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Chiropractors: New age GPs or Quacks

Discussion in 'General Issues and Discussion Forum' started by SjjDavs, Jul 24, 2013.

  1. SjjDavs

    SjjDavs Member

    Members do not see these Ads. Sign Up.
    This Youtube clip has been doing the rounds over the last few weeks.
    What is everyone's opinion?

    Kind Regards
    Last edited by a moderator: Sep 22, 2016
  2. Craig Payne

    Craig Payne Moderator

    I watched it on Catalyst when it was broadcast. Following the subsequent extensive commentary on social media sites have been interesting and illuminating.

    The chiropactic fan boys are up in arms about it being a biased hatchet job, but still can't produce any evidence to back up what they are claiming.

    The evidence or scientist based medicine afficandos think it was brilliant.

    Given that there is so much rhetoric and propaganda in social media on this, we need to rely heavily on what the scientific evidence says to avoid those claims of bias, rhetoric and propaganda .... when you do that things do not look good for the junk being touted by "chiropractic".

    Having said that there are some damn good chiropractors out there trying damn hard to rid their profession of that element that embarrasses them and get some good evidence to support what they are doing.
  3. SjjDavs

    SjjDavs Member


    The hot topic of some chiros leaning towards anti-immunization was a whole other can of worms all together
  4. Craig Payne

    Craig Payne Moderator

    Luckily we have good evidence on that to guide us and that evidence is extraordinarily clear. ,,,, except to the fan boi's
  5. Admin2

    Admin2 Administrator Staff Member

    Chiropractic controversy and criticism

    Throughout its history chiropractic has been the subject of internal and external controversy and criticism.[1][2] According to magnetic healer Daniel D. Palmer, the founder of chiropractic, "vertebral subluxation" was the sole cause of all diseases and manipulation was the cure for all diseases of the human race.[3] A 2003 profession-wide survey found "most chiropractors (whether 'straights' or 'mixers') still hold views of Innate Intelligence and of the cause and cure of disease (not just back pain) consistent with those of the Palmers."[4] A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today."[3] Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license.[3] D.D. Palmer considered establishing chiropractic as a religion to resolve this problem.[5] For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as subluxation.[6]

    Chiropractic researchers have documented that fraud, abuse and quackery are more prevalent in chiropractic than in other health care professions.[7] Unsubstantiated claims about the efficacy of chiropractic have continued to be made by individual chiropractors and chiropractic associations.[3] The core concept of traditional chiropractic, vertebral subluxation, is not based on sound science.[3] Collectively, systematic reviews have not demonstrated that spinal manipulation, the main treatment method employed by chiropractors, was effective for any medical condition, with the possible exception of treatment for back pain.[3] Although rare,[8] spinal manipulation, particularly of the upper spine, can also result in complications that can lead to permanent disability or death; these can occur in adults[9] and children.[10]

    In 2008, Simon Singh was sued for libel by the British Chiropractic Association (BCA) for criticizing their activities in a column in The Guardian.[11] A preliminary hearing took place at the Royal Courts of Justice in front of judge David Eady. The judge held that merely using the phrase "happily promotes bogus treatments" meant that he was stating, as a matter of fact, that the British Chiropractic Association was being consciously dishonest in promoting chiropractic for treating the children's ailments in question.[12] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[13] The libel case ended with the BCA withdrawing its suit in 2010.[14][15]

    Chiropractors historically were strongly opposed to vaccination based on their belief that all diseases were traceable to causes in the spine, and therefore could not be affected by vaccines.[16] Some chiropractors continue to be opposed to vaccination.[17] Early opposition to water fluoridation included chiropractors in the U.S. Some chiropractors opposed water fluoridation as being incompatible with chiropractic philosophy and an infringement of personal freedom. Recently, other chiropractors have actively promoted fluoridation, and several chiropractic organizations have endorsed scientific principles of public health.[18]

    1. ^ Kaptchuk, TJ; Eisenberg, DM (November 1998). "Chiropractic: origins, controversies, and contributions". Archives of Internal Medicine. 158 (20): 2215–24. doi:10.1001/archinte.158.20.2215. ISSN 0003-9926. PMID 9818801. 
    2. ^ Jaroff, Leon (27 February 2002). "Back Off, Chiropractors!". Time. Retrieved 7 June 2009. 
    3. ^ a b c d e f Ernst, E (May 2008). "Chiropractic: a critical evaluation". Journal of Pain and Symptom Management. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. ISSN 0885-3924. PMID 18280103. 
    4. ^ Gunther Brown, Candy (July 7, 2014). "Chiropractic: Is it Nature, Medicine or Religion?". HuffPost. 
    5. ^ Palmer, Daniel (May 4, 1911), D.D. Palmer's Religion of Chiropractic (PDF), The Chiropractic Resource Organization, retrieved February 22, 2015 
    6. ^ Keating JC Jr; Cleveland CS III; Menke M (2005). "Chiropractic history: a primer" (PDF). Association for the History of Chiropractic. Retrieved 2008-06-16. A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine. Chiropractors' tendency to assert the meaningfulness of various theories and methods as a counterpoint to allopathic charges of quackery has created a defensiveness which can make critical examination of chiropractic concepts difficult (Keating and Mootz 1989). One example of this conundrum is the continuing controversy about the presumptive target of DCs' adjustive interventions: subluxation (Gatterman 1995; Leach 1994). 
    7. ^ Murphy, DR; Schneider, MJ; Seaman, DR; Perle, SM; Nelson, CF (August 2008). "How can chiropractic become a respected mainstream profession? The example of podiatry" (PDF). Chiropractic & osteopathy. 16: 10. doi:10.1186/1746-1340-16-10. PMC 2538524Freely accessible. PMID 18759966. 
    8. ^ Cite error: The named reference WHO-guidelines was invoked but never defined (see the help page).
    9. ^ Ernst, E (July 2007). "Adverse effects of spinal manipulation: a systematic review". Journal of the Royal Society of Medicine. 100 (7): 330–38. doi:10.1258/jrsm.100.7.330. ISSN 0141-0768. PMC 1905885Freely accessible. PMID 17606755. Lay summaryMed News Today (2 July 2007). 
    10. ^ Vohra, S; Johnston, BC; Cramer, K; Humphreys, K (January 2007). "Adverse events associated with pediatric spinal manipulation: a systematic review". Pediatrics. 119 (1): e275–83. doi:10.1542/peds.2006-1392. ISSN 0031-4005. PMID 17178922. 
    11. ^ Eden, R (16 August 2008). "Doctors take Simon Singh to court". The Daily Telegraph. London. Retrieved 16 August 2008. 
    12. ^ Boseley, Sarah (14 May 2009). "Science writer accused of libel may take fight to European court". London: The Guardian (UK). Retrieved 2009-05-19. 
    13. ^ "Unjust burdens of proof". Nature. 459 (7248): 751. June 2009. Bibcode:2009Natur.459Q.751.. doi:10.1038/459751a. PMID 19516290. 
    14. ^ Pallab Ghosh (2010-04-15). "Case dropped against Simon Singh". BBC News. 
    15. ^ Mark Henderson (2010-04-16). "Science writer Simon Singh wins bitter libel battle". London: Times Online. 
    16. ^ Busse, JW; Morgan, L; Campbell, JB (June 2005). "Chiropractic antivaccination arguments". Journal of manipulative and physiological therapeutics. 28 (5): 367–73. doi:10.1016/j.jmpt.2005.04.011. ISSN 0161-4754. PMID 15965414. 
    17. ^ F. Nelson, Craig (1 April 1999). "Spinal Manipulation and Chiropractic: Views of a Reformist Chiropractor". American Council on Science and Health. Archived from the original on April 9, 2009. Retrieved 7 June 2009. 
    18. ^ Jones, RB; Mormann, DN; Durtsche, TB (October 1989). "Fluoridation referendum in La Crosse, Wisconsin: contributing factors to success". American Journal of Public Health. 79 (10): 1405–08. doi:10.2105/AJPH.79.10.1405. ISSN 0090-0036. PMC 1350185Freely accessible. PMID 2782512. 
  6. Paul Bowles

    Paul Bowles Well-Known Member

  7. David Wedemeyer

    David Wedemeyer Well-Known Member


    Thank you Craig. Hot controversy but as an evidence-based practitioner this doesn't phase me one bit. Sadly, until the chiropractic profession as a whole embraces quality research and funding becomes more available the situation won't change.
  8. Craig Payne

    Craig Payne Moderator

    Here is a personal story, but it illustrates a point:

    One of the Arena'ette's was very sick when born; was intubated and pneumothorax with drain in lungs .... months later we noticed she had trouble raising head too far off the ground during tummy time compared to the twin ... we heard about a pediatric osteopath (yes, I know its not a chiropractor; but it illustrates my point) ... who did an awesome job of mobilizing the ribs due to issues from the events after birth; they used a very gentle two finger mobs - two treatments and there was a "personality" change and she could lift her head off the ground with increased mobility - it really was impressive.

    BUT, was I spun some absolute bull**** by the osteopath that insulted my intelligence. A whole lot of yin and yan crap .... I will avoid osteopaths at all costs in the future because of that crap they spun me.
    Why could they not just have said and done: ribs restricted due to pneumothorax and drain that was inserted just after birth --> now needs gentle mobs to increase range of motion --> problem solved.... why insult my intelligence with crap?
  9. Paul Bowles

    Paul Bowles Well-Known Member

    If there is evidence - the journalist above wants to know exactly what you practice ;)

    I'm with Craig - cut through the wiffl waffle pseudo religious bibble babble and tell me that "mobilizing" the joint improves its function. At least that's plausible and has some evidence behind it. If I hear another chiro try to convert me to the the religion of proprioceptive innersoles and structural leg raises for every patient i'll need a valium!

    In saying that I know some bloody great Chiros and Osteos who do amazing muscuoskeletal work minus the BS
  10. David Wedemeyer

    David Wedemeyer Well-Known Member

    Acupuncture just suffered a similar blow recently Craig. I do believe acupuncture may help with nerve pain, I find the rest questionable. I believe manipulation as I provide is effective for many condition specific uses but as a whole and like the osteo you are describing, many of their claims need review. In the US traditional osteopathy is pretty much extinct, they have become allopaths and the two professions are completely disparate in their delivery.

    Amen Paul but lets not forget podiatry has more of these people than we do among its ranks with regard to the insoles.

    There is high level evidence for acute mechanical low back pain that it is much better than usual care (UC - CHIRO study), the AMA went on record supporting chiropractic spinal manipulation for LBP (shocked even me) recently. The American Pain Society and American College of Physicians joint guidelines Acute mechanical Low Back Pain that does not improve with UC etc had only one recommendation for (recommendation #7 and their ONLY recommendation for AMLBP); spinal manipulation. Chronic listed everything else we're used to, chiro, pt, heat, massage etc

    I don't claim to cure asthma, colic, remove subluxations etc and I cannot speak for how others practice but as Craig mentioned above, there is certainly a place for chiropractic and no other profession perform the procedure or adjustment in the same manner as my profession and none trains as long to deliver it safely. If it was useless the PT lobby wouldn't be trying so damn hard for open access and high-velocity manipulative rights across the US. They're even pushing "wellness" and "posture" currently.

    Actually Paul in facet syndrome as an example I've seen numerous patients where "mobilizing the joint" does exactly that. Let's not forget joint facet capsules are synovial and contain sensory apparatus which often respond well to manipulation, particularly chiropractic. I feel you are referring to the concept of "subluxation"?

    But we're all quacks ;)
  11. Lab Guy

    Lab Guy Well-Known Member

    Speaking of quackery, two months ago I took Eric Pearl DC seminar on Reconnection Healing. I became certified in all the levels. There is no touching involved and you can feel the energy. I am also a Reiki Master as well as certified in other crazy non evidenced based medicine healing modalities. I love science and research and also love pseudoscience :wacko:

  12. Paul Bowles

    Paul Bowles Well-Known Member

    Amen to that!

    With regards to proprioception - lets just not go there......its a wound that cuts deep back to an argument while presenting at a conference some years ago now...... Lets just say when 200 chiros gang up on one poor lonely Podiatrist it doesn't mater how good his evidence is he aint going to win!!!!

    I'm all for mobilization and manipulation to a large degree. I do work and have worked with some great Chiro's and Osteo's who do some marvelous stuff!
  13. wdd

    wdd Well-Known Member

  14. wdd

    wdd Well-Known Member

    When is medicine going to do something about the reasons why people turn away from conventional medicine and turn towards alternative medicine, which professor Dwyer alluded to when he said something along the lines of - there is dissatisfaction with the quickie turnstyle approach to medicine?

    Humanbeings need to be recognised as individuals, have time spent on them, be touched, talked to, empathised with, etc, etc, etc.. In fact all of the stuff that maximises the placebo effect.

    Having just enrolled in a medical practice in the UK, I am not assigned a doctor I will just have to see the duty doctor. Before arranging a home visit I need, initially, to 'phone the practice. Sometime later a doctor will 'phone back to carrry out a telephone examination and diagnosis (I wonder how much of their training is spent on perfecting their telephone examination and diagnostic technique) before deciding whether or not he/she will come out to see me.

    Medicine is in crisis at the level of interpersonal skills and ongoing excuses about lack of finances or practitioners or simply attacking those who, no matter how poor their therapies, are offering features that people find vital in a therapeutic setting, doesn't rub.

  15. Lab Guy

    Lab Guy Well-Known Member

    Bill, who is professor Dwyer, never heard of him.

  16. Craig Payne

    Craig Payne Moderator

    BUT, she is still overstriding and heel striking; appalling arm swing .... go figure that she is smiling and having fun!

    Attached Files:

  17. wdd

    wdd Well-Known Member

    John Dwyer is/was emeritus professor of immunology at the university of NSW and is one of the people interviewed in the Youtube clip that started this thread.

  18. I would agree completely with Bill's observation - and not just in the medical profession. It is a strange thing when the body of knowledge has grown and developed tremendously over the past three decades but the practical application of that knowledge has not seen the same advances - far from it.

    I had a recent check-up at my local NHS hospital - appointment time 09.15 - but was not seen until 10.50. My appointment was with the consultant but I was seen by his registrar. When I was called and entered the consulting room, he didn't look up from his computer, didn't introduce himself or apologise for the delay in being seen - but he continued to read what was on the screen (which turned out to be an email from a colleague regarding a seminar). After a few minutes he mumbled something about my results looked ok (what results?) and that I would be seen by the consultant again around 6 months time.

    By the time I had finished with him he was a little more au fait with the etiquette of patient consultation and a little more familiar with my medical history than he was before I started. I would accept that the 'system' has much to answer for - the protocols and practices of the NHS, undergraduate education, all have their part to play - but at the end of the day the responsibility for the standards of care and practice in any interaction with the patient, should be that of the clinician. End of.

    I don't know much about the chiropractic profession but I worked with an osteopath recently whose knowledge of anatomy and physiology was on par with my knowledge of the mating habits of prehistoric crustaceans. He hadn't a clue and when pressed he would usually say something along the lines of "it's all jammed up and needs a little bit of this and that". This was to colleagues, not patients. The unfortunate thing these days is how some clinicians approach marketing and promotion - with the desire to establish a unique selling point (USP). See Rothbart, Glasier, Shavelson, etc etc for podiatry's version of the above..
  19. Craig Payne

    Craig Payne Moderator

    From the Wikipedia page above:
    In the news here today:
    Full story
  20. Rob Kidd

    Rob Kidd Well-Known Member

    Mark, I read all the above and take it on board. Yet when I was associated with the university of Western Sydney, I taught PROPER anatomy to their osteopathic course. Of course, you can lead a horse to water............................. Whether they maintained it, I have no idea. Rob
  21. wdd

    wdd Well-Known Member

    Another visit to the osteopath maybe?

    Best wishes,


    PS The bit of your quote that I missed out is the feature I'd focus on.
  22. wdd

    wdd Well-Known Member

    Unfortunately to many it seems a little like teaching astronomy to astrologers.

  23. David Wedemeyer

    David Wedemeyer Well-Known Member

    Craig here are some stats and facts straight from the Office of the Inspector General (OIG) from 1985. Searching for the current stats but DOH!:


    "Disciplinary action rates concerning podiatrists are much higher than those concerning medical doctors, or both dentists and chiropractors, the subjects of the first two reports of this inspection. In 1985 podiatry boards disciplined about 9.7 per 1000 active podiatrists; dental boards, about 5.4 per 1000 active dentists; chiropractic boards, about 5.3 per 1000 active chiropractors; and medical boards about 4.2 per 1000."

    I'll look for more recent stats if need be. I completely question Wiki as an objective source on anything Craig, so even if the stats were dramatically different now, a historic investigation of the facts and reliable data are important to the conversation and I question the apparent hyperbolic value of those stats. I saw their references and couldn't decide how they arrived at their figures?

  24. David Wedemeyer

    David Wedemeyer Well-Known Member

    Please take me along next time Paul, I bet you and I agree on more re the lower extremity and orthotics than all of them agree on re chiropractic! :D
  25. Lab Guy

    Lab Guy Well-Known Member

    I am exhibiting at the National Chiropractor Convention August 22 in Orlando, Florida. It will be my first time attending a Chiropractor meeting and I look forward to it.

    Ten years ago, I had several epidural blocks for my lower back pain. A neurosurgeon and orthopedic surgeon strongly recommended I have a lower back fusion for a herniated disc, and joint space narrowing with osteophytosis as I was only getting worse and risked permanent injury to my spinal nerve. Between a few visits from my Chiropractor and Acupuncture from a Chinese doctor, I am still pain-free without surgery.

    For me, I believe Chiropractor Medicine deserves a place in Health Care but must straighten up their act and police themselves better to clear out the weeds in their garden. All professions have their weeds and we all need to take care of our own gardens.

    There is an old saying, "To a carpenter with a hammer, all problems look like a nail".
    The more tools we have, the less likely all the problems will look like a nail and we can all deliver better care.

  26. Craig Payne

    Craig Payne Moderator

    To be clear; I have no problemo at all with a lot of the "chiropractic technique"; all I object to is the woo, pseudoscientific, snake oil, quackery sold by some chiropractors and the wooish, pseudoscientific, snake oil, quack explanations used by some chiropractors (ie like the osteopathy eg I used above). They are the ones that make all chiropractors look like woo peddlers, pseudoscientific quacks and snake oil salesmen that lead to TV shows like the one that started this thread to damage the "chiropractic" brand.
  27. wdd

    wdd Well-Known Member

    The number of tools in your bag doesn't change a thing because the saying then becomes, "To a carpenter with a lot of tools all problems look like carpentry problems".

  28. Paul Bowles

    Paul Bowles Well-Known Member

    The issue isnt about the tools on your tool belt as WDD has pointed out. Its about a profound understanding and respect for the fact that as a carpenter you shouldn't be doing the plumbing as well! Assuming of course you knew anything about carpentry in the first place!
  29. wdd

    wdd Well-Known Member

    Of course it could be that the figures are more representative of the relative diligence of the respective boards rather than the relative errancy of the members?

  30. Tuckersm

    Tuckersm Well-Known Member

    and even more interesting to read the VCAT transcript
    scroll to the end to see "a short history of the litigation"
  31. wdd

    wdd Well-Known Member

  32. musmed

    musmed Active Member

    Dear Team

    Just filling you in on a few things re this study on acute back pain and chiros.
    1. the patient saw the GP once
    2. the patient was given advice on CHRONIC back pain not acute
    3. the patient saw the chiro 6 times

    80% of people get over their acute back pain in 6 weeks whether they ahve treatment or not.

    let you work it out

    regards from a warm Sydney winter/summers day

    Paul Conneely
  33. owrang

    owrang Member

    Some years ago I was suffering terrible back pain from probably doing too many nursing homes. From 1 treatment from a Chiropractor I got off the couch with virtually no pain whatsoever. I had been suffering for months and could no longer put 1 foot on the ground anymore. It was truly remarkable. That was my experience.
  34. David Wedemeyer

    David Wedemeyer Well-Known Member


    Ninety-two patients were recruited, with 36 SC and 35 UC patients completing all follow-up visits. Baseline prognostic variables were evenly distributed between groups. The primary outcome, the unadjusted mean improvement in RDQ scores, was significantly greater in the SC group than in the UC group (p=.003). Regarding unadjusted mean changes in secondary outcomes, improvements in RDQ scores were also greater in the SC group at other time points, particularly at 24 weeks (p=.004). Similarly, improvements in SF-36 PF scores favored the SC group at all time points; however, these differences were not statistically significant. Improvements in SF-36 BP scores were similar between groups. In repeated-measures analyses, global adjusted mean improvement was significantly greater in the SC group in terms of RDQ (p=.0002), nearly significantly greater in terms of SF-36 PF (p=.08), but similar between groups in terms of SF-36 BP (p=.27).
    This is the first reported randomized controlled trial comparing full CPG-based treatment, including spinal manipulative therapy administered by chiropractors, to family physician-directed UC in the treatment of patients with AM-LBP. Compared to family physician-directed UC, full CPG-based treatment including CSMT is associated with significantly greater improvement in condition-specific functioning.


    Intensive spinal manipulation is effective for the treatment of chronic low back pain. This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels. Future studies, however, are needed to confirm the finding in a larger group of patients with chronic low-back pain.


    Detailed Description:
    The identification of alternative safe and effective interventions for chronic lower back pain in the elderly is critical in view of its high prevalence, negative impact on quality of life and the treatment risks associated with chronic medication use. This is particularly germane to the veteran population, with a prevalence of lower back pain in excess of 40%. In 1998, published guidelines from the American Geriatric Society listed chiropractic management among the non-pharmacologic strategies for treating chronic pain symptoms in older adults. A recent study showed that a substantial number of older patients who received chiropractic care were less likely to be hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously and more likely to be mobile in the community. Patients undergoing chiropractic care have also reported greater satisfaction as compared to standard medical care. Despite the general clinical acceptance of chiropractic care and satisfaction with chiropractic services, evidence on the potential benefit and safety of chiropractic management of lower back pain in older adults is lacking. The purpose of this study is to evaluate the effectiveness of chiropractic management in older adults with chronic lower back pain, by comparing spinal manipulation to a sham intervention.

    For Acute and Chronic Pain
    “Many treatments are available for low back pain. Often exercises and physical therapy can help. Some people benefit from chiropractic therapy or acupuncture.”
    --Goodman et al. (2013), Journal of the American Medical Association
    “[Chiropractic Manipulative Therapy] in conjunction with [standard medical care] offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute low back pain.”
    --Goertz et al. (2013), Spine
    In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.
    -- Korthals-de Bos et al (2003), British Medical Journal
    “Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.”
    – Nyiendo et al (2000), Journal of Manipulative and Physiological Therapeutics

    In Comparison to Other Treatment Alternatives
    "Reduced odds of surgery were observed for...those whose first provider was a chiropractor. 42.7% of workers [with back injuries] who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor."
    – Keeney et al (2012), Spine
    “Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically important differences in pain and disability improvement were found for chronic patients.”
    – Haas et al (2005), Journal of Manipulative and Physiological Therapeutics
    “In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group (general practitioner). Manual therapy scored better than physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care.”
    – Hoving et al (2002), Annals of Internal Medicine

    For Headaches
    “Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.”
    -- McCrory, Penzlen, Hasselblad, Gray (2001), Duke Evidence Report
    “The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” ‘
    -- Boline et al. (1995), Journal of Manipulative and Physiological Therapeutics

    For Neck Pain
    In a study funded by NIH’s National Center for Complementary and Alternative Medicine to test the effectiveness of different approaches for treating mechanical neck pain, 272 participants were divided into three groups that received either spinal manipulative therapy (SMT) from a doctor of chiropractic (DC), pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with DCs and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups continued to report at least a 75 percent reduction in pain; compared to just 38 percent pain reduction among those who took medication.
    -- Bronfort et al. (2012), Annals of Internal Medicine

    Cost Effectiveness
    Low back pain initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), according to a study that analyzed data from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two-year span. The study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee. They also concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.
    – Liliedahl et al (2010), Journal of Manipulative and Physiological Therapeutics
    “Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.”
    – Haas et al (2005), Journal of Manipulative and Physiological Therapeutics

    Patient Satisfaction
    “Chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care. Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks.”
    -- Hertzman-Miller et al (2002), American Journal of Public Health
    And Finally from the Annals of Internal Medicine and American Pain Society's joint guidelines on chronic LBP, their ONLY recommendation for CLBP that does not improve is...drumroll:
    Recommendation 7: For patients who do not improve with self-care options, clinicians should consider the addition of nonpharmacologic therapy with proven benefits—for acute low back pain, spinal manipulation; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation (weak recommendation, moderate-quality evidence).

    Yes, lets let them work it out Paul. After all "when you have a hammer everything looks like a nail" cuts both ways.

    Happy Wednesday from sunny southern California :rolleyes::rolleyes:
  35. musmed

    musmed Active Member

    Good to see you are following us in the weather stakes, the only problem here is that it is winter.

    I like what you have quoted. I bet 99% of people who read this will be totally unable to understand the jsrgon eg UC and SC for starters.

    Now lets get serious. The first paper you quote says 92 were recruited and only 71 were followed up.
    This paper has no relevance what so ever. a loss of 21/71(final numbers) is woeful and basically nothing can be drawn from a massive 34% loss to follow up. It smacks of bias in favour of the outcome.

    Thus I did figure and read no more.

    Still sunny and lovely-
    Paul Conneely
  36. Certainly it doesn't make sense to discard a whole profession's skills just because it has a few "bad apples". I know a number of chiropractors who are not only skilled but also very ethical and sought-after for treatment within Northern California. Chiropractors as a profession have helped hundreds upon hundreds of my patients so I am a believer in what they can do for my patients.

    Chiropractic medicine does suffer, however, from a number of practitioners, who are less than ethical, just as podiatry and medicine does. It is up to each profession to not only weed out or discipline the unethical practitioners from their own profession but also produce the research evidence that what they do as a profession actually works better than placebo and non-treatment.

    I do however have to worry about clinicians that need to rely on testimonials on their websites to impress people about what they can do as clinicians. Are testimonials on clinician websites an ethical way to advertise???
  37. And how's the weather in Northern California, Kevin? It's hot and sticky here in Plymouth; nice if you're with a lady, but it ain't no good if you're in the city tonight. http://www.youtube.com/watch?v=gwsyU0PD1zc http://www.youtube.com/watch?v=qXdmTtk1Mm4 Hopefully it will be cooler come "Novemner" when I'm hoping to start my "Maters" degree.
  38. BEN-HUR

    BEN-HUR Well-Known Member

    All good points Kevin. I felt reluctant contributing to this thread as it only contributes fuel to the flame which doesn't need to keep burning for a long time (i.e. thread bouncing up the list). Sure points/concerns/good & bad experiences should be aired - but all professions have the so called skeletons in the closet. I too am aware of some "bad apples" within Chiropractic (albeit most have been via hearsay). However, there are some very good ones & although I've never met David Wedemeyer - my association with him on this forum (i.e. regarding views of so called 'orthotic' company "Foot Levelers")... & reading his insights on other topics have lead me to believe he is a credit to his profession (i.e. knowledgeable, passionate & sincere). Sure Chiropractic requires some needed house cleaning (as a result of what I interpret as New Age elements within some treatment regimes i.e. interpretation thereof) - maybe more than other professions (???). However, closer to home - I am aware of a "bad" Podiatrist in my area who has given our profession a bad name which has been picked up by other professions (I'm referring to orthotic therapy - poorly made, high cost & forced onto many patients regardless of symptoms)... which then requires some fixing up & faith restoring (because subsequently other professions begin to think that all orthotics are useless & heavily pushed by all Podiatrists regardless of the patient's needs... for the sake of $$$).

    I hope this incident will seriously motivate the Chiropractic profession in Australia to clean out some of the "cow boys" & New Age (pseudoscientific) elements - as their grounding skills do have a place within optimal holistic treatment options.
  39. musmed

    musmed Active Member

    Dear Kevin et al
    I Australia under APHRA (the national governing body of 9 professions-medical, dental, nursing, chiro, osteo etc), it is illegal to use testimonials, no iff's or but's.

    Hot lovely 23 C. clear day.
    Paul Conneely
  40. David Wedemeyer

    David Wedemeyer Well-Known Member

    This will be my final post on the subject, mainly because anyone with such a level of bias as yourself cannot be objective nor taken seriously. You sell courses in "manual therapy" to podiatrists(and apparently massage therapists!). A good number of your techniques overlap with chiropractic and osteopathic techniques both in theory and application. Therefore you are a hypocrite of the highest order and pedantic and arrogant if you believe any differently that because you teach it a course it must be different or better than when performed by you than a chiropractor. The fact that you are even teaching these techniques and denigrating the chiropractic profession is ironic; you must have knowledge that we all don't regarding physical medicine? Utter BS, pure ego driven biased rubbish.

    The irony is that your websites claims "Dr. Conneely has teamed up with Ms. Donna Eddy of www.postureplus.com.au Donna is an expert in the art of Pilates, stretching, kick boxing as well as being a University Graduate in TCM." Is that Traditional Chinese Medicine, acupuncture etc which recently took a huge facial in the news and was discussed here on PA? I believe that you promote dry needling in your courses, don't bother with the research I'll give it as much attention as you gave mine (and the only reason you dismissed it is because you can't overcome that much quality evidence and it's precisely the type of research that your colleagues here in the US found favorable enough to refer a lot of their patients for chiropractic care).


    "Acupuncture is a theatrical placebo: the end of a myth"

    But yes if they're aligned with Paul it's good practice because Paul is omniscient and "better' than everyone else. Get over yourself and feel free to have the last word. :sinking:

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