pulpyboy

turtonm,

Obviously you have strong emotional feelings about this subject. I don't recall making an argument that chiropractic is correct and that modern medicine is wrong. I don't believe that modern medicine is wrong only that it is subject to the same shortcomings of other disciplines of health care.

I enjoyed my time on chirobase.org. There were some truths as well as some editorial prejudice. I try and stay current on the arguments against my profession.

Your use of the word stole has me confused. I cited all the original references. I have taken seminars from Dr. Murphy and became aware of this information from that originally. I also subscribe to the Journal of Clinical Chiropractic where his original article was printed. I was unaware that it was even posted on the internet. So how is it that I "stole" this information?

You also state that chiropractic does not work for low back pain. There have been over 30 randomized controlled studies stating that manipulation is effective for low back pain. What sort of evidence do you require?

Obviously you also misread my statement that there are research articles in peer reviewed MEDICAL journals.

Chiropractic is not perfect and does not have all the answers. It is a profession that does need to address its problems and continue to research its premises and change according to the results of that research.(see <a href="http://www.idealspine.com" target="_blank">www.idealspine.com</a> research) There is research however that strongly supports the use of chiropractic for neck pain, headaches, and back pain.

It is amazing to me that my profession has been able to survive for over 100 years when what we do supposedly does't work and is harmful to those treated. If chiropractic was as dangerous as implied, not only would we have been legislatively outlawed, but our patients would have stopped returning a long time ago.

To end, I thought that the tone of your response was quite condescending. Most of your posts that I have read do not take this tone. I wonder how any of my posts necessitated the derisive tone.

Respectfully,
Michael

Vorkosigan

Originally posted by pulpyboy:
turtonm,

Obviously you have strong emotional feelings about this subject.

Yes, I have strong feelings about medical fraud. I just lost a good friend's mother to Chinese traditional medicine. She gave up proven western medicines for pseudoscience. I lost some of my students in Africa to it too. Fraud kills.

I don't recall making an argument that chiropractic is correct and that modern medicine is wrong.

Let's see....you cited a statement saying modern medicine is a "religion." I am supposed to take this remark as not an attempt to discredit modern medicine?

You then listed problems with overmedication. You linked the two with statements like this:

• The drug industry's consumer ad spending rose 39% from 1995-1997 to $3.2 billion. USA Today 7-20-98 $3.2 billion in advertising is approximately the same income as all practicing chiropractors combined per year in the USA.

Unless you are making an implied statement about the implicit worth of Chiropractic, there is no need to link these two ideas. You supported this with another link.

• Dr. David Lawrence, chief executive of Kaiser Permanente "Medical accidents and mistakes kill 400,000 people a year, ranking behind only heart disease and cancer as the leading cause of death. Mistakes alone kill more people each year than tobacco, alcohol, firearms, or automobiles."
  
  And chiropractors are the dangerous quacks?

Again your rhetorical comment here implies something about chiropractic vs. organized medicine. You added to emphasize the point you were making. Perhaps you can clarify what you meant.

Never mind that there is no evidence to support Lawrence's remark, as actual death statistics show.

I don't believe that modern medicine is wrong only that it is subject to the same shortcomings of other disciplines of health care.

There are no other disciplines of health care that are not psuedosciences. This does not mean that such disciplines may not, from time to time, hit on successes. But without empirical grounding -- of which there is none for chiropractic -- no health care discipline can be properly evaluated or confirmed.

on the internet. So how is it that I "stole" this information?

Actually, I wrote "paraphrased." As you can see. It is customary, when citing, to give the cite.

You also state that chiropractic does not work for low back pain. There have been over 30 randomized controlled studies stating that manipulation is effective for low back pain. What sort of evidence do you require?

I stated this where?

Obviously you also misread my statement that there are research articles in peer reviewed MEDICAL journals.

Bring on the research then.

There is research however that strongly supports the use of chiropractic for neck pain, headaches, and back pain.

There is no objective, empirical research that supports chiropractic. Subluxtions do not exist.

It is amazing to me that my profession has been able to survive for over 100 years when what we do supposedly does't work and is harmful to those treated.

That's nothing. I'll be impressed when you're around as long as fortune-telling, faith healing, Chinese traditional medicine and astrology, all of which are proven failures (with the exception of some aspects of Chinese traditional medicine).

If chiropractic was as dangerous as implied, not only would we have been legislatively outlawed, but our patients would have stopped returning a long time ago.

Failure has never stopped fortune tellers, some of whom are even sincere in their belief. People value their personal relationships, even when harm is proven. Like my friend's mother who died even as her family and friends begged her to see a real doctor. Sometimes identity is more important than life.

Lots of proven dangerous substances and behaviors, from alcohol to nicotine, are legal. So is driving a motorcycle without a helmet in several states. In several states you can kill your children by withholding medication. Diet supplements are legal even when not supported by research. Why should chiropractic be any different?

To end, I thought that the tone of your response was quite condescending. Most of your posts that I have read do not take this tone. I wonder how any of my posts necessitated the derisive tone.

You provoked a strong response with this statement:

• I'd like to think that a board such as this that looks upon the authority of the church with skepticism would surely also look at the authority of organized medicine with the same zeal of skepticism.

As if skeptics were so dumb, we believe it just because the medical establishment says it. If you don't want condescension, don't dish it out.

Michael

pulpyboy

turtonm,


Actually as you can see, you also used stole. You used paraphrase at the beginning of your post.

I am sorry to hear about your good friend's mother. Are you sure that the proven western medicines would have saved her? If so, was no one able to get this across to her?

I cited the opinion of Robert S. Mendelsohn,M.D. former chairman of the Medical Licensing Board for the State of Illinois in his book Confessions of a Medical Heretic. It was to state that even some within the medical profession see that not everything is backed by scientific evidence. Again, I have tremendous respect for most of the people I have met in medicine. I have a healthy working relationship with several medical doctors with referrals back and forth. I also treat several of them as well as their families.

What I meant is that with regard to life and death, chiropractors are not dangerous. One would think that if we were dangerous, our malpractice rates would reflect that. However, malpractice rates are low for chiropractic in comparison to others in medicine.

see above

Here are just a couple.
Farrell JP, Twomey LT. Acute low back pain. Comparison of two conservative treatment approaches. Med J Aust 1982 Feb 20;1(4):160-4
Glover JR, Morris JG, Khosla T. Back pain: a randomizedclinical trial of rotational manipulation of the trunk. Br J Ind Med 1974 Jan;31(1):59-64
Godfrey CM, Morgan PP, Schatzker J. A randomized trial of manipulation for low back pain in a medical setting. Spine 1984 Apr;9(3):301-4.
Hadler NM, Curtis P, Gillings DB, Stinnett S. A benefitof spinal manipulation as adjunctive therapy for acute low-back pain: a stratified controlled trial. Spine 1987 Sep;12(7):703-6.
MacDonald RS, Bell CM. An open controlled assessment of osteopathic manipulation in non-specific low-back pain[published erratum appears in Spine 1991 Jan;16(!):104]. Spine 1990 May;15(5):364-70.

I will be happy to provide more. The website that I provided earlier idealspine.com is a website dedicated to a chiropractic technique by the name of Chiropractic Biophysics. The originator of the technique holds a masters in engineering, a doctorate in mathmatics, as well as a doctor of chiropractic. He has decided to address some of the shortcomings in chiropractic research in a step by step process. He and his son as well as colleagues have been published in various journals many times as the first chiropractor ever published in those certain journals. There is belief in the scientific process of putting forth a theory and then trying to rip it to shreds. His theories have changed to reflect the research findings.


As an aside, could you please explain or point me to a website that discusses why meta-analysis is non-reliable. Thanks.

I apologize if my earlier statement was interpreted as condescending. It just seems to me that much in the field of modern medicine has not been proven by scientific findings. I also am wary of the role that drug companies play in health care decisions and research. I believe that any intervention should be questioned.

For me, I find it far more rational that back pain is due to postural changes causing dysfunction expressed as pain rather than an absence of medication in the bloodstream.

Respectfully
Michael

Vorkosigan

turtonm,

Here are just a couple.

I'll get back to them in a while.

As an aside, could you please explain or point me to a website that discusses why meta-analysis is non-reliable. Thanks.

ERIC has a large database. Here is a survey defining meta-analysis:

Here is a basic explanation of meta-anlaysis:
<a href="http://www.colorado.edu/epob/epob4640mwalker/lect14.html" target="_blank">http://www.colorado.edu/epob/epob4640mwalker/lect14.html</a>

Another:
<a href="http://ericae.net/pare/getvn.asp?v=2&n=8" target="_blank">http://ericae.net/pare/getvn.asp?v=2&n=8</a>

Criticism of meta-analysis has focused on several issues -- can different studies be lumped together and worked with like that? Many writers complain that the same complaints could be leveled at ordinary statistical analysis, as if that refuted them. Another common complaint is that they use only published trials -- trials in which results were obtained. That hugely biases them, according to critics.

Yet another discussion.
<a href="http://www.ecologynet.stir.ac.uk/Home/Universities/stirling/courses/aqib/meta.html" target="_blank">http://www.ecologynet.stir.ac.uk/Home/Universities/stirling/courses/aqib/meta.html</a>

I apologize if my earlier statement was interpreted as condescending. It just seems to me that much in the field of modern medicine has not been proven by scientific findings. I also am wary of the role that drug companies play in health care decisions and research. I believe that any intervention should be questioned.

I agree with all this! But it doesn't justify a turn to psuedoscience. I hear the same arguments from people here in Taiwan who take Chinese medicines whose effects have never been empirically explored.

For me, I find it far more rational that back pain is due to postural changes causing dysfunction expressed as pain rather than an absence of medication in the bloodstream.

Respectfully
Michael[/QB][/QUOTE]

I apologize for being nasty. My fault alone.

Pain always has a cause, and I know of no reputable researcher who thinks that pain is caused by the absence of medication in the bloodstream. Besides, you are still focused on attacking conventional medicine. Destroying it completely will not make chiropractic true.

Nor does showing that manipulation itself is sometimes useful a workable strategy. Nobody denies that manipulating bones can produce short-term positive effects. The issues with chiropractic lie in its absurd metaphysical basis, the inability of chiropractors to agree on basic diagnostic issues (the failure of chiropractors to find subluxtions in controlled studies is well known), and so on. Is there an Innate Life Force traveling down the nerves? Nobody's ever found it.

Chirobase has a good review here:
<a href="http://www.chirobase.org/01General/skeptic.html" target="_blank">http://www.chirobase.org/01General/skeptic.html</a>

Michael

pulpyboy

turtonm,

First of all thanks for the links to the meta-analysis sites. In an earlier post you had stated something about a BS meta-analysis. However, the first link that you provided stated this; and The second link you provided stated the following;
I am by no means anywhere near an expert on research analysis but these do not seem to condemn meta-analysis.

On to other things. British Medical Journal Volume 303 5 October1991
Where is the Wisdom...? The poverty of medical evidence by Richard Smith Editor BMJ
"Yet only about 15% of medical interventions are supported by solid scientific evidence,David Eddy, professor of health policy and management at Duke University, North Carolins, told a conference in Manchester last week. This is partly because only 1% of the articles in medical journals are scientifically sound and partly because many treatments have never been assessed at all."

Associated Press 6-1-92 Study finds drug ads are misleading "Of 109 full page ads from 10 major medical journals, researchers determined that 100 or 92% failed to meet at least one FDA rule, says the study in today's Annals of Internal Medicine."
"Wilkes said the ads put the public at risk because some studies have shown that they are doctors major source of information on new drugs"

Associated Press 10-13-94 Drug Makers Pay Off Doctors to Boost Sales,FDA Says "Drug makers improperly induce doctors and pharmicists to prescribe certain medicines, using marketing incentives that range from direct cash payments to multi-million dollar research grants, regulators contended yesterday."

JAMA July 27, 1994 Vol 272. No.4 Inappropriate Drug Prescribing for the Community-Dwelling Elderly "Conclusion.-Physicians prescribe potentially inappropriate medications for nearly a quarter of all older people living in the community, placing them at risk of drug adverse effects such as cognitive impairment and sedation."

"In the summer of 1986, two studies arrived in the offices of the New England Journal of Medicine, the biomedical community's most influential journal. Both concerned the effectiveness of an antibiotic called amoxicillin on middle-ear infections in children, and both papers were based on the same set of data. One found the drug effective; the other did not. The positive one was written by a doctor whose laboratory had over the past five years collected 1.6 million in research grants from pharmaceutical companies. The other was written by a bioengineer who had cut himself off from all pharmaceutical industry money.
Perhaps no case of biomedical research more starkly illustrates the dangerous ground that lies between researchers and the wealthy drug companies that pay them." Tainted Truth The Manipulation of Fact in America by Cynthia Crossen 1994 Simon & Schuster

Some recommended reading about Modern medicine would include the above book as well as
Medicine, Monopolies, and Malice by Chester A. Wilk 1996 Avery Publishing Group
Confessions of a Medical Heretic by Robert S. Mendelsohn 1979 Warner Books
Reclaiming Our Health by John Robbins 1996 HJ Kramer Inc
The Great Medical Monopoly Wars by P.J. Lisa 1986 International Institute of Natural Health Sciences, Inc.
Medical Nemesis The Expropriation of Health by Ivan Illich 1976 Random House,Inc.

The reason for all of the above posting is to show that there is some room for freethought with regard to modern medicine not to tear down modern medicine. I realize that posing questions about conventional medcine in no way proves anything about chiropractic. I also realize that were conventional medicine not around that also would not make chiropractic true. What I do know, is that not everything that modern medicine espouses is necessarily true. They do not have a stranglehold on the scientific method nor do they hold all the truth.

On to some more chiropractic research.

I picked out a couple that I thought you might find interesting to tear apart.
Terrett,AGJ, Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury, JMPT volume 18 number 4 May 1995

Thomas,MD, Wood,J.,Upper Cervical Adjustments May Improve Mental Function. Journal of Manual Medicine volume 4 no.1 january 1994

Biedermannn, H., Kinematic Imbalances Due to Suboccipital Strain in Newborns. Journal of Manual Medicine 19926:151-156 "The symptom complex of "kinematic imbalances due to suboccipital strain"(KISS syndrome) has a wide range of clinical signs and can in many cases be dealt with effectively by manual therapy. The main symptoms are torticollis, unilateral microsomy, C-scoliosis and motoric asymmetries, often accompanied by unilaterally retarded maturation of the hip joints and slowed motor development."

Kuo,PPF, Loh,ZC. Treatment of Lumbar Intervertebral Disc Protrusions by Manipulation. Clinical Orthopaedics and Related Research. Number 215 February 1987

Vernon,H,Spinal Manipulation and Headaches of Cervical Origin A review of literature and presentation of cases. Journal of Manual Medicine 1991 6:73-79

Murphy,BA et al.Sacroiliac Joint Manipulation Decreases the H-Reflex. Electromyogr. clin. Neurophysiol. 1995, 35, 87-94 "These findings indicate that joint manipulation exerts physiological effects on the central nervous system, probably at the segmental level. The fact that the changes persisted in the presence of cutaneous anaesthesia suggests that the reflex changes are likely to be mediated by joint and/or muscle afferents."

Gorman,RF. The Treatment of Presumptive Optic Nerve Ischemia by Spinal Manipulation. JMPT1995

I also found some research in the book Principles and Practice of Chiropractic edited by Scott Haldeman 2 ed. In the chapter on Effectiveness of Spinal Manipulation and Adjustments there are 176 references at the end of the chapter. I would be happy to try and scan those pages and post the references here if you would like.

The following are research articles already published or in the process of being written that describe the ideal spinal model. These studies are being done on a research budget of about $50,000 per year raised mostly by donations from individual D.C.s such as myself.

Spinal Modeling
1. Harrison DD, Janik TJ, Troyanovich SJ, Holland B. Comparisons of Lordotic Cervical Spine Curvatures to a Theoretical Ideal Model of the Static Sagittal Cervical Spine. Spine 1996;21(6):667-675.

2. Harrison DD, Janik TJ, Troyanovich SJ, Harrison DE, Colloca CJ. Evaluations of the Assumptions Used to Derive an Ideal Normal Cervical Spine Model. J Manipulative Physiol Ther 1997; 20(4): 246-256.

3. Troyanovich SJ, Cailliet R, Janik TJ, Harrison DD, Harrison DE. Radiographic Mensuration Characteristics of the Sagittal Lumbar Spine From A Normal Population with a Method to Synthesize Prior Studies of Lordosis. J Spinal Disord 1997;10(5): 380-386.

4. Harrison DD, Cailliet R, Janik TJ, Troyanovich SJ, Harrison DE, Holland B. Elliptical Modeling of the Sagittal Lumbar Lordosis and Segmental Rotation Angles as a Method to Discriminate Between Normal and Low Back Pain Subjects. J Spinal Disord 1998;11(5): 430-439.

5. Janik TJ, Harrison DD, Cailliet R, Troyanovich SJ, Harrison DE. Can the Sagittal Lumbar Curvature be Closely Approximated by an Ellipse? J Orthop Res 1998; 16(6): 766-770.

Not Available:

6. Harrison DE, Harrison DD, Cailliet R, Janik TJ, Harmon S. A Statistically Averaged Normal Model of the Thoracic Kyphosis. (Being written)

7. Harrison DE, Harrison DD, Cailliet R, Janik TJ, Harmon S. An Ideal Anthropometric Model of the Thoracic Kyphosis. (Being written)

8. Janik TJ, Harrison DD, Harrison DE. The Harrison Spinal Model: Evaluation of the Slope, Shear, and Bending Moments at the Points of Inflection. (Being written)

I would think that some of the above information would indicate that there are some chiropractors who embrace the scientific model and welcome the research of their profession. Your continuing reliance on quoting from chirobase.org which is editorially biased against chiropractic is getting somewhat tiring. What I have cited above are all studies published in journals listed in the index medicus. Most of chirobase.org is editorial in content or cites outdated references.
Again I will state that there are quacks in my profession that make chiropractic almost a religious experience. I do believe that while these people may be vocal, they make up the minority of chiropractic.

Thank you for the change in tone of your last response. It is appreciated.

Respectfully,
Michael