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ChiroZine Articles Archive

This section was compiled by Frank M. Painter, D.C.
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Alternative-Medicine Articles in all Recent Journals – Collected
NOTE:   The Alternative Healing Articles/Abstracts Section has moved, and may be found on the CAM drop-down on our new tan toolbar, located at the top of each section's home page. Please update your links as needed. Many NEW additions! Review the new British Complementary Medicine recommendations. Also, check out the 1993 NEJM article, by David M. Eisenberg, which first generated all the "medical" interest in alternative forms of care.

The Chiropractic Research Page
NOTE:   The Chiropractic Research Section has moved, and may be found on the RESEARCH drop-down on our new tan toolbar, located at the top of each section's home page. Please update your links as needed. This section showcases articles, abstracts, grant proposals and information pertaining to the ever-growing body of Chiropractic Research. Please feel free to contribute!

NOTE:   The Documentation Section has moved, and may be found on the CHIROPRACTIC TOOLS drop-down on our new tan toolbar, located at the top of each section's home page. Please update your links as needed. This new Section is devoted to a full description of what is considered "complete" patient file documentation, as described by National Associations and Third party Payors. It is the intention of this page to inform our profession about the most efficient means of communicating patient information, as well as outlining what is considered an "adequate" presentation. It is not the intention of this Documentation section to create standards –– just to clarify them.

Chiropractic Integration or Isolation: What Price?
Robert Mootz, D.C.
Dynamic Chiropractic – October 22, 2001

Despite all of the advances and inroads our profession has made, we remain outsiders in many ways, particularly in the world of conventional health care. In the past, this was due in great measure to the ostracism of organized medicine. Today, I suspect it is primarily our own fear of success and all it might entail. As a profession, we want the accolades and rewards that mainstream recognition has to offer, but often seem to shun the responsibilities, competition, and additional work required to achieve it.

Chiropractic Use of Glucosamine Sulfate in the Treatment of Osteoarthritis
J Manipulative Physiol Ther 1997; 20(6); 400–404

The rationales for using NSAIDs in the treatment of osteoarthritis is controversial and openly contested. Given the detrimental effects of NSAIDs on joints and other organs, their use should be discouraged and their classification as a first choice conservative treatment should be abolished. (emphasis added) A truly effective and conservative approach to the treatment of osteoarthritis should include chiropractic manipulation, essential nutrient supplementation, exogenous administration of glucosamine sulfate and rehabilitative stretches and exercises to maintain joint function.

Single-blind Randomised Controlled Trial of Chemonucleolysis and
Manipulation in the Treatment of Symptomatic Lumbar Disc Herniation

European Spine Journal 2000; 9 (3): 202–207 ~ FULL TEXT

Crude cost analysis suggested an overall financial advantage from manipulation. Because osteopathic manipulation produced a 12–month outcome that was equivalent to chemonucleolysis, it can be considered as an option for the treatment of symptomatic lumbar disc herniation, at least in the absence of clear indications for surgery. In this study it was shown that for managing disc herniations, the cost of treatment failures following a medical course of treatment [chymopapain injections] averaged 300 British pounds per patient, while there were no such costs following spinal manipulation.

The House Approves Chiropractic Care to Veterans in All VA Medical Centers
Dynamic Chiropractic – November 19, 2001

The Department of Veterans' Affairs (DVA) has been dragging its feet for a number of years on incorporating chiropractic within its medical centers. On Oct. 16, 2001, the 31–member House Veterans' Affairs Committee, chaired by Christopher Smith (R-NJ), acted. It approved, with only one dissenting vote, legislation (H.R. 2792) to mandate chiropractic benefits in the Department of Veterans Affairs (DVA), and placed it on the House calendar for consideration.

Mid-Thoracic Dysfunction: A Key Perpetuating Factor of Pain
in the Locomotor System

Dynamic Chiropractic – September 12, 2001

Mid-thoracic dysfunction involves increased kyphosis of the thoracic spine from T4–T8, usually the result of prolonged sitting in a constrained posture. Thoracic, lumbopelvic and cervicocranial posture are interrelated as links in a chain (see Figure 1). When excessive slumping becomes habitual, according to Brügger, it is called the sternosymphyseal syndrome.

Chiropractic Care in Pregnancy for Safer, Easier Births
Jeanne Ohm, D.C.

Another important reason for chiropractic care throughout pregnancy is to help establish balance in the mother’s pelvis. Because of a lifetime of stress and trauma to her spine and pelvis, her pelvic opening may be compromised, resulting in a less than optimum passage for the baby. Williams Obstetrics Text tells us that, "Any contraction of the pelvic diameters that diminish the capacity of the pelvis can create dystocia (difficulty) during labor." You can find more articles like this in the Pediatric Section.

Models of Vertebral Subluxation: A Review
Journal of Vertebral Subluxation Research 1996; 1 (1): 1–6 ~ FULL TEXT

Enjoy this Adobe Acrobat file (59 KB) from the first issue of JVSR, a review of clinical models of the vertebral subluxation, including neurobiological mechanisms. Models reviewed include the subluxation complex model, subluxation degeneration, nerve compression, dysafferentation, the neurodystrophic model and segmental facilitation. Clinical models, including the segmental, postural, and tonal approaches are discussed. You may also want to review our Subluxation Articles Section.

In Memoriam –– Richard C. Schafer
I am sad to announce that Richard C. Schafer, DC, PhD, FICC, pioneer chiropractic author, has passed away following a long struggle with cancer.

What's in a Name? The Labelling of Back Pain
Medl Journal of Australia 2000; 173 (16 Oct): 400 –1 ~ FULL TEXT

Diagnostic labels are important in the management of patients. Patients expect a name for their condition. A label shows that the doctor knows what is wrong. But such labels should not be incorrect or specious, lest they lead to therapeutic misadventure.

Characteristics of Sagittal Vertebral Alignment in Flexion
Determined by Dynamic Radiographs of the Cervical Spine

Spine (Phila Pa 1976) 2001 (Feb 1); 26 (3): 256–261

This study was conducted to depict the change patterns of intervertebral motion of the cervical spine during flexion, upright, and extension positions using dynamic radiographs. Special interest was focused on the flexion position.

Antibiotics/Antimicrobials Ineffective for Treatment of Children With Acute Sinusitis
PEDIATRICS 2001; 107 (4) April: 619–625

This randomized trial found that neither amoxicillin nor amoxicillin-clavulanate offered any clinical benefit compared with placebo for children with clinically diagnosed acute sinusitis.

Research perspectives in Asthma: A rationale for the
therapeutic application of magnesium, pyridoxine, Coleus forskholii
and Ginkgo biloba in the treatment of adult and pediatric asthma

The Internist 1998 (Sept); 5 (3): 14–16 ~ FULL TEXT

Thanks to the American Chiropractic Association's Council On Family Practice for their permission to reprint this article exclusively at Chiro.Org.

Children and the Caffeine Culture
Do you know what your kids are drinking right now???

NutraSweet (TM): The Bitter Truth
It looks like sugar, tastes like sugar (so I'm told), even feels like sugar. But it has virtually no calories, doesn't rot your teeth, and, unlike saccharin, has not been proven to cause cancer. The advertisements say it's as natural as a glass of milk and a banana. I always say if it sounds too good to be true, it probably is.

Antimicrobial Resistance: A Plan of Action for Community Practice
American Family Physician 2001; 63 (6) Mar 15; 1087

Antibiotic resistance was once confined primarily to hospitals but is becoming increasingly prevalent in family practice settings. Recent reports of pediatric deaths and illnesses in communities in the United States have raised concerns about the implications and future of antibiotic resistance.

Posturing for Wellness: Good Health Begins with Good Posture
Doctors of chiropractic have long emphasized the importance of posture and other lifestyle factors in the body's ability to function optimally. In a broad sense, good posture can be considered an ongoing battle against bad habits.

What the Government says about Chiropractic

Chiropractic in the United States: Training, Practice, and Research
AHCPR Publication No. 98-N002
December 1997

One hundred years ago, the founder of the chiropractic profession, D. D. Palmer, reportedly used spinal manipulation to restore a deaf janitor’s hearing. A series of events following this dramatic incident ultimately led to the establishment of what is now one of the largest health care professions in the United States. From its beginnings, this new profession eschewed more invasive treatments in favor of spinal adjusting (or manipulation) as its central approach to care. During much of its first century of existence, chiropractic was shunned by the medical profession and remained on the fringe of mainstream health care. In fact, as recently as 1980, the American Medical Association’s Principles of Medical Ethics proscribed any associations between physicians and chiropractors or other "unscientific practitioners."

The COMPLETE article: Chiropractic in the United States
in Adobe PDF Format

Diagnoses and Treatment Recommendations on Workers Compensation
Medical Certificates for Back and Neck Pain

Medical Journal of Australia 2000; 173 (16 Oct): 419–422 ~ FULL TEXT

In recent years, national and international guidelines and systematic reviews -- some evidence-based -- have established standards for diagnosis and treatment of people with back or neck pain, [5–10] including the most recent National Health and Medical Research Council (NHMRC) guide to acute pain management [11] and the definitive publication on classification of pain by the International Association for the Study of Pain (IASP). [12]

Abnormal Spinal Curvature and its Relationship to Pelvic Organ Prolapse
Am J Obstet Gynecol 2000 (Dec); 183 (6): 1381–1384

This Study found that an abnormal change in spinal curvature, specifically, a loss of lumbar lordosis, appears to be a significant risk factor in the development of pelvic organ prolapse.

Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache
Duke University Evidence-based Practice Center

In 1996, the Agency for Health Care Policy and Research (AHCPR) was scheduled to produce a set of clinical practice guidelines on available treatment alternatives for headache. This headache project was based on the systematic evaluation of the literature by a multidisciplinary panel of experts. Due to largely political circumstances, however, their efforts never came to fruition. The work was never released as guidelines, but was instead transformed with modifications and budget cuts into a set of evidence reports on only migraine headache. Thanks to FCER funding, the evidence reports have now been updated on both cervicogenic and tension-type headaches.
You may also download this as an Adobe Acrobat (PDF) file.

Does Early Joint Trauma Lead to Osteoarthritis?
Annals of Internal Medicine 2000; 133(5) Sept 5: 321–328

This page describes the increased risk of oateoarthritis following trauma, then reveals that surgery also increases that risk, and goes on to suggest that those risks can be reduced with conservative chiropractic care.

A Prospective Study of Back Belts for Prevention of Back Pain and Injury
JAMA 2000 (Dec 6); 284 (21): 2727–2732

In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain.

Chiropractic Theory in Research:
Subluxation Theory Finally Gets the Attention It Deserves

Robert Mootz, D.C. ~ FULL TEXT

I have been hearing and reading a lot of negative comments about chiropractic lately, mostly from chiropractors. It seems many e-mail discussions have centered on negative research studies, bashing of "out-of-touch" trade organizations, media slams, and tug-of-wars among some of the chiropractic "factions." Oh, and let's not forget the challenge of staying in business with all the competition for patients and an abusive managed care reimbursement environment.

Improving Medical Documentation   PDF
Medicare Part B Bulletin–– November 2000

This Adobe Acrobat page describes Medicare's efforts to improve the use of E&M codes, and has some interesting comments on the quality of medical documentation. Enjoy!

Dietary Exposures to Food Contaminants across the United States
Environmental Research 2000; 84 (2) Oct

Food consumption is an important route of human exposure to pesticides and industrial pollutants. Average dietary exposures to 37 pollutants were calculated for the whole United States population and for children under age 12 years by combining contaminant data with food consumption data and summing across food types.

Backpacks and Children
A Chiro.Org article collection

This new section on the effects of backpack loading on children's spines will compile articles from the scientific and popular press.

Chiropractic Care for Children?  – Recent Additions
A Chiro.Org article collection

Is Chiropractic care for children a controversial topic?   This page is devoted to discussing the literature supporting the need for, safety, and the benefits of chiropractic care for children.

The “Kids Need Chiropractic, Too” Page
A Chiro.Org article collection

This page is a collection of articles by various authors about the need for, safety, and the benefits of chiropractic care for children.

Join us as we shed some light on these self-appointed guardians of the Public Good.

President Clinton Signs Permanent Chiropractic Benefit for Military Into Law
WASHINGTON, Oct. 31, 2000 /PRNewswire/ – –
President Bill Clinton yesterday signed into law the historic legislation, H.R. 4205, mandating that chiropractic care be made available to all active duty personnel in the United States armed forces.

The Art of Pioneer Chiropractic Technic
This extensive monograph was written by Richard. C. Schafer, DC, PhD, FICC. for the benefit of new graduates, who are better trained in diagnosis but may be less secure in their technique skills. Enjoy!

Chiropractic Care for Common Industrial Low Back Conditions
Chiropractic Technique 1993 (Aug); 5 (3): 119–125 ~ FULL TEXT

This is the first guideline I have seen which actually states the number of visits which may be appropriate for a variety of common low back conditions.   I have used these "care plans" for years, presenting them to third party's as a "working diagnosis" care plan, which need ongoing "fine tuning" during patient care. Check out this Chiropractic Technique article, and the attached care plans, which have been released exclusively to Chiro.Org by the National College of Chiropractic. Thanks, Dana! You will find other information like this in the GUIDELINES Section.

Lawmakers Criticize Veterans Affairs Witnesses
On Inadequate Chiropractic Policy

Tuesday Oct 5, 2000 –
During a hearing before the House Committee on Veterans Affairs Subcommittee on Health, congressional lawmakers sharply criticized officials from the U.S. Department of Veterans Affairs (VA) for that agency's failure to take aggressive action to ensure that veterans are provided with chiropractic care.

Evidence-Based Medicine: What It Is and What It Isn't
British Medical Journal 1996 (Jan 13); 312 (7023): 71–72 ~ FULL TEXT

Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise we mean the proficiency and judgement that individual clinicians acquire through clinical experience and clinical practice.

Fragmentation of Patient Care Between Chiropractors and Family Physicians
Archives of Family Medicine 2000 (May); 9 (5): 446–450 ~ FULL TEXT

These findings indicate that care is fragmented between chiropractors and the general medical sector, with little information communicated between health care providers on issues with critical importance to quality of care. Further study is needed to identify ways to improve communication and coordination of care.

CDC Reports: Hospital Infections and Drug-resistance Rise in U.S.
The rate at which patients pick up an infection while being treated in a U.S. hospital has increased 36 percent in the past 20 years, U.S. health researchers said Wednesday.

The Placebo Prescription
New York Times Magazine   Jan 9, 2000 ~ FULL TEXT

An interesting article posits the question: "How did (the arthroscopic surgeon) know that whatever benefit came from this surgery wasn't a product of the placebo effect -- that is, that those who improved did so, not because the operation actually healed the knee joint, but because (the patient) expected it would?"   Fascinating reading, and may be applied to the chiropractic intervention as well.

Vitamin and Mineral Supplement Use in the United States:
Results From the Third National Health and Nutrition Examination Survey

Arch Fam Med 2000 (Mar); 9 (3): 258–262 ~ FULL TEXT

Consumption of vitamin and mineral supplements is a common behavior in the United States. We recommend that physicians and health professionals include questions about the use of dietary supplements when obtaining a medical history from their patients, that all dietary supplements clearly list ingredients and known contraindications to use, and that all those planning to use supplements first have their dietary practices and lifestyle evaluated by a health professional.

ABC of Complementary Medicine: The Manipulative Therapies:
Osteopathy and Chiropractic

British Medical Journal 1999 (Oct 30); 319: 1176–1179 ~ FULL TEXT

Osteopathy and chiropractic share a common origin. Their roots can be found in folk traditions of "bone setting," and both were systematised in the late 19th century in the United States: Daniel D Palmer, the founder of chiropractic, is said to have met with Andrew Taylor Still, the founder of osteopathy, before setting up his own school. The therapies remain relatively similar, and many textbooks and journals are relevant to both. The term "manipulative therapy" refers to both osteopathy and chiropractic.

ABC of Complementary Medicine:
Complementary Medicine and the Doctor

British Medical Journal 1999; 319 (11 December): 1558–1561 ~ FULL TEXT

Doctors deal with complementary medicine in a variety of professional situations. Patients may ask for advice about whether to pursue complementary therapies or which therapist to consult; they may request referral or delegation, either privately or on the NHS; or they may want to discuss treatment or advice given by complementary practitioners. Doctors prescribing drugs to patients taking complementary treatments may have concerns about possible interactions. Doctors should therefore consider strategies for minimising risk and facilitating sensible and appropriate discussions with patients and complementary practitioners.

ABC of Complementary Medicine:
What is Complementary Medicine?

British Medical Journal 1999; 319 (11 December): 1558–1561 ~ FULL TEXT

Complementary medicine refers to a group of therapeutic and diagnostic disciplines that exist largely outside the institutions where conventional health care is taught and provided. Complementary medicine is an increasing feature of healthcare practice, but considerable confusion remains about what exactly it is and what position the disciplines included under this term should hold in relation to conventional medicine.
There are more articles like this in our ALT-MED Section

Coverage for Alternative Treatments Rises, and Trend Has Yet to Peak
CNN (Cable News Network) ~ November 23, 1999

Managed care organizations and health insurance companies are becoming more open-minded about covering alternative treatments. Fueling the trend: consumer demand, a growing body of evidence that some of the treatments work and, much less often, government mandates.

Show me the Food Guide Pyramid
This contains serving sizes and suggestions for how to make the best choices for you and your family.

The Leading Causes of Death
The leading causes of death are all lifestyle related and often preventable.   Chronic diseases comprise the three leading causes of death in the United States--heart disease, cancer, and cerebrovascular disease--and they account for nearly two thirds of all deaths.

Neck Disability Index (NDI)
Thanks to Howard Vernon, D.C. for releasing the NDI exclusively to Chiro.Org
This modified Oswestry questionnaire is a very useful Outcome Assessment Tool.

Understanding Alternative Health Care
J Neuromusculoskeletal System 1998; 6 (3): 95–99 ~ FULL TEXT

It is first useful to ask in what sense AHC is alternative. Alternative to what? It is not necessarily alternative to medicine. Some of the most prominent advocates/theorists of the alternative health care movement are medical physicians, and there are many instances of alternative therapies being used by medical physicians in medical settings. What does set AHC apart are the metaphysical belief systems upon which most are predicated. Most systems propose novel physical or biological laws, or the existence of as yet undiscovered forces: chiropractic has its innate Intelligence and subluxations, acupuncture has its meridians and chi, and homeopathy has its laws of infinitesimals and similars. Alternative status derives principally from these beliefs and the means by which they are conceived and examined alternative, therefore, to the conventions of the scientific method, and to the orthodox understanding of the nature of health and disease.

The Failure of Standard Orthopedic and Neurologic Tests, Part II
Dynamic Chiropractic ~ Septtember 25, 1995

In the previous article I claimed that the majority of patients involved in motor vehicle accidents rarely present with radicular-type symptoms. Although from my experience this is true, it does not dismiss the responsibility of the chiropractor to still evaluate for this possibility. The chiropractic physician should pay careful attention to de-emphasize these testing procedures which we would expect normally to be negative, and create emphasis on those testing procedures which tend to be more sensitive.

Quack-watch gets a well-deserved black-eye in this Village Voice review titled:
Doctor who? Diagnosing Medical Fraud May Require a Second Opinion

Village Voice   June 23–29, 1999

Barrett believes most alternative therapies simply should be disregarded without further research. "A lot of things don't need to be tested [because] they simply don't make any sense," he says, pointing specifically to homeopathy, chiropractic, and acupuncture. He believes that consumers should rely solely on established medical groups and studies, and that anyone who wants to consider info on both sides is "waiting to be quacked in a major way."

Common ICD-9 Codes For The Chiropractic Office
This is a cross-section of the ICD-9 Codes commonly used in chiropractic offices, listed by body region and complaint. These codes were compiled from the International Classification of Diseases (ICD-9) 9th Revision by PMIC.

The Response to the Dysmenorrhea Study
Published April 1999 in the Pain Journal

Anthony Rosner, PhD, director of research
Foundation for Chiropractic Education and Research (FCER)

Patricia Brennan's dysmenorrhea study, a full-scale clinical trial begun in 1992, has resulted in a paper accepted for publication in April 1999 by the journal Pain.1 It was preceded by a pilot study addressed to the same issue which was published in the Journal of Manipulative and Physiological Therapeutics in 19922. Unfortunately, the recent publication in Pain suffers from a number of design flaws, omissions of data, and unexplained contradictions with the earlier pilot study--all of which significantly compromise its validity and leave more questions unanswered than resolved. One wishes that greater efforts were made by the authors to resolve what had appeared to be a positive result in the earlier investigation with the negative findings obtained in the more recent publication, above and beyond what sometimes might be expected with the differences of population types and numbers between the two investigations.

"Customized Individual Supplements" may be fraudulent
Companies who claim to make nutrients for consumers, based upon their own individual requirements are often frauds. Many of these companies request a urine sample as the basis for determining what your patient's individual nutritional requirements are. The supplement for your patient is then "created", based on deficiencies found in the urine sample. This completely ignores considerations, such as the fact that while some nutrients are retained in the body and are not depleted for a number of days, other nutrients are excreted in the urine. Keep in mind also that excess nutrients are often flushed out of the body in the urine, while the absence of other nutrients from a urine sample do not provide any indication as to whether there is a need for that specific nutrient or not.

Learn Why There Has Been No Significant Chiropractic Legislation Passed
During the Last 20 years: One Man's Opinion

R. C. Schafer, DC, PhD, FICC

For over 30 years, the Journal of the ACA listed headquarters staff. This policy was discontinued last year because presently there is not a single DC on the professional staff. The interests of DC members are now under the complete control of lay people. These people shuffle to work each day, do what they are told by the non-DC administrator, and collect their high salaries without any idea of what is important or not to the professional membership.

MDs Employ Spinal Manipulation After a Short Training Course:
The Ensuing Study Then Reveals Limited Benefit for the Patients

The Back Letter 1998: 13 (11): 123 ~ FULL TEXT

Timothy Carey, MD's trial involved teaching MD's manipulation in two one-day sessions, and a refresher session, adding up to a grand total of 18 hours of training. When it yielded "poor" patient outcomes (what a shock, eh?), he stated that: "Overall, the results do not support training primary care physicians in manipulative techniques" said Carey."

Paresthesias: A Practical Diagnostic Approach
American Family Physician 1997 (Dec); 56 (9): 2253–2260 ~ FULL TEXT

Paresthesias may be caused by central or peripheral nervous system abnormalities. Central nervous system­induced paresthesias are most commonly caused by ischemia, structural or compressive phenomena, infection, inflammation or degenerative conditions. Peripherally induced paresthesias can be caused by entrapment syndromes, metabolic disturbances, trauma, inflammation, connective tissue diseases, toxins, hereditary conditions, malignancies, nutritional deficiencies and miscellaneous conditions. Confirming the diagnosis and establishing an etiology may require appropriate laboratory and radiologic studies, or other studies. In most cases, the specific clinical syndromes associated with the paresthesias, coupled with the presenting neurologic findings, provide the physician with a framework for the diagnosis.
There are 3 excellent dermatome sketches in this article.

Dysafferentation: A Novel Term to Describe the Neuropathophysiological Effects of
Joint Complex Dysfunction. A Look at Likely Mechanisms of Symptom Generation

J Manipulative Physiol Ther 1997; 20: 9 ~ FULL TEXT

Check out this thought provoking David Seaman article, which has been released exclusively to Chiro.Org by National College of Chiropractic and JMPT . Thanks, Dana!
You may also enjoy this response from a chiropractic researcher.

Philosophy and Science versus Dogmatism in the Practice of Chiropractic
Journal of Chiropractic Humanities 1998; 8(1): 55–66 ~ FULL TEXT

In the minds of many chiropractors, there is an ongoing battle in the chiropractic profession between two factions, one of which believes that the practice of chiropractic should be guided by philosophy and another which believes that science should guide the practice of chiropractic. It is my contention that a battle between philosophy and science does not and cannot exist within the chiropractic profession or any other discipline. I contend that the real battle is between the great majority of chiropractors who unknowingly allow dogmatism to guide the practice of chiropractic and the extremely rare variety of chiropractor who's practice of chiropractic is guided by philosophy and science.

Medical Malpractice Implications of Alternative Medicine
D. M. Studdert, D. M. Eisenberg et al.
JAMA 1998; 280: 1610–1615

This article reviews the liability for medical doctors who refer to chiropractors (and other "alt-med" practitioners). They found that claims against DC's were considerably lower than against MD's: 2.67 claims per 100 policy-holders for DC's versus 7.61 claims for MD's.

U.S. Drug Safety Monitoring Must Be Expanded
JAMA 1998; 279: 1571–1573

Thomas J. Moore of the Center for Health Policy Research at George Washington University Medical Center in Washington, D.C., and colleagues, note that an estimated 1.5 million people require hospitalization and 100,000 die each year because of injuries linked to prescription drugs

Chiropractic for Low Back Pain
British Medical Journal 1998; 317 Jul 18: 160 ~ FULL TEXT

Chiropractic includes various techniques used in the hope of correcting vertebral disc displacements, freeing spinal joint adhesion, inhibiting nociceptive impulses, or correcting spinal misalignment. Several national guidelines on the treatment of low back pain recommend spinal manipulation, including chiropractic, as a symptomatic treatment for acute uncomplicated cases where pain fails to resolve spontaneously within the first months. (1)

Responses to BMJ's "Chiropractic for low back pain"
British Medical Journal 1999 (Jan 23); 318: 261 ~ FULL TEXT

By various chiropractic researchers and authors

Children not eating enough fruit and vegetables new research project reveals
Of 168 US preschoolers who participated in a week- long nutrition study, none ate the five recommended daily servings of fruits and vegetables, report researchers in the Journal of the American College of Nutrition.

Are Antibiotics Indicated as Initial Treatment for Children With Acute
Otitis Media? A Meta-Analysis

British Medical Journal 1997 (May 24); 314 (7093): 1526–1529 ~ FULL TEXT

Early use of antibiotics provides only modest benefit for acute otitis media: to prevent one child from experiencing pain by 2–7 days after presentation, 17 children must be treated with antibiotics early.

Manipulation and Tension Headaches in the AMA Journal
Commentary on JAMA 1998 (Nov 11); 280 (18): 1576-1579

Check out the article on tension headaches and chiropractic, and correspondence with the author.

Chiropractor's Opinion Concerning Subluxation Takes Precedence
Over Medical Radiologist's, HCFA Confirms

ACA Today ~ June 1999

Chiropractor's Opinion Concerning Subluxation Takes Precedence Over Medical Radiologist's, HCFA In a significant step toward parity for the chiropractic profession under the Medicare program, the Health Care Financing Administration (HCFA) has clarified that a doctor of chiropractic's findings of a subluxation in a Medicare patient takes precedence over the opinion of a medical radiologist. In addition, at the request of the American Chiropractic Association (ACA), HCFA has clarified that chiropractic principles and definitions of a subluxation are to be used to determine Medicare coverage, and an existing MRI may be used to demonstrate the existence of a subluxation in a Medicare patient.

Alternative Medicine -- The Risks of Untested and Unregulated Remedies:
A Medical Opinion

NEJM 1998; September 17 339 (12)

It's clear from the tone of this NEJM article that organized medicine is running scared...and they not reading the literature very closely...The NUTRITION Page is filled with the sort of studies that they claim haven't been done. I do agree that manufacturer's should be regulated to assure the public that they are actually getting what the bottle claims it contains.
See also:   St. John's Wort Fails Potency Tests

Subluxation and Neurology Articles
A Chiro.Org article collection

This page contains articles relating to the vertebral subluxation complex.

"Outcome of Low Back Pain in General Practice: A Prospective Study"
(FULL TEXT) states that "Back Pain Persists One Year Following Treatment
In Three-Quarters Of Patients"

British Medical Journal 1998 (May 2); 316 (7141): 1356–1359 ~ FULL TEXT

The results are consistent with the interpretation that 90% of patients with low back pain in primary care will have stopped consulting with symptoms within three months. However most will still be experiencing low back pain and related disability one year after consultation.

Deja Vu ... Kirlian photography?
In 1973, while finishing my senior year at college, I jumped at the opportunity to take an elective course from a renown economics professor. The course, "The Future - year 2000" , required analyzing current economic, political and scientific developments and forecasting their influence at the turn of the century. In addition, each student must find and make a presentation on some obscure discovery that might have future importance. So, I researched Kirlian photography.

More Drug Rules Needed in Nursing Homes
USA Today ~ Nov. 17, 1997
Ten years after Congress attacked improper drug use by nursing homes in a sweeping set of reforms, federal investigators say tougher rules are needed to combat lingering problems.

The Challenge of Antibiotic Resistance
Scientific American March 1998

Last year an event doctors had been fearing finally occurred. In three geographically separate patients, an often deadly bacterium, Staphylococcus aureus, responded poorly to a once reliable antidote--the antibiotic vancomycin. Fortunately, in those patients, the staph microbe remained susceptible to other drugs and was eradicated. But the appearance of S. aureus not readily cleared by vancomycin foreshadows trouble.

FDA Warns Against New Painkiller
February 11, 1998 -- Patients who take a potent new painkiller for longer than 10 days can suffer potentially fatal liver damage, the Food and Drug Administration said in a stern warning Tuesday to doctors who prescribe the drug Duract.

Child Acetaminophen Deaths Reported
At least 24 children in the United States have died and three have required liver transplants after receiving accidental overdoses of acetaminophen -- the most widely used medication for relief of pain and fever in children and infants, according to a report in the Journal of Pediatrics.

Back Pain Risk Continues After Pregnancy
Obstetrics & Gynecology 1998 (Feb); 91 (2): 182–186

Women with severe low back pain during pregnancy are at high risk for back pain for more than 10 years after the pregnancy –– and the problem is likely to recur in a subsequent pregnancy, according to a new study in the journal Obstetrics & Gynecology.

Spinal Manipulation for Low Back Pain:
Charlatan, Chicanery or Scientifically-tested Treatment?

Orthopedics Today 1996 (Mar)

Following the 1994 release of the Acute Lower Back Problems in Adults by the Agency for Health Care Policy and Research (AHCPR), medicine, and in particular, orthopedic surgeons, have been on the warpath.   The AHCPR report stated that the only treatment that reduced pain AND improved function was spinal "manipulation". It also concluded that many medical treatments for low back pain were either useless or were actually harmful. Orthopedics Today arranged a Point-Counterpoint collection of articles, positing Vert Mooney, MD against our own Scott Haldeman, MD, PhD. Enjoy this historic series of articles!

Cervical Discogenic Pain: Prospective Correlation of Magnetic Resonance Imaging and Discography
in Asymptomatic Subjects and Pain Sufferers

Spine 1996 (Feb 1); 21 (3): 300–311

Significant cervical disc anular tears often escape magnetic resonance imaging detection, and magnetic resonance imaging cannot reliably identify the source(s) of cervical discogenic pain.

Conservative Management of Mechanical Neck Pain:
Systematic Overview and Meta-analysis

British Medical Journal 1996 (Nov. 23); 313 (7068): 1291–1296 ~ FULL TEXT

Twenty four randomised clinical trials met the selection criteria and were categorised by type of intervention: nine used manual treatments; 12 physical medicine methods; four drug treatment; and three education of patients (four trials investigated more than one form of intervention). The intervention strategies were summarised separately. Pooling of studies was considered only within each category. Five of the nine trials that used manual treatment in combination with other treatments were combined. One to four weeks after treatment the pooled effect size was -0.6 (93% confidence interval -0.9 to -0.4), equivalent to an improvement of 16 (6.9 to 23.1) points on a 100 point scale. Sensitivity analyses on study quality, chronicity, and data imputation did not alter this estimate. For other interventions, studies could not be combined to arrive at pooled estimates of effect.

Atrophy of Suboccipital Muscles in Chronic Pain Patients
We have observed previously unreported muscle atrophy in the rectus capitis posterior minor (RCPMI) muscles of a group of chronic pain patients. We hypothesize that chronic pain, in this select group of patients, is a consequence of tramua that occurs to the C1 dorsal ramus during whiplash. Damage to a peripheral nerve can result in motor and sensory dysfunction within peripheral and/or central structures, effecting a perception of pain that is consistant with the clinical symptoms of our chronic pain patients.

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