What's Wrong With Chiropractors?

A skeptical look at medical practices
JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Mon Dec 19, 2005 9:43 pm

rational doc wrote

"i already visited the chiropractic subluxation issue, the debate is in it's effects on the human body, minor to severe? i've seen both in my office"

NO, YOU HAVE NOT ADDRESSED "CHIROPRACTIC" SUBLUXATION OR HOW YOU DIAGNOSE IT. YOU SIMPLY, SADLY, SAID YOU BELIEVE.

NOR HAVE YOU ADDRESSED MY QUESTION WHETHER YOU BELIEVE CHIROPRACTIC TREATMENT OF SUBLUXATIONS IS GOOD FOR EAR INFECTIONS (AS THEY CLAIM).

"i think what you need to also look at with the wilk case is ..."

THE TOPIC HERE IS "WHAT IS WRONG WITH CHIROPRACTIC," AND THE JUDGE FOUND THAT THERE IS GOOD EVIDENCE IT IS HARMFUL.

"as far as organ transplants go, you do have nerve regrowth into the affected organs, otherwise you heat beat in a heart transplant would never get above the low inherent beat of the heart itself"

ACCORDING TO A PROFESSOR AT HARVARD MED, THE LIMITED REINERVATION OF A TRANSPLANT HAS NO SIGNIFICANT EFFECT (WITH PARTCULAR REFERENCE TO THE HEART). IF YOU HAVE CONTRARY INFORMATION, I WILL PASS IT ALONG FOR EVALUATION (BUT GIVE REAL CITATIONS, NOT "THE FRENCH STUDY" OR "BODACIOUS AND WHATSIZNAME").

"chiropractors never said that an organ won't work without nerve supply, it is more of an issue as to how well it works in conjunction with the rest of the body and the needs of the body at that point"

AH, YOU ARE A CHIROPRACTOR.


ONCE AGAIN I WILL POSE A SIMPLE PROBLEM:
IDENTIFY FIVE VISCERAL DISEASES THAT BENEFIT FROM SPINAL MANIPULATION. PROVIDE REAL, LITERATURE CITATIONS.

DJHarkavy
Poster
Posts: 167
Joined: Sat Nov 12, 2005 2:29 am

Re: boy, sorry for trying to have an exchange of ideas here

Postby DJHarkavy » Mon Dec 19, 2005 10:37 pm

rational doc wrote:as far as organ transplants go, you do have nerve regrowth into the affected organs, otherwise you heat beat in a heart transplant would never get above the low inherent beat of the heart itself


If I remember my anatomy correctly, the heart has its own 'pacemaker' (technically the sinoatrial node) which starts the contraction of the heart and is self-excited. The vagus nerve leads into the heart, and will slow the heart when stimulated, but is not necessary to cause heartbeat. Various sympathetic nerves will speed up the heart, but once again are not necessary for heartbeat. The SA node itself responds to hormonal changes and carbon dioxide levels.

Regrowth of nerves into the heart takes the better part of a year and is somewhat random.

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

i am a physiatrist specialing in pain management

Postby rational doc » Tue Dec 20, 2005 4:16 pm

ear infections - from what i have read the proposed mechanism is that swelling of the upper cervical joints and surrounding tissues along with the associated muscle contracture in the upper cervical region are said to produce pressure on the eustacian tube limiting the drainage of the inner ear, and providing a situation more conducive for infection

as far as the heart - i believe what i was saying was that organs can function on their own to some degree, the body has controlling mechanisms via the hormonal and nervous systems though the body part should function at a higher level and be more integrated with the rest of the body if these systems are intact and fully functional

why do organs have a nerve supply if it is not a necessary element (as was proposed on this board)?

what in the body serves absolutely no function or has had no purpose? the parts we don't need or lose the need for should normally disappear or become vestigual (like the appendix?) - wouldn't that be logical

do i think that chiropractic works or is the best course of action for people with visceral disease - no , but can there be an influence of the nervous system on the funtion of visceral organs, of course, that is logically why these parts have a nerve supply, the 10,000 question is can the nervous system influence on the organ be great enough to cause the organ to malfunction or work inappropriately - this i think needs more study because i think in theory there is that potential,

parapalegics have visceral problems that may be due in part to the lack of or inappropriate nerve function

as far as visceral diseases go, i think you should use your MD first and if you want to see a chiropractor, or DO or nutritionist on top of that, fine,

it doesn't make sense to actively treat an infection with just chiropractic like don't think it makes sense to just treat with antibiotics without considering consoling the patient on how to avoid infection, and how to improve the immune response of the body to the infection, if i minimize my patient's exposure to antibiotics, they work better for that patient when they are needed,

we used to give out antibiotics for colds - how does that make any sense? we did it because the patient wanted them, and we avoiding seconday infections -doesn't happen often enough - we also created antibiotic resistent strains of bacteria - that was smart on our part - did we forget about natural selection?

as far as the subluxation ( sorry if i skip around a bit - do this for fun in between patients), mechanically stiff joints are considered subluxations - i can them mechanical lesions - different verbiage, where the debate is in my opinion is how much of an effect this mechanical lesion has on associated tissues - does a subluxation exist - yes, does it exist to the degree as described by chiropractors? - i think it needs more study

User avatar
corymaylett
Regular Poster
Posts: 954
Joined: Wed Nov 09, 2005 6:03 am

Postby corymaylett » Tue Dec 20, 2005 10:11 pm

rational doc wrote:ear infections - from what i have read the proposed mechanism is that swelling of the upper cervical joints and surrounding tissues along with the associated muscle contracture in the upper cervical region are said to produce pressure on the eustacian tube limiting the drainage of the inner ear, and providing a situation more conducive for infection

Can you cite some references on that, because it sounds like typical chiropractic rationalization?

The four muscle pairs associated with the Eustachian tubes are not innervated from the cervical spine, so I don't see the relationship. Instead the nerves whose branches innervate these muscles originate in the brain and the brain stem — bypassing the spine altogether. Besides, even if there were a causal relationship, "swelling of upper cervical joints and surrounding tissues" would result in pain, numbness, tingling, etc. long before it would manifest itself in increased incidence of infection due to constricted Eustachian tubes. And you know, I just don't know very many kids with ear infections who also complain about chronic neck pain.

rational doc wrote:but can there be an influence of the nervous system on the funtion of visceral organs, of course, that is logically why these parts have a nerve supply, the 10,000 question is can the nervous system influence on the organ be great enough to cause the organ to malfunction or work inappropriately - this i think needs more study because i think in theory there is that potential

Internal organs are obviously connected to the (autonomic) nervous system, and the relationship between the various organs and the ANS needs more clinical research. However, little to no clinical evidence supports the proposition that "sublaxations," pinched nerves, and the other chiropractic mainstays are causal or even contributory factors in diseases that commonly afflict these organs.

rational doc wrote:it doesn't make sense to actively treat an infection with just chiropractic...

It doesn't make any sense to treat an infection with chiropractic, period. Infections are caused by micro-organisms, not impinged nerves and misaligned bones.

rational doc wrote:we used to give out antibiotics for colds - how does that make any sense?

No, it makes no sense at all unless there's a significant risk of a dangerous secondary bacterial infection, and I'm happy that most physicians finally seem to be standing up to the pressure from patients to prescribe them.

rational doc wrote:does a subluxation exist - yes, does it exist to the degree as described by chiropractors? - i think it needs more study

In chiropractic lingo, there are likely various conditions that chiropractors would claim to be their mysterious "sublaxations." But these elusive chiropractic mainstays, under whatever name(s) they're given, just don't live up to the stature of being a prime cause or contributor to disease.

Really, arriving at a conclusion (like chiropractic theory being valid) and then trying to bend or selectively search for evidence to support it, while simultaneiously ignoring the mountains of evidence that dismiss it, is just a bassackwards and illegitimate attitude that doesn't lend itself to doing decent clinical research.

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Tue Dec 20, 2005 10:35 pm

So, we see r doc has no evidence, and no medical understanding of the 'chiropractic' subluxation, as defined above.

Concerning 'chiropractic' subluxation, consider:
"This experimental study demonstrates conclusively that the subluxation of a vertebra as defined by chiropractic-the exertion of pressure on a spinal nerve which by interfering with the planned expression of Innate Intelligence produces pathology-does not occur. This is what should be expected when one recognizes that the vertebral column has been evolving for over 400 million years to support the body and protect the central nervous system. By a process of natural selection the vertebral column of mammals has evolved into one in which the articulations allow an overall range of motion so that individuals may function well for survival within their environment. At the same time the selective process has favored vertebral columns that have spacious intervertebral foramina in combination with the barest minimum of displacement between adjacent vertebrae-two factors that preclude impingement upon the spinal nerves as they pass through the foramina."
>Edmund S. Crelin "American Scientist" September/October 1973 issue.

"If the motor nerve cells to a skeletal (voluntary) muscle die, the muscle will be paralyzed and also die. This is because the motor nerve cells continuously supply skeletal muscle cells with substances needed for their survival, above and beyond the hormone the nerve cells secrete to make the muscle contract. This is not the case with the motor nerve cells to glands, heart muscle, or smooth (involuntary) muscle. Complete severance of the motor nerves from the spinal nerves to the heart, glands (salivary, thyroid, liver, pancreas, etc.), and smooth muscle of the lungs, esophagus, stomach, gall bladder, intestines, etc., has only transient effects. The gland cells and smooth and cardiac muscle cells not only survive, but function normally. They surely do not become diseased."
Edmund S. Crelin, Ph.D., 1975
http://www.quackwatch.org/01QuackeryRel ... pinch.html

At that time, Dr. Crelin was Professor of Anatomy and Chairman of the Human Growth and Development Study Unit at the Yale University School of Medicine. He had published over 100 papers on the development, structure, and physiology of bones and joints and was the author of the first atlas of the anatomy of the human newborn ever published.

r doc thinks more research is needed. They have had 110 years; but all they have is anecdote and testimonial.

Regardless of whatever "rational doc" learned in chiropractic school, the 'chiropractic' subluxation is a joke. Chiropractic 'spinal' manipulations do not affect visceral organs (or much else except, possibly, low back pain of short duration).

Joe

User avatar
Sock Monkey
Poster
Posts: 224
Joined: Tue Dec 06, 2005 2:56 am

Re: i am a physiatrist specialing in pain management

Postby Sock Monkey » Wed Dec 21, 2005 1:57 am

rational doc wrote:ear infections - from what i have read the proposed mechanism is that swelling of the upper cervical joints and surrounding tissues along with the associated muscle contracture in the upper cervical region are said to produce pressure on the eustacian tube limiting the drainage of the inner ear, and providing a situation more conducive for infection


And is there any evidence that this is actually true?

it doesn't make sense to actively treat an infection with just chiropractic


Agreed.

Now, why do you think it makes sense to include chiropractic in the treatment regime at all?

as far as the subluxation ( sorry if i skip around a bit - do this for fun in between patients), mechanically stiff joints are considered subluxations - i can them mechanical lesions - different verbiage, where the debate is in my opinion is how much of an effect this mechanical lesion has on associated tissues - does a subluxation exist - yes, does it exist to the degree as described by chiropractors? - i think it needs more study


Or indeed, any study at all.
Pixy Misa's pet monkey.

User avatar
sparks
Poster
Posts: 454
Joined: Wed May 18, 2005 11:45 pm
Location: Constant and total amazement

Postby sparks » Wed Dec 21, 2005 7:56 am

I've been watching this thread for a while now, and correct me if I'm wrong, but...... If it makes you feel good, then why not do it? If it hurts while it's being done, then why continue?

Hubris claims of adjusting your feet in order to fix an ear problem or cause your nose to stop running snot are obvious crap and have nothing to do with anything real whatever.

Did I miss something?



On the other hand, I could be wrong.
The Ramans do everything in threes. A. C. C.

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Wed Dec 21, 2005 12:56 pm

Sparks asked "If it makes you feel good, then why not do it?"

That is a huge question. It could equally be asked about other irrational uses of time and money such as going to astrologers or buying lottery tickets.

Read the books I recommended in earlier posts.

Go to http://www.quackwatch.org and read how chiropractors talk healthy people into spending money on a regular basis for sham "maintenance" treatments (this is called "practice building"). Read about undercover investigations that found parents being told that their (perfectly healthy) children need regular "adjustments" to avoid trouble later. What parent could resist that sales pitch?

In school, these people are taught sham diagnoses and treatments. Why ask for health care from someone who has no reliable health knowledge and, moreover, was foolish-enough to waste a lot of time and money studying fictional conditions such as "chiropractic subluxations?" One investigator went to a series of chiros and was told that his left leg was longer, his right leg was longer, and his legs were of equal length!? Is this competent diagnosis?

Incompetent diagnosis can be a serious problem. Read about the chiropractors who gave "spinal adjustments" when serious, even emergency, medical care was needed. A doctor surreptitiously visited chiros complaining of symtoms that could represent either appendicitis or a heart attack. Out of eight chiros, only one suggested the right diagnosis. And he did not treat it as an emergency! Eight is a small sample; but when results are 100% consistent, a small sample is enough to make a point.

Our resident chiro is going to chime in, again, saying there are fraudulent and incompetent doctors, as well. But that is still not a defense of chiropractic. And our chiro is also going to claim that these complaints do not represent mainstream chiropractic; but surveys of chiropractors (including the survey cited in a previous post) show otherwise.

I figure, if you have a health problem, go to a health professional (MD, DO, nurse practitioner). If you want to feel good, go to a masseur.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

resident chiro?

Postby rational doc » Wed Dec 21, 2005 3:19 pm

now who would you be referring to there?

looks like i hit a few nerves, and i don;t think you guys are getting my point,

have you heard the expression can't see the forest for the trees?

i love the research from the 70's - nothing like having a current opinion

like i have said some of the things i have been writing about is from my own personal experience as a practicing physician, i think common sense and clinical experience are still valuable tools in the practice of medicine

and my opinion about mechanical lesions is that we should not throw out the baby with the bathwater - i think the treatment of visceral conditions wioth manipulation is suspect at best, but from clinical experience it is useful in the treatment of musculoskeletal conditions

can nerves get physically pinched between two vertebrae - rarely unless significant trauma occurs, but your reseacher doesn't look at chemical irritation, and the effects of traction on the nerve root

i'd love to hear how you would explain cases of sciatica, brachial neuritis, and neuralgia, i'd like to hear you views on the causative mechinisms behind these problems? it should be entertaining for me

you skeptics sound like broken records at times and do not stay very current with the topic we are discussing

i was looking to discuss the benefits (and risks) of manipulation for mechanical problems in joints, becuase i don't think you are being fair in your rational

you lump manipulation solely with chiropractic, and you want to rip chiropractic a new one to put it bluntly

i think chiropractic was put in a situation (due to the ama ?) where they had to self fund research and i think from looking at the history , they were more interested in survival, more research has been presented in medical forums from chiropractic institutions, and chiropractic colleges has been recieving government grants to do research - something that they were excluded from until recently - so saying that they had 110 yrs to do it is not really fair when you look at the history, i don't see medicine priviately funding research from the donations of individual doctors - but that is what we ask chiropractic to do

i am not giving excuses for them, but put them on a level playing field and make it fair at least

i think that you need to look at the courses taken at chiropractic colleges better, science is science - they use the same books that i do, most of the examination is the same, orthopedic and neuro tests are the the same
i personally think that orthpedic testing has a limited use and doesn't always test what we think we are testing, motor, reflex and sensory testing has a limited use too and needs to be taken into the context of the patient as a whole, then you have the problems of false negatives and false positives with testing, and you have the patient with atypical signs and symptoms even though they have a problem - part of medicine is an educated guess (which is where the clinical experience part comes in)

so my point here is that if you look at the reliability of orthopedic and neurological testing - not all tests hold up very well to scrutiny, but it is a start and hopefully starts leading the practitioner down the right path

as far as the ear infections - i think what is said was "proposed" mechanism, and i don't think that it was nerve related

as far as kids complaining of chronic neck pain- this shows a poor understanding of how pain works in the human body, an your bodies response to pain,

it also makes me ask, is it a common belief that there has to be a pain finding to have a health problem or more specifically a back problem?

most of the muscle problems i treat are not painful, so i must be "mis-informed" also

by the way even though it seems that there are alot of athiest skeptics, i would like to wish the participants of this board a Merry Christmas and a happy and healthy New Year

svengali
Poster
Posts: 149
Joined: Wed Dec 14, 2005 2:57 am

Re: resident chiro?

Postby svengali » Wed Dec 21, 2005 3:29 pm

"by the way even though it seems that there are alot of athiest skeptics, i would like to wish the participants of this board a Merry Christmas and a happy and healthy New Year"

I bloody don't.

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

that's pretty harsh

Postby rational doc » Wed Dec 21, 2005 4:00 pm

how about a little peace on earth, good will to men?

svengali
Poster
Posts: 149
Joined: Wed Dec 14, 2005 2:57 am

Postby svengali » Wed Dec 21, 2005 6:28 pm

If you say so. I suppose I am a psychic reverend and man of the cloth after all.

User avatar
corymaylett
Regular Poster
Posts: 954
Joined: Wed Nov 09, 2005 6:03 am

Re: resident chiro?

Postby corymaylett » Wed Dec 21, 2005 7:53 pm

rational doc wrote:looks like i hit a few nerves...

A chiropractor pun, I assume. :wink:

rational doc wrote:as far as the ear infections - i think what is said was "proposed" mechanism, and i don't think that it was nerve related

I think what I said was to please cite your references so I could gain a better understanding of what you're talking about, which you have not done. Even so, let's assume your proposed causal relationship between "swelling of the upper cervical joints and surrounding tissues" is not nerve related. The Eustachian tubes are largely surrounded by bone and cartilage which isolates and protects them. The four muscles associated with the Eustachian tubes, not only have no nerve connections to the cervical spine, but the muscles are physically isolated, as well. So tell me, how is it that "swelling" in the "upper cervical joints" (what, C1 through C4, maybe?) could produce "muscle contracture" in muscles physically isolated from those structures? Remember, you're the one who said it was from "swelling" of "cervical joints and surrounding tissues." So are you telling me that chronic swelling in a vertebral joint so severe as to produce muscle contractures in physically isolated muscle groups would not be noticeable? I think a logical assumption is that there would be, at the very least, some physical discomfort associated with a cervical swelling of that sort.

Hey, I'm open to being convinced that the mechanism is more subtle than that or that I've failed to take something into consideration, but first, I'll need a reference to those studies.

rational doc wrote:as far as kids complaining of chronic neck pain- this shows a poor understanding of how pain works in the human body, an your bodies response to pain

I was mostly making a smart alecky comment, but, seriously, I think that swelling of the cervical joints severe enough to impact the Eustachian tubes would be noticeable to the patient.

rational doc wrote:it also makes me ask, is it a common belief that there has to be a pain finding to have a health problem or more specifically a back problem? most of the muscle problems i treat are not painful, so i must be "mis-informed" also

No, of course not. But we're not talking about all health problems, we're talking about a specific one, and we're discussing it in the context of chiropractic. And there is a "common belief" that chiropractors often treat bogus illnesses under the pretext of there being hidden and asymptomatic problems that will blossom out into bigger illnesses if not treated through chiropractic procedures.

rational doc wrote:by the way even though it seems that there are alot of athiest skeptics, i would like to wish the participants of this board a Merry Christmas and a happy and healthy New Year

We do, however, agree on that. :wink:

User avatar
corymaylett
Regular Poster
Posts: 954
Joined: Wed Nov 09, 2005 6:03 am

Re: resident chiro?

Postby corymaylett » Wed Dec 21, 2005 7:56 pm

Thylacine wrote:
rational doc wrote:looks like i hit a few nerves...

A chiropractor pun, I assume. :wink:

rational doc wrote:as far as the ear infections - i think what is said was "proposed" mechanism, and i don't think that it was nerve related

I think what I said was to please cite your references so I could gain a better understanding of what you're talking about, which you have not done. Even so, let's assume your proposed causal relationship between "swelling of the upper cervical joints and surrounding tissues" is not nerve related. The Eustachian tubes are largely surrounded by bone and cartilage which isolates and protects them. The four muscles associated with the Eustachian tubes, not only have no nerve connections to the cervical spine, but the muscles are physically isolated, as well. So tell me, how is it that "swelling" in the "upper cervical joints" (what, C1 & C2?) could produce "muscle contracture" in muscles physically isolated from those structures? Remember, you're the one who said it was from "swelling" of "cervical joints and surrounding tissues." So are you telling me that chronic swelling in a vertebral joint so severe as to produce muscle contractures in physically isolated muscle groups would not be noticeable? I think a logical assumption is that there would be, at the very least, some physical discomfort associated with a cervical swelling of that sort.

Hey, I'm open to being convinced that the mechanism is more subtle than that or that I've failed to take something into consideration, but first, I'll need a reference to those studies.

rational doc wrote:as far as kids complaining of chronic neck pain- this shows a poor understanding of how pain works in the human body, an your bodies response to pain

I was mostly making a smart alecky comment, but, seriously, I think that swelling of the cervical joints severe enough to impact the Eustachian tubes would be noticeable to the patient.

rational doc wrote:it also makes me ask, is it a common belief that there has to be a pain finding to have a health problem or more specifically a back problem? most of the muscle problems i treat are not painful, so i must be "mis-informed" also

No, of course not. But we're not talking about all health problems, we're talking about a specific one, and we're discussing it in the context of chiropractic. And there is a "common belief" that chiropractors often treat bogus illnesses under the pretext of there being hidden and asymptomatic problems that will blossom out into bigger illnesses if not treated through chiropractic procedures.

rational doc wrote:by the way even though it seems that there are alot of athiest skeptics, i would like to wish the participants of this board a Merry Christmas and a happy and healthy New Year

We do, however, agree on that. :wink:

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

gosh!

Postby rational doc » Wed Dec 21, 2005 10:07 pm

you wrote:Hey, I'm open to being convinced that the mechanism is more subtle than that or that I've failed to take something into consideration, but first, I'll need a reference to those studies.

look what i said was with the ear infection issue was that it was a proposed mechanism that i read about- i do not recall reading specific studies, it was a long time ago - but i was just indicating that what i had heard did not relate to actual nerve compression issues as was stated on the board -

whether it actually hurts enough to cause the child pain at that particular area - don't know, maybe yes , maybe no

unfortunately the photographic memory doesn't work to well anymore ( haha) - i believe though that this mechanism may be referenced in JMPT, but don't hold me to it - i was speaking from memory

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

rational chiro? !!

Postby JJM » Wed Dec 21, 2005 11:57 pm

JMPT: JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS
http://www.elsevier.com/wps/find/journa ... escription
>A chiropractic publication. When one is a quack, guess who one's peer-reviewers are ...

r "doc," if you think Crelin's 1973 debunking of chiropractic subluxation is outdated, provide the citations to the more recent research that refutes it. Your own diagnosis of chiropractic subluxations must depend on that literature. And how does the subluxation relate to visceral disease (your reference to musculoskeletal conditions is a red-herring diversion). Chiros claim (with no valid, clinical studies) to identify and treat subluxations that influence visceral disease. You assiduously avoid discussing/defending the irrationality of that claim with literature citations. In your ramblings, you say it needs study; but, your colleagues are proceeding as though valid studies have been done.

Harriet Hall, MD, in a recent review of uber-quack Andrew Weil noted that "in my experience" is no longer acceptable. ("Skeptical Inquirer" 2006, 30:1, 56-7.) Yet, that is all you have offered.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

let me say it again

Postby rational doc » Thu Dec 22, 2005 2:57 pm

i do not think that "subluxations" cause visceral disease, but i can see an anatomical basis to conclude that the nervous system exerts some influence on the function of visceral organs or helps coordinate the function of that organ with other body systems

it seems that you all want to debate something that we both agree on

my issue with some of the board members is that they tend to think that all of manipulative care is useless because of poor premise held by some chiropractors

i started commentating on this board to try to give some personal experience to the mix other than "quackwatch quotations" , i live in the field of physical medicine - you do not,

i have tried to provide perspective to the way healthcare REALLY functions, not everyting is done as well as it should be

you say ramblings, i say insight

check this out by the way, from an osteopathic journal (already suspect?) about manipulation of ankle sprain injuries

http://www.jaoa.org/cgi/reprint/103/9/417.pdf

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

and by the way what fun is a debate if you are all in agreem

Postby rational doc » Thu Dec 22, 2005 3:03 pm

i think this is a much more interesting,
i'm glad that some of you have good manners, those without should try to step up to the plate and show some respect for the people they are talking too

it's like table manners - it shows how much respect you have for yourself and the people around you

so does anyone believe in santa? ( seasonal question) and if not do you spoil it for your kids? - just curious

svengali
Poster
Posts: 149
Joined: Wed Dec 14, 2005 2:57 am

Postby svengali » Thu Dec 22, 2005 3:09 pm

Oh. I believe in Santa. As a matter of fact he is a member of this forum.
He might introduce himself to you.

Don't expect any presents from him though. He is not as jolly as I thought.

I wouldn't sit on his knee either if I were you.

User avatar
Pyrrho
Administrator
Posts: 10249
Joined: Tue Mar 08, 2005 12:31 am
Contact:

Postby Pyrrho » Thu Dec 22, 2005 3:54 pm

svengali wrote:Oh. I believe in Santa. As a matter of fact he is a member of this forum.
He might introduce himself to you.

Don't expect any presents from him though. He is not as jolly as I thought.

I wouldn't sit on his knee either if I were you.

[mod="Warning from Maestro"]svengali has been kicked from this topic, and is warned to avoid posting insults.[/mod]

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Thu Dec 22, 2005 5:43 pm

r d said

"my issue with some of the board members is that they tend to think that all of manipulative care is useless because of poor premise held by some chiropractors"
>I have no knowledge of physical medicine, my only complaint (as far as this discussion goes) has always been strictly with chiropractic. And I don't see anyone else disparaging physiatry, either. If that was your concern, you should have stated it and we could have saved a lot of time.

"you say ramblings, i say insight"
>Sorry; but, it is rambling when I ask how you diagnose a 'chiropractic' subluxation and your reply turns, instead, to irrational practices in medicine. And it is rambling when it takes so many posts to say you thought physical medicine was under attack.

"check this out by the way, from an osteopathic journal (already suspect?) about manipulation of ankle sprain injuries
http://www.jaoa.org/cgi/reprint/103/9/417.pdf"
>Thanks; but that is off topic and of no interest to me. And I do know that modern DOs are essentially interchangeable with MDs.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

sorry for wasting your time

Postby rational doc » Thu Dec 22, 2005 9:22 pm

who knew it was so valuable??

and the article may help address what people think is the uselessness of manipulative treatment

i've already said what i think a subluxation is, and what it can reasonably affect,

check out the WHO website for chiropractic guidelines if you are interested in another viewpoint besides quackwatch

User avatar
Pedantica
Regular Poster
Posts: 729
Joined: Wed Oct 26, 2005 4:35 pm
Location: Precinct Fabulous

Re: sorry for wasting your time

Postby Pedantica » Thu Dec 22, 2005 11:05 pm

rational doc wrote:check out the WHO website for chiropractic guidelines if you are interested in another viewpoint besides quackwatch


Do you want to point us to them. Chiropractic is not listed in their list of Health Topics or Factsheets and I searched the first few pages of their search engine for Chiropractic and found no guidelines.

http://www.who.int/topics/en/
http://www.who.int/mediacentre/factsheets/en/

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

who excerpts

Postby rational doc » Fri Dec 23, 2005 11:37 pm

Acknowledgements



The World Health Organization (WHO) greatly appreciates the financial and technical support provided by the Regional Government of Lombardy, Italy, for the development and publication of these guidelines, as part of the implementation of collaborative projects with WHO in the field of traditional medicine. The Region of Lombardy kindly hosted and provided financial support for the WHO Consultation on Chiropractic, held in Milan, Italy, in December 2004.

Thanks to Dr John A. Sweaney, New Lambton, Australia, who prepared the original text.

WHO acknowledges its indebtedness to over 160 reviewers, including experts and national authorities and professional and nongovernmental organizations, in over
54 countries who provided comments and advice on the draft text.

Special thanks are due to participants of the WHO Consultation on Chiropractic (see Annex 1), who worked towards reviewing and finalizing the draft guidelines, and to the WHO Collaborating Centre for Traditional Medicine at the State University of Milan, Italy, in particular to Professor Umberto Solimene, the Director, and to Miss Elisabetta Minelli, the International Liaison Officer, for their assistance to WHO in organizing the Consultation.


1.1. Historical information

Although spinal manipulation dates back to Hippocrates and the ancient Greek physicians (4), the discovery of chiropractic is attributed to D.D. Palmer in 1895 (5), with the first school for the training of chiropractors commencing in the United States
of America in Davenport, Iowa in 1897 (6).

Palmer developed the chiropractic theory and method from a variety of sources, including medical manipulation, bonesetting and osteopathy, as well as incorporating unique aspects of his own design. The term “chiropractic”, derived from Greek roots to mean “done by hand”, originated with Palmer and was coined by a patient, the Reverend Samuel H. Weed (7).

Chiropractic developed in the United States of America during a period of significant reformation in medical training and practice. At the time, there was a great variety of treatment options, both within conventional medicine and among innumerable other alternative health care approaches (8).


1.2 Philosophy and basic theories of chiropractic

Chiropractic is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on the subluxation.

The concepts and principles that distinguish and differentiate the philosophy of chiropractic from other health care professions are of major significance to most chiropractors and strongly influence their attitude and approach towards health care.

A majority of practitioners within the profession would maintain that the philosophy
of chiropractic includes, but is not limited to, concepts of holism, vitalism, naturalism, conservatism, critical rationalism, humanism and ethics (9).




5

Guidelines on basic training and safety in chiropractic



The relationship between structure, especially the spine and musculoskeletal system,
and function, especially as coordinated by the nervous system, is central to chiropractic and its approach to the restoration and preservation of health (9, 10:167).

It is hypothesized that significant neurophysiological consequences may occur as a result of mechanical spinal functional disturbances, described by chiropractors as subluxation and the vertebral subluxation complex (9, 10:169‐170, 11).

Chiropractic practice emphasizes the conservative management of the neuromusculoskeletal system, without the use of medicines and surgery (10:169‐170,
11). Biopsychosocial causes and consequences are also significant factors in management of the patient.

As primary‐contact health care practitioners, chiropractors recognize the importance of referring to other health care providers when it is in the best interests of the patient (10).

Part 2: Guidelines on safety
of chiropractic






1. Introduction



When employed skilfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems. There are, however, known risks and contraindications to manual and other treatment protocols used in chiropractic practice.

While it is beyond the scope of these guidelines to review the various indications for chiropractic care and the supportive research evidence, this part will review contraindications to the primary therapeutic procedures used by chiropractors – techniques of adjustment, manipulation and mobilization, generally known as spinal manipulative therapy.

Contrary to the understanding of many within health care, chiropractic is not synonymous with, or limited to, the application of specific manipulative techniques. The “adjustment” and various manual therapies are central components of a chiropractor’s treatment options: however, the profession as an established primary contact health service has the educational requirements and respects the responsibilities associated with such a status.

Chiropractic practice involves a general and specific range of diagnostic methods,
including skeletal imaging, laboratory tests, orthopaedic and neurological evaluations,
as well as observational and tactile assessments. Patient management involves spinal
adjustment and other manual therapies, rehabilitative exercises, supportive and adjunctive measures, patient education and counselling. Chiropractic practice emphasizes conservative management of the neuromusculoskeletal system, without the use of medicines and surgery.

Manipulation is regarded as a relatively safe, effective and conservative means of
providing pain relief and structural improvement of biomechanical problems of the spine. As with all therapeutic interventions, however, complications can arise. Serious neurological complications and vascular accidents have been reported, although both are rare (43).

Vascular accidents

Understandably, vascular accidents are responsible for the major criticism of spinal manipulative therapy. However, it has been pointed out that “critics of manipulative therapy emphasize the possibility of serious injury, especially at the brain stem, due to arterial trauma after cervical manipulation. It has required only the very rare reporting
of these accidents to malign a therapeutic procedure that, in experienced hands, gives
beneficial results with few adverse side effects” (43).

In very rare instances, the manipulative adjustment to the cervical spine of a vulnerable patient becomes the final intrusive act which, almost by chance, results in a very serious consequence (54, 55, 56, 57).


5.4.1 Mechanism

Vertebrobasilar artery insufficiency is the result of transient, partial or complete obstruction of one or both of the vertebral arteries or its branches. The signs and symptoms of vertebral artery syndrome arising from that compression include vertigo, dizziness, light‐headedness, giddiness, disequilibria, ataxia, walking difficulties, nausea and/or vomiting, dysphasia, numbness to one side of the face and/or body, sudden and severe neck/head pain after spinal manipulative therapy (43:579).

Most cases of arterial thrombosis and infarction generally occur in the elderly and are spontaneous and unrelated to trauma.


5.4.2 Incidence

Vertebral artery syndrome attributed to cervical manipulation occurs in younger patients. The average age is under 40, and it occurs more often in women than men. In
1980, Jaskoviak estimated that five million treatments had been given at National
College of Chiropractic clinics over a 15‐year period, without a single case of vertebral
artery syndrome associated with manipulation (58).

While it is understood that the actual incidence of cerebral vascular injury could be higher than the number of reported incidents, estimates from recognized authorities in research in this area have varied from as little as one fatality in several tens of millions
of manipulations (59), one in 10 million (60) and one in one million (61) to the slightly
more significant “one important complication in 400 000 cervical manipulations” (62).


26

Guidelines on safety of chiropractic



Serious complications are very rare, and it would seem unlikely that the adverse
occurrences have been solely attributable to the therapeutic intervention.


5.5 Prevention of complications from manipulation

Incidents and accidents that result from manipulative therapy can be prevented by careful appraisal of the patient’s history and examination findings. Information must
be sought about coexisting diseases and the use of medication, including long‐term steroid use and anticoagulant therapy. A detailed and meticulous examination must be carried out. The use of appropriate techniques is essential, and the chiropractor must avoid techniques known to be potentially hazardous (19:234‐235).

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

WHO subluxation definition

Postby rational doc » Fri Dec 23, 2005 11:37 pm

Spinal manipulative therapy
Includes all procedures where the hands or mechanical devices are used to mobilize, adjust, manipulate, apply traction, massage, stimulate or otherwise influence the spine
and paraspinal tissues with the aim of influencing the patient’s health.

Subluxation1
A lesion or dysfunction in a joint or motion segment in which alignment, movement
integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.

Subluxation complex (vertebral)
A theoretical model and description of the motion segment dysfunction, which incorporates the interaction of pathological changes in nerve, muscle, ligamentous,
vascular and connective tissue.

botsford
Posts: 1
Joined: Sun Dec 25, 2005 6:00 am

Postby botsford » Sun Dec 25, 2005 6:13 am

Hi all, just want to say that this is my first time at this forum, and i'm really enjoying this debate. Anyway, by way of introduction, I am an emergency room physician and this topic really hits home for me as just a couple of months ago I treated a patient who suffered an acute stroke of the cerebellum from a chiropractic manipulation of the neck. This poor fellow was paying out of pocket cash for chiropractic neck manipulations twice a week, yet didn't have any medical insurance! The patient suffered an acute tear of his vertebral arteries immediately after a neck manipulation. The lesson here is that a visit to a chiropractor is a roll of the dice...you may get pain relief, you may not...and yet there is the outside chance of a disasterous outcome...you may want to ask you doctor about your pain first before paying good money for a chiropractic manipulation which could cost you dearly.

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

same old same old

Postby rational doc » Mon Dec 26, 2005 1:43 pm

if this truly happened , my condolences to the family,

the problem is again here is that we are assuming that one event naturally leads to another, manipulation gets blamed for arterial dissection days after the actual manipulation, was this person ready to dissects spontaneously??

i lost a patient to this myself this year, he was in his early 50's and bleed to death in the emergency room on a gurney in the hall for over 1.5 hours because the emergency room doctor's missed it - so is going to the emergency room inherently dangerous now?? people die there!

please give detail (HIPPA compliant) - where , when, background on the patient (without using names) and i could check into it with the hospital

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Sat Dec 31, 2005 11:20 pm

Pedantica wanted to know the source for WHO information on chiro, it seems to be:

http://www.chiroeco.com/50/bonus/WHOguidelines.pdf

It is a document written by chiropractors for the WHO. The WHO does not necessarily approach "alternative medicine" critically, they wholeheartedly endorsed acupuncture, too. Chiropractic is still irrational and unsupported by adequate clinical evidence, and, mostly (if not entirely), the same is true for acupuncture.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Sun Jan 01, 2006 3:03 am

what a way to twist information and lose credibility!!

the report says:

"WHO acknowledges its indebtedness to over 160 reviewers, including experts and national authorities and professional and nongovernmental organizations, in over
54 countries who provided comments and advice on the draft text. "


lets see, out of the list of participants 3 of 20 are chiropractors

4 representatives from professional organizations were represented

i guess the only facts we consider are the ones that support your point

science gets easy when you only consider the information that supports the conclusion you want to see

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Sun Jan 01, 2006 9:59 am

World Chiropractic Alliance works with the World Health Organization on chiropractic projects
http://www.worldchiropracticalliance.org/un/slides.htm

WHO Establishes Official Relations with the Chiropractic Profession
http://www.chiroweb.com/archives/15/04/28.html

The World Health Organisation (WHO) Consultation on Chiropractic, from which the 2005 guidelines contained in this link evolved, took place in Milan, Italy, on 2-4 December 2004.
__Of the 27 listed participants, 18 appear to be professionally involved with either chiropractic__ or Complementary and Alternative Medicine (CAM). ...
http://www.ebm-first.com/?cat=33

True. Quacks of other types were involved; but their opinions are not reliable. After all, they are quacks. That's not Ad Hom, I have already said what is wrong with chiro (not a shred of clinical support) and nobody has refuted that with anything other than "belief."

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Mon Jan 02, 2006 3:16 pm

so let me get this straight,

the WHO should write a position paper on chiropractic without ever talking to chiropractors or chiropractic organizations and they should have no input from chiropractors on the subject - name another profession that would stand for this?

all complementary medicne professionals are in cahoots with each other - sounds like a big conspiracy to me - and totally unbelieveable

so what do you call a medical doctor that practices acupuncture ( as about 5 do in my immediate area) along with medicine - these highly educated people are quacks also - one doctor - who is the director of lifetime health in wny - a HMO owned by Univera Insurance - was requested by Univera to learn acupuncture to better serve their clients - so this million dollar corporation is stupid enough to take a risk that will open them up to lawsuits? again highly unlikely

do some of you guys check your common sense at the door??

there is clinical research to say that patients respond favorably to manipulation, but not every study does - so is this a problem with manipulation or a problem with how the study was done? not all studies done by scientists are valid studies - use your critical thinking skills for both sides of the argument and get your "feelings" and "bias" out of the picture if you really want to be a rational thinker

from what i have read on this board - many skeptics have a hard time having their "beliefs" challenged - i find this disturbing

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Tue Jan 03, 2006 11:45 pm

rational “doc” said:
“WHO should write a position paper on chiropractic without ever talking to chiropractors … ?”

>One would hope that they would consult legitimate, health professionals before accepting and publishing irrational chiropractic literature. (Chiropractic brochures do not qualify as research data.)

“all complementary medicine professionals are in cahoots with each other - sounds like a big conspiracy to me - and totally unbelievable“

>No, not conspiracy, simply collective ignorance. Look at the section on “alternative medicine” in Robert Park’s book, “Voodoo Science” (Oxford, 2000).

“so what do you call a medical doctor that practices acupuncture …”

>That is irrelevant to chiropractic and this thread, otherwise it is a great topic for another thread. I put that question to a friend who once shared a lab with me. He is brilliant, and is now a professor of anesthesiology at Harvard Med. He had no good answer. I looked up the American Academy of Medical Acupuncture (http://www.medicalacupuncture.org/) and found they promote abject nonsense.
I have to wonder about someone who studies physiology in medical school and then subscribes to: “[The] Kidney supervises bones, marrow, joints, hearing, head hair, will, and motivation; Spleen oversees digestion, blood production, blood-related functions such as menstruation, and nurturing and introspection.” (Quoted from JM Helms of the AAMA.) Hey r ”doc,” open a new thread and provide the scientific evidence for those claims.

“many skeptics have a hard time having their "beliefs" challenged”

>“Beliefs” are the subject of another sub-forum. These are facts:
1- The chiropractic, spinal subluxation is imaginary. Chiropractic literature describes it. However, other literature describes unicorns and they don’t exist, either.
2- There is no reliable evidence that chiropractic manipulation of "spinal subluxations" has any effect on visceral disease (as chiros are told in school).

>Those (1&2) are chiropractic claims you have supported only with your own “beliefs.” This is another chance to prove me wrong. I expect you to change the subject.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Thu Jan 05, 2006 2:25 pm

i have said before that i think that the spinal effect on visceral disease is minimal if it is at all - and it would depend on what type of visceral problem is going on - i never said that i gave that a lot of weight

i gave an alternate description of what is called a mechanical lesion in PT which is mobilized using what is called a grade 5 mobilization - this is basically a joint manipulation - i have a problem with the way it is defined in the chiropractic profession, but mechanical lesions - "stuck joints" exist and manipulation is an effective way of increasing range of motion and reducing pain

so if we disagree with any part of a profession it is totally wrong?
the MD acupuncturist does not subscibe to the acupuncture Tenants as you describe but has found it to be effective for certain problems, i personally have found it to be effective in controlling my carpal tunnel symptoms - i don't think that the explanation that the acupuncturists give for how it works is correct - but that doesn't mean that it doesn 't have an effect

just like i don't think that the explanations that chiropractors give for why manipulation works is accurate , but i know from experience that it works well with a portion of my patient base

i look at it like going to a smorgasbord - i pick and choose what i think works and helps my patients - i do not have to subscribe to all the philosophy to use it as a tool

we don't really disagree on your points 1 and 2 as much as you think

i still that it is ignorant and arrogent to totally discount anything that reports favorably on manipulation or chiropractic, and to ignore that millions of people get relief from chiropractic care.

i think we should be problems with chiropractic philosphy and tenants without saying that everything about chiropractic is bad

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Sat Jan 07, 2006 12:06 pm

"rational" "doc" wrote:
"so if we disagree with any part of a profession it is totally wrong?"

>The foundation, and still the defining characteristic, of chiropractic (the subluxation) is wrong and based in profound ignorance.
>Chiros are united by the fact that they are/were ignorant-enough to spend time and money studying this irrational, unphysiological, unproven notion.
>In school, DCs are told they are primary care physicians and, as such, they often offer poor, even harmful, advice and treatments.
>DCs fleece people by recruiting them for useless, routine treatments (to be sure sure, many of them are well-meaning and don't know better).
>Many DCs subscribe to "practice building" programs to enlist even less-gullible marks for uneccessary visits.
>The judge in the Wilk decision found that the AMA had made their case that chiropractic is deleterious; but, she had to decide against the AMA under laws of commerce (not health care).

Yes, those reasons are sufficient for a rational person to relegate the entire "profession" (really, a cult) of chiropractic to the rubbish bin.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Sun Jan 08, 2006 2:05 am

Incidence of VBS following Spinal Manipulative Therapy (SMT):

1972 – Maigne suggested: “There is probably less than one death of this nature out of several tens of millions of manipulations.”

1978 - Cyriax stated: “…this risk works out to about one in ten million manipulations, and is no argument against manipulative reduction in suitable cases.”

1981 – Hosek et al suggested: “…we may form a conservative likelihood estimator by looking at the ration of vertebrobasilar injuries to adjustments performed. This ration would be 100 injuries per 100 million adjustments…one in about one million.”

1983 – Gutman concluded: “There are 2-3 serious incidents involving the vertebrobasilar system occurring in 1 million manipulations to the upper cervical spine.”

1993 – Carey found: “In a study of a five year period (1986-1990), using statistics from Provincial Governments of Canada, the Canadian Protective Association, and reported legal/insurance claims, concluded an incidence rate of one in every 3,846,153 neck manipulations. None involved death, one had complete recovery, six had some neurologic deficit, four completely resolved, and two had psychological problems, but no physical deficit. If the Province of Quebec were isolated, with 14 million manipulations performed and only one CVA in a five year period, there would be an incidence of one in 14 million.”

1995 – Dabbs and Lauretti following their research wrote “…in a three year period 1991 to 1993, NCMIC closed a total of 96 claims for cerebrovascular accident. Of this total, 61 were closed with payment and 35 were closed without payment. If one concludes that there was little or no merit to the 35 claims that were closed without payment, this would average 20 cerebrovascular accident claims per year. This figure was recently accepted by a popular consumer magazine as a correction to a previously published article (Corrections. Consumer Reports March 1995, page 132). Because NCMIC insures about one-half of the US chiropractic profession, their members should be similar to the national average…Curtis and Bovee report that rotary adjustments of the cervical spine make up about 30% of the visits made to chiropractors. Therefore, chiropractors insured by NCMIC each performed some 1,800 cervical manipulations in each of the three years reported above. Considering these numbers, we calculate that NCMIC’s 24,000 D.C.’s perform some 43 million cervical manipulations per year. Twenty post SMT strokes indicate a rate of less than one stroke per 2 million cervical manipulations.”

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Sun Jan 08, 2006 2:09 am

DEATH AND MORBITY OF COMMON MEDICAL TREATMENTS

“In 1994, Cloud reported the following complications from medical therapy:

1.5 million people will be hospitalized annually because of iatrogenic (physician caused) reactions, and 100,000 will die.

1,000 people will die this week from complications of surgery that was unnecessary.

1,600 children will die this year from allergic reaction to aspirin, and thousands of people will die this year from anaphylactic reactions to prescribed drugs.

“Dr. Lucian Leape (adjunct professor of health policy at the Harvard School of Public Health) estimated that one million patients nationwide are injured by medical errors during hospital treatment each year, and 120,000 patients die because of medical error. That’s equivalent to a jumbo jet crashing every day and is three times more the number of people killed each year in U.S. motor-vehicle accidents…They found out that one out every 200 patients died as a result of a hospital mistake, and that errors accounted for 69% of injuries caused by medical treatment that lengthened hospitalization or led to a disability upon discharge.”

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Sun Jan 08, 2006 2:12 am


rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Sun Jan 08, 2006 2:50 am

let's see where to start

The foundation, and still the defining characteristic, of chiropractic (the subluxation) is wrong and based in profound ignorance.

like i said - the subluxation is essential the same mechanical lesion that is treated by PT's DO's and physiatry - the debate is how much of an effect this lesion has on the human body locally and as a whole

>Chiros are united by the fact that they are/were ignorant-enough to spend time and money studying this irrational, unphysiological, unproven notion.

this is a really dumb point - or should i say lack of a point - so all chiros spent money to go to school and get taught something you disagree with -
so what

>In school, DCs are told they are primary care physicians and, as such, they often offer poor, even harmful, advice and treatments.

dc's are not taught to be primary care physicians but do act as a portal of entry into the healthcare system because patients have direct access to them, therefore it is important that they can diagnoses other conditions other than spinal so they can know when to refer and who to refer to - unfortunately like ALL doctor's they make errors as to who to refer, when to refer, and where to refer them - all doctor's give sometimes harmful and inappropriate advise and treatments - people have drug and therapy reactions all the time, sometimes severe

>DCs fleece people by recruiting them for useless, routine treatments (to be sure sure, many of them are well-meaning and don't know better).

useless and routine - that can be said for many medical treatments

>Many DCs subscribe to "practice building" programs to enlist even less-gullible marks for uneccessary visits.

medicine is also a business and every field has practice management groups and practice buiding groups - look at the ads in any professional journal

>The judge in the Wilk decision found that the AMA had made their case that chiropractic is deleterious; but, she had to decide against the AMA under laws of commerce (not health care).

the wilk case was about commerce so yes she had to decide under the laws of commerce - DUH - so what expertise does she have as a judge to decide a clinical healthcare issue?

Yes, those reasons are sufficient for a rational person to relegate the entire "profession" (really, a cult) of chiropractic to the rubbish bin.

bad argument that ignores that despite all the problems with the profession - chiropractic still gains support with the Medical profession, hospitals, insurance companies and the general public -

is every one out there stupid except for "skeptics" ?

at ECMC - that erie county medical center - they are developing a manipulation under anesthesia program to work with patients that are progressing slowly with their rehab of have failed conventional rehab but are non surgical

and speaking of failed therapy patients - what do you propose we do with them if we cannot try alternatives to standard medical care? - just curious

JJM
Veteran Poster
Posts: 2131
Joined: Sun Jul 31, 2005 6:48 pm
Location: Taxachusetts

Postby JJM » Sun Jan 08, 2006 7:05 am

"like i said - the subluxation is essential the same mechanical lesion that is treated by PT's DO's and physiatry"
>Then why do they have their own definitions (ACC or WHO)? (By the way reference 1, indicated but not included, in your post of the WHO text differentiates it from a medical subluxation). And why can't you tell us, with respect to the definitions given above, how you diagnose the spinal subluxation that almost everyone who visits a chiro is found to have? (Feel free to ignore these questions, as usual.)

"useless and routine - that can be said for many medical treatments"
"medicine is also a business ... look at the ads in any professional journal"
>Do you really condone preying on people this way? (I worked in a doctor's office for a while in the 1960s and the "practice management" literature was quite dismaying.) It is already established that "you too" is not a defense of chiro, why do you persist? (Feel free to ignore ...)

"the wilk case was about commerce ... so what expertise does she have as a judge to decide a clinical healthcare issue?"
>You introduced Wilk v. AMA, in this thread, in support of the "clinical healthcare issue" of chiro (as chiros usually do). You shot yourself in the foot with that.

"and speaking of failed therapy patients - what do you propose we do with them if we cannot try alternatives to standard medical care? - just curious"
>Irrelevant to the topic of "what's wrong with chiro," of course.

Joe

rational doc
Account Locked
Posts: 423
Joined: Wed Nov 30, 2005 11:41 pm

Postby rational doc » Mon Jan 09, 2006 4:19 pm

"like i said - the subluxation is essential the same mechanical lesion that is treated by PT's DO's and physiatry"
>Then why do they have their own definitions (ACC or WHO)? (By the way reference 1, indicated but not included, in your post of the WHO text differentiates it from a medical subluxation). And why can't you tell us, with respect to the definitions given above, how you diagnose the spinal subluxation that almost everyone who visits a chiro is found to have? (Feel free to ignore these questions, as usual.)

yes there is a difference in definition between a chiropractic subluxation and a medical subluxation - that is why i prefer the term mechanical lesion so it is not confused with a medical subluxation - a subluxation to my understandding is a mechanical lesion that has effects on the tissues around it locally and perhaps peripherally - in real life the two are interchangeable

ok why do people always get diagnosed with a mechanical lesion (subluxation) - well, probably becuase they are common in the general public, and may be symptomatic or asymptomatic - kind of like cavities - not all subluxations need to be treated or treated right away - besides saying that most people going to see a chiropractor are found to have subluxations is like saying most people going to the emergency room are found to have a problem - the people going to see chiropractors are already a select group of people that have problems - usually pain - and do not represent the general population - only about 10 to 15 percent of the population ever goes to see a chiropractor - now considering that at about 50 to 80% or the population is experiencing back pain to some degree (depending on who you read) -then a pretty small percentage of the population at any one time thinks that they are bad enough to seek treatment - so the population in the doctor's office are people with problems - therefore, people with problems usually have something wrong with them, everybody coming to my office for a physiatry eval has a problem - it is already a pre-selected population from the MD's and DC's

"useless and routine - that can be said for many medical treatments"
"medicine is also a business ... look at the ads in any professional journal"
>Do you really condone preying on people this way? (I worked in a doctor's office for a while in the 1960s and the "practice management" literature was quite dismaying.) It is already established that "you too" is not a defense of chiro, why do you persist? (Feel free to ignore ...)

thanks for putting word in my mout, no i do not condone it , i am saying that it is not unusual and you should not fault chiropractors any more than you fault every other branch of healthcare for doing this - ethical practice building is OK, and is necessary to survive

"the wilk case was about commerce ... so what expertise does she have as a judge to decide a clinical healthcare issue?"
>You introduced Wilk v. AMA, in this thread, in support of the "clinical healthcare issue" of chiro (as chiros usually do). You shot yourself in the foot with that.

what i am saying about the wilk case is that the AMA illiegally tried to limit access to chiropractic, limit the availabilty of funds or research, limit access to insurance companies, limit a MD's ability to work with a chiropractor and the AMA spread false and misleading information about chiropractic, i believe that it was said that the AMA did this to protect their "turf" more so than to protect the public interest - so if the AMA is willing to illegally try to restrict trade and attempt ot destroy another profession, don't you think that they should also lose their credibility when it comes to their clinical opinions on chiropractic? I think a more accurate portrayal of the AMA is to liken them to a trade union.

"and speaking of failed therapy patients - what do you propose we do with them if we cannot try alternatives to standard medical care? - just curious"
>Irrelevant to the topic of "what's wrong with chiro," of course.

geez - every question that i ask "is irrelevant to the topic" - you don't here me saying that

answer the question and don't be so rude
Joe


Return to “Healthcare”

Who is online

Users browsing this forum: No registered users and 1 guest