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Dr. Chad
2nd August 2000, 20:46
This argument is now over 100 years old. Every time a chiropractor states that his or her patients are responding to adjustments and experiencing a higher level of health and well-being, the medical world dismisses it as anecdotal and "mumbo jumbo" and want to see double blind controlled studies. Individual chiropractors do not have the funding to fund such studies and no giant drug companies to provide the money. So...all we usually have is our 100 years of experience to show that it works and our satisfied patients that refer their families and loved ones. When I adjust a four month old infant for injuries caused by a traumatic birth and see dramatic improvements in that childs health, I don't need to read it in a peer reviewed journal that what I did is TRUE. The parents don't need any more proof than that either. That is why I see families and my practice is families from new babies to great grandparents. They all come in together and if subluxated, recieve their CHIROPRACTIC spinal adjusments that they know interfere with their nerve systems therefore decreaseing their level of health. This confidence factor as well as placebo effect I feel is not significant when I adjust a baby. I don't tell them "This is going to stop your colick and fevers.", but they still respond...just like everyone does. I've seen studies that show a sham operation (one where only scars were made) actually showed a better result for meniscal tears found on MRI than the actual knee surgery that was performed. Which has a stronger influence, the surgry or the placebo? According to this study, you'll fair er influence the surgery or the placebo. According to this study, you'll fair better if you have your doc make a few random cut around your knee. If you want results you can come to my office and see better than 90% but you must remember, that is anecdotal so you may want to talk to the individual patients that have no more symptoms but still want their spines checked for any residual or new subluxation so they can maintain their newley achieved higher state of wellness. If you do find a 90% effective rate in medicine it still usually will be much more invasive than a chiropractic adjustment. ie.liver or renal toxicity and side effects...but yet this is the "GOOD SCIENCE"that some think is the ultimate in health care today. I agree that we need research in order for the allopathic world to accept what we say but I also am sometimes suspicious of research, the stats provided and who funded the studies. The research told us that we should give all our children the wonderful new rotavirus to keep them healthy, (a recommendation that M.D.s held stead fast to), and now we see that the risks greatly outweigh the risks...but "GOOD SCIENCE" told us first that it was OK. Medicine use to say to circumcise, now they say there is no benefit. Prozac is good for depresion, now it can cause suicidal tendencies. The list goes on and on and keeps getting longer and longer. These ideas were at one time supported by "GOOD SCIENCE." Where were the real experiments being performed?...I feel it wasn't in the labs. In most of these cases it's the "anecdotal" evidence that gets bad medicine off the shelves and get erroneous procedures stopped. I don't know what chiropractic MEDICINE is but it does sound dangerous since it is not being perfomed by a doctor of chiropractic...as for chiropractic spinal adjustments and chiropractors, I have not seen this evidence that it is dangerous but would be interested in it and by what means it was attained. As for what I've seen, I would put a CHIROPRACTORS record up against that of any practitioner of "GOOD MEDICINE". I would even check it against the Mayo clinic where in one study showed after autopsy that 70% of teh original diagnosis was wrong...GOOD SCIENCE?!? As long as medicine remains the allopathic entity that it is it will never be able to understand the vitalistic view that the world is crying for. We will try to show you the way but as long as you want GOOD SCIENCE, our ideas will fall on deaf ears. THANK YOU

3rd August 2000, 04:44
Yes, some MDs are probably lousy at diagnosis. Yes, some studies thought to be correct were later found to have errors in the methodology or the results. Yes, some researchers are not above skewing their data to get the results which get the funding continued or their theories proven.

Yet, I still maintain that chiropractic and spinal manipulation are no more effective than the placebo effect and definitely more dangerous. You may be able to get some improvement in symptoms, but I fail to see any actual treatment.

In the end, I prefer to go with the tested, tried, and true rather than risk my health with a mysterious spinal manipulation and a story about someone's aunt who "felt much better" after seeing her chiropractor.

Gil Gillespie
3rd August 2000, 05:25
Yo, Dr Chad

Hit ENTER once in a while, brother. Break up that tome into paragraphs, you know, like your text books did. When I started aikido 12 years ago I was advised to see a chiropractor frequently to keep myself realigned. I have my truck realigned, but so far stretching and ukemi have kept me realigned. My back stiffens when I can't train, but if I just keep DOING aikido it keeps doing me.

I'm not knocking your profession but I'm asking you if ukemi and stretching keeps me warm and loose, what added benefits should I pursue through chiropractics?

IchiRiKen1
3rd August 2000, 05:52
Once upon a time I was a massage therapist (trained and certified by an accredited school, thank you), and the dean of our school was a DC.

He tried to tell us that such and so could be "cured" by spinal manipulations, that a man regained the ability to see after a pinched nerve was un-"subluxated," etc.

It is my experience that since bones don't move unless a muscle pulls them out of proper alignment, or the bones' positioning are acted on by another outside force (i.e. a really bad breakfall...), then there is no need for a DC to go popping and cracking me. In fact, it is not so good to have someone pop and crack you, as you wear away at some of the bony surfaces, making such popping and cracking much more likely without outside help (e.g. if you dislocate your shoulder once, you will create a place in the joint where the head of the humerus may more easily slip out, dislocating the joint again).

I think that occasional spinal adjustments along with massage to deal with muscles that may pull the bones back out of alignment once they are "realigned" is a valid option for physical injuries. I don't believe, however, that a man can regain the use of lost senses (see above), nor do I believe that once healthy a regular pop and crack will keep me healthy. Popped or cracked, if you get exposed to viruses, bacteria, or an overly zealous uke, you are still gonna end up "less healthy.

As far as ukemi and stretching are concerned, I think you are taking care of whatever possible "subluxations" may occur by doing preventative maintenance on yourself. I know that when I practice rolling, warming up for ukemi practice, my back will pop a bit, and the stretching I do before and after practice I can feel some changes in the alignment of my beat up ol' bod.

Just my misinformed 2 yen...

IchiRiKen1
3rd August 2000, 06:47
I attended the Midwest College of Massage Therapy in Omaha, Nebraska (a virtual bastion of open minded approaches toward health and wellness ;-) ).

I attended school (which was geared toward Swedish technique and pre-licensing qualifications) back in 92-93 I think it was... Due to some "professional discourtesy" during my externship with an established local practitioner, I was unable to attend the state licensing board. This further resulted in a financial necessity for an increase in my income, and due to the climate toward massage therapy in Omaha (i.e. it is a luxury and not quite yet fully accepted as an adjunct for wellness care), I had to abandon over a year of schooling and seek other career paths.

I wish I could get back into it, as I seemed to have had the knack of helping my clients deal with their pain. Combining a healthy dose of Qigong along with my regular technique appeared to have an increased effect on their recovery. I am not overly skilled in Qigong healing, however, so my knowledge of its most beneficial application is lacking.

I hope to move to Seattle in the near future (within the next 4 years; I am military, so I may or may not get what I want in terms of assignment) and when I do I plan on investigating the possibility of pursuing further education, obtaining my license and perhaps practicing part time (until I finish my degree in Anthropology anyway...).

Dr. Chad
4th August 2000, 21:27
What is Chiropractic?



When a sperm fertilized an ovum and you became you, a

genetic blueprint

was created that determined the color of your eyes and

millions of other

details about you.



To control and organize your growth, the nervous

system consisting of

your brain, spinal cord, and all the nerves of your

body were the first

tissues formed.



Today your nervous system controls the function of

every cell, tissue,

organ and system of your body.



The skull protects your brain. The vital communication

pathway of

the spinal cord is vulnerable, covered by 24 moving

bones of the spinal

column. Pairs of nerve roots branch off the spinal

cord between each spinal joint to service the organs

and tissues of your body.



Because of the way your spine was designed, improper

motion or position

of spinal bones can irritate or choke delicate nerves

-- interfering with

the function of the tissues they control. Doctors call

this a subluxation.

Trauma, which may occur to the spine from the birth

process, is often the

first source of nervous system interference.



Car accidents, stress, poor diet, long periods of

sitting, and many other

everyday activities can cause the bones that cover you

spinal cord to

lose their normal position and motion.



Without a normal nerve supply, affected organs and

tissues are more

susceptible to disease, often producing the symptoms

of pain and ill

health.



Headache and low back pain can often be traced back to

spinal malfunction

and nervous system interference.





Doctors of Chiropractic are specialists in the

detection, reduction, and

prevention of nervous system interference.



Today chiropractors require four years of

undergraduate study plus four

years of chiropractic school. Before starting practice

they must pass National and State Board Examinations.



To determine the cause of your health problem,

chiropractic doctors

examine your spine to locate any areas causing nervous

system interference. You'll be shown the exact

locations of any nervous system interference and get

specific recommendations for your chiropractic care

program. Your doctor will use carefully directed and

controlled pressure to return malfunctioning spinal

bones to their proper motion and position, reducing

nerve interference. This procedure is called a

chiropractic adjustment.



There are many ways to adjust the spine. Adjustments

feel good. Millions of chiropractic adjustments are

safely delivered every day.



In fact, chiropractic adjustments are safer than back

surgery, muscle

relaxers and even aspirin! So safe, even newborns can

receive

chiropractic adjustments.





Regardless of the type of doctor you consult,

doctors don't heal. Only your body can heal itself.



The chiropractic approach to better health is to

remove the interference to your own inborn healing

ability. Chiropractic makes sense. Itıs provided by

well-educated doctors. Itıs safe. Itıs natural. It

looks to correct the underlying cause(s) of your

problem.

And most of all -- it works.

IchiRiKen1
5th August 2000, 01:35
I don't dobt that chiropractic works on some things, and being a firm believer in TCM (Traditional Chinese Medicine), I am aware that situations in a person's body can set them up for illness down the road. But it seems that the underlying theory of chiropractic and its approach to all things is that the spine is this incredibly fragile thing, and I have a hard time believing that if my own body can heal so many things on its own and is so powerful in that right, that I am so touchy in structure that just sitting at my desk is going to blow my system out of whack.

I maintain that chiropractic is good for things dealing with the skeletal system, and that improper alignment of the spine and other bones will set the patient up for pain and discomfort later (if the bones are misaligned, the muscles have to work overtime to compensate, which "burns out" the muscles involved, in turn pulling other muscles in to support the now overly fatigued muscles, burning those out as well, etc.). And while I can accept the fact that compression of a nerve (spinal or otherwise) can cause the body to become more susceptible to illness or injury, I find it difficult to accept that adjusting the alignment of my spine will make cancer go away, or return my eyesight, or any other far out problem.

How does chiropractic address illnesses like cancer, lupus, MS? Can you adjust the spine and cause these diseases, which by your theory are merely symptomatic of spinal subluxation, to be cured by the body's own natural healing process?

Chiropratic, massage, herbology, aromatherapy, colon cleansing, etc., are all well and good alternative therapeutic approaches to the ills the body may allow itself to have. But the entire concept of "holistic" is that it includes everything, and excludes nothing. While I am no fan of the "take a pill and call me in the morning" approach many traditional MDs have, or the idea that cutting me up will fix everything wrong with me and cause no additional problems in the process, to exclude pharmaceuticals or surgery entirely goes against the ideal that the alternative health care field claims to espouse!

ALL options for treatment MUST be considered, weighed against the standard of quality of life and wellness for the good of the PATIENT. The ego of the health care practitioner CAN NOT be a factor in deciding what is best for the patient. If chiropractic is not going to work, then the DC MUST tell the patient the truth and refer them to someone that CAN help them. A massage therapist has absolutely no business to tell a patient that taking a drug is a bad thing and that the patient should stop. Neither does an osteopath, a DC, a homeopath, etc. Just because our individual beliefs caused us to choose a particular path toward wellness does not mean that our particular path is necessarily the "be all / end all" approach. We all practice martial arts, and I think we can agree that no system is the "be all / end all" system. The logic applies the same way toward most things.

My personal feeling is that traditional medicine and alternative health care need to partner up and stop the adversarial relationship they have had so far. The AMA needs to worry less about profit margins and deals for kickbacks from pharmaceutical and biomedical companies and worry more about patient health, wellness, and quality of life. The alternative people need to stop trying to earn the respect of the AMA, and admit that they already have the respect of their patients. That should be enough.

I will put away the soapbox.

As always, just my humble, misinformed, user oriented, people centered 2 yen...

Eric McKillican
5th August 2000, 18:32
Mr. Stone;

Thank you for your comments, I will try to address them as best as I can. By the way I am currently practicing in Omaha and have been a guest lecturer and guest teacher at the Omaha School of Massage Therapy. Massage has made great strides in Omaha over the past few years, therapists can be found at every heath fair in town, the Med. center has two on staff, major companies are incorporating them into their wellness programs. Things change.



Chiropractic does not cure anything. It does however remove the interference to the healing process. Chiropractors address every illness and condition with the same approach detection and correction of the vertebral subluxation complex (VSC). In addition to this we recommend changes in life style, such as nutrition, exercise, sleep habits, mental attitude. All with the effort to establish a positive healing environment.



Chiropractic does not "cure" every one that comes in. In chiropractic there is something that we call limitless innate, limited matter. What that means is that the life giving forces in your body are limitless in their possibilities, but the matter has limitations. If the matter (the body) has been damage or injured it can only heal to within the limits that the bodyıs tissues allow.



I have a patient who has a history of being carried and delivered breach. She is 19 and has been blind in her left eye since birth; she has been getting migraine headaches behind her left eye every day for the past 10 years. She has 10 years ago, undergone corrective surgery to her left eye to allow it to track with the other eye. On her third adjustment she came in and said her daily headache was gone. On her fourth adjustment she came in claiming she could now see from her left eye. Her Eye doctor has reexamined her and he has confirmed that she has 20/400 vision in her left eye. Today she is headache free and her vision continues to improve. This does not mean that I can cure blindness. I have adjusted dozens people with severe eye sight problems and she is the only one that has had such dramatic results. We just remove the interference and let the body repair what can be repaired.



Eric McKillican D.C.

Joseph Svinth
5th August 2000, 22:46
When I want drugs, I see a physician. When I want an operation, I see a surgeon. When it's time for new orthotics, I see a podiatrist. If it's time for new glasses, I see an optometrist. When I want some general advice, I talk to the RN or the PA. And when I want my back adjusted, I see a chiropractor. In other words, I try to go to the person most likely to do what it is that I want done at the moment. Yes, this means that I have to do some diagnosing of my health care problems by myself, but usually diagnosing isn't rocket science, simply a matter of objectively matching symptoms to descriptions found in books.

For links to chiropractic colleges and such, try http://www.nonforce.com/links.html

IchiRiKen1
6th August 2000, 01:27
Originally posted by Eric McKillican
Chiropractic does not cure anything. It does however remove the interference to the healing process. Chiropractors address every illness and condition with the same approach detection and correction of the vertebral subluxation complex (VSC). In addition to this we recommend changes in life style, such as nutrition, exercise, sleep habits, mental attitude. All with the effort to establish a positive healing environment.

Chiropractic does not "cure" every one that comes in. In chiropractic there is something that we call limitless innate, limited matter. What that means is that the life giving forces in your body are limitless in their possibilities, but the matter has limitations. If the matter (the body) has been damage or injured it can only heal to within the limits that the bodyıs tissues allow.

Please don't misunderstand; I am not saying that chiropractic does not have its uses. It is only the snake oil claims of ANY health care modality that I take issue with... Massage is not the answer to all ills, nor is Acupuncture, Herbology, etc. I defer to your second quoted paragraph above wherein you state that you do nothing more than facilitate the body in attempting to do what it can with what it has. Personally, based on my experience with my own aches, ills and injuries, I think the last two sentences of the first quoted paragraph are the answer, or at least the better part of the answer, to most peoples alleged "dis-ease."


I have a patient who has a history of being carried and delivered breach. She is 19 and has been blind in her left eye since birth; she has been getting migraine headaches behind her left eye every day for the past 10 years. She has 10 years ago, undergone corrective surgery to her left eye to allow it to track with the other eye. On her third adjustment she came in and said her daily headache was gone. On her fourth adjustment she came in claiming she could now see from her left eye. Her Eye doctor has reexamined her and he has confirmed that she has 20/400 vision in her left eye. Today she is headache free and her vision continues to improve. This does not mean that I can cure blindness. I have adjusted dozens people with severe eye sight problems and she is the only one that has had such dramatic results. We just remove the interference and let the body repair what can be repaired.

I am not sure how to respond to this. I suppose that, like anything, there are the appearance of "miracles" whereby a seemingly irreversible condition is reversed. I congratulate you on your ability to be part of her healing. I suppose the issue I would take is not so much that you say that this situation was resolved due in part to your adjustments, but rather when this is used as advertisement, sensationalized and thrown at the masses that are uneducated regarding the benefits and hazards of different health care treatments. In the same vein as the surgeon that recommends surgery to a patient for carpal tunnel, because surgery is what he does and is how he makes his living, instead of recommending that the patient try changing their work habits, stretching, etc., first. I just have a REAL issue with self-promotion at the expense of the patient. I have been a victim of that, and would not want that to happen to anyone else.

If I ever get back to Omaha again (I live in Japan now, and my family just moved to Arkansas), I would like to look you up. Your demeanor (at least in writing) and explanation inspires me to give chiropractic a little less flack and judge for myself.

Just my humble, misinformed 2 yen.

Bob Steinkraus
15th August 2000, 18:13
A few points from the skeptic -

- Chiropractic's version of 'subluxations' cannot be demonstrated on X-rays. If you show an X-ray of a person with back problems to a chiropractor, he/she will find subluxations. If you show him/her an X-ray of a person with no back problems, he/she will find subluxations. If you mention that the second person had no back problems, they usually respond "he will" or start fishing around for other symptoms to diagnose (headache, upset stomach, dandruff) and then say 'Aha'.

- The good doctor's anecdote of the woman with eye problems who was cured or improved by chiropractic is an interesting one.

1) The two nerves that control vision are the optic nerve, which carries the signal from the retina to the brain, and the oculo-motor nerve, which controls eye movement. Since neither of these two nerves pass thru the spinal column (both are cranial nerves), I am at a loss to explain how cracking a spine would affect an unrelated structure like the eye. Most chiropractors are as well, since there is no way to manipulate these nerves without opening the skull, so they tend to fall back on theories about unproveable mystic healing energies no one has seen.

2) He goes on to explain that before his 'treatment', she was blind in her left eye, but afterwards, she had 20/400 vision in that eye. Since the definition of blindness is 20/200 corrected vision, what our friend is saying is that his treatment had no effect on her vision.

3) He further states that her problems are due to her 'history of being carried and delivered breech'. Dr. McKillican apparently does not know that all babies are carried breech until shortly before birth. Before that, they are smaller than the womb, and their movement is limited only by the umbilical connection.

- Dr.McKillican's first post dismisses the failure of double-blind scientific testing to discover any benefits of chiropractic beyond placebo (and the undeniable discovery that a back rub can be soothing). He points instead to '100 years of experience' by chiropractors. I need do no more than point out that astrology is many thousands of years older than astronomy, and ask which does the reader find more convincing, based on the evidence.

Regards,
Bob Steinkraus

jbernard
17th August 2000, 19:05
When does chiropractic end? I understand after sustaining an injury chiropractic can be very helpful. Both of my parents used it and so have I. But, after one recovers from an injury such that they are able to rehabilitate themselves with active, versus passive, stretching and exercise, why bother to see the chiropractor? Mine wanted to see me every three weeks perpetually, long after my symptoms dissapated. I didn't feel like shelling out $50.00 a month to get my joints cracked.

Eric McKillican
17th August 2000, 23:18
Just a few comments about Mr. Steinkrausıs latest post.



- First of all no one has ever mentioned X-rays, so I donıt know where that comes from.



- Your assumption about the specifics of the adjustment for the patient who was blind is based from ignorance. I used both upper cervical adjusting and cranial adjusting on this patient. But I wonıt even begin to expect you to understand what that entails.



- Next, I never mentioned she was just "clinically blind" I said she could not see anything from her left eye. Which means her left eye was in total blackness, and now she can see and even read with her left eye. Regardless of what the finite details are or weather you believe it happened. It matters to the patient who is now out of the dark.



- Go back to embryology and you will learn that the baby should turn head down after the seventh month (vertex position). If this does not happen the baby is then considered to be in In-utero-constraint. After weeks to months of abnormal compressive pressures to the babies soft cranial bones. Molding happens where the scull changes shape and puts stress on the structure in side (the brain).



I am tired of wasting my time explaining the specifics of chiropractic only to have the same narrow-minded opinionated responses. I was hoping that you might learn something you donıtı know about chiropractic. After 18 years in the martial arts I still consider my self a student. I donıt presume to know everything about other styles from talking to one practitioner or seeing one tournament.



Imagine if the public perception of martial arts was from the Yellow pages or TV or the experience with one martial artists. What do you think their impression would be about martial arts? I think it would be narrow and limited. Not enough to make absolute statements, regarding the arts.



This is what has happened here, you have let your brief personal experiences control your beliefs and what you deem to be truths. If anything challenges this narrow interpretation of chiropractic, you dismiss it as mystic and mumbo jumbo. I expected more from martial artists. So I am going to say good bye to you all and get back to the people who matter. I leave you with this quote from a man who was in his time thought to be a bit crazy.



"Great spirits have always encountered violent opposition from mediocre minds..."

Albert Einstein



Good bye

Eric Mckillican

Bob Steinkraus
21st August 2000, 20:24
I love this sort of thing....

1) The reason I mentioned X-rays was that X-rays are objective. Since subluxation cannot be demonstrated on X-ray, this is one indication that they don't exist. Subluxation is defined as a partial dislocation of a joint putting pressure (in chiropractic) on the spinal cord. No such entity exists.

2) You mention 'upper cervical adjusting and cranial adjusting' on your allegedly blind patient. Neither the optical nor the oculo-motor nerves pass thru the cervical portion of the spine (nor any other part - as I mention, these are cranial nerves). Cranial adjusting refers to the attempt to change the relative position of the plates of the skull along the lines of the cranial sutures. Cranial sutures are the lines along which the cranial plates fuse. Once these plates fuse, there is no way short of fracturing the skull (or using a bone saw) to change their alignments. Your post made no mention of fracturing your patient's skull or of opening her skull. Is this what you attempted?

3) Your post mentioned that your patient now has 20/400 vision in one eye, allegedly as a result of your 'treatment'. Follow-up posts now claim that she can read with that eye. Extraordinary, as I have 20/300 vision (uncorrected), and I cannot read without my glasses or contacts. You seem much more precise in your measurement of her sight after your treatment. Could you post exactly what her vision was before you treated her?

4) You seem to have discovered the change in fetal positioning that occurs during the seventh gestational month. Congratulations. You have not seemed to taken into account the pressure exerted on the baby's head during the birth process. How would you imagine this is different if the baby is born normally or breech? It is relatively common for newborns to have misshapen heads as a result of this pressure, and yet this is not at all a common cause of blindness. Do you have an explanation for this?

You post a good deal of stuff about the Yellow Pages and my alleged lack of understanding of chiropractic. The problem is not (from your point of view) that I do not understand chiropractic, but that I do. This understanding, I might add, is not based on personal experience, as you seem to think. It is based on a layman's review of the scientific literature, and the undoubted fact that chiropractic has not been found to be effective in the treatment of any disease (apart from placebo and the comforting effects of a back rub, as I mentioned earlier). Chiropractic used for the medical problems you describe (blindness, migraine, enhanced healing) is worse than useless, in that there is no clinical benefit to offset the real risks. Chiropractors who attempt to treat such problems are not simply annoying quacks, but actually dangerous.

You close with an interesting quote from Albert Einstein. Allow me to quote another from the same source.

"There are two things that are infinite - the Universe and human ignorance. And I am not sure about the Universe."

And also

"They laughed at Einstein. They laughed at Newton. Of course, they also laughed at Bozo the Clown." - Carl Sagan

22nd August 2000, 03:25
edited as per forum policy.

Slander and attacks will not be tolerated.
W.Kent Bergstrom


[Edited by W.Kent Bergstrom on 08-21-2000 at 09:39 PM]

22nd August 2000, 03:42
Kent,

I didn't slander or attack anyone! I only pointed out that you seem to have a problem with the truth. You view it as an attack if it doesn't agree with your opinion.

Me thinks you do protest too much.

Bob Steinkraus
22nd August 2000, 13:31
I am being warned that my posts are offensive, not by the DC who started the thread but by the moderator.

May I ask to see the post from Mr. Cunningham which is offensive? I am finding that many of my attempts to point out impossibilities in the chiropractic treatment as described here are not being well received.

I am not clear on what the ground rules are here. If it is necessary to agree that chiropractic, homeopathy, 'therapeutic touch', astrology, etc., are effective, and that requests for evidence are offensive, please say so.

I am not sure what the enforced orthodoxy is.

22nd August 2000, 14:00
I merely pointed out that Kent has a problem with the truth when it disagrees with his opinion. Then he views it as a personal attack. I also mentioned this is a tendency of those with small minds who often view anything which disrupts their personal and emotional view of the world as negative. Finally, I asked how chiropractic could possibly be considered a profession?

Kent is upset with me about my exposure and ridicule of Juko Kai, a modern martial arts organization which sells certificates of academic achievement and sokeships for money. Apparently, Kent feels that since he paid for his Juko Kai certificate, then anyone who ridicules this practice is personally attacking him. He is also apparently afraid that other members of this forum will see it for what it really is.

22nd August 2000, 21:21
"Finally, I asked how chiropractic could possibly be considered a profession? This for the sake of the people in this profession of which I am not is offensive behavior. We have re-hashed this in the past and when you were told it is a licensed medical profession in other states (pre-crash) you continue to attack the Profession of Chiropractic."

Kent,

Plumbers are licensed in Illinois and many other states. It's still a trade, not a profession.

"HOW DARE YOU make generalizations about things in my private life you know nothing about. Plus IT IS NONE OF YOUR BUISNESS nor is this forum your personal bashing center.How many times do you have to be told that your words and actions are offensive and continually insulting."

How dare you accuse me of such things? You are as guilty as I am in any of this. If you find the stuff I write to be offensive, then I suggest you don't read it. By the way, how much did you pay for your Juko Kai soke certificate? Inquiring minds want to know. I know exactly how much it cost you, but I feel that it is up to you if you want to let others know.

[Edited by budokai on 08-22-2000 at 03:24 PM]

MarkF
22nd August 2000, 23:42
Don admits upfront that he is a "professional part time jerk." Can't we all agree with that and leave it there?

Wasn't it Palmer who "cured" a person of total deafness with his maunipulations? My aunt was born totally deaf, and when she was about one year old she was dropped on her head...(waiting for the laughter to die down) and immediately got full hearing in both ears and still does to this day. She is 82. I am a pharmacy doctor and I have plenty to say of the inadequacies of "double/blinds," having just read of a case in which a "double blind" was halted because the half receiving the drug was improving at a much faster rate. What the entire group didn't know that the drug, in long term studies, could actually speed up the deterioration if taken for too long which, in this case, would be a life time. Did they feel the placebo group was missing out? Hardly. The faster they could prove a drugs efficacy, the more quickly it is out for public consumption. $$$

Unfortunately, "tried and true" is more often a misnomer, as can be seen with the drug Rezulin which after passing all double blind and animal testing, it then appeared to be killing the patients it was supposed to free of their frequent shots of insulin. The lawyers have it all over the airwaves and in print ads.

Personally, since pharmacists are asked for counseling when it comes to taking their prescribed drugs, no one has stopped me "yet" from recommending the homeopathic pharmacy down the street. Thus, I practice clinical pharmacy where these days the toughest question I am asked when on rounds with an attending and students isn't what works best, but what's the cheapest. Frankly, all this crap is making the wrong people wealthy, and the people who "rely" on their drugs have to go across the border (doesn't matter whether south or north) to afford these "lifesaving" chemicals. Personally, after back surgery which only made the problem worse, I will stick with the "tried and true" which doesn't leave my treatment up to a big corporation who will soon be raising prices, again, because they are being sued, and all of us are paying. Hey, if a chiropractic can lay hands on and I feel better, that is where I am going. But I will say one thing about the allopaths in this country, they seem to know when and what you need and why if, like Joe Svinth said a while back on this thread, you go to a surgeon, they say it is time to operate. Go to an internist and he/she will say "take this, this and this," then make an appointment for week," and If I really have a subluxated or luxated thumb, I am going to the ER, where I will wait hours for a kid in a labcoat to say what I all ready know. Spinal subluxations can be seen by MDs BTW, they just don't believe that it means anything, so you are all barking up the wrong tree. Go into a bookstore and get educated. Ultimately, you are responsible for your own lives, not your doctor, no matter what he is. Every doctor who is honest will tell you that seventy percent, minimum, of all visits are unnecessary. Am I leaving you out? Oh, yeah, dentists. Welll,eeeerrrrrrggggghhhhhhhh!:redhot:

[Edited by MarkF on 08-22-2000 at 05:48 PM]

Bob Steinkraus
23rd August 2000, 15:56
Mark et al -

Your post mentioned a double blind study which was discontinued because the placebo group was improving faster than the treated group. My question is, how would we know the drug did not help if we did not do a double blind study? If we simply relied on the anecdotal evidence, we would be recommending and using the drug - and doing real harm.

Suppose a patient came to you and said "My doctor says I have skin cancer. I don't believe in all this modern nonsense. My grandfather rubbed all his moles with kerosene, and he lived to be eighty-four. I trust my feelings, and my feelings say do what worked for my grandfather." Would you, as a responsible health care provider, take the New Age approach and say that whatever you believe in is true for you? If you do, the likelihood is very high that the patient will die.

Suppose it was the patient's child who had diabetes, and they decided to take the child to Dr. McKillican, who would adjust the child's spine and let the natural energies of the body heal the diabetes? Isn't that cheaper and more cost effective than a lifetime of insulin?

You mention Rezulin as a drug that is now causing problems after passing double blind testing. Without knowing anything about the drug or what problems it may cause, I believe we have hit on a good example of a general principle.

'First, do no harm.' This is the basis of good medical practice. All treatments must 'work' in some sense, and must do more good than harm, or it is unethical (and stupid) to use them. This principle states that all treatments, drugs, or what have you, must have some real, clinical benefits or it is wrong to use it.

Chiropractic has no clinical benefits, and some definite risks. Therefore, on balance, it should not be used or recommended by responsible practitioners.

The question is not, should you go to a chiropractor if you want your back adjusted. The question is whether or not having your back adjusted is a good idea. Based on all the evidence, it is not.

I have posted several times listing reasons why adjustment of the spine will not affect the nerves controlling vision. Deafness, which you mention as a successful cure from the originator of chiropractic, has the same issues, in that the auditory nerve does not pass thru the spine. I repeat, how can this work?

MarkF
24th August 2000, 10:16
Hi, Bob!
I believe I said the group which was receiving the drug was improving, not the placebo group, and, as this is very new to double blinds, people who did not improve while taking a placebo, demanded, through attorneys, that they be allowed to take the drug, which seemed to be showing a remarkable benefit, as with Rezulin, but the study was stopped far short of the probable duration of five to twenty years, thus, many people down the road had conditions, proved to be be a possibility with the same class of drugs many years earlier, and caused the lifespan to actually be shortened and the illness it was to treat, made worse. The drug, incidentally, was a beta II cardioselective alpha adrenergic blocker, such as Tenormin (Atenolol). People showed marked improvement of the symptoms, but down the road, it made the condition worse. Rezulin is a good example because people with juvenile onset diabetes were so anxious to be relieved of the multiple injections taken everyday that a bill was passed which has now become law for any medicine which shows improvement for testing periods to be cut if shown it would be dangerous NOT to take the drug. This was true also of the most recent diet drugs removed from the market which caused permanent and untreatable heart failure and death. Another pain drug, an NSAID called Zomax, was the first to be given leeway in testing to get it to market sooner, and after several deaths, it also had to be removed.

That said, we are not comparing rubbing kerosene on possible skin lesions which could prove to be malignent, although there are hundreds of athletes out there who will swear that using DMSO on arthritic joints showed definite benefit when used this way. Previously, it was only used in urinary bladder problems (Rimso 50) and this was also when that drug was categorized as "less than effective" for treatment of bladder problems. Asi es la vida.

Well, as far as cancer is concerned, most people who receive chemo and/or radiation treatment do eventually die, and more than fifty per cent of those die of the chemo-induced viral load and is the one major setback which shows these drugs to be failures. I mean, the reason for taking them is to kill CEAs or carcinoembryonic antigens which all of us carry, and few are attacked by these antigens, but when we are, chemo not only kills cancer cells but kills the body as well, thus the definition of allopathy (MDs). Sure, you are in remission, but at what cost? In all too many cases, the price is your life. A few years ago, five years was the goal, and that was considered a cure. Today, it is three years because of all the new and potentially deadly viruses which can and do kill.

Of course I would never tell someone who is being treated for any illness that they should do other than what there doctors say, but I also will caution them that they need to take certain amounts of food supplements, such as antioxidents, to help the immune system to fight the viral load. You wouldn't believe the wild stories I have heard from medical doctors who tell their patients to get them to stop these very necessary nutrients, especially in these cases, so I would hesitate to say chiropractic doesn't work, if MDs are going to tell patients that their immune systems, which are literally made useless by these drugs, need to stop immune supporting supplements to help them survive their treatment. I would say the same for chiropractic, if the claim is that they can cure baldness or dandruff. The example of Palmer "curing" deafness was a once in a lifetime thing, but there are nerves everywhere in which certain interference can lead to severe problems such as deafness. I believe in homeopathy also, but I am not stupid either:) If I had known before my back surgery that laminectomies are thiry per cent likely to cure my problem, the same as with Papain injections and other treatments, I wouldn't have had that surgery, and I asked as well, but never received an answer, as they also had me sign my permission slip while I was under the unfluence of narcotics. No, I may not have made a different decision, but it would have been, at the very least, fair of them to inform me. I also found out later that I had a two per cent chance of dying from the side-effects of any one of the many anesthetics I received, as well. I just believe in balance. And people wonder why we self-medicate:D

Another good example is the injudicious prescribing of antibiotics for anything and everything. If a patient comes into the retail outlet I am working, and says they have a cold and the doctor gives them a scrip for penicillin, you bet I will ask the patient if there is some other problem which an antibiotic may improve, such as bacterial bronhcitis, and if they say no, I am on the phone faster than you can say "safety caps on this today, Mrs. Parker?" Today, we are all paying for the antibiotics-immune bacterial infections which no longer respond because antibiotics have been and still are being over prescribed, thus, I do clinical pharmacy in a hospital.

I just think we need to be careful and informed, and I don't think anyone would disagree with that. "Doctor" is not a synonym meaning God.

Today, there are DOs (doctors of Osteopathy who do spinal manipulation) who also perform surgery, specialize in pediatric orthopaedics, and any number of other specialties, but ask an MD who does the same thing what they think of the DOs. If it had been a *DO* who posted the topic here, would we be having the same discussion? Perhaps. I just like to get out of the way when there is an out of control Peterbilt roaring down on me, at least until I find the sidewalk.

Nice chatting, Bob.:wave:

Bob Steinkraus
24th August 2000, 12:54
Hi, Mark.

Crash time at work, so my reply will need to be short.

I went back and re-read your post, and I misunderstood your point. The drug was working, but that meant the long-term effects of the drug couldn't be studied.

Sorry for my mistake.

I would like to read your latest carefully before I respond.

24th August 2000, 15:19
Mark,

Reading your last post raised a question. I've often heard that the overprescription of antibiotics has led to the especially virulent infections which are resistant to antibiotics. I have a theory that this is not so much due to over prescribing antibiotics, but is due to under-prescribing treatment courses. Usually, doctors tend to only prescribe for 7 to 10 days. I've heard that this is because they feel most patients won't continue longer than this. However, I have also heard that 6 weeks is the minimum necessary to treat Most sinus infections. In my opinion, the short term antibiotic treatment has done more to cause problems than over prescribing. By not knocking out the infection completely, the short term series only reduces the symptoms and the infection often comes back even stronger later. I realize this is just a layman's opinion, but I get into this discussion with my own doctor. I refuse to take antibiotics for less than 6 weeks if I have any kind of infection. Since I started this, I have not had the kind of reoccurence that I used to suffer from.

Bob Steinkraus
24th August 2000, 22:06
Mark -

Having read your last post carefully, I think we are at least on the same page. We have certainly wandered more than slightly from chiropractic, which is what started this, so maybe this can stop me from beating this topic to death.

I get the strong feeling that at least you and I (and I hope others in the forum) agree that the scientific method is a valid approach to evaluating medicine. There are lots of topics of human investigation that do not lend themselves to scientific examination (philosophy, history, religion, cosmology, literature, human relations, etc.) but medicine and medical practices can, by and large, be studied and understood by good, double blinded, large scale studies.

If we agree on that, it becomes simply a matter of the evidence. The more I study, the more I find that chiropractic just does not hold water. It doesn't work the way it says it does, and the evidence for that statement is not particularly ambiguous or slight.

Dr. McKillican (sp?) made a series of posts containing a number of what struck me as obviously problematic statements. My knowledge of anatomy is not exhaustive, but I do know a bit, and it was not terribly difficult to shoot holes in his post. Right or wrong, a sitting duck like that was too tempting for me to resist. Disrespectful? Probably, but as I think I have made clear, I don't have much respect for chiropractic, and I didn't see anything in his post to change that.

If, on the other hand, someone can come up with reasons why I should change my mind about the scientific method and its application to chiropractic (or homeopathy, or astrology, or pretty much anything you care to name), I would appreciate hearing about it. Same goes for well designed and administered studies producing evidence in favor of this theory or that. I may be a skeptic, but I like to think I am at least an open-minded one.

"Subtle is the Lord" said Albert Einstein, but I think He at least plays fair with us. And I think most of us can judge fairly well when something is proven - and when it ain't.

MarkF
25th August 2000, 10:45
HI, Don,
Antibiotic therapy works. It does, as these drugs are prescribed, if all are included, more often than any other therapy, especially for bacterial infections which you obviously had, and many believe what works, works better the more often it is taken. This is true, as you do need to kill the bacteria left over from the first week or so, even if you feel better. Time periods differ as there are now a whole slew of newer antibiotics, mostly synthetics, or cyclosporins. These are much broader, or "stronger" (meaning they cover more types of bacteriums) and so are prescribed probably too often, as they are expensive, and in most cases, not necessary.
This is what happens when you take antibiotics when you have an infection: It kills bacteria. Not just the bacterium which is causing you your misery, but all those that the body needs to keep it "clean." There are an almost infinite number of bacteria which the average person carries, and all are beneficial to health. What is not said these days, or before today, is the resulting death of "good" bacteria. This is a good example of chemotherapy (anytime you take a medication for something, no matter what it is, even aspirin, is chemotherapy). What more and more doctors are recommending, along with your antibiotics, you must replace the good baceria at the same time (meaning during or after the illness). Good products for this are milk, yogurt, creamcheese, cottage cheese, or any number of dairly products which have a milk base. The old thought was that if you take dairy products with antibiotics, they will not be as effective, as yogurt, etc, provides the body with bacteria.

Today, more and more physicians will say "well, try not to drink milk while taking this, but if you cannot put up with a little indigestion and nausea, then it will be ok." The cyclosporins do not have this stigma when taken with dairy products (the most well-known of these is called Keflex). As it turns out, there is only one antibiotic in which it is necessary to avoid milk, and that is tetracylcine and its cousins (vibramycin, etc). On the other side, there is erythromycin, which is making a comeback of sorts, as this is the only type of antibiotic which those who are allergic to penicillin and cyclosporins, can take without allergic reaction. This one you must take with milk or food, as nausea and indigestion is almost always going to happen on some scale along the path. Complicated, isn't it?

Well, I could go on, but since I am not being graded or paid for this, I will shorten it:) Sinus infections are difficult to treat, as usually it it very "case-specific." That simply means ther are few which work, and sometimes a sample of the crud in the holes in your face (sinus cavities) is needed to do a culture to see which antibiotics will be effective in killing the one you have. If this is consistent with you, then your doctor probably knows which works. Not all illnesses or infections are alike, and if you were hospitalized, a culture would be taken without question. In office practice, this can be difficult if you cannot get a sample by blowing your nose, as this is what causes the pain. Besides, it can take up to three days, and sometimes a week, for the bacteria to grow in a Petri dish, and then hours or days more to find the correct drug which kills it.

This is stricly a guess, as I would not be so high and mighty to tell you it is wrong. All my statements come with opinion and experience so do what helps and continue to do it. However, a possible reason for the six-week course is that since antibiotic therapy rarely makes you feel good, even if your symtoms improve, that it takes that long for your body to adjust to the drug regimen so that any side-effects orignally felt, even though not bad, you still feel "off." So six weeks is an arbitrary figure, just as seven days, or ten days, or three months are. In the doctor's practice, he uses a few drugs because he knows what his patients come to him/her for. This is very common, and not wrong, it is just how it is. Ask a psychiatrist to prescribe something for a sinus infection, and he/she has no idea.

Anyway, my guess is six weeks are how long you need. Maybe it is because your body has a resistence because of whatever reason, or maybe the infection really needs to be treated that long. I may be a doctor but I ain't no doctor;) This is very personal. My comments only address the overall picture of the business. I won't argue about personal opinions. I take food supplements (vitamins) and try and treat my problems with these or herbal remedies, but I know when I need to see my doctor, as well. However, if it is a practice of yours to take six weeks of medication for every infection you have which differs with the one in your sinuses, it may be a good idea to have a talk with your doctor about it. Certainly, facts do speak for themselves, and he fact is that this society is over-medicated in general. You have all ready said this makes you feel better. Natural cures make me feel better, but then, I take them daily. There are antibiotic-resistent forms of tuberculosis which are showing up with regularity these days, and it sometimes takes another discovery to find one which works. Flesh-eating resistent bacteria, pneumonia which attack so fast that when the cure is finally found, it is to late for the patient. Jim Henson is a good example as it was his death which started this debate in a more serious arena. But the problem I have is whith doctors who prescribe antibiotics for viruses which simply will have no effect on the virus whatsoever. They do it because the patient simply feels better if they are taking something for it, even though it will go away when it wants to, no matter what they prescribe. It is like an old "proverb" (joke, really): "If you don't take any vitamin C for your cold, you are going to have it for seven days, but it you do, it will only last a week." This was the medical profession's answer to patients who would ask. Today, they do say it may help in lessening the severity and/or the length of time of the symptoms. Certainly, it will not harm you, and this is because there are just toom any people who do get better faster, and get less colds with a regimin of vitamins, etc. Just recently, the FDA raised the RDA of vitamins C and E, ro mosre than twice what was recommended before. Did those flower eating liberals know something the goverment didn't?

Hey Don. Keep up your strength for healing;)

Bob, disrespectful? Not in the least. Opinionated? Of course it was but we all have one or two, and mine have been know to cause fires around here. Don and I have been in some beaties, but not directed at each other. We know each other too well. There aren't that many. Opinions are facts which aren't fact yet, and history books are full of them, and we believe because we don't have a choice, unless we have done the same research. For my part, I don't believe in censoring much, as that is like throwing the baby out with the bath water. It just makes it worse, but if I disagree, you will hear about it. No offense is ever intended, except for this type: "I don't believe you." "You don't? Why?" "Jus cuz!":burnup:

Mark

Bob Steinkraus
25th August 2000, 14:10
There are some citations at the end.

This is regarding chiropractic neck manipulation ('cervical') which the DC who started this thread mentioned.




LESSONS FROM PRACTICE

MJA 21st August 2000
Vol 173, Number 4 p213


Serious complications with neck manipulation and informed consent

Patient 1

A 27-year-old woman had chiropractic manipulation for right shoulder
stiffness. She had previously been well, with no history of diabetes,
hypertension or neck trauma. She had four neck manipulations within one
month; the first three were uneventful and provided some pain relief. Within
48 hours of the fourth manipulation, she developed right facial, trunk and
limb paraesthesiae with mild dysphagia. She had no headache, vertigo or
ataxia. Computed tomography (CT) scans of head and cervical spine were
normal, except for mild misalignment of the C5 vertebra. Her general
practitioner advised conservative management.
Symptoms fluctuated during the following five months before worsening right
facial paraesthesiae led her to seek specialist
advice. She denied pain or distress and was apyrexic, with a pulse rate of
80 bpm and blood pressure of 130/80 mmHg. There were no heart murmurs or
bruits. Pupils were equal
and reactive, with normal fundi, She had mild right facial asymmetry but no
other neurological signs. Vertebral artery dissection (VAD) was suspected.
A magnetic resonance imaging (MRI) scan with angiography revealed complete
termination of flow in the distal portion of the right vertebral artery (VA)
at about the level of the C3/C4 intervertebral disc space (Figure 1). Axial
scans showed high signal strength in the region of the VA lumen consistent
with thrombus through this segment, with minimal to no patency. Collateral
vessels, with some refilling of the right VA more distally, suggested
chronic dissection. No intracranial
infarct was seen.
The patient was placed on aspirin, and had only minimal right facial
paraesthesiae on follow-up at one month.

Patient 2

A 37-year-old man sought chiropractic treatment for a persistent bitemporal
headache of four weeks' duration. On history, the headache seemed to be of
muscular tension type. The patient had previously been well, with no history
hypertension, diabetes or neck trauma. He smoked 20 cigarettes daily, drank
little alcohol, took no regular medications, and had no relevant family
history. Immediate following his first cervical manipulation, while still in
the chiropractor's rooms, he reported severe diplopia, dysarthria and
ataxia. He sat in the waiting room for an hour before driving back to his
office; he was not advised to seek a medical opinion. The symptoms worsened,
and a colleague drove him home, where he slept. On waking, he had only mild
headache.
Two days later, the patient presented to hospital with severe ataxia, nausea
and vomiting, and complaining of vertigo, diplopia and right-sided neck
pain. He was afebrile had a pulse rate of 88 bpm and a blood pressure of
130/80 mmHg. He had no heart bruits or murmurs, and was alert and oriented.
His pupils were equal and reactive, with normal fundi. Nystagmus and
diplopia were present bilaterally, but more pronounced on right gaze. He had
a profound right sensorineural hearing loss (confirmed by audiometry). The
other cranial nerves were normal. Ataxia was predominantly right-sided, with
upper-limb past pointing, intention tremor, poor heel-shin coordination,
'ataxic wide-based gait, and a tendency to fall to the right. Tone and power
were essentially normal bilaterally, with symmetrical deep tendon reflexes
and downgoing plantar
responses. Dissection of vertebral artery with emboli was suspected.
Cerebral CT scan suggested a right brainstem infarct, and the patient was
commenced on intravenous heparin. Routine blood tests, electrocardiogram and
chest films were unremarkable (apart from a cholesterol level of 6.0 mmol/L
[normal range, 3.9-5.5 mmol/L] and triglyceride level of 2.79 mmol/L [normal
range, 0.5-1.7 mmol/LI). An MR1 scan five days after presentation showed
multiple infarcts within the deep white matter of both cerebellar
hemispheres, and a well defined, wedge-shaped infarct of the inferior aspect
of the right cerebellar hemisphere, with involvement of the adjacent portion
of the right middle cerebellar peduncle without appreciable mass effect
(Figure 2). Axial scans demonstrated high signal strength in the vessel wall
consistent with mural thrombus. Magnetic resonance angiography demonstrated
a patent right VA, but there was minimal to no filling of the left VA for
virtually its entire extracranial course (Figure 3). Appearances were
consistent with a left VAD, a large right anterior inferior cerebellar
artery territory infarct, and several smaller infarcts in the superior
cerebellar artery territory.
The symptoms of vertigo, nausea and vomiting settled quickly, with residual
diplopia, hearing impairment and rightsided limb and gait ataxia. Following
initial physiotherapy, occupational therapy and alternate eye patching, the
patient was transferred for rehabilitation. At outpatient review one month
later, he was mildly ataxic, with right-sided past pointing and intention
tremor. During the following six months, his symptoms resolved further but
the diplopia and ataxia failed to resolve.

(Discussion)

VERTEBRAL ARTERY DISSECTION (VAD) is the most common cause of posterior
circulation infarction in young people.' It remains the leading cause of
cerebellar infarction' and can be responsible for considerable morbidity, as
seen with Patient 2, who has residual ataxia, diplopia and sensorineural
deafness. Extracranial dissections are more commonly trauma related, whereas
intracranial dissections are usually spontaneous.2,3 There are no proven
methods of risk reduction for spontaneous VAD.

Cervical manipulation is often perceived as benign and risk-free. 4 However,
postmortem studies6 support the belief that rotary head movements and
hyperextension of the neck, such as those used in chiropractic neck
manipulation4 and presumably used in both of our patients, may narrow
arterial lumens and cause kinking. Case reports have related the onset of
posterior circulation symptoms to cervical manipulation in the absence of
another explanatory event.5 An increased awareness of this relationship
might prompt earlier investigations Looking for VAD.

The exact incidence of VAD following cervical manipulation is unknown,5 and
its determination may be compli
cated by the occurrence of asymptomatic dissectionS2,3 and by the
possibility of significant delays before a symptomatic event, whether it be
due to embolism or progression of the dissection to complete occlusion of
the artery.2,5

The association of neck manipulation and VAD, with the potential for
subsequent stroke, has been well established,1,2,5 yet in neither patient
was this discussed with the patient before they "consented" to undergo the
procedure.
Chiropractors are not the only therapists who perform neck manipulation.
Physiotherapists, some occupational therapists, orthopaedic surgeons, family
physicians dealing in manipulative management, and even some neurologists,
offer various types of physical manipulative intervention. We suspect that
they too neglect to warn patients of the very real potential for serious
adverse effects from this type of treatment.
Any procedure which carries a significant material risk to the patient must
be performed only if the therapist has gained informed consent.7 Many
manipulative procedures are performed for relatively minor complaints,4 and
may lack proven potential for benefit. Patients must be in a position to
decide whether they are prepared to accept the risks associated with these
procedures.

Information on the risks and the lack of proven benefit should be routinely
relayed to the patient, not only to gain informed consent, but also to
encourage the patient to seek prompt attention should he or she experience
any symptoms suggestive of VAD.

Roy G Beran,* Andrew Schaefert Toos Sachinwalia*
*Senior Visiting Medical Officer, Department of Neurology
t Neurology Registrar, Department of Neurology t Neuroradiologist,
Department of Radiology Liverpool Hospital, Sydney, NSW

1. Barinagarrementeria F, Amaya LE, Cantu C. Causes and mechanisms of
cerebellar
infarction in young patients. Stroke 1997; 28: 2400-2404.
2. Hinse P, Thie A, Lachenmayer L. Dissection of the extracranial vertebral
artery:
report of four cases and review of the literature. J Neurol Neurosurg
Psychiatry
1991; 54: 863-869.
3. Capian LR, Baquis GD, Pessin MS, et al. Dissection of the intracranial
vertebral
artery. Neurology 1988; 38: 868-877.
4. Lagone J. Chiropractors: a consumer guide. Massachusetts: Addison-Wesley
Pub
lishing Company, 1982; 80, 123.
5. Nakamura CT, Lau JM, Polk N, Popper JS. Vertebral artery dissection
caused by
chiropractic manipulation. J Vase Surg 1991; 14: 122-124.
6. Tatlow WIFT, Barnmer HG. Syndrome of vertebral artery compression.
Neurology
1940; 7: 331-340.
7. Rogers v Whittaker(1991) 23 NSW LR 600; [19921175 CLR 479. Q

25th August 2000, 16:24
So, if I understand this correctly, chiropractic spinal manipulation is a bad thing. :)

Thank you for this information.

Bob Steinkraus
25th August 2000, 16:33
Well, I would phrase it that chiropractic spinal manipulation has associated risks, and I am not aware that it has any offsetting benefits beyond placebo.

All medical procedures, as well as all drugs, have side effects in a certain number of cases. It is very important that the good outweigh the harm for procedures to be used or recommended.

My basic reason for the post was to counter arguments that say we should try chiropractic because it can't do any harm.

It can.

MarkF
25th August 2000, 18:28
You're right Bob. ALL medical porcedures have benefit against risk, and for every case of illness cause by a chiropratic, I could find at the very east, one thousand bad effects to allopathic medicine, some a serious of giving the wrong patient a transplanted liver who died, andwway to many people no walking becasue the amputed to wrong leg. In the long run, I would say information is not forthcoming, and this goes for chiropractic, osteopathic, and allopathic medicine.

You first example may look bad on the surface but in truth, this patient had nothing which would not happen to anyone whether the visited a chiropractic or not. Basically, this person had slight numbness and showd absolutely no signs of anything which isn'tobserved by a patient who awakes, twiste up like a pretzel, and has no reason, other than poor sleep habits for this mild, two sided very mild two sided numbness in hthe face, and on one sideofthe body. Nothing came of it and there is no proof in these case studies that it was caused by the manipulation. Bottom line; be informed. How many times hasan MD prescribed drugs with no counnseling as to the major side effects, or any sid effects at all? Too many.

In the second case study there is no evidence offered that proved to medical certainty that this happened because of the manipulation, that the ischemic and/or mini strokes and the blockage of blood flow the particular area had anything to do with chiropractic and the conclusions are base on "caveat emptor."

That said, I wouldnt go to a chiropractor in New Mexico on a bet, as most are so afraid of giving complete treatment becaue they do not want want to be sued. However, I may be inclined to go to a student of chiropractic doing an externship as this person would try to help in any way s/he could. And less expensive. And the worst thing is that here in New Mexico, ther is not a single chropractic who will take you unless you have been in some kind of accident. Why? $$$. There aome rea winners out there, but it still doeant mean they are not a help in relieveing symtoms, as it soesn't mean every MD is bad. There is an entire section in the yellow pages in which MDs and chritopractics have set up dual practices and often work together in office based practices.

Anyway, I have been up all night "practicing" sgtaying awake through eighteen hours straight through.

The answer would seem to be to be informed, and many times doctors of all stripes do NOT counsel their patients about their treatents. This goes for all of them, medical, osteopathic, chiropractic, homeopathic, and holistic healers. Everyone, no matter what, should ask or demand written instruction to any prodedure, and take your vitamins and stay away from doctors and especially the scrip pad, as doctors are visited by the detail person from any number of drug companies, someone who is not medically literite in telling a doctor what is proper medication for his patients, no matter what. Behind all this are the drug companies who resist any change in the status quo, and the continue to raise prices and have made record profits in the last two quarter, alone and in 1999 quintupled prices, not to mention all the animals they have killed in the name of science when computer have been shown to be much better equpped to handle the job.

I am not going to respond in this detail anymore because it is tiring, and besides, I do not disagree that there are quacks out there, just that they are there in any nmber of medical or non-medical practice.

BTW: I hope you can make out wha I wrote because I can't. Time for bed. Nite nite.

Mark

Onikudaki
11th November 2000, 22:09
I hope this isn't just one additional blow to that poor deceased mister ed, but i had to weigh in with my self important opinion.

Interesting points were made here about Chiropractics and spinal manipulation. I must first say that i am a Physical Therapist, and we as a profession have had a somewhat antagonistic relationship at times with Chiros. Having said that, i will say that I LIKE THEM. They are interesting people who challenge our views.

Like chiros and some osteopaths, i have been trained in, and often perform, spinal manipulations on my patients. I manipulate (adjust, correct, whatever) the lumbar (lower) and thoracic (middle) spines. Never the Cervial spine. Why? Because there is a demonstrated and serious risk inherent in this. Someone gave some interesting citations earlier that help point out why it is bad to go cranking on somebody's neck.

So let's discuss what the 'scientific method' has objectively proven in the way of spinal manipulation:
-There is no more effective treatment for acute lower back pain than manipulation. Not drugs, not rest, not stretching, nothing works better than manipulation.
-There is no evidence that supports the long term use of manipulation in treating chronic back pain.
-There is no evidence examining spinal manipulation for treatment of any other malady, including blindness, deafness, or just plain stupidity (tough luck for me).
When i say 'evidence' in my points, i mean Randomized Controlled Trials, the so-called "gold standard" for medical research.

Do manipulations/adjustments help in certain situations and for certain conditions? DEFINATELY. They work. Now on to the topic of subluxations/Xrays, etc.

Why do these manipulations work? NOBODY KNOWS.
Not the chiros(they do have an interesting theory), not the MDs, not me. Nobody. But for certain situations, namely acute spinal pain, manipulation is the treatment of choice. It is just a piece of the puzzle. And it's one that no one profession has been able to completely assemble. For those that are interested, i will provide a bibliography of articles in PEER-REVIEWED(scientifically valid) journals which contain the aforementioned evidence. I just don't want to bore those not interested. And believe me, reading those studies IS boring.

I respect anyone who dedicates their life to helping others, even if i don't understand all that's involved in what they do. That goes for Chiropractors, MDs, nurses, martial arts instructors, and the ice cream man. Especially if he has those dove bars. Man, i love those things.

MarkF
13th November 2000, 08:26
Hi, Jason,
I have to admit opening this thread up again may bring out the flames of the past, but I have a twenty-one year history of a bad back. I had surgery (Lumbar 4-5 laminectomy/partial discectomy), physical therapy forever, chiropractic/osteopathic manipulation, papain injections, bio-feedback, acupuncture, accupressure and shiatsu, kappojutsu/katsu, and an alphabet of medication and vitamins/holistic/homeopathic regimes (still on the vitamins, holistic meds/herbals (from family upbrining habits), and now I have three ruptured discs, and basically the only thing short of narcotics which actually relieves the pain is lots of calcium/magnesium and acupuncture.

That said, I have a phone book filled with the names of Physical Therapists, and not one has ever "manipulated" my spine, lumbosacral or anywhere else.

Massage loosening spasms which help take the pressure of the nerves has always helped, but I have never had a spinal manipulation from a PT.

Is this what you mean by manipulation? The above and Ultra-sonic heat therapy? I must admit you are the first PT who has stated h/she does manipulate the spine, but if you are that good, where are you located? Egypt, Shmegypt, I'm a Jew and I will cross the oceans to find true relief.

Oh, BTW: Do you do transcutaneous nerve stimulation (TNS)? I've got one of those in a box somewhere. It cost 1200.00 American, and works just great...when I turn it on. The problem is that these things can cause damage if you aren't careful, but we are speaking of true pain relief, so in it goes with all the bindings, traction supporters, belts, etc.

Oh yes, and at the UCLA Pain Control Center (the one which was formerly in Franz Hall basement, right next to the nuclear fission equipment, not the Pain Managemanent Department at the clinic) I was told that I was, well, special because with my background in MA, they couldn't understand why that couldn't control the pain. Swear to God.!

And I went to school there. Hmmmmm.:redhot:

Mark

Onikudaki
27th November 2000, 22:09
Hey, Mark.

First of all, sorry you are having such back pain! That really sucks, i have been there, truthfully not as long as you have, but i know some of the things you're going through.

Not every PT does spinal manipulation. Just as in medicine, there are different specializations, such as orthopaedics and sports (my area), acute hospital care, wound care, neuro rehab including stroke and spinal cord injury victims, and hand therapy. Those are just a couple, there are many more. My background and training is in manual therapy, and while i thank you for the 'if you're that good' comment, i must stick with my signature message below on this one, and be modest. I am a relatively young therapist and there are MANY, MANY more skilled manual therapists out there than I. I am a gaijin among the koryu grandmasters, so to speak.

Now that we've affirmed my lack of true ability to speak for ALL PTs or ALL manual therapists, i can keep going. Remember that in what research we have, it shows that manipulation ('cracking the back' so to speak -- i actually manipulate the same way chiros do) is not all that effective for CHRONIC back pain. Then again, massage has not been studied as far as i know, and ultrasound is a truly outdated modality for back pain. That would be a hard treatment to justify using available research data.

I do use a program called Lumbar Stabilization or Functional Lumbar Stabilization that has been found by research to be very effective in managing chronic back pain. It is a detailed and specific neuromuscular reconditioning program that does not involve manipulation. It teaches you new ways to control your abdominal and back muscles to protect your spine like nature's back belt. Being a skilled martial artist, you have the kind of body awareness and discipline to really benefit from this program. Open up your black book of PTs and ask about it. In the mean time, check out a good book on the "Pilates" exercise program. Get one with pictures and DETAILED explanations. The basics of spinal stabilization were used by Joseph Pilates in his theory of exercise. I am not a pilates guy myself, but i sure was impressed with how similar that stuff is to the programs i use to help my patients.

By the way, i am sorry to hear you had surgery on your back for a disc problem. In patients who have had discectomies (removed the bulging 'slipped' disc) for back (not leg) pain, studies show us that after 1 year they report no significantly different functional level than those who don't have the surgery. Food for thought.

Please let me know if there's anything else i can help with.

btw, i'm in egypt because the Army sent me there (signing a dotted line...), i am an active duty army soldier, too. Doing my time here, can't wait to see my wife when i get outta here, and speaking of back pain, she owes me some massages!

MarkF
28th November 2000, 23:52
Hi, Jason,
Thanks for your words of encouragement. You do get a sense of "dealing with it" after so long, but some therapies work, they just don't go all the way. I've gotten email on my post, so I think I spilled my guts here.

I wish I had PTs who knew, or if they knew, would do some kind of severe therapy, but when they work for medical groups, the patients are all "in house," some have a habit of not wanting to be sued, so one in particular, literally just passed his hand, barely touching me, in circular motions. When he wasn't in, the woman who came in, would give me that kind, but rough treatment I wanted. Damn she was good.

Manipulation works great, but usually for certain periods of time, and then I am back for another course of this treatment. Like acupuncture, I am never sure anything will work, but one thing that convinced me concerning all kinds of PTs, is that those who really work at it, even hurt you some, are the best. I've found, other than drugs, that relieveing migraine can be done by manipulation, but you have to be willing to hurt yourself some.

Well, as far as my surgery, I was going out of my mind, and what scared me more than anything wasn't only the pain in my legs down into my feet, but that sometimes, I had no feeling in one or both legs, especially after sitting for a ong while. I had an Lumbar 4-5 laminectomy, partial disectomy, the reason being for not removing the disc completely and not welding them together was simply that I was young and the doc thought that would probably work it self out if he took the pressure of the sciatic nerve. But I returned to work too early, which limited what I could do on the mat, but I got around that by changing my technique somewhat. At the time, after spending a lot of time in bio-feedback, acupuncture, massage/shiatsu/accupressure, TENS treatement, with no real lasting results, I finally took the plunge. BTW: you are right about surgery for bulging/even ruptured discs and conservative therapy. Relief has a high range and a low range, and if I hadn't had the surgery, I might have avoided the problems which have come up with time.

Anyway, thanks for the tip on the book. I will look it up and see what's what. Even bio-feed back paid dividends. I can now induce sleep by simply using what I learned to control the machines and do it without them. While I look like sh*t, my health is really good, and I can work out. I just had to develop certain habits to avoid the muscle spasms.

Oh, and Kent. Thanks for the follow up in email.;)

Mark

Joseph Svinth
29th November 2000, 09:02
Mark --

To induce sleep, I find speeches by presidential hopefuls work marvellously.

Bob Steinkraus
29th November 2000, 13:45
I tried counting sheep, but then I had to re-count them, and re-re-count them.

Then a bunch of voters in Florida said they couldn't tell the difference between sheep and elephants, so they counted the wrong species.

Then a bunch of people sued me because they said people who couldn't count weren't being represented by my count.

Then another bunch of lawyers sued me because there were 19,000 people who were counting goats really meant to count sheep instead, and it wasn't fair not to include their counts because every count should count.

And every time I fell asleep someone woke me up and told me to count sheep again.

Regards,
Bob Steinkraus

Ken Cooper
8th December 2000, 18:13
Ok, Going to keep this simple

1)Xray- Correct. It does not show subluxation(chiropractic definition). It is a tool to identify exactly how the bone misaligned so that it can be addressed appropriately. It also idnetifies any major contraindications to adjusting that area such as fusion, metastasis, bone cysts, etc. To Identify a subluxation, there must be a neuronal component which is demonstrated by leg length analysis, SEMG, Palpation, Muscle testing, IR readings on each side of the spine, etc. I am not going to explain each of these because there are volumes written on this and if you want the info, it is readily available from many sources on the web.

2) the thought on how can a back adjustment affect the optic nerve- If the atlas(C1) or occiput, depending on the DC's approach as to what subluxates on what in that area, misaligns, the rest of the skulls bones misalign and torque with it(albeit minimally). Yet more and more research shows that it takes minimal pressure to cause a change in the function of the nerve being interfered with. So, the Occiput misaligns causing the rest of the skelaetal bones to also misalign, thus causing the optic foramen to change shape and the soft tissure/connective tissue to also change shape. This change then places pressure on the optic nerve indirectly with soft tissue swelling and misplacement. Correct the misalignment of the Occiput, correct the misalignment of the optic foramen, removing pressure on the optic nerve and improving the function of said nerve therefore possibly improving eyesight. As far as how much, that is really up to the genectic structure of the individual patient. (BTW, 20/200 is not legally blind. I'm 20/200 in the left and 20/300 in the right. Still not legally blind.)

3) the danger of cervical adjustments is a long winded ongoing argument by Chiropractic detractors that has been overplayed. The chance of a person having a stroke from a chiropractic adjustment is considerably less than than a person who turns thier head and experiences the stroke spontaneously without any type of care or intervention. If you would like to argue this point, call Dr. Gentempo and Dr. Kent of Chiropractic Leadership Alliance out of New Jersey. I just listened to an hour long presentatation on the stats concerning the safety of the chiropractic adjustments. THE MOST IMPORTANT POINT IS THAT THE ADJUSTMENT MUST BE DONE PROPERLY!ESPECIALLY IN THE CERVICALS!I have seen many people (chiropractors, PTs, MTs, laypersons, martial artists) Putting WAY TOO MUCH ROTATION in the neck to adjust atlas(c1). That is why I am not an advocate of the weekend seminars to teach manipulation to anyone.
Also an interesting fact on the stats of the cervical adjustment dangers, we chiropractors are blamed for the problems, but did you know almost all of the negative effects from cervical spinal manipulation is from another source other than chiropractic? one study even reported one person responsible for adverse effets as "one kung fu teacher".

4) trivia- the founder of Chiropractic(DD Palmer) WAS a magnetic healer, but to clarify what that is , it does not involve using magnets. the thoughts behind what Dr. Palmer was doing was that the body was polarized and by putting one hand over the affected area and one under the affected area, one could direct "magnetic energy" through that area and heal it. Sortakinda like reiki.

5) Chiroparctic not any more effective than placebo? hehehehehehe. O.k. Well, I just wasted 10 years of my life. Now where's that number for truck driving school.....hehehehe......

Please do more reasearch. We are showing in preliminary studies(double blind!!!!!) that the t4 cells of patients diagnosed with AIDS recieving Chiropractic adjustments increased. This is an ongoing study at Life University, Marietta, GA. There are tons of both case studies, experiments, and double blinds supporting the efficacy of chiropractic. Read the JMPT and just begin.

Why am I not stating specific stats? because I do not want to get into another healing art bashing contest. this neither the time nor place for such.

My overall concept is that ALL healers must work together in sort of a triangle. All of the healers at the bottom, working towards the common good of the patient at the top.

>I am not going to respond in this detail anymore because >it is tiring, and besides, I do not disagree that there >are quacks out there, just that they are there in any >nmber of medical or non-medical practice.
I agree wholeheartedly.

Thanks for the time and understanding of my lengthy post. I'm just going to say that I am not going to get into a flame war with anyone, so I will clarify my posts if I am not clear, but I will not trade punches or get into a pi...ng contest. Thank you.


Kenneth Cooper

Bob Steinkraus
8th December 2000, 21:18
OK, why not?


Ok, Going to keep this simple

1)Xray- Correct. It does not show subluxation(chiropractic definition). It is a tool to identify exactly how the bone misaligned so that it can be addressed appropriately.

X-rays don't show subluxation. Subluxation is misalignment of the bones. If x-rays don't show bone misalignment, how can they be a tool to show how the bone misaligned? This makes no sense.


2) the thought on how can a back adjustment affect the optic nerve- If the atlas(C1) or occiput, depending on the DC's approach as to what subluxates on
what in that area, misaligns, the rest of the skulls bones misalign and torque with it(albeit minimally). Occiput refers to one of the plates of the skull. These plates fuse in adolescensce. The atlas is the first of the cervical (neck) vertebrae. If the atlas is pressing hard enough on the plates of the skull to move them, the head would be pushed forward, probably hard enough to break the neck. The jaw would also have to be pressed against the chest (permanently). Again, this is patently absurd.


2) Yet more and more research shows that it takes
minimal pressure to cause a change in the function of the nerve being interfered with. So, the Occiput misaligns causing the rest of the skelaetal bones
to also misalign, thus causing the optic foramen to change shape and the soft tissure/connective tissue to also change shape. This change then places
pressure on the optic nerve indirectly with soft tissue swelling and misplacement.

This is roughly equivalent to saying that finger pressure on the neck can cause blindness. The brain floats in the cerebro-spinal fluid. Pressure on the neck is not referred to the brain. It takes sudden acceleration, such as a blow to the jaw, to cause the brain to strike against the inside of the skull, to affect brain processing and function. The optical foramen is bone. How soft tissue pressing on a bone-lined ring such as the optical foramen can deform it is beyond me.

In case it matters, 20/200 corrected is legally blind, (or a field of vision of less than 20 degrees). I am 20/300 uncorrected, but 20/30 with my contacts.

As regards cervical adjustment, the point is not that it is done too forcefully, but that it is done at all. There is no corresponding clinical benefit to offset the increased risk of stroke and other damage. In other words, it can do no good and some harm.

"Magnetic healing" is like reiki, in its theory and practice. Also in the fact that it is totally without scientific foundation, and based entirely on the placebo effect.


5) Chiroparctic not any more effective than placebo? hehehehehehe. O.k. Well, I just wasted 10 years of my life. Now where's that number for truck
driving school.....hehehehe......
You are completely correct. Unfortunately.


Please do more reasearch. We are showing in preliminary studies(double blind!!!!!) that the t4 cells of patients diagnosed with AIDS recieving Chiropractic
adjustments increased. This is an ongoing study at Life University, Marietta, GA. There are tons of both case studies, experiments, and double blinds
supporting the efficacy of chiropractic. Read the JMPT and just begin.

I am way ahead of you. I have been researching this for years. And when the study you mention is published in a peer reviewed journal (if it ever is), it can be evaluated for merit. The overwhelming number of such studies find that chiropractic is worthless in treating infections of any sort.

Why am I not stating specific stats? because I do not want to get into another healing art bashing contest. this neither the time nor place for such.

An evidence-based argument is not the place for evidence? I can't think of a better one.


My overall concept is that ALL healers must work together. And mine is that I agree with you, but that chiropractors do not fall into the category of 'healers'. Involving those who do no good in the treatment of a patient is not to his common good. "First, do no harm" is a good principle. So is "Second, don't waste my time and money to no purpose".

MarkF
9th December 2000, 10:47
Inducing sleep. OOOOOOh, I read "reduce sleep." I suppose it depends on which side of the bed you're on.;)

Ken Cooper
9th December 2000, 15:01
>X-rays don't show subluxation. Subluxation is misalignment >of the bones. If x-rays don't show bone misalignment, how >can they be a tool to show how the bone misaligned? This >makes no sense.

Not when imposing the improper, simplistic definition of Subluxation.

Quoted from:

http://chiropracticresearch.org/NEWSsubluxation.htm

"Subluxations are really a combination of changes going on at the same time. These changes occur both in your spine and throughout your body. For this reason chiropractors often refer to vertebral subluxations as the "Vertebral Subluxation Complex", or "VSC" for short.

In the VSC, various things are happening inside your body simultaneously. These various changes, known as "components" are all part of the vertebral subluxation complex. Chiropractors commonly recognize five categories of components present in the VSC. These five are:

The osseous (bone) component is where the vertebrae are either out of position, not moving properly, or are undergoing physical changes such as degeneration. This component is sometimes known as kinesiopathology.

The Nerve Component is the malfunctioning of the nerve. Research has shown that only a small amount of pressure on spinal nerves can have a profound impact on the function of the nerves. This component is scientifically known as neuropathology.

The Muscle Component is also involved. Since the muscles help hold the vertebrae in place, and since nerves control the muscles themselves, muscles are an integral part of any VSC. In fact, muscles both effect, and are affected by the VSC. This component is known as myopathology.

The Soft Tissue Component is when you have misaligned vertebrae and pressure on nerves resulting in changes in the surrounding soft tissues. This means the tendons, ligaments, blood supply and other tissues undergo changes. These changes can occur at the point of the VSC or far away at some end point of the affected nerves. This component is also known as histopathology.

The Chemical Component is when all these components of the VSC are acting on your body, and therefore causing some degree of chemical changes. These chemical changes can be slight or massive depending of what parts of your body are affected by your subluxations. This component is often known as biochemical abnormalities."

>Occiput refers to one of the plates of the skull. These >plates fuse in adolescensce. The atlas is the first of the >cervical (neck) vertebrae. If the atlas is pressing hard >enough on the plates of the skull to move them, the head >would be pushed forward, probably hard enough to break the >neck. The jaw would also have to be pressed against the >chest (permanently). Again, this is patently absurd.

Not true. Look at not only information from Chiropractic, but DO's as well Cranosacral therapies are based on the concept of PARTIALLY moveable "plates" of the skull.


>This is roughly equivalent to saying that finger pressure >on the neck can cause blindness. The brain floats in the >cerebro-spinal fluid. Pressure on the neck is not referred >to the brain. It takes sudden acceleration, such as a blow >to the jaw, to cause the brain to strike against the >inside of the skull, to affect brain processing and >function. The optical foramen is bone. How soft tissue >pressing on a bone-lined ring such as the optical foramen >can deform it is beyond me

again, you are wrong. Look at the dentate ligament/cord distortion hypothesis at the orthospinology(chiropractic tech.) websites or go to http://www.life.edu and look at their research department. If you want to switch to CSF concepts, SOT(chiro tech.) and Craniosacral techniques(DO's) suggest that an aberrant flow of CSF through the ventricles of the brain and surrounding the brain can cause changes in the proper nutrition getting to all parts of the central nervous system therefore causing malfunction of that part of the "starved" brain.

>I am way ahead of you. I have been researching this for >years. And when the study you mention is published in a >peer reviewed journal (if it ever is), it can be evaluated >for merit. The overwhelming number of such studies find >that chiropractic is worthless in treating infections of >any sort

No, you are way behind me. Reasearch means to read and study BOTH sides of the information without bias and come to a fully informed conclusion. I am clear that nothing I will say and no amount of research I persent will change your mind and to be perfectly honest, I don't really want to. I just want to clarify for the others reading this post that there is alot of one sided arguing going on here and to encourage them to do their own research and make thier own decisions. This is the coolest part of America. Freedom.

For those that are interested in the preliminaries on the T4 cell/AIDS study, they are available at http://www.life.edu and go to thier research department or call the school directly and ask to speak to research. And, final note, Much of the new research out there is not from chiropractors, but from various entities studying the effects of the nervous system on the human body and what can cause aberration in that system. It has recently been identified that the nervous system directly innervates and controls the immune system, causing a new area of study in "Neuroimmunomodulation". I come from a back ground of allopathic medicine and know the effects. I made my choice. I am happy with it and truely love this PROFESSION.

"Above all else, do no harm"..........Do NOT start me on this one. Like I said I am not getting into a pi..ing contest, but look at the number of deaths from allopathic mistakes each year and make your own decision.

ENUF SAID.

Thank you everyone,
Always yours in Chiropractic,

Ken Cooper

Bob Steinkraus
11th December 2000, 17:35
Mr. Bergstrom posted:

I would love to get access to those studies

If and when they are published in a genuinely peer reviewed publication, you would not only have access to the studies, but to the input of others with wide experience in the field offering their views on the validity (or otherwise) of the study. Chiropractors are free to state what they like. They must, however, have proof of what they say, and that proof better stand up under inspection by people who are not already convinced.

And Mr. Cooper posted (in his attempt to define why subluxations do not appear on Xrays):

Chiropractors commonly recognize five
categories of components present in the VSC. These five are:

The osseous (bone) component is where the vertebrae are either out of position, not moving properly, or are
undergoing physical changes such as degeneration. And this osseous component does not show up on Xray, although the position and state of other bones do.


The Nerve Component is the malfunctioning of the nerve. Research has shown that only a small amount of
pressure on spinal nerves can have a profound impact on the function of the nerves. And the bones allegedly applying such pressure do not show up on Xray.

The Muscle Component is also involved. Since the muscles help hold the vertebrae in place, and since nerves
control the muscles themselves, muscles are an integral part of any VSC. In fact, muscles both effect, and are
affected by the VSC. And these alleged misalignments of the vertebrae produced by muscle malfunction do not show up on Xray.

Neither do either of the other alleged components of VSC.


Cranosacral therapies are based on the
concept of PARTIALLY moveable "plates" of the skull. And are equally nonsensical.

The only way to move the relative position of the fused plates of the skull is to fracture it. I hope you are not attempting this.

Mr. Cooper further quoted some chiropractic websites alleging (I think) that pressure on the vertebrae can create pressure on specific nerves. I couldn't quite follow the relevance, since the dentate ligaments have no role in vision, but I did notice that SOT apparently believes that cerebro-spinal fluid 'flows thru the ventricles of the brain'. It does not; it forms the bath of liquid in which the brain floats. Nor does it supply nutrition to the brain, which is carried by blood thru the circulatory system
The idea of brain damage caused by a lack of cerebro-spinal fluid 'flowing' thru the brain that can either be caused by misalignment of the spine or cured by adjusting the plates of the skull is, to say the least, problematic.

And, of course

No, you are way behind me. Reasearch means to read and study BOTH sides of the information without bias and
come to a fully informed conclusion.

No, I am still a bit further ahead. Research means not only to study, but to come to an informed conclusion as to which side has the better evidence. Chiropractic has no good evidence in its favor. This is its problem. If and when good evidence is presented, not only I but the whole scientific community will be only to glad to examine and to evaluate it. If we are wrong, I for one will change my mind. Such evidence, however, does not seem to be forthcoming.

I am clear that nothing I will say and no amount of research I persent will
change your mind and to be perfectly honest, I don't really want to.

You are mistaken. Anything you say and any research you may present will be evaluated for merit, based on the same rules that all other scientific research follows. If your research is invalid or your reasoning unsound, however, your contentions about what chiropractic can and cannot do will have to be taken with a grain of salt.

Ken Cooper
12th December 2000, 17:47
Mr. Steinkraus,

Now I understand.

I did a search to see where you would turn up elsewhere, and I found your name associated with the "health care reality check", obviously an overt bashing and flaming campagin based on one sided and misguided information in the area of Chiropractic. Took a little time to read some, especially the recommendations from the DC on how to choose a DC. Wow, Talk about unfounded.

It really cleared up where you are coming from, thank you.

Mr. Bergstrom, I agreed to keep it civil on this list when I signed up and will continue to do so. Thank you for your support and thank everyone else for thier patience in this. I hope I at least shed some credible light on this subject for all of the others on this list. I am willing to answer questions by email or in another thread if someone is really trying to learn and is sincere in thier requests for info. But, I will no longer encourage tail-chasing. Again, I encurage everyone to do thier own research (and this applies to EVERYTHING) and do not run into anyting blind or just on the recommendations of another. Those recommendations should just point you in a direction to explore on your own and come to a well-educated and informed decision. Be it health care, The proper Sensei, or the best flavor of ice cream.

Thanks again, I'm done with this thread.

BUFU IKKAN!!!!!
Ken Cooper

Bob Steinkraus
12th December 2000, 18:34
Mr. Cooper -

If my view of chiropractic seems one-sided, this is because that is the way that the evidence stacks up. I am not dismissing evidence contrary to my position; there just isn't any good evidence for chiropractic.

If you have evidence to back up any of the claims you have made, or any clarification of the flaws in your logic, please cite them. So far all I have found is a reference to an unpublished, un-peer reviewed study that you allege shows that chiropractic helps change the course of AIDS infection. If this were true, it would be an extraordinary advance in the treatment of this incurable disease. Extraordinary claims, however, require extraordinary evidence, which does not seem to be forthcoming.

I am sorry that requests for evidence strike you as 'tail-chasing' or bashing or rudeness. If these requests offend you, you can deal with them in a couple of ways. You can produce evidence or clarify your logic - or you can abandon the thread, just another quack who couldn't back up what he claimed.

I repeat, chiropractic based on the theory of subluxation is quackery, on the same level as homeopathy and astrology, and with no more evidence to back it up than voodoo. I welcome discussion of claims to the contrary, but you'd best be ready to back up what you say, and I am not prepared to take your word for it.

Next?

Hank Irwin
17th December 2000, 06:06
Back in the 70's I worked as a roughneck in the G. of Mex and while sitting on top of a workover stand trying to remove the flange with a 32" stiltson wrench, it slipped, I fell about 20', hit the edge of the barge on my back, right above my waist. Fell about 4' to the water between the landing and where the barge slipt up to it. This was in Janurary( at the time I was out of Cameron Bay,Corpus Cristi,Tx.)in about a 100' of water. Needless to say, after they fished me out, took me to medi-Vac for countless pokes and pictures, they sent me home, paralyzed from the waist down. The prognosis: 21/2 crushed discs, 3 cracked vertibrae; spinal trauma to say the least. They wanted to cut me open, take 3 disc out, weld the vertibra together, along with laying a steel rod next to the repair. Also said I would be 40% dissabled and never run again, have a limp and need a cane to walk too. I was stupified to say the least. I thought at that point I would be a wet noodle the rest of my life. The only inspiration I had was Ted Volrath, a parapalegic Karate-Ka. He was a great inspiration, but my faith at that time was weak. I was in bed 24/7. My mother, I kid you not, called a lady, Kyoshi Chiro(that's what I call her)Mary Norman. My Mom had taken a fall as a waitress and called on this lady to help her. She was so impressed with her she asked her to take a look at me. I am where I am today because of this help and the chiropractic/homeopathic skills of this woman. I am not dissabled in any way. Can still kick the header of a door jam at 45. Will run a lot of 18 yr. olds in the ground in the Dojo too. Every now and then my back flares up a little, I go straight to my Chiropractor Sensei. Find a good one. And not one of those one's from the "Chiro schools" that are spit out like donuts.

Hank Irwin
17th December 2000, 06:39
Originally posted by Bob Steinkraus
Mr. Cooper -

If my view of chiropractic seems one-sided, this is because that is the way that the evidence stacks up. I am not dismissing evidence contrary to my position; there just isn't any good evidence for chiropractic.

If you have evidence to back up any of the claims you have made, or any clarification of the flaws in your logic, please cite them. So far all I have found is a reference to an unpublished, un-peer reviewed study that you allege shows that chiropractic helps change the course of AIDS infection. If this were true, it would be an extraordinary advance in the treatment of this incurable disease. Extraordinary claims, however, require extraordinary evidence, which does not seem to be forthcoming.

I am sorry that requests for evidence strike you as 'tail-chasing' or bashing or rudeness. If these requests offend you, you can deal with them in a couple of ways. You can produce evidence or clarify your logic - or you can abandon the thread, just another quack who couldn't back up what he claimed.

I repeat, chiropractic based on the theory of subluxation is quackery, on the same level as homeopathy and astrology, and with no more evidence to back it up than voodoo. I welcome discussion of claims to the contrary, but you'd best be ready to back up what you say, and I am not prepared to take your word for it.

Next?


You don't believe in Gri Gri Cher? Western medicine; Hipocratic Vows, Laws, PROFIT. If we can't make a buck on it or tax it, it ain't flying. I have been using Zing Gui Shui Tincture for years. It will pull broken bones back together, fact. Yuinan Paiyo, works,...for many an ailment. Prescriptions from doctors of such ailments will cost you 100's if not $1000's to get you fixed. I have to get Zing Gui from Canada now as a result in the F.D.A. not being able to "regulate" it. What is this crap? Stop and think of all the money that is being made on drug manufacturing in the US for US medicine. Gazillions!Some of these drugs are not even complete in thorough examanation of side effects.We worry about drugs wars in the streets! Man, there's drug wars in the Doctors offices. And the good old addage of you have to put up with some discomfort in the process is not going to get it. WAKE UP WORLD! This is from someone who had open heart surgey at Touro Infirmary in '65. Not one, I repeat ONE doctor, was from the US, except Dr.Glass, and he was there as an observer. Thank God!! Some of you Doctors aren't worth the power to blow you to...well you know what I mean. These words may seem harsh, this I know. For those of you that this message does not apply to, will sympatize. Look alive!

Hank Irwin
17th December 2000, 15:49
Originally posted by W.Kent Bergstrom
Thanks much Hank,
I'm working on waking up every day. ;)
If you want to learn how to make Zheng Gu Shui from scratch instead of ordering it e-mail me private.Some of the stuff out there is coming in from China without all the ingredients.
Kent Oh thank you so much! Will be in touch later,ok? The wife's got a "honey do" list a mile long for me to take care of today, and I still have gifts to finish making and packing as of yet. This is always a crazy time for me. I'll get a break later this evening.

Bob Steinkraus
18th December 2000, 15:52
Mr. Irwin -

Some minor quibbles....

- Ted Vollrath is not a paraplegic; he is a double amputee. Chiropractic is not going to help him either.
- I have never heard of 'Gri Gri Cher'. What is it, and what is its relevance?
- You stated
I have been using Zing Gui Shui Tincture for years. It will pull broken bones back
together, fact. How long have you had broken bones, and why has Zing Gui not pulled them together? And could you briefly describe how the Zing Gui can exert this force? A quick search of the Web found no references to Zing Gui Shui. Has it ever been tested? How exactly do we know that it will heal fractures?
- I hope you don't think that those who sell un-approved herbs are doing so for free.
- You also quote:
Some of these drugs are not even complete in thorough
examanation of side effects Neither are the herbals, which is another of their problems. Another is the case wherein they were tested and found to be worthless.

Congratulations on your recovery from your accident. The plural of 'anecdote', however, is not 'data', and 'post hoc' is not always 'ergo propter hoc'.

Hank Irwin
18th December 2000, 18:11
Originally posted by Bob Steinkraus
Mr. Irwin -

Some minor quibbles....

- Ted Vollrath is not a paraplegic; he is a double amputee. Chiropractic is not going to help him either.
- I have never heard of 'Gri Gri Cher'. What is it, and what is its relevance?
- You stated
I have been using Zing Gui Shui Tincture for years. It will pull broken bones back
together, fact. How long have you had broken bones, and why has Zing Gui not pulled them together? And could you briefly describe how the Zing Gui can exert this force? A quick search of the Web found no references to Zing Gui Shui. Has it ever been tested? How exactly do we know that it will heal fractures?
- I hope you don't think that those who sell un-approved herbs are doing so for free.
- You also quote:
Some of these drugs are not even complete in thorough
examanation of side effects Neither are the herbals, which is another of their problems. Another is the case wherein they were tested and found to be worthless.

Congratulations on your recovery from your accident. The plural of 'anecdote', however, is not 'data', and 'post hoc' is not always 'ergo propter hoc'.
Gri Gri is voodoo, Cher; friend in french. Sorry bought the paraplegic thing, I know he had his legs amputated from an accident, the biggest thing I meant to say about him is that he was PURE inspiration. As far as bones go, I have broken many. ALL of which have healed so far, some broke more than once. Herb remedies have been around a LOT longer than prescriptions remedies but that's nothing unusual. My personal experiences with Red Flower(Zhing Gui Shui) have been very good. I know countless others that are of the same opinion. Awhile back I had an injury due to a blow to my sternum, seeing how it was already cut clean through from open heart surgery may play a part in the fack that it cracked at the bottom, up about an inch. An inch in thinking terms does not seem like much, but, when it is at the bottom of the sternum it is extremelly painful. Like having broken ribs, but worse. Hurts to breathe, sit and move. I used Zhing Gui Shui for healing. It works. This "crack" has been monitored since it happened(x-rays) and shows the cracks pulling together. I have no idea how this stuff works, all I know is that it does. I have a special healing/training Jow that is very good also, but you have to bury it for a year before you can use it. We are so oblivious to natural healing remedies because of the "hogwash" that has been spooned down our throats by American Physicians over the years. "Chinese" medicine is being embraced with a fervor now like never experienced before. These have been MY experiences, they will differ with others. As far as un-approved, how many drugs have already produced disastrous effects amid their infancy? Many,I say. Time, patience, and thorough experimentation is a constant for Western medicine. The same applies to Eastern medicine also. But the Far East has about a 3000 year jump on us. I'll stick with the old timers for now. As far as "worthless" in testing. I don't believe half of what "modern"( and they are mostly in the US)doctors are telling us is true. But that is just my opinion. But opinions are just like a**h***s,....well you know, everybody has one.

Eric McKillican
24th December 2000, 18:23
Ok, so I swore I would not respond to any more of these posts, I found my input to be judged by predetermined opinions and it made no sense to waist my time. I have however been keeping tabs on what has been said here. The only reason for my input now is to provide you with some facts. Understand that chiropractic is not void of its research, in fact their are vast amounts, both medical and chiropractic, supporting chiropractic. The only reason you have not been presented with these fact in the past is it takes time and energy to locate, read and interpret to you. I like most others here have a life outside this forum, up until now I have not wanted to sacrifice my personal energy to present these facts to a small vocal group who will discredit them before they even read them.

So hear are some studies and reviews on the risk of stroke, with cervical manipulation. As I have said before their is a big difference between manipulation and adjustment. But we will review the information we have.

Myler L: Letter to the editor. JMPT 1996; 19:357 : in which he reviews information from the National center for health statistics; The risk to stroke by random chance alone was .00057%

Dabbs V, Lauretti WJ: A risk assessment of cervical manipulation Vs. NSAIDS for treatment of neck pain. JMPT 1995; 18:530 : the risk of stroke following a cervical manipulation was .00025%. So one is almost twice as likely to have a stroke doing nothing then they would be having a cervical manipulation.

Leboeuf- Yde C, Rasmussen LR, Klougart N: The risk of over reporting spinal manipulative therapy induced injuries: a description of some cases that failed to burden the statistics. JMPT 1996; 19:536 : This paper finds that the cause of stroke was was attributed to spinal manipulation but the patient never went to a chiropractor. At most,they only thought about going.

Terrett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. JMPT 1995; 18:203 : This paper found that the authors placing the incidence of stroke on chiropractic, were using the term CHIROPRACTIC MANIPULATION as a generic term and was given to such providers as medical doctors, orthopedist, physical therapist. They found that slightly less then half reported were not chiropractors in any fashion.

Terrett AGJ: Vertebral stroke following a manipulation. NCMIC, Des Moines, 1996. page 32. : This paper found that the incidence of stroke following a manipulation, found that the manipulation was performed by non chiropractors. The list of persons included; medical doctors, osteopath, massage therapist, physical therapist, house wife, kung fu practitioner, indian barber ect. ect.

Dye M: Silent danger of medical malpractice. Third leading cause of preventable death in the U.S. Public Citizen. May/ June 1994.

Those are just a few of the many studies and reports on the risk of stroke and spinal manipulation. And according to Dr. Kent a chiropractic researcher and one who reviews all of the medical literature “their is no compelling evidence that manipulation causes stroke”. He says “to consider a manipulation the cause of a stroke is conjecture at best”. First of all a stroke following a manipulation is an extremely rare event and to say that the two are linked is a ridiculous as saying that dentists cause car accidents, because a few people got into car accidents following their dentist appointment.

Rotation of the cervical spine seems to be the contributing factor to the stroke, however several factors have to be taken into account before we can say stroke is caused by a chiropractic adjustment. Manual chiropractic adjustments are designed to eliminate any rotation, those trying to reproduce chiropractic tend to use only rotation. Then you have to consider all of the other chiropractic techniques that do not use any spinal rotation or a spinal joint to go to tension, nor do you hear the proverbial “popping” sound. With millions of chiropractic adjustments every year and an incidence of stroke following a manipulation at .00025% (not all by chiropractors), compare that with your risk of death in the hands of the medical profession (third leading cause of preventable death), I would certainly feel safer with chiropractic. Thank god I have that choice.

Chiropractic techniques use gentle methods of adjusting, using specific lines of correction. Chiropractic is safe and effective, chiropractors are required to attend four years of graduate school, pass numerous state and national boards, attain re-licenser education hours every year, are licensed in all 50 +1 states, have several major companies battling over the right to provide malpractice insurance, included in state and national health care programs. Do you honestly think that if chiropractic was such a risk factor to the population that we would have attained so much in such a medically dominated society??? I think not.

I will go now because I am tired of trying to change your opinion, I know that is hopeless. I have however shown you that you are not justified in your crusade against chiropractors. I will not be responding to any more of these opinionated unsubstantiated posts.

Chiropracticly yours

Eric McKillican D.C.

Bob Steinkraus
26th December 2000, 13:39
Mr. McKillican -

I repeat -

The only bias I have is one in favor of the evidence. If you (or anyone else) can present serious evidence in favor of some clinical benefit produced by chiropractic manipulation to offset the dangers it presents (and its cost), chiropractic can be added to the list of scientifically tested medical treatments.

As regards your cites -

[list]
None of the citations gives any evidence of clinical benefit for manipulation. Therefore any non-zero risk is too much, as patients are exposed to risk for no benefit. Check this out from Harvard http://neuro-www.mgh.harvard.edu/forum_2/StrokeF/8.3.999.42PMChiropracticN.html

Check http://webmd.lycos.com/content/article/1728.57752 for some an article with statistics collected by non-chiropractors. Note especially that the techniques Mr. McKillican denies are used by chiropractors are in fact used.

A quote from the University of California- San Francisco - "all
patients with neck pain who undergo cervical manipulation are at risk for stroke." Details are here http://itsa.ucsf.edu/~stroke/colm/colm96-2/colm96-2.html

Bob Steinkraus
26th December 2000, 13:46
To follow up -

I had a look at the study that Mr. McKillican cited that seemed to indicate that chiropractic reduced the risk of strokes.

The following is from a pro-chiropractic website making the same citation:



The
study was never published, and when questioned Dr. Gregory Albers, one of the researchers, said, "It was a small survey and it wasn't anything to make a big fuss over."

Note for the record that the study in question was never published (and therefore never peer reviewed) and even one of the authors admitted the sample size was too small to draw conclusions from.

The citation is here http://www.wowcoach.com/Articles/does_chiropractic_prevent_stroke.htm

Bob Steinkraus
26th December 2000, 13:59
Sorry for the multiple replies. I am posting from home, and my home PC is set up differently from the one I usually use.

Mr. McKillican also posted a citation listing medical malpractice as a leading cause of death, and suggesting that chiropractic was better than evidence-based medicine in that it did not suffer from the same level of malpractice.

Medical malpractice (from scientifically trained doctors and other health care providers) is certainly a serious problem. However, I am sure the reader will be able to think of benefits that scientific medicine has produced to offset this risk. I would ask Mr. McKillican, and the chiropractic community, to cite the scientifically proven benefits produced by chiropractic, to offset the dangers that it presents. Until he can produce such evidence, and show that it has been reviewed by other than those already convinced, I will continue to follow the evidence.

And for those who claim that chiropractic does not suffer from malpractice, check this out. http://www.medicalpost.com/mdlink/english/members/medpost/data/3603/16A.HTM

I repeat - chiropractors who base their practice on their belief in subluxations of the spine, and who attempt to eliminate these subluxations thru manipulation, are quacks who are doing more harm than good. I base this opinion on the evidence. My mind is not made up in advance against chiropractic. Neither am I already a true believer. You gotta show me, and you ain't shown me yet.

Caveat emptor.

Dr. Chad
27th December 2000, 16:04
WOW!!!



BOB!!

I keep reading your posts this keeps getting more hilarious every time.



First "Mr." McKillican does have D.C. after his signature and I subscribe to the idea that you should give people the respect they deserve and McKillican does deserve to be addressed as "Dr." since he has earned that title.



Next...You keep saying you only base your opinion on evidence that comes from studies published in peer reviewed journals and none of the pro-chiropractic presented in this thread qualify. Well Mr. Steinkraus, I've looked at the literature that you presented and based your opinion on (I presume, since you cited it as evidence) and none of it is in peer reviewed journals! Also the studies that were used in the reviews that you cited are very flawed.



The one paper that you cited as proof that anyone having a cervical adjustment performed was at risk for stroke was in my opinion the most ridculous example of "PROOF" of anything presented in this thread so far. This was a "CASE OF THE MONTH", that even said that the adjustments could not be blamed as the cause of the patients symptoms. Also, the literature cited in this case study (Dr. Lee's article) was nothing more than a show of hands at a Califonia convention of neurologists who were asked how many have observed a complication in a patient over the last two years after receiving a so called chiropractic manipulation. The problem is that there was no criterea for what happened at the chiropractors office or even any evidence of what was observed. In this it was even accepted that the onset of symptoms could have been several weeks after the visit to the chiropractor!!!...I don't think you can correlate the adjustments with the onset of stoke symptoms several weeks after the procedure.



Anyway...I pulled up a couple of studies showing the benefits of chiropractic adjustments in peer reviewed journals, but I'm sure in you're mind they will be flawed and of no use to you.



Gorman RF: "Mononucular vision loss after closed head trauma: immediate resolution associated with spinal manipulations" Journal of Manip. Therapy 1993; 16:138



Giesen J, Center D, Leach R: "An evaluation of chiropractic manipulation as a treatment of hyperactivity in children." Journal on Manip. Therapy 1989; 12:353



Just a couple that are at least as respectible as those presented as proof that chiropractic doesn't give any benifit.



I do feel sorry for Mr. Steinkraus for he and his will probably never experience the life giving experience of a chiropractic adjustment. BUT, I am more worried about anybody else that may read his posts and be steered away from a healing art that has helped millions in so many ways. I applaud Dr. McKillican, Cooper and all the others that have endured the criticism and disrespect in order to try to uphold the truth about chiropractic.



Just my two cents,

Bob Steinkraus
27th December 2000, 21:22
Sir -

I cannot locate anything called "The Journal of Manipulative Therapy" with a Web search. Is it available online?

I cannot comment on the studies you cite unless I can see them.

If you put the web address (cut and paste should work) into your posts, and checkmark the 'Automatically parse URLs' option, you can create a hyperlink which readers can click on and access the website themselves.


TIA.

Dr. Chad
27th December 2000, 22:37
Sorry Bob,



I the journal is "Journal of Manipulation and Physiological Therapeutics"

I find it interesting that you made no comment on the validity of the papers you cited as the proof for the views you have about chiropractic.



I was very curious as to what you would say about the lack of evidence present in the papers you cited as PROOF that chiropractic adjustments are dangerous.



But...As I expected you had no comment. I'm sorry about the misprint of the title but am still interested in your comments on your proof (THE ARTICALS YOU CITED).

Bob Steinkraus
28th December 2000, 13:12
The good doctor begins the thread as follows:

Every time a chiropractor states that his or her patients are responding
to adjustments and experiencing a higher level of health and well-being, the medical world dismisses it as
anecdotal and "mumbo jumbo" and want to see double blind controlled studies. Individual chiropractors do not
have the funding to fund such studies and no giant drug companies to provide the money.
And

I don't need to read it in a peer reviewed journal that what I did is TRUE
And

I
have not seen this evidence that it (chiropractic medicine) is dangerous but would be interested in it and by what means it was attained.

And
In most of these cases it's the "anecdotal" evidence that gets bad medicine off the shelves and
get erroneous procedures stopped.

Now he insists on double blind studies, and dismisses my cites as anecdotal. In pursuit of this, he cites two studies.


Gorman RF: "Mononucular vision loss after closed head trauma: immediate resolution associated with spinal
manipulations" Journal of Manip. Therapy 1993; 16:138

I was able to locate this article, although my date of publication does not match yours.

Sample size: One patient.
Control group: No
Double blinded: No
See my previous posts on the problems associated with trying to affect cranial nerve function by manipulating the neck.

He also cites:

Giesen J, Center D, Leach R: "An evaluation of chiropractic manipulation as a treatment of hyperactivity in
children." Journal on Manip. Therapy 1989; 12:353

Sample size: Seven children.
Control group: No.
Double blinded: No.
Comment from the published article:
The results of this study, then, are
not conclusive

Contrast this, if you like, to the following published in the 'New England Journal of Medicine', Oct 1998, regarding the use of chiropractic in the treatment of childhood asthma.
Sample size: 91 children.
Control group: Yes.
Double blinded: Yes.
Conclusion of the authors:
In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.

Or check out the following (conducted by chiropractors)

Aker PD, Martel J. Maintenance Care. Topics in Clinical Chiropractic 3(4):32-35, 1996. [Two Canadian chiropractors
who conducted an extensive literature search found no scientific evidence supporting the widely held chiropractic belief
that periodic spinal adjustments improve health status.]
Or this

Koes BW and others. Spinal manipulation for low back pain: An updated systematic review of randomized clinical trials.
Spine 21:2860-2873, 1996.

The efficacy of spinal manipulation for patients with acute or chronic low back
pain has not been demonstrated with sound randomized clinical trials.

How about

Bove G, Nilsson N. Spinal manipulation in the treatment of episodic tension-type headache: A randomized controlled
trial. JAMA 280:1576-1579, 1998.

Their conclusion:
As an isolated intervention, spinal manipulation does not seem to have a
positive effect on episodic tension-type headache.

There's plenty more where that came from.

Have a great day!

Eric McKillican
28th December 2000, 19:45
Bob,

First let me say you need to read the posts more carfully before you make comments. I was posting information about the risk of stroke to chiropractic adjustment, not the benafits of chiropractic.
There were several errors in your resopnce to my post on the risk of stroke.

I sighted medical malpractice as the third leading cause of preventable death, NOT the leading cause of death. See referance on page 5 of this thread.

You say that I sighted studies that were not published nor peer-reviewed. Yet you so conviently left out which study you were refering to. Hmm I wonder why? Could it be that they ALL were well refrenced in well established journals.

I too reviewed your evidance based studies which you support your opinion and found Dr. Steskal review to be accurate. A show of hands in a nourology conferance is not science. It is junk .

Since you wont take my presenting information on the risk of stroke, why don't you take the World Chiropractic Alliance position on this matter. In a very well documented paper they look at all the studies, Pro and con.

http://www.worldchiropracticalliance.org/Positions/stroke.htm

This have been over the RISK OF STROKE by CHIROPRACTIC ADJUSTMENT. Not the benafits of chiropractic. Your posts lack any quality rebutal, I only see you avoiding the issues presented to you and creating new issues that you think you can argue.

Well, as far as your concern for the chiropractic profession and it's lack of evadance to support the benafits of its use. You couldn't be more wrong. The Journal of Vertebral Subluxation Research (JVSR) is a highly respectable peer reviewed journal that does just what you claim is not being done. Check it out. I too feel sorry for you, You really have no idea what chiropractic is. I do hope you will discover it some day. But to do so you may have to open your eyes a little.

Chiropracticly Yours

Eric McKillican D.C.

Eric McKillican
29th December 2000, 04:25
Bob,

I took a closer look at your posted link to a pro-chiropractic sight that you said was never published and that I sighted. Well first of all this sight was not sighted by me but is in fact being used as a referance in one of your other links. If you read it carefully you sill see it supports my claim that the evadance used againsed chiropractors is junk. I wonder why you only chose to select parts of this article to make your point. Hmmm?

quote:
The American Hospital Association (AHA), in 1994, publicly announced a survey of 486 California neurologists. The doctors were to report on the number of patients suffering from a stroke that they had treated within 24 hours of cervical manipulation. The resulting information was snatched up by the newspapers and soon the headlines read, "Stroke can be triggered by Twist of Neck, Study Claims." The truth was not reported, it is as follows: Only 177 of the 486 neurologists responded to the survey, of those only 37 claimed they had seen cases in which there might be a connection between cervical manipulation and the onset of stroke. The study was never published, and when questioned Dr. Gregory Albers, one of the researchers, said, "It was a small survey and it wasn't anything to make a big fuss over.


Eric McKillican D.C.

Dr. Chad
29th December 2000, 15:15
Just checked the thread...funny funny funny.



Bob, I never said that I was concerned with peer reviewed double blind controlled anything pertaining to the benefits of chiropractic. I saw that proof long before I became one and see it everyday in my practice. I like Cooper thank you for letting me know that I've wasted all the time and energy in the pursuit of a career that is of no benifit. I'm sure that my patients will be happy when they learn this too.



The fact is that I take the time to tell my patients that they should check the literature out themselves. I have been telling them to check this thread out for themselves to see the kind of STUFF that is out there. They've been checking the referances that all of us put in here and acually they are more excited about chiropractic and their care in my office than ever before...THAT IS AWESOME!!!



As I said...my patients and I don't need proof that chiropractic works we live the proof everyday. YOU Sir, were the one screaming for peer review, controlled, double blind STUFF, well it's out there and for both sides. You do seem very proficient at literature searches and find it very hard to believe that it the only pro-chiropractic you can come across are the things pointed out to you in this thread.



I am only concerned with your comments on the "DANGERS" of chiropractic!! This is one thing that I as a chiropractor am very proud of. I know that it is very safe...Your chance of stroke is higher in the nonchiropractic public than in percentage of the public that gets adjusted!! I don't see alot of RISK there. Sounds to me like if you get adjusted your chance of stroke is lower...WOW!! YOU Sir, still haven't responded to the fact that your proof for the danger is bogus...I would still like to hear from you on this subject since frankly, that's the only part of what you say that I am concerned with. I think you commented on everything else but that. I waiting for you to start correting gramaticalll errors next!



Great spirits have always encountered violent opposition from mediocre minds........ALBERT EINSTEIN

Bob Steinkraus
29th December 2000, 19:02
Thanks to both of you for your responses.

The purpose of my last posts was to contrast the quality of the research finding no benefit to chiropractic to that purporting to show a benefit. The trend of the data is that the better designed and executed the study, the more likely it is to demonstrate that chiropractic is without merit.

The estimable Dr. Steskal mentions that he wants me to cite good, double blinded evidence. Upon being presented with such evidence, he reverts to his previous position that the evidence does not matter, and that chiropractic works because he says so. Well and good. None so blind as those who will not see, and, as he admits himself, if chiropractic is proven to be bogus, he is out of a job.

He also mentions
I waiting for you to start correting gramaticalll errors next! Sorry, no, haven't got that kind of time. I prefer to allow readers to judge for themselves the quality of research presented by those who cannot even spell the names of the journals in which they believe.

He finishes with an interesting quote:
Great spirits have always encountered violent opposition from mediocre minds........ALBERT EINSTEIN Let me respond with another:
They laughed at Einstein. They laughed at Newton. Of course, they also laughed at Bozo the Clown. - Carl Sagan

Astonishingly enough, however, we seem to have stumbled across an area of agreement. Dr. Steskal claims that he encourages his patients to review the literature before submitting to his ministrations. A worthy thought, and a recommendation I would make as well.

As I reread this very long thread, I realize that it is reduced to just the three of us arguing with each other. Neither of the two of you have presented much by way of hard evidence, and I can't see that you are waiting eagerly for my pearls of wisdom, so I think I will end my participation in this particular thread by addressing not you two, but anyone else who may be reading.

If you carry anything away from this discussion, please let it be this.

Don't take my word for it. Don't take anyone's word for anything.

The truth is out there. The wonder of the Internet is that with the click of a mouse button, you have access to information about which Galileo and Newton and Pasteur never dreamed. You can look up the studies for yourself, and judge (with a little thought) whether they are valid or bogus. I recommend Medline, an excellent free service to search a wide variety of medical databases, as a good starting point to collect data from scientific medical publications. (NB - the reason I could not locate the cites from the 'Journal of Manipulation and Physiological Therapeutics' at first is that Medline does not consider it one of the 237 best journals published in English. You can access it if you do not check the box for this option when searching. Keep in mind that this is a journal published by and for chiropractors, and its rules of review reflect this, and draw your own conclusions.)

The beauty of the scientific method is that it is self-correcting. People used to believe in leeches and bleeding their patients. Now it is homeopathy and subluxations. The ideas that will survive into the twenty-first century are not the comfortable ones, or the familiar ones, but the ones that have been tested and found to be true. The others? They were worth considering. But after they are disproven, they are good for nothing but the scrap heap.

That having been said, my participation in this thread is done. I leave it to my spine-cracking friends to have the last word, should they feel the need.

Happy New Year to all.

Daniel M. Page, D.C.
14th February 2001, 21:01
I found it interesting that no one commented on the role of chiropractic treatment with regard to the conservative management of neuromusculoskeletal conditions. I wouldn't expect joint manipulation to have an impact on eyesight or hearing. However, these conditions aren't my specialty. DC's are NMS conservative care professionals. I feel we are important (as are physical therapists), because we provide patients with functional assessment and treatment of the NMS system. The conditions we should focus on are syndromes that are NMS in nature (ie lateral epicondylitis, carpal tunnel syndrome, low back pain, cervicogenic headache, etc, etc). Many of these conditions can be managed concurrently with MD's, DO's, PT's, OT's and other providers. Obviously, DC's must remain cautious about overstepping their bounds and stating they have an impact on non-NMS conditions until there is documentation in the literature, or they risk a loss of credibility with patients and other health care professionals. Another thing I wanted to add is that DC's don't exclusively use manipulation as a treatment. In my practice, I utilize stretching/strengthening, deep tissue massage, electric muscle stimulation, ultrasound, and hot/cold therapy. Other providers also use these modalities to improve NMS function. As a result of continuing cooperation between MD's and DC's, medical facilities are beginning to bring DC's on staff (commonly labelled "complementary care"). Despite what you are aware of in the research, studies continue to surface that demponstrate the effectiveness of spinal manipulative therapy (SMT) for acute low back pain.

I agree that chiropractic overutilization exists. I think the reason for this is 1)dogmatic philosophical views that more SMT = "better for your body" and 2)most DC's are sole practitioners and more visits = higher income. I feel that while passive care should be utilized in the short term, active rehabilitation must eventually fall on the shoulders of the patient. Stretching and excercises at home have a tremendous impact on many NMS conditions.

Thank you for your opinions and excellent debate. I hope you will respond to my viewpoint.

Sincerely,
Daniel M. Page, DC
Barrow, Alaska

Daniel M. Page, D.C.
14th February 2001, 23:35
Bob,

I really like http://www.ncbi.nlm.nih.gov, which is the National Library of Medicine's website. I noticed you listed a few references about manipulation in a recent post.

While doing further investigation, I found that you may be misinformed on the study regarding tension headache. Here is a more recent article from the same authors:
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Ugeskr Laeger 2000 Jan 10;162(2):174-7 Related Articles, Books, LinkOut

Therapeutic manipulation of episodic tension type headache. A randomized, controlled clinical trial.

Grunnet-Nilsson N, Bove G

Institut for Idraet og Biomekanik, Syddansk Universitet, Odense. n.nilsson@imbmed.ou.dk

In a randomized controlled clinical trial, 75 subjects fulfilling the IHS criteria for episodic tension-type headache were treated for four weeks. One group received spinal manipulation plus soft tissue therapy in the neck, the other received soft tissue therapy plus low-power laser therapy to the same region. In the three month follow-up period both groups showed significant improvement, but there were no differences between the groups. Thus, spinal manipulation had no effect on episodic tension-type headache, in contrast to the significant effect of spinal manipulation which has previously been demonstrated in cases of cervicogenic headache. These two headaches should therefore be diagnostically differentiated in the future.
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Notice 2 things. First, the abstract states that manipulation has been found to have a "significant effect" in cases of cervicogenic headache. Secondly, this study states that both the soft tissue/manipulation group and soft tissue/laser therapy group showed "significant improvement". In other words, soft tissue therapy is effective for tension headache. This study does demonstrate that manipulation has no added effect to soft tissue therapy for this condition. However, I would like to see a study that compares joint manipulation/laser therapy with soft tissue therapy/laser therapy. It would be interesting. Another point I want to address is that many DC's use soft tissue therapy in their practices along with manipulation. Therefore, DC's (and any other health care provider) who utilize soft tissue therapy in their practices may have significant success with patients who suffer from tension headache.

Please let me know your thoughts....I'm interested.

Sincerely,
Daniel M. Page, DC
Barrow, Alaska

Daniel M. Page, D.C.
14th February 2001, 23:40
I'm sorry, the correct website address for the research site I referred to in my last post is:

http://www.ncbi.nlm.nih.gov/Literature/index.html

Through PubMed, anyone can access MEDLINE's 10,000,000 biomedical journal citations to research biomedical questions.

One interesting note - during my searches, JMPT (Journal of Manipulative and Physiological Therapeutics) came up many times. It is among those journals included in MEDLINE.

Take care,
Daniel M. Page, DC