of the human body" and I realize that. I'm just curious if I could better nail down the difference in how those such as yourself, an OMM fellow, would go about manipulation as opposed to a Chiro. I'll gladly change the poll but I'm not sure how.

The OMM course I was describing is like every Thursday night. I think that it is about 2 and half hours long. However, there isn't any testing or examination to my knowledge. I agree with the "not being" clinically proficient as I was told by several DO students they didn't feel clinically proficient even after a couple of years in OMM classes.

sorry geronimo-misread your post-please let me answer your question better: yea, if someone had uncomplicated LBP we would likely fix them pretty quickly - A range would be somewhere b/t 2 to 6 visits, no more frequently than every 2 weeks, always a full body treatment, and very specific evaluation of both skeleton and soft tissues. I recently have worked on a collegue who has been in chiro. practice for many years and also a student here who is a chiro and they both feel we get much more in depth with sacrum and innominate diagnosis (and some other areas)-that being said-I have run into chiro techniques (like activator) that do a better job with extremities, especially via the diagnostic system they use. I think, in general I would rather see an OMT specialist if I had a chronic condition b/c they spend more time on the tissues (fascia, etc.) as well as the joints.
 

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Now go and post this in DC section and see what there response would be. Also go and post this in allopath and see what they would say.

I choose none of the above. Cause I don't know enough about this.
 

BackTalk

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MaloCCOM said:
Just out of curiosity, how do you fix 30 years of degenerative joint disease with chiropractic care? What do you do?
The best we can do is to restore partial function to the affected joints. After that some rehab will help stabilize the area. There is no permanent fix or cure. My point was that it would take time to restore function and will take some time for the patient to experience symptomatic relief. From my experience 1-4 visits typically is not enough.

macman said:
I agree that generalizing about any profession is dangerous and unproductive. Unfortunately as a chiro you are likely very aware of the financial focus that many practictioners have and the similar bent of chiropractic of many seminars and colleges. That does not mean that a portion or a majority run that kind of practice. As I mentioned I know many D.C.'s (including my mother) and I have taken the activator course twice. I have two brother in laws and my best freind who are also D.C.'s. I have great respect for activator methods and use it regularly-the D.C.'s who run that group are world class. I think D.O's have our own skeletons such as the fact that the majority of practicing D.O.'s do zero spinal manip and do not really distinguish themselves as a member of a distinct field.

In terms of what has been said above-we at DMU do not claim to be able to treat complex conditions in 1-4 visits and if that was said (I was not on campus then) then you were misinformed.
I agree that generalizing about any profession is dangerous and unproductive. Unfortunately as a chiro you are likely very aware of the financial focus that many practictioners have and the similar bent of chiropractic of many seminars and colleges.

Yes, I’m well aware of these practices. Most colleges do not train DC’s to practice this way. It is the post graduate practice management seminars where chiropractors are unfortunately taught how to squeeze every penny out of a patient.

That does not mean that a portion or a majority run that kind of practice.

True, I’m glad you realize this.

As I mentioned I know many D.C.'s (including my mother) and I have taken the activator course twice. I have two brother in laws and my best freind who are also D.C.'s. I have great respect for activator methods and use it regularly-the D.C.'s who run that group are world class.

I’m familiar with this technique but do not practice it. It probably saves the doctor from developing DJD by using it. What I have found with patients is that they either love it or hate it. Some prefer the hands on method while others do not.

I think D.O's have our own skeletons such as the fact that the majority of practicing D.O.'s do zero spinal manip and do not really distinguish themselves as a member of a distinct field.

I know. It seems they have been absorbed into the allopathic community. I still see many here that struggle with their identities. Some want to be distinct and different while others want to be allopathy as opposed to osteopathy.
 

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My feeling is that OMM is good for some things, bad for others, and ineffective for still others. I also don't believe that just giving NSAIDs is the answer either. I think there are combinations of therapies that should be utilized given the particular pathology.
 

macman

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Elysium said:
My feeling is that OMM is good for some things, bad for others, and ineffective for still others. I also don't believe that just giving NSAIDs is the answer either. I think there are combinations of therapies that should be utilized given the particular pathology.

What type of things do you have in mind that OMM would be bad for? I agree with you that mulitple modalities are often best for long term relief
 

Elysium

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macman said:
What type of things do you have in mind that OMM would be bad for? I agree with you that mulitple modalities are often best for long term relief
I think cranial can be bad, because it's total quackery. When our profs have done it on some of the students in class (we haven't started learning it yet), some people have had an acute headache or worsening of migraines. Another student's sinus infection became very, very painful after the OMM "cure". One of our lunatic profs said she cured dyslexia by cranial, but this person is a fruit loop so no one cares what they say anyway. Another one of my classmates was doing cervical Still technique on his friend (and this classmate is a great student and good at OMM) and his friend passed out and they had to call the paramedics. So, all is not rosy in the world of OMM. But, I know some OMM fellow on this board is going to get into a big argument with me about it and I just really don't care enough to pay attention to all that. This is just my .02.
 

macman

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Elysium said:
I think cranial can be bad, because it's total quackery. When our profs have done it on some of the students in class (we haven't started learning it yet), some people have had an acute headache or worsening of migraines. Another student's sinus infection became very, very painful after the OMM "cure". One of our lunatic profs said she cured dyslexia by cranial, but this person is a fruit loop so no one cares what they say anyway. Another one of my classmates was doing cervical Still technique on his friend (and this classmate is a great student and good at OMM) and his friend passed out and they had to call the paramedics. So, all is not rosy in the world of OMM. But, I know some OMM fellow on this board is going to get into a big argument with me about it and I just really don't care enough to pay attention to all that. This is just my .02.

I think its useful to distinguish b/t contraindications and adverse effects. There have been times that OMM had made my back pain worse instead of better, that does not mean it is a 'bad idea' to do OMT for pts. with LBP. On one hand you call cranial total quackery but then you state how people had an effect (Albiet negative). If its quackery then they should have felt no different? My personal take on cranial is that it is a myofascial technique for the head-and I'm not convinced on the CSF stuff and feeling bones move.

I hope that did not qualify as a 'big argument'
 

MaloCCOM

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I had a DC do the "activator" on me and I did not notice anything, nor do I understand how it can do anything. Can you explain the theory behind it?

As for cranial... I don't think it can make anything worse, it's probably more placebo than anything.

HVLA may initially hurt for 24 hours after fixing a chronic problem, but afterwards you should be much better.
 

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MaloCCOM said:
I had a DC do the "activator" on me and I did not notice anything, nor do I understand how it can do anything. Can you explain the theory behind it?

As for cranial... I don't think it can make anything worse, it's probably more placebo than anything.

HVLA may initially hurt for 24 hours after fixing a chronic problem, but afterwards you should be much better.
All I know is there is some article written by a D.C. that uses his activator to treat anything from a woman in labor to a myocardial infarction. I wish I could find it for ya, but there was a post on it before.

It basically looks like a small pogo stick.
 

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No offense, but I would see a message therapist first, for typical back pain. It would also depend on what kind back pain I had: location, intensity, duration, etc.
 
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Geronimo

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macman said:
sorry geronimo-misread your post-please let me answer your question better: yea, if someone had uncomplicated LBP we would likely fix them pretty quickly - A range would be somewhere b/t 2 to 6 visits, no more frequently than every 2 weeks, always a full body treatment, and very specific evaluation of both skeleton and soft tissues. I recently have worked on a collegue who has been in chiro. practice for many years and also a student here who is a chiro and they both feel we get much more in depth with sacrum and innominate diagnosis (and some other areas)-that being said-I have run into chiro techniques (like activator) that do a better job with extremities, especially via the diagnostic system they use. I think, in general I would rather see an OMT specialist if I had a chronic condition b/c they spend more time on the tissues (fascia, etc.) as well as the joints.
Thanks. I think I've got a better perspective now. I will continue to research this and study "a variety of methods" in my aim to help patients. I think excluding any one treatment could be a mistake but including all treatments could also be a mistake. The informed physician is often the best one. Thanks to everyone.
Geronimo
 

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Geronimo said:
I'm a student who has decided on an allopathic school for several reasons, mostly financial and keeping my wife happy by keeping her close to family. :D It just so happens that my school has an informal/unofficial OMM elective. It is put on by DO residents at ETSU's family medicine residency program. So, I plan to take every advantage of this once a week class.

My purpose in this thread is to learn a little more about OMM. I've heard and read tons but have a specific instance where I felt things were unclear. While interviewing at DMU, we spoke at length to the OMM fellows. They spoke of how most "manipulations" are way overdone by chiropractics. In other words, a chiropractor would want to see a patient 3-5 times a week for 10-20 weeks in order to "fix" a curvature of the spine or "back pain." They explained that a DO would probably see the patient 1-4 times with OMM to fix/treat the problem. Maybe I am way over generalizing a "very complex" part of the human body but there seems to be a difference in philosophy when it comes to manipulation.

I have a good friend who is a chiropractor and he couldn't give me a good answer to my question because he is unfamiliar with the DOs and OMM.

Let's say you are dealing with severe scoliosis or a severe back injury, how does that change things?
Not exactly a "fair" poll now is it. Bash Chiro's like they are damn fools and then go down the list to the "enlightened" approach. C'mon.

Reality check. I see "pain" patients everyday and regardless if they get care or not they will be healing 24 hours a day. My use of chiropractic is to help them in that process. Typically, most are back to normal ADL in about 4 weeks-6 weeks depending on what they do after they leave the clinic. Patient visits? I see them every day for a couple of weeks (business days). Why? because you are healing the most during that time right after an accident. Your body doesn't care what business hours the doctor keeps or if your asleep or awake...you just hurt. After that things progress more slowly and I cut back care drastically, 2-3 times for a couple of weeks...that's usually it. It just depends on the patient...no preset time limits, just averages. Not scientific averages, clinical averages.

As for OMM vs. CMT who cares? The joint moves in either case, sometimes it even goes "Pop!". Activator, my thumb, fist, "chiropractic hand", foot or shovel-whatever it takes to restore normal ROM and alleviate pain. That includes along with my adjustment, physio and physical therapy sessions, medications from my D.O. (who doesn't ever manipulate anyone but get's adjustments regulary from the D.C.'s...how's that for a laugh). I have read dozens of posts arguing Manipulation vs Adjustment...my conclusion what a bunch of hooey. MOST of the time, D.C.'s or D.O.'s can't even be sure they even moved a specific joint, just general movements.

When it comes to "bone setting" which is all these things really are, people try to make a science out of something very simple. Chiro's argue PT's can't do it, D.O.'s argue Chiro's can't do it, M.D.'s argue NOBODY should do it but the bottom line is patients ask for ANYONE to do it that knows how. That usually means practice, more hands-on skill. This is NOT an academic exercise that too many D.O.'s/M.D.'s think it is. I think PT's would be great at adjusting and probably already do and just don't say anything, because they work with patients directly A LOT. However, the very idea that Patients have a "real" choice out there of where to get their "backs cracked" is just silly...only chiropractors "really" offer this service. I would NEVER trust someone who learned it at a weekend seminar or YEARS AGO at D.O. school but never put their hands on anyone. This is pretty much ALL chiro's do all day long, day after day...they are the most competent, confident and skilled at this art (yes, art like martial arts (manual dexterity needed)) simply because of the time spent learning the skill.

Frankly, if D.O.'s would just start using OMM their wouldn't be a chiropractic profession!!! So to answer your poll. I pick "All the above" on behalf of the patient who should get whatever care they need to get well.

chirodoc
 

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chirodoc said:
Not exactly a "fair" poll now is it. Bash Chiro's like they are damn fools and then go down the list to the "enlightened" approach. C'mon.

Reality check. I see "pain" patients everyday and regardless if they get care or not they will be healing 24 hours a day. My use of chiropractic is to help them in that process. Typically, most are back to normal ADL in about 4 weeks-6 weeks depending on what they do after they leave the clinic. Patient visits? I see them every day for a couple of weeks (business days). Why? because you are healing the most during that time right after an accident. Your body doesn't care what business hours the doctor keeps or if your asleep or awake...you just hurt. After that things progress more slowly and I cut back care drastically, 2-3 times for a couple of weeks...that's usually it. It just depends on the patient...no preset time limits, just averages. Not scientific averages, clinical averages.

As for OMM vs. CMT who cares? The joint moves in either case, sometimes it even goes "Pop!". Activator, my thumb, fist, "chiropractic hand", foot or shovel-whatever it takes to restore normal ROM and alleviate pain. That includes along with my adjustment, physio and physical therapy sessions, medications from my D.O. (who doesn't ever manipulate anyone but get's adjustments regulary from the D.C.'s...how's that for a laugh). I have read dozens of posts arguing Manipulation vs Adjustment...my conclusion what a bunch of hooey. MOST of the time, D.C.'s or D.O.'s can't even be sure they even moved a specific joint, just general movements.

When it comes to "bone setting" which is all these things really are, people try to make a science out of something very simple. Chiro's argue PT's can't do it, D.O.'s argue Chiro's can't do it, M.D.'s argue NOBODY should do it but the bottom line is patients ask for ANYONE to do it that knows how. That usually means practice, more hands-on skill. This is NOT an academic exercise that too many D.O.'s/M.D.'s think it is. I think PT's would be great at adjusting and probably already do and just don't say anything, because they work with patients directly A LOT. However, the very idea that Patients have a "real" choice out there of where to get their "backs cracked" is just silly...only chiropractors "really" offer this service. I would NEVER trust someone who learned it at a weekend seminar or YEARS AGO at D.O. school but never put their hands on anyone. This is pretty much ALL chiro's do all day long, day after day...they are the most competent, confident and skilled at this art (yes, art like martial arts (manual dexterity needed)) simply because of the time spent learning the skill.

Frankly, if D.O.'s would just start using OMM their wouldn't be a chiropractic profession!!! So to answer your poll. I pick "All the above" on behalf of the patient who should get whatever care they need to get well.

chirodoc
How do you explain the chriropractors treating medical emergencies (pregnancies...heart attacks) with an "activator." Do you really need a pogo stick to do the work for you? No need for medicines when you have one of those....

http://www.activator.com
 

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OSUdoc08 said:
All I know is there is some article written by a D.C. that uses his activator to treat anything from a woman in labor to a myocardial infarction. I wish I could find it for ya, but there was a post on it before.

It basically looks like a small pogo stick.
I think this is what you were talking about.

http://www.chiroweb.com/archives/16/07/03.html

Dynamic Chiropractic
March 23, 1998, Volume 16, Issue 07

Chiropractic at 33,000 Feet

by Bruce C. Hagen, Sr., DC
In 1991, my wife and I journeyed to England to partake in the wonders of Wimbeldon. We were joined in London by our son Eric, who was a student at Heidelberg, Germany. We then flew on to Frankfurt, where our daughter, a Pepperdine student studying in Madrid, Spain, joined us for an additional two-week tour of Europe. After touring through Europe, including the Scandinavian countries, we returned to Frankfurt to depart for London. We were supposed to stay overnight in London and then return to the U.S.

However, upon calling my office in South Dakota, I learned that my son, Dr. Mark Hagen, was about to have root canal surgery and would be unable to operate our Sioux City clinic. I decided to avoid overnighting in London and proceed directly to the US so I could take his practice. Lufthansa Airlines informed me that if I left an hour earlier for London in order to fly directly to the USA, it would cost an additional $800. I agreed, then checked with the US airline that we were scheduled to take from London back to Sioux Falls. They were accommodating and put us on a standby flight from Frankfurt to Boston, on to Minneapolis, then to Sioux Falls.

Our standby status looked precarious as the airline loaded the passengers on board. Suddenly, policemen appeared with dogs and made everyone get off the plane. After an hour-and-a-half delay to search the plane, the passengers re-boarded. My wife and I got the last two seats. Needless to say, there was a surly group of passengers concerned about missing their flight connections out of Boston.

About 90 minutes out of Frankfurt, an announcement was made over the loudspeaker: "If there is a doctor on board, please identify yourself." The announcement was urgently repeated about five minutes later. I pushed my call button, advised the head stewardess that I was a chiropractor, and asked if there was anything I could do. She took me forward to the first-class compartment, then related to me that a young lady, seven-and-a-half months pregnant, was complaining of severe headaches, nausea and back pain. She might have been experiencing premature labor. (I later found out that this young lady was a military dependent who originally had been pregnant with twins but had one of the babies aborted without her permission. She was so angry with the health care she had received that she was returning to Boston to have her baby delivered in the private sector.)

I assisted the patient to a standing position, palpated the level of the hips, and found a PD right. I adjusted the standard Activator listings in the standing position. I also adjusted the sixth thoracic area for the nausea, and found the spinous axis was projecting way out to the right. Fifteen minutes later, the adjustment was complete and she was sound asleep in her seat.

Needless to say, the head stewardess was ecstatic with the results I had achieved. She informed me that they would have been forced to land in Iceland or return to Frankfurt for emergency services. After the long delay from our original estimated time of departure, a further delay could have created a passenger mutiny on board!

To thank me, the stewardess offered to move me up to the last seat in first class. As tempted as I was, I thought it better to return to my wife. The stewardess brought us one of France's finest champagnes a little later. Being a total abstainer, I still have the bottle. Several other crew members also thanked me for my services.

In February and March of 1997, we traveled to New Zealand and Australia thanks to the generosity of our oldest daughter, who had given us business-class accommodations from LA to New Zealand, Sydney, Perth, Ayers Rock, and Cannes; then back to Sydney and home again. While in Port Douglas at the conclusion of our vacation, we were caught in a cyclone with wind speeds up to 180 knots per hour.

After a hair-raising ride from Port Douglas to Cannes that included striking a tree that had blown across the road, we flew from Cannes to Sydney, then boarded our flight from Sydney to LA. We were served a meal, and I settled back in my seat for the first sleep in three days due to the cyclone. I was abruptly awakened by the head flight steward. He asked me if I was a medical doctor, and I replied that I was a chiropractor. I asked him what the problem was, and he said a man in coach was apparently having a heart attack. I quickly asked him if there were any medical doctors on board. He said I was the only one listed as a doctor. I could see his disappointment at learning I was not a medical doctor, but I volunteered to take a look at the patient.

He escorted me to the man's seat in the mid-section of the plane. They had moved him to an aisle seat, and he was using the oxygen mask hanging down from the ceiling. He looked cyanotic and in severe distress. He was perspiring profusely. I felt his pulse and found it weak but rhythmical. I opened his shirt and listened to his heart with my ear. I found out that the man had seen his cardiologist that morning and been given the OK to travel. He was on quite a bit of medication. I did the applied kinesiology, neurovascular, and neurolymphatic procedures for heart problems. I also held pressure against his axis vertebrae, which afforded him considerable relief. After he was resting comfortably, I told him I would be back in thirty minutes to check on his status.

Thirty minutes later I returned with my Activator. An Australian nurse was checking the patient with a stethoscope and other instruments she had found in the airplane. She wanted to hook him up to a defibrillator in case his heart quit. I palpated his cervical and upper thoracic region, and adjusted the second thoracic and the axis with the Activator.

There was no place to hook him up to the defibrillator equipment except up in the galley, so we moved him there with a portable oxygen tank. We laid him on the floor, and just then the plane was caught in severe turbulence and we were ordered to take some seats in the flight-crew compartment for about twenty minutes. We left the poor patient lying on the floor. When we returned, the patient was feeling much better, and didn't want to be hooked up to the defibrillator. He returned to his seat, eventually got off the oxygen, ate his breakfast, then departed the plane on his own.

Upon returning home to Sioux Falls, my wife received a call at our residence from the overseas marketing director of the airline, commending and thanking me for my services, and especially for helping avoid an emergency landing in Hawaii. That kind of delay would have resulted in rebooking 400 passengers on different flights. He called me several weeks ago and thanked me again.

In reflecting back on this situation, I can recall how disappointed the head steward was when he discovered I was not a medical doctor. However, when one considers scientifically the capabilities of a chiropractor and a medical doctor on an airplane, who has the advantage? Does the medical doctor carry a suitcase full of cardiac meds? I think not.

I have also traveled to Jamaica on five occasions for missionary work, to the Ukraine, and to Poland twice. A chiropractor does not need an MRI -- or a CAT-scan, an x-ray or an automatic processor. Even in an emergency, your hands, an Activator, a bed, a couch, a chair or a portable table are all you need to render care to 98% of the populace.

Thinking back on my 44 years of practice and my varied experiences, I think maybe I should become a cruise-ship chiropractor in my retirement.

Bruce C. Hagen, Sr., DC
Sioux Falls, South Dakota
 

OSUdoc08

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Apollyon said:
I think this is what you were talking about.

http://www.chiroweb.com/archives/16/07/03.html

Dynamic Chiropractic
March 23, 1998, Volume 16, Issue 07

Chiropractic at 33,000 Feet

by Bruce C. Hagen, Sr., DC
In 1991, my wife and I journeyed to England to partake in the wonders of Wimbeldon. We were joined in London by our son Eric, who was a student at Heidelberg, Germany. We then flew on to Frankfurt, where our daughter, a Pepperdine student studying in Madrid, Spain, joined us for an additional two-week tour of Europe. After touring through Europe, including the Scandinavian countries, we returned to Frankfurt to depart for London. We were supposed to stay overnight in London and then return to the U.S.

However, upon calling my office in South Dakota, I learned that my son, Dr. Mark Hagen, was about to have root canal surgery and would be unable to operate our Sioux City clinic. I decided to avoid overnighting in London and proceed directly to the US so I could take his practice. Lufthansa Airlines informed me that if I left an hour earlier for London in order to fly directly to the USA, it would cost an additional $800. I agreed, then checked with the US airline that we were scheduled to take from London back to Sioux Falls. They were accommodating and put us on a standby flight from Frankfurt to Boston, on to Minneapolis, then to Sioux Falls.

Our standby status looked precarious as the airline loaded the passengers on board. Suddenly, policemen appeared with dogs and made everyone get off the plane. After an hour-and-a-half delay to search the plane, the passengers re-boarded. My wife and I got the last two seats. Needless to say, there was a surly group of passengers concerned about missing their flight connections out of Boston.

About 90 minutes out of Frankfurt, an announcement was made over the loudspeaker: "If there is a doctor on board, please identify yourself." The announcement was urgently repeated about five minutes later. I pushed my call button, advised the head stewardess that I was a chiropractor, and asked if there was anything I could do. She took me forward to the first-class compartment, then related to me that a young lady, seven-and-a-half months pregnant, was complaining of severe headaches, nausea and back pain. She might have been experiencing premature labor. (I later found out that this young lady was a military dependent who originally had been pregnant with twins but had one of the babies aborted without her permission. She was so angry with the health care she had received that she was returning to Boston to have her baby delivered in the private sector.)

I assisted the patient to a standing position, palpated the level of the hips, and found a PD right. I adjusted the standard Activator listings in the standing position. I also adjusted the sixth thoracic area for the nausea, and found the spinous axis was projecting way out to the right. Fifteen minutes later, the adjustment was complete and she was sound asleep in her seat.

Needless to say, the head stewardess was ecstatic with the results I had achieved. She informed me that they would have been forced to land in Iceland or return to Frankfurt for emergency services. After the long delay from our original estimated time of departure, a further delay could have created a passenger mutiny on board!

To thank me, the stewardess offered to move me up to the last seat in first class. As tempted as I was, I thought it better to return to my wife. The stewardess brought us one of France's finest champagnes a little later. Being a total abstainer, I still have the bottle. Several other crew members also thanked me for my services.

In February and March of 1997, we traveled to New Zealand and Australia thanks to the generosity of our oldest daughter, who had given us business-class accommodations from LA to New Zealand, Sydney, Perth, Ayers Rock, and Cannes; then back to Sydney and home again. While in Port Douglas at the conclusion of our vacation, we were caught in a cyclone with wind speeds up to 180 knots per hour.

After a hair-raising ride from Port Douglas to Cannes that included striking a tree that had blown across the road, we flew from Cannes to Sydney, then boarded our flight from Sydney to LA. We were served a meal, and I settled back in my seat for the first sleep in three days due to the cyclone. I was abruptly awakened by the head flight steward. He asked me if I was a medical doctor, and I replied that I was a chiropractor. I asked him what the problem was, and he said a man in coach was apparently having a heart attack. I quickly asked him if there were any medical doctors on board. He said I was the only one listed as a doctor. I could see his disappointment at learning I was not a medical doctor, but I volunteered to take a look at the patient.

He escorted me to the man's seat in the mid-section of the plane. They had moved him to an aisle seat, and he was using the oxygen mask hanging down from the ceiling. He looked cyanotic and in severe distress. He was perspiring profusely. I felt his pulse and found it weak but rhythmical. I opened his shirt and listened to his heart with my ear. I found out that the man had seen his cardiologist that morning and been given the OK to travel. He was on quite a bit of medication. I did the applied kinesiology, neurovascular, and neurolymphatic procedures for heart problems. I also held pressure against his axis vertebrae, which afforded him considerable relief. After he was resting comfortably, I told him I would be back in thirty minutes to check on his status.

Thirty minutes later I returned with my Activator. An Australian nurse was checking the patient with a stethoscope and other instruments she had found in the airplane. She wanted to hook him up to a defibrillator in case his heart quit. I palpated his cervical and upper thoracic region, and adjusted the second thoracic and the axis with the Activator.

There was no place to hook him up to the defibrillator equipment except up in the galley, so we moved him there with a portable oxygen tank. We laid him on the floor, and just then the plane was caught in severe turbulence and we were ordered to take some seats in the flight-crew compartment for about twenty minutes. We left the poor patient lying on the floor. When we returned, the patient was feeling much better, and didn't want to be hooked up to the defibrillator. He returned to his seat, eventually got off the oxygen, ate his breakfast, then departed the plane on his own.

Upon returning home to Sioux Falls, my wife received a call at our residence from the overseas marketing director of the airline, commending and thanking me for my services, and especially for helping avoid an emergency landing in Hawaii. That kind of delay would have resulted in rebooking 400 passengers on different flights. He called me several weeks ago and thanked me again.

In reflecting back on this situation, I can recall how disappointed the head steward was when he discovered I was not a medical doctor. However, when one considers scientifically the capabilities of a chiropractor and a medical doctor on an airplane, who has the advantage? Does the medical doctor carry a suitcase full of cardiac meds? I think not.

I have also traveled to Jamaica on five occasions for missionary work, to the Ukraine, and to Poland twice. A chiropractor does not need an MRI -- or a CAT-scan, an x-ray or an automatic processor. Even in an emergency, your hands, an Activator, a bed, a couch, a chair or a portable table are all you need to render care to 98% of the populace.

Thinking back on my 44 years of practice and my varied experiences, I think maybe I should become a cruise-ship chiropractor in my retirement.

Bruce C. Hagen, Sr., DC
Sioux Falls, South Dakota

Yeah, thanks for finding that for me. I love to show it to all my friends at school. It keeps us laughing for days.
 

DRDCMD

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OSUdoc08 said:
Yeah, thanks for finding that for me. I love to show it to all my friends at school. It keeps us laughing for days.
I am a practicing DC with about 14 years of experience. I do treat a number of conditions that may not be thought to be amenable to chiropractic care, however, if the situation is deemed "critical" we call the ambulance or advise them to get to the nearest ER. In treating my patients I employ chiropractic procedures, cranials, meridian therapy, neurolymphatic/vascular reflexes, nutrition, phytotherapy etc. I often help patients that have failed prior interventions. I would describe the majority of these disorders as "functional", that is, they are not clear-cut "pathological" but the body is in a state of dysfunction. "Dis-ease" preceding disease to use the chiropractic lexicon.

I am considering returning to medical school and am currently exploring the options of doing so. Hence, I peruse these forums a lot. I offer this caveat. Since we are in the same boat, that is, taking care of people, you should open the lines of communication between us. The following descriptions may be of interest. When I first began practicing, I had a gentleman see me for sciatica, he was in his 60s and generally seemed to be in good health. In fact he was gearing up for a ski weekend with some "lady friends" and wanted to be in good shape for the trip. He had consulted his medical doctor a number of times for this same condition but it remained persistent. An x-ray taken at my practice revealed a sclerotic blastic pedicle at the L3 vertebrae. He also had diffuse idiopathic skeletal hyperostosis (DISH). I knew what the diagnosis was likely to be. When I contacted his PCP, the doctor could not have been more rude, especially after having introduced myself as a doctor of chiropractic. As I was attempting to explain myself he continued to interject a curt "yes, yes" ... like get to the point ... until I screamed over the phone that his patient has blastic metastasis and that I ordered a bone scan and he better damn well do a PSA and rectal - that shut him up. The patient was admitted for surgery and later thanked me profusely for "setting everyone straight". That same doctor later called me and confirmed that the prostate was like a rock with an elevated PSA and commended me for my good work - we maintained a favorable relationship following.

Just recently a patient came to me for back pain, a moderately overweight, 37 yoa female with thoracolumbar pain for a few months, she consulted her PCP who ran some tests, diagnosed her with "sprain/strain" and sent her off with some muscle relaxers. Her description of her condition seemed "over the top" so-to-speak. The physical findings did not accord with her complaint of being in "agony". After the second visit, I became worried, something was not right. I told her I want her to go back to her PCP (if I suspect pathology, I will refer to a radiology facility for a radiologist's review) for some films, maybe an MRI. After she left my office, I even called her PCP, who would not get on the phone with me, and explained to the office manager that I felt that "something more serious may be going on here". When she returned to her PCP, he chewed her out every which way from sunday about seeing this "quack". He also never called to thank me for saving his ass when the patient was found to have hodgkin's lymphoma.

This happened about 3 years ago. A female patient in her 70s, maybe 90 lbs, presented to my clinic with severe back pain. I had seen her maybe a half-dozen times in the past. She has a hx of heart dz, diabetes, and was diagosed with one non-functional kidney. She had a triple by-pass some years prior and appeared to be chronically anoxic (her nails and lips were always bluish). X-rays were basically unremarkable but for DJD, some osteopenia. Her condition was persistent even after a few treatments, and, again, I grew concerned. I pulled her daughter aside and told her that I felt something "more serious" was going on - possibly cancer, infection, serious inflammation, but was not sure what. To her mother, I stated that I believed something beyond what I could treat was occurring and advised her to visit her doctor for blood/urine tests and maybe a scan. Her daughter reported back to me that her blood tests were completely "normal". I found this perplexing and requested copies of the results. Her BUN was off but I figured that was due to her non-functioning kidney, however, the ESR and CRP were extremely elevated. I told her daughter to PLEASE go back and discuss these findings with her mother's doctor. He replied, verbatim, "those numbers don't mean anything". 2 weeks later the patient died.

This stuff happens EVERY day on BOTH sides of the fence. We are all human and do not always find what is wrong with patients on the first shot. We NEED to work together - no single discipline has all the answers. If I was heading down the wrong path on a patient, I would hope/pray that another health professional would re-direct me. I hope that I would never let my ego result in my not doing what is best for a patient. Primo non nocere.

Medicine has saved countless lives, however, iatrogenic disease/death has never been more prevalent. I believe it was in the JAMA article of 2000, "Is U.S. Healthcare Really the Best In the World", that Barbara Starfield stated that medicine was the third leading cause of death in the U.S. (approximately 250,000 lives per year). Clearly reforms are necessary. The latest fiasco with the COX 2 inhibitor drugs, estimated to have killed 150,000 to 200,000 worldwide, attests to this. I wonder how many deaths could have been avoided if medical doctors had referred these patients with joint pain to a doctor of chiropractic rather than than placing them on the aforementioned prescription meds? It would keep me awake at night for weeks if I were the one who had done the prescribing.

Something to ponder. In my career, just about every pathological condition I have discovered on a patient was found AFTER the patient had consulted their medical doctor. How would you feel if YOU were the treating physician? How will you react in the future? Remember, we are all in the same boat. Also, just in case it's in your mind, I do not always make the definitive diagnosis on every patient that comes thru MY door - we are all human.

Good luck to all of you in your studies. I hope to be working with you as a colleague in the future - PLEASE keep an open mind.
 

BMW19

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Once again the osteo forum is reduced to chiro bashing. I always find this perplexing considering how much DO's have had to go thru to become a legit member of the medical community. Do you remember nothing of the struggles to fit in? If OMM works then Chiro has to work as well. I am sick of the B.S. that OMM has a different methods and therefore can work when moving a joint. But of course chiro is quakary when moving the same Joint! As a D.C. going on to become a D.O. for various reasons I am constantly amazed how a profession that struggled against the allos continues to bash a profession that has done the same. Whatever OMM works for fill in the blanks and chiro prob has some beneficial effect as well.

jkhamlin, I suppose you were alive in 1895 to know exactly what went on. I also suppose that Dr. Still's theory that bone was out of place impeding on blood flow was light years ahead of Palmer's synopsis that is was nerve involvement. Once again when Still did it it was a miracle but Palmer is a snake oil salesman. Give the rationale behind that.

Chirodoc, excellent post. When a pt. is in pain they want to get better. They don't care if it is a D.O., PT or chiro working on their back.

BMW-



jkhamlin said:
Are you aware that Chiropractic is an illegitimate derivitave of Osteopathy? Daniel David Palmer was a "magnetic healer" and a patient of Andrew Taylor Still, MD. He took what he could remember of the Osteopathic techniques Dr. Still used on him and applied them to his brand of snake oil to come up with Chiropractic.