August 2011
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And, Speaking of Professor Edzard Ernst:
If The Shoe Fits…

Chiro.Org Blog: Dr Iain Chalmers, the director of the UK Cochrane Centre and a vociferous proponent of systematic reviews, told delegates: “Critics of complementary medicine often seem to operate a double standard, being far more assiduous in their attempts to outlaw unevaluated complementary medical practices than unevaluated orthodox practices.” He also said: “These double standards might be acceptable if orthodox medicine was based solely on practices which had been shown to do more good than harm, and if the mechanisms through which their beneficial elements had their effects were understood, but neither of these conditions applies.” […]

Manipulative Therapy: Just a Placebo?

Chiro.Org Blog: Chiropractic care, particularly spinal manipulation or adjustment, is an increasingly frequent topic in medicine and health care policy circles. As evidence has accumulated to support use of these services, there is frequent reference to a presumption of placebo effect being the mechanism of favorable responses reported in the literature. These charges are easily refuted by specific data. In my experience, a professional head-on response silences these critiques and allows the discussion to refocus on a much more useful topic: appropriate use the paragraphs that follow were crafted as a part of a book chapter on the role of chiropractic manipulation in management of pain the basis often used to set the stage for a claim of a placebo effect. An effective rejoinder follows. […]

Edzard Ernst ruffles feathers in the UK

Professor Edzard Ernst caused an uproar this week when he labelled Prince Charles a ‘snake oil salesman’ for his dandelion and artichoke detox remedy. […]

Utilization, Cost, and Effects of Chiropractic Care on Medicare Program Costs

Chiro.Org Blog: An older study of Medicare cost data completed in June (2001 or 2002) by the well-known Washington, DC-based firm Muse & Associates helps prove the cost-saving impact that chiropractic care has on the current federal Medicare program. The study, titled “Utilization, Costs, and Effects of Chiropractic Care on Medicare Program Costs,” was commissioned by the ACA and is the first study of its type to compare the global, per capita Medicare expenditures of chiropractic patients to those of non-chiropractic patients receiving care in the federal Medicare program. The study utilizes data obtained from Medicare’s Standard Analytical Files for 1999–the most recent year cost data is available for analysis. […]

Steroid Injections Offer Little Relief for Lower Back Pain

Chiro.Org Blog: A randomized, controlled trial has shown an epidural or translaminar steroid injection is ineffective for the relief of lower back pain. “I’m not saying that steroids don’t work. I’m just saying there’s definite reason to question whether they work or not,” Dr. Daniel Steinitz, an orthopedic surgeon at Belleville General Hospital in Ontario, said in an interview after his presentation at the American Academy of Orthopedic Surgeons meeting here. […]

The Evolution of Chiropractic — Science & Theory

Chiro.Org Blog: I have had the privilege of being associated with chiropractic and chiropractic ideas all of my life through my father and grandmother, both of whom were practicing chiropractors. I have also been lucky to have participated in one of the most exciting phases in the evolution of chiropractic over the past 35 years. I thought that it would be of interest to younger researchers and clinicians to present my views on how the profession has evolved to its current position in society and how this evolution has impacted our understanding of chiropractic. I plan to discuss how we can put the changes in the role of science over the past 100 years in perspective and how these changes are likely to impact our lives as researchers, chiropractors, and physicians studying and treating patients with spinal disorders. […]

Spinal Manipulation May Help Reduce Spinal Degenerative Joint Disease and Disability

Chiro.Org Blog: Has the hypomobile manipulable joint lesion been demonstrated to exist? Historically the manipulable joint lesion has, from the beginning of the chiropractic profession, been described as a painful stiff joint. [1, 2] Joint stiffness, commonly called hypomobility (also known in the chiropractic profession as “fixation”) has become by consensus one of the most important aspects of the manipulable joint lesion in the professions of chiropractic, osteopathy, and manual medicine. [3, 4] Nearly 100 years of clinical agreement between three separate professions supports the existence of such a lesion although research now supports its existence. […]

Bipartisan Group Urges Pentagon to Examine Chiropractic Provider Status

Chiro.Org Blog: 15 members of the U.S. House of Representatives Armed Services Committee have requested that the Department of Defense (DoD) address disparities in its treatment of doctors of chiropractic. In an Aug. 5 letter to Dr. Jonathan Woodson, Assistant Secretary of Defense for Health Affairs, the bipartisan group noted that pay and job classification disparities have resulted in doctors of chiropractic (DCs) who treat patients at military treatment facilities (MTFs) being compensated at much lower rates than providers with comparable, or even lesser, training, skill sets and responsibilities. They urged Woodson to examine the more equitable system used by the Department of Veteran Affairs health care system to integrate chiropractic and adopt a similar approach. […]

The Inherent Problems With Randomized Controlled Trials

Chiro.Org Blog: From the point of view of clinical practice, however, especially in areas in which physical treatments are applied, the principles of fastidious treatments and blinding begin to wear thin and in a few recent examples regarding spinal manipulation, appear to have fallen apart completely. This difficulty is by no means confined to physical treatments, as the literature pertaining to the use of medications has also suggested that the inexperienced use and/or uncritical acceptance of the results of RCTs can lead to confusion. […]

Chiropractic Research Testimony at the National Institute of Medicine

Chiro.Org Blog: Anthony Rosner, Ph.D., Director of Research and Education for the Foundation for Chiropractic Education and Research, presented testimony on behalf of chiropractic research and practice standards at hearings conducted at the Institute of Medicine (IOM) headquarters in Washington, D.C. […]

The Obstacles and Barriers to CAM or Alt-Med Research

Chiro.Org Blog: Until 25 years ago, chiropractic research was vastly underdeveloped and appeared to some as an oxymoron. In 1975, a conference at the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institutes of Health (NIH) concluded that “There are little scientific data of significance to evaluate this (chiropractic’s) clinical approach to health and to the treatment of disease.” [1] From that time onward, both clinical and basic research have advanced to the point at which (i) over 40 randomized clinical trials comparing spinal manipulation with other treatments in the management of back pain have been published in the scientific literature, [2, 3] (ii) meta-analysis and systematic reviews attesting to the support of spinal manipulation in the management of back pain [4, 5] have also appeared, and (iii) multidisciplinary panels representing the governments of the United States, [6] Canada, [7] Great Britain, [8] Sweden, [9] Denmark, [10] Australia, [11] and New Zealand [12] have expressed similar recognition of the robust evidence base in support of spinal manipulation for managing low back conditions. […]

Symptomatic Classification of Whiplash Injury and the Implications for Treatment

Chiro.Org Blog: Gargan and Bannister are renowned orthopedic trauma researchers from the Department of Orthopedic Surgery, John Radcliffe Hospital in Bristol, Oxford, England. In 1994, they published a paper in the European Spine Journal on the recovery rate of patients with whiplash injuries, and discovered that IF a patient was still symptomatic after three months, there was almost a 90% chance they would remain so. [1] […]