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Brad Hirakawa
12-23-2003, 12:21 PM
I am wondering your thoughts on chiropractic medicine? I have been thinking about a debate I had with myself a few years ago, after I suffered a fractured (not severe) L3 vertebrae, and my spine-doc. advised me to strongly consider not going to a chiropractor. I did not, and I am fully recovered.

My basic (undergraduate) education was in Physiology / Neuroscience, and my textbooks lack the scientific information to validate the basic theories of chiropractic medicine. That is not to say that there is not a scientific basis for the practice, rather my information simply does not lend support to some of the methods of chiropractic medicine (subluxations, spinal manipulation, and the like).

I searched Medline and found hundreds of articles. There is certainly a huge debate over the issue. Journals that focus on chiropractors, alternative medicine, manipulative practices, etc., tend to publish articles that support chiropractic medicine. Journals that focus on physicians, neurology, medicine (western), etc., tend to publish articles that do not support chiropractic medicine.

Some studies demonstrate correlations between chiropractic manipulation and damage tissues related to the spine. Others say this association is weak, and full of confounding variables. Some studies show that chiropractic medicine is as effective as mainstream physical therapy, while other show that neither is any more effective than simple rest and relaxation. The American Chiropractic Association is a strong presence in our country, but they tend to quote only the supporting research, and assert that millions of people see chiropractors each year (millions of people eat like **** and do drugs, doesn’t mean it’s a good thing). The NCAHF (http://www.ncahf.org/pp/chirop.html) are not big fans, but we know they can be awfully critical at times, and their positional paper on the topic may be out of date. Others argue that the general population is achieving good results with chiropractic medicine, as evident by the recent widespread acceptance and coverage of chiropractic treatments by health insurance companies and health organizations. However, others claim that chiropractic medicine is now being covered by insurance/health care organizations simply due to economic factors. That is, chiropractic medicine is big business, and the insurance companies will always jump on business opportunities. Also, some believe the general population is afflicted with hypochondriosis, and tends to flock together in ways reminiscent of mass hypnosis/suggestion.

So… I just wanted to hear your thoughts.

David Wood
12-23-2003, 03:23 PM
Brad:

I'm not going to help much.

I doubt anyone has a definitive answer in this area. As far as I can understand it, the original premise of "chiropractic medicine" (fixing "sublaxations" of the spine that only a chiropractor is trained to detect) is bull****.

That said, I suspect that there is a HUGE variation in the quality of practitioners, moreso even than among classic Western-trained doctors. I have family horror stories with chiropractic, and I have heard of near-miraculous cures (maybe that should be "cures") at the hands of skillful healers who called themselves chiropractors.

Many skillful healers work on an almost intuitive basis, and provide genuine healing. The honest ones admit as much. Some will try and explain it by generating theories about processes that allow them to adopt a "scientific" explanation (hence, we have "sublaxations").

Note: much of classic, Western, allopathic, whatever-you-want-to-call-it medicine works in the same way . . . someone notices something that works, that helps at least some patients. They try to repeat it, and, being human, try to come up with theories that explain it . . . it helps in understanding.

The only "strength" that Western medicine has is a semi-willingness to subject those theories to unbiased testing . . . and even that strengh is honored in theory much more than in practice . .. (look at what it's taken for Atkins to get even a smidgeon of respect).

Generally, though, chiropractic medicine (as an institution) has fiercely resisted objective testing of its outcomes and theories.

Finally, full disclosure: Many years ago (1960's and 70's) chiropractors in the worst form took my family for ridiculous amounts of money, offering false hope to my brother, worsening his condition, and ultimately hastening his death. These people were, and still are, scum.

Others people who called themselves chiropractors have relieved my wife of truly painful sciatica that appeared without known cause and vanished just as irrationally after treatment. Was it their treatment? Was it all 'in her head'? Who knows?

I would certainly go to a chiropractor if I was being told "there's nothing we can do" by other practictioners . . . but I would prefer one who didn't try to claim my problem was some mysterious misalignment of the spine that no one else was smart enough to see.

Robert Wolf
12-24-2003, 12:16 AM
Personally I have had some significant releif from chiros with some neck problems. The folks I went to however in addition tot he orthopedic adjustments did soft dissue mobilization(massage) including some things like myofacial release. I think in some circumstances chiropractic ( or osteopathic) manipulation can be just the ticket. Add in a good rehab program (CrossFit for the BROKEN?) and "miracles" can be had.

Most choros unfortunately are a "rack-em & Crack-em" operation spending only a few minutes with each patient. This makes it virtually impossible for chiros who want to do comprehensive care because the insurance companies pay relatively little due to the high-volume operations of some folks.

Not sure if that answers your question Brad, sorry if it was just rambling!
Robb

Tyler Hass
12-24-2003, 01:42 AM
Brad,
I agree with Robb. Chiropractic is just one of many methods. In some instances, it is the only thing you need. Quick fixes are sometimes appropriate and it's great when they are. When I was at the RKC seminar, I had a sore left trap. One of the guys I met was a chiropractor. We were all sitting in the break room and he had people lining up to have him fix their ailment. One by one, we all told him what was wrong and he fixed it. My tight trap released instantly. Of course, after another full day of KB lifting the next day, it flared back up a bit, but he probably wouldn't have recommended that I go out and do that. But for the problem I had, chiro worked really well. However, when I hurt my back a few years ago, chiro did nothing whatsoever. It was a real injury and it took time to heal. I think chiropractic does well with the residual effects of an injury, but not soo good on fresh, unhealed wounds. What do you guys think?
I have heard good things about Active Release Technique and Rolfing as more comprehensive approaches. But the most important factor above all is the doc himself. Some guys are just complete frauds, regardless of their branch of medicine. This includes allopathic medicine!
One book I have found useful is the Trigger Point Therapy workbook by Clair Davies. I have only used it for some elbow pain, but it seemed to do the trick. My only gripe is the line drawings in the book are a bit vague. Another book I have heard good things about is the back pain book by Dr. Sarno. I can't remember the title, but it seems to have worked for a lot of people.
Brad, I am considering neuroscience as a major. I have been a bit indecisive as to which area of bio to go into. I like biology and chem is okay, but I'm not too strong there. Kinesiology is a bit too soft for me and the focus is usually on energy metabolism and not the interesting neurological effects of training. What did you think of neurosci as a course of study? I realize it's different for everyone, but it would be fun to hear your impressions.

Tyler

Brad Hirakawa
12-30-2003, 05:26 PM
Tyler,
I think neurosci is a great course of study... just read a few recent pubs regarding stem cells and re-growing injuted nerves in lab animals. Cool news. I recommend checking out a neurosci text book, or attend the next Neuroscience convention. You'll get a solid overview of the science. I may indeed pursue that area in a Ph.D. program myself. Glutton for punishment.. masters not enough.
Brad