User talk:Dematt/Archive 1

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Happy editing!

–Sango123 (e) 01:15, 20 April 2006 (UTC)

P.S. Feel free to leave a message on my talk page if you need help with anything or simply wish to say hello. :)

A warm welcome to you; sounds to me like you have a great attitude. Don't mind the occasional barbs that fly around the place, don't get too frustrated, and keep a sense of humour. Hope you enjoy it Gleng 08:26, 20 April 2006 (UTC)

Off to a good start!

Good work on the introduction. It looks good. If you could locate the original source (not Dynamic Chiropractic) for the information quoted here,you could use it as the source/documentation for this part:

"Regardless, a majority of chiropractors still believe that subluxations play a significant role in all or most diseases and practice accordingly, while others choose to limit their practices to the care of low back and neck pain." [1]

-- Fyslee 18:54, 20 April 2006 (UTC)

Just go for it; don't be shy, trust your sense of fairness. I'll do some copyedits on it to show I've read it Gleng 11:41, 26 April 2006 (UTC)

You're doing quite well! This is what we've been needing in the article. We've had a tendency to get bogged down in debating controversial details, and letting the fleshing out of the article take the back seat. Too bad. The article (and chiropractic) deserves a well-rounded coverage of the whole topic, with all aspects being covered. There is still much that is neutral or even positive that can be written. As long as it's factual and NPOV, then go for it. There are many articles on non-chiropractic websites that describe the profession. While copyrights must be respected, you can get ideas as to basic topics and formatting, and you can find things to paraphrase. I mention non-chiropractic sites because chiropractic sites will have a tendency to paint a rosy picture, which (here) would be a sale's talk, and not a simple NPOV presentation.

One thing to keep in mind -- go slow. Too many changes at one time are hard to handle, and suspicions may get raised (among those who aren't acquainted with your editing history) that you are trying to sneak something under the radar in the whole cloud of changes. This kind of thing happens here at Wikipedia, and the reaction is often that the whole thing gets reverted back to a previous version. No need to have that happen. Take a few sentences at a time and then save that edit. Then move on. That way each step is registered and easy to understand. Keep up the good work. Nice to have a level-headed chiro on board! -- Fyslee 17:52, 1 May 2006 (UTC)

Thank you. And thanks for the advice. I did notice when Mccready was not happy with all my changes. Thanks for reverting and letting him know whats happening. I'll try to keep it slow. It's hard because I want the article to have a starting point that builds to an ending point. There are points where it looks good for chiro and points that look bad. If I stop at either, we have another war! So I try to get it all in at the same time. Then it becomes neutral. --Dematt 20:00, 1 May 2006 (UTC)

BTW, don't go anywhere!--Dematt 20:01, 1 May 2006 (UTC)

I understand your well-justified impatience. If this weren't a collaborative effort, you'd have the article done very quickly. Wikipedia is frustrating in that way, but that can't be changed. If your additions are well-documented and balanced, they will be protected by other editors who sympathize with you and support you, which means the edits will survive for a longer period of time. That's the best strategy. Unfortunately there is no way that an article achieves any finality and gets protected when it's "finished." That means that if the current editors get shifted out with others, the whole article can get vandalized and the whole process starts all over again, and a different article takes its place. I have no plans on going anywhere right now. It's just a matter of whether I have time or not. -- Fyslee 20:36, 1 May 2006 (UTC)

Chiro quote

Regarding this quote:

"For all practical purposes, there is no debate on the vertebral subluxation complex. Nearly 90% want to retain the VSC as a term. Similarly, almost 90% do not want the adjustment limited to musculoskeletal conditions. The profession – as a whole – presents a united front regarding the subluxation and the adjustment."

I have located the source of the quote for you and hope you can use it:

How Chiropractors Think and Practice: The Survey of North American Chiropractors - 2003

Published by the Institute for Social Research, Ohio Northern University

Here are selected quotes from an interview with the author, where he paraphrases parts of the survey. I have highlighted parts I find interesting:

JACA: Looking back, what would you say was your most important finding?

Dr. McDonald: That's not a difficult question. I found that, regardless of how DCs label themselves philosophically, they express considerable unity on the specific issues.

For example, most self-labeled broad-scope doctors of chiropractic (73 percent) and most self-designated focused-scope practitioners (93 percent) teach patients a relationship between spinal subluxations and visceral health.

Similarly, most broad-scope DCs (74 percent) and most focused-scope chiropractors (93 percent) agree that the adjustment "usually elicits improvement" in an allergic-type asthma case.

http://www.findarticles.com/p/articles/mi_qa3841/is_200305/ai_n9274621/pg_3

Dr. McDonald: The survey results suggest four major conclusions. For all practical purposes, there is no debate on the vertebral subluxation complex. Nearly 90 percent of the surveyed DCs want to retain the VSC within the chiropractic lexicon. Similarly, almost 90 percent do not want to see the adjustment limited to musculoskeletal conditions. The profession - as a whole - presents a united front regarding both the subluxation and the adjustment.

http://www.findarticles.com/p/articles/mi_qa3841/is_200305/ai_n9274621/pg_5

When it comes to broad-scope and focused-scope DCs, the old stereotypes are misleading. We find, for example, that the typical broad-scope respondent - in addition to favoring an array of clinical services and limited prescription rights - believes that the subluxation is a significant contributing factor in a majority of visceral ailments, and thinks that a majority of prescription medicines are clinically ineffective. We also find that the typical focused-scope practitioner - in addition to emphasizing the detection and adjustment of vertebral subluxations - performs a differential diagnosis, provides exercise recommendations, and believes vitamins and minerals are appropriate for the chiropractic scope of practice. On most issues, broad-scope and focused-scope DCs differ more in degree than in kind.

http://www.findarticles.com/p/articles/mi_qa3841/is_200305/ai_n9274621/pg_5#continue

Hope you can use this. -- Fyslee 20:32, 28 April 2006 (UTC)

That's definitely it. I remember reading it. Here's the thing, you seem to be keenly aware of all the nuances that make up the total of this profession so I think you will understand this. There is a set of chiros that never would have answered that question in the affirmative had it said "subluxation". Somewhere in the late 80's or early 90's, the concept of VSC was presented to the profession. Because VSC emphasized the musculoskeletal components and perhaps minimized the "neuropathophysiological", the subset of chiros that would except it was much, much greater.

We would have to change our sentence to reflect the VSC to accurately quote this. Otherwise, we'll have a straight/reform battle again. But I think it says exactly what we need. --Dematt 22:30, 28 April 2006 (UTC)

Sandbox

Here's your new sandbox to play with:

• Chiropractic History

You can delete it or change it. You create a subpage simply by making a link to it, then going to it and writing. You can also create more if you need them. Simple as that.

You are doing a lot of research and writing right now, and you shouldn't lose all of that good stuff, just because it will end up being shortened and edited (often by others). You may be able to use it other places as well, for example if you have a blog or ordinary website. Have fun! -- Fyslee 16:33, 4 May 2006 (UTC)

Thank you, thank you, thank you!!!! You knew exactly where I was with this didn't you:) I bet you even knew I had ten windows open trying to keep it all straight! Not to mention home and office.. Thanks again--Dematt 16:49, 4 May 2006 (UTC)

I can even talk to myself!..:P --Dematt 17:06, 4 May 2006 (UTC)

Ha ha ha! I just knew you'd enjoy it. It's nice to have your own place to store stuff and play with it. You can test various edits and formats, links, etc.. You can have pages that are a mixed bag, others that are archives for particular subjects, and others that are articles "in the making." I can see that you are already taking to it like a fish to water. Go for it and you'll find that it will free your creative gene. You will be able to produce alot, but be careful -- when you place that stuff back in the "real world" of Wikipedia talk pages and articles, all your carefully worded gems may get mercilessly edited and reverted. It sucks, but that's life here at Wikipedia. You can make other subpages, and subpages of subpages. Don't hesitate to contact me for help in any way. -- Fyslee 18:09, 4 May 2006 (UTC)

More specific link

This edit needs to have a more specific link. -- Fyslee 07:21, 7 May 2006 (UTC)

Thanks, try this. --Dematt 19:17, 7 May 2006 (UTC)

Chiropractic

Thanks for the comment. Nice addition with the chiropractic caduceus. -AED 02:39, 13 May 2006 (UTC)

---

This should take you to the template discussion:[2]. -AED 05:37, 14 May 2006 (UTC)

Thanks again!--Dematt 05:49, 14 May 2006 (UTC)

Hi Dematt, sorry to be slow on the Science side - been busy and a bit diverted. Been following the discussion page with interest. Will try something in a few days for you to look at though. Really like the way the articles been going though.Gleng 22:03, 15 May 2006 (UTC)

---

Hi, doctor. I was wondering if you could review the third sentence here and let me know if you think it is accurate enough to be incorporated into the revision you are planning on making:

Chiropractic, or chiropractic care, is a complementary and alternative medicine health profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general healthThere is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation. (Chiropractors/Some chiropractors/Many chiropractors/Most chiropractors/The majority of chiropractors) believe that abnormal displacement of vertebrae, termed vertebral subluxations, can impair or alter nerve function to interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability.

I do recognize and appreciate your efforts in writing for the enemy. Cheers! -AED 07:42, 17 May 2006 (UTC)

AED, this is nice. To be even more accurate I would add abnormal function or motion to abnormal displacement and you should be able to satisfy most chiropractors. Please bring it to the chiro talk page.--Dematt 12:15, 17 May 2006 (UTC)

Could you clarify what you had in mind, or rewrite the sentence to show me? My goal for the third sentence is to tie it together with the second sentence and explain why chiropractic places an emphasis on manual treatments. My understanding of chiropractic is that the answer to that question is the correction of vertebral subluxations, and I thought that this sentence would allow us to introduce subluxation without quotation marks, without 19th century mysticism, and from a point-of-view that straights, mixers, and skeptics could all agree. Such a statement that was referenced would certainly be a bonus!

Although the point appears to be moot now, I had hoped to solicit the opinions of a few DCs in order to verify accuracy prior to taking it to the sharkfest. The trend there appears to rewrite three sentences at a time then obtain consensus rather than attempt to seek consensus on one or two points.-AED 21:55, 17 May 2006 (UTC)

I like the sentence just the way it is. It already sounds better than most definitions and is an accurate assessment and should satisfy straights, mixers and skeptics. Occasionally, a vertebra may be aligned properly, but may be fixated due to adhesions or hypermobile from laxity in its supporting ligamentous structures. The more modern vertebral subluxation complex definition includes this phenomenon. Therefore, your sentence could be even more accurate by stating perhaps;

Most chiropractors believe that abnormal displacement and/or motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function to interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability.

And I suppose that since abnormal displacement sounds somewhat redundant, it might be more accurate to say;

Most chiropractors believe that displacement and/or abnormal motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function and interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability.

So the whole thing would go like this;

Chiropractic, or chiropractic care, is a complementary and alternative medicine health profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general healthThere is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation. Most chiropractors believe that displacement and/or abnormal motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function and interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability.

Wow, that sounds good. You would think that should satisfy everybody. Of course the last sentence would have to add the skeptical disclaimer:) What do you think?--Dematt 00:20, 18 May 2006 (UTC)

It seems accurate and neutral to me. Is there any sort of reference we could use to show that this is the view held by most chiropractors? Is there a definition of "subluxation" that you prefer or is most in line with what other DCs think? -AED 06:59, 18 May 2006 (UTC)

The survey you listed earlier This survery is probably the closest reference that I have seen to support this sentence. Though we may have changed the wording too much to quote a reference directly.

As far as a definition of subluxation goes, IMO any of the definitions that you cited work for most chiropractors. The challenge remains the straight and reform concepts. I was waiting to see if your method could solve that one:)--Dematt 15:05, 18 May 2006 (UTC)

Regarding your suggestion for the third sentence: "Chiropractic principles suggest that displacement and/or abnormal motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function and interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability." I think we're moving in the right direction, but there might be a few contradictions that need to be resolved with the aforementioned survery. That survey states that the "majority of chiropractors (68.1%) believed that 'most diseases were caused by spinal malalignment'", that "the majority of chiropractors (52.2%) disagreed that 'the subluxation is the cause of many diseases'", but that they "still believed in the concept of the subluxation as evidenced by their continuing belief in its detection by x-ray" (54% believed that they could be found via radiography. With that in mind, is it inaccurate for us to imply that chiropractic principles regard "vertebral subluxations" and "displacement and/or abnormal motion of vertebrae" as one and the same? -AED 18:17, 18 May 2006 (UTC)

You're right. That is contradictory and it doesn't seem to offer any reasons that help us. Perhaps the only way to go about it is to define chiropractic as above and then differentiate it from chiropractic care. In other words, define chiropractic according to the book and then allow for the deviations to be in the chiropractic care sentence. For instance, some DC's don't use spinal manipulation. Some use Logan Basic Method, Applied Kinesiology, Activator, acupuncture, nutritional counseling, exercise and rehab, muscle stim, ultrasound, diathermy, etc., etc.. Are they treating subluxations? In order to handle these and/or straights and reformers and rationalists and emperialists, etc., We can make a statement to say some feel differently. We don't have to be specific in the lead, but in the history we can bring out the controversies that caused some of the divisions.

Chiropractic is a complementary and alternative medicine health profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general healthChiropractic principles suggest that displacement or abnormal motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function, and thus interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability. Chiropractors differ in their application and philosophy of these principles depending on their training, region of practice, and professional experience. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation. Some studies suggest benefits in patients with tension headache and low back pain.

How we doing so far?--Dematt 02:59, 19 May 2006 (UTC)

There is a problem with relying too much on one set of statistics. Even this one has mutually exclusive opinions. Depending on the situation, you can get very different answers from the same chiropractor. Some are very consistent, understand their own beliefs very clearly, and will be able to satisfactorily give reliable answers, while others will waffle and change the wording of their answers if it can serve a politically convenient purpose. I've found websites that have literally been vacuumed for all occurrences of the word "subluxation," and substituted it with more politically correct wording. A check of the site using the Internet Archives reveals that nothing but those words has been changed, IOW deliberate deception for a political purpose. Even some official definitions of chiropractic have eliminated the "s" word, yet those associations still believe in and teach about subluxations in their literature and seminars. They have both philosophical and legal reasons for not abandoning the concept. Chiropractic legislation in most states defines chiropractic in terms of its relationship to the subluxation. This matter isn't all that simple and clear cut.....;-) If you want to get the straight and unvarnished truth about chiropractic's relationship to VS, just ask the ICA and WCA. They don't hide their lamp under a bushel. -- Fyslee 19:06, 18 May 2006 (UTC)

New chiropractic lead, synthesized version

From here, where I have attempted to synthesize our three versions (I have chosen to use two paragraphs, as it makes for easier reading and parsing.):

Chiropractic, or chiropractic care, is a complementary and alternative medicine health profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.

While chiropractors acknowledge the body's own natural ability to regulate itself, they believe they can support this process by using manual treatments, especially spinal manipulations termed "adjustments." Most chiropractors believe that abnormal displacement or motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function, and thus interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability. Some studies suggest benefits in patients with tension headache and low back pain.

When I read it, there seems to be redundancy in the 2nd,3rd and 4th sentences. How about;

Chiropractic, or chiropractic care, is a complementary and alternative medicine health profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the functions of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.

While chiropractors acknowledge the body's own natural ability to regulate itself, they believe they can support this process by using manual treatments. Chiropractic principles suggest that displacement or abnormal motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function, and thus interfere with the body's ability to stave off disease or other pathology, and that adjustments to the spine and/or extremities can restore this ability. Some studies suggest benefits in patients with tension headache and low back pain.

Fyslee, what do you think? Oh, Oh, late for work, better run!--Dematt 18:06, 18 May 2006 (UTC)

After comparing them word for word, I see what you mean. The only change I'd make is to replace "to" with "of":

"...that adjustments of the spine and/or extremities..."

Otherwise it looks good and I'd support its inclusion, with or without the references. (I'm not comfortable with using references in the lead. It should be very "clean," without references or discussion. The references can be used in the article.)

The last sentence could be in a third paragraph, along with the skeptical doubts. That paragraph could be short, with just one more sentence. We don't need to wait for that to be worked out before placing the above in the article. If AED and Gleng will also support this, we can go for it, then work out the last skeptical sentence as an add-on, rather than continually revising this part. -- Fyslee 19:32, 18 May 2006 (UTC)

Okay, let me run it by AED and see what he thinks.--Dematt 20:00, 18 May 2006 (UTC)

Hi guys, just wanted to add some input. You are working hard at coming to a consensus and that's great. Good to see some cooperation instead of combat. If I might add my two bits, the only group in chiro that doesnt' agree with the sublux appears to be the reforms. Maybe they should be mentioned separately, I don't think they even list how many members they have, so it's kinda tough to gauge what percentage they are. 1,5,10% ???? The ACA, ICA, WCA, WFC, FSCO don't appear to disagree much on the definition of chiro.(the correction of a V.S.), they more seem to differ on what should be the approach of how to deal with it. Super straights say don't address disease in any way, shape or form, VS is bad so it needs addressing, period. Reforms say only treat joint problems with "manal therapy", which would be like a PT. The others are in the middle, they still emphasize the importance of VS correction, but seem to differ on how much can be achieved by it. OK, I don't know if that helps too much ;) In my reading of chiro philosophy, they main diff in how "traditionally" chiros thought can be summed up in the example of a fever. If someone with a fever goes to a homeopath, they would try and heat the person up to "break the fever". Same person geos to a PT and they say "ice that fever to reduce it". Chiro's would say, a fever is a natural response to an invading organism, the adjustment of a subluxation would not be to stimulate or inhibit, but rather to allow the body to work its best.

I went ahead and tried to reword what ya'll have been putting together to try and make it fit the majority and have a good flow. I didn't like the "stave off disease or other pathology" part, for some reason it didn't "sit well" with me.

While chiropractors stress the body's natural ability to heal and regulate itself, they believe they can improve a hinderence to this process by using manual treatments. Chiropractic principles suggest that displacement or abnormal motion of vertebrae, termed vertebral subluxations, can impair or alter nerve function, and thus interfere with the body's ability to adapt or function normally, and that adjustments to the spine and/or extremities can restore this ability. Some studies suggest benefits in patients with tension headache and low back pain

What do you think?--Hughgr 04:39, 19 May 2006 (UTC)

References

(There may be different formats below, since this picks up all versions on this page.)

Next

Dematt: "The only thing it is missing from a chiropractic POV is the prevention."

Fyslee: Yes, that should be in there.

Fyslee: Another thing that is missing is that most chiropractors believe subluxations can cause disease. It is only the super straights (like F.A.C.E.) that don't "treat" disease, only correct subluxations. Other chiropractors also treat and prevent disease using adjustments. There is nothing in the statement above that says more than any super straight would agree with, which means it doesn't represent the viewpoint of most other DCs. They not only "support this process," they believe they can actively prevent future illness and treat existing disease processes.

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Chiropractic (lead section)

I've noted that the little I thought we had agreed upon was first altered (to slightly change the context, as you noted), then removed by Mccready with the comment "we in wp write the definition, we don't accept holus bolus defn's written by outsiders." Whether or not it was written by outsiders, they were referenced statements that were viewed as accurate by the large majority of contributors including myself. There is presently no evidence (!!!) that our contributions to the other three to five sentence wouldn't eventually end up in the trash bin, too, so I'm going to take Chiropractic off my watchlist for awhile. Best wishes! -AED 20:34, 20 May 2006 (UTC)

AED, I'm sorry to see you go, you make an excellent intermediary. Dematt, is that rfc against mccready still active? I will sign on as he seems to be the largest hinderence to progress. Hmmm.--Hughgr 00:10, 21 May 2006 (UTC)

Maybe you could share

Hi Dematt, don't want to step on your toes, just want to improve the article. If you've already got something in the works, maybe you could share what you've got on my talk page and I can help. I just noticed the history section seemed pretty bad after the initial paragraph you submitted. I'll wait to edit more until I hear from you. No worries, have a great weekend!--Hughgr 02:19, 21 May 2006 (UTC)

Roger doger, got the message. I've got all the "green" books including DD's 1910 on cdrom if you need any other references. I was hoping to get the chiro page lined up (pun intended) first, then move onto the BJP page and add to it, but I think the "resistance" here will follow me there as well, like a bad case of herpies, it won't go away! hehe--Hughgr 04:13, 21 May 2006 (UTC)

I went to work after writing to you last and finished a section up until the 1920's. Check it out. Those CD's would be awesome. You can use them, too. And keep up your good work. You are a very important part of getting chiros side out. And remember, they aren't attacking you, just what you are saying. They keep you honest. We all have areas that we can improve and the way we find them is to get attacked at our weak spots. This can only make us stronger. It is a great opportunity to learn about what others think about us, whether we want to know it or not:) Then we can all move over to the BJ page together;)--Dematt 04:36, 21 May 2006 (UTC)

This is looking good! There are some minor copy edits that could be made, but keep up the good work. -- Fyslee 11:56, 21 May 2006 (UTC)

Thanks for all your help. We're getting there. Though, sometimes it feels like delivering a baby! And not from the doctor's POV - I mean the mother's POV:) You can see I still need help with the links and references, too.--Dematt 14:36, 21 May 2006 (UTC)

Is this in the right spot?

Hi, is User Dematt/Chirohistory2 in the right spot? It seems more sutied to User:Dematt/Chirohistory2.--blue520 17:19, 22 May 2006 (UTC)

Thanks! Glad somebody is keeping an eye on me:) --Dematt 17:24, 22 May 2006 (UTC)

How about this one User Dematt/Chiropractic Definitions?--blue520 17:25, 22 May 2006 (UTC)

No, of course not. Thanks again!--Dematt 17:29, 22 May 2006 (UTC)

Use the page move tag at the top of the page (the one next to the watch tag) to move the page where you want it to go or just copy and paste to the new place. Then put a {{db-author}} tag on the old page, this tells a admin that you wish the page deleted. I hope this helps.--blue520 17:43, 22 May 2006 (UTC)

Pubmed

Pubmed reference maker

{{subst:navpop}}

Cochrane Protocols

Cochrane Chiropractic search

• Musculoskeletal group

Gout [uric acid, hyperuricemia, pseudogout] Lupus Erythematosus [systemic, discoid, cutaneous, lupus nephritis] Osteoarthritis Osteoporosis [premenopausal, post-menopausal, corticosteroid induced, osteoporosis in men ] Pediatric Rheumatology [juvenile rheumatoid] Legg Perthes Paget's Disease Physical activity Rheumatoid Arthritis Soft tissue [rheumatism, rheumatic disease, bursitis, tendonitis] Spondylo-arthropathy [psoriatic arthritis, ankylosing spondylitis, reiters disease] Systemic sclerosis [Raynauds, scleroderma] Vasculitis [Behcet's, takayasu's arteritis, purpura, schoenlein-henoch, polyarteritis, nodosa, giant cell, arteritis, Wegener's granulomatosis]

Levels of evidence From Cochrane Back and neck pain group

• Strong => consistent finding among multiple high quality RCTs
• Moderate => consistent finding among multiple low quality RCTs &/or CCTs &/or one high quality RCT
• Limited => one low quality RCT and/or CCT
• Conflicting => inconsistent finding among multiple trials (RCTs &/or CCTs)
• No evidence from trials => no RCTs or CCTs

For Chronic Asthma from Cochrane Airway group Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma.

Main results

From 473 unique citations, 68 full text articles were retrieved and evaluated, which resulted in nine citations to three RCTs (156 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed.

Evidenced Based Medicine

from Oxford-Centre for evidence based medicine

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. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisi ons about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centred clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer.

Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicabl e to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients.

This description of what evidence-based medicine is helps clarify what evidence-based medicine is not. Evidence-based medicine is neither old-hat nor impossible to practice. The argument that everyone already is doing it falls before evidence of striking variations in both the integration of patient values into our clinical behaviour [7] and in the rates with which clinicians provide interventions to their patients [8]. The difficulties that clinicians face in keeping abreast of all the medical advances reported in primary journals are obvious from a comparison of the time required for reading (for general medicine, enough to examine 19 articles per day, 365 days pe r year [9]) with the time available (well under an hour per week by British medical consultants, even on self-reports [10]).

The argument that evidence-based medicine can be conducted only from ivory towers and armchairs is refuted by audits in the front lines of clinical care where at least some inpatient clinical teams in general medicine [11], psych iatry (JR Geddes, et al, Royal College of Psychiatrists winter meeting, January 1996), and surgery (P McCulloch, personal communication) have provided evidence-based care to the vast majority of their patients. Such studies show that busy clinici ans who devote their scarce reading time to selective, efficient, patient-driven searching, appraisal and incorporation of the best available evidence can practice evidence-based medicine.

Evidence-based medicine is not "cook-book" medicine. Because it requires a bottom-up approach that integrates the best external evidence with individual clinical expertise and patient-choice, it cannot result in slavish, cook-book appr oaches to individual patient care. External clinical evidence can inform, but can never replace, individual clinical expertise, and it is this expertise that decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision. Similarly, any external guideline must be integrated with individual clinical expertise in deciding whether and how it matches the patient's clinical state, predicament, and preferences, and thus whether i t should be applied. Clinicians who fear top-down cook-books will find the advocates of evidence-based medicine joining them at the barricades.

Evidence-based medicine is not cost-cutting medicine. Some fear that evidence-based medicine will be hijacked by purchasers and managers to cut the costs of health care. This would not only be a misuse of evidence-based medicine but suggests a fundamental misunderstanding of its financial consequences. Doctors practising evidence-based medicine will identify and apply the most efficacious interventions to maximise the quality and quantity of life for individual patients; this may raise rather than lower the cost of their care.

Evidence-based medicine is not restricted to randomised trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. To find out about the accuracy of a diagnostic test, we need to find proper cross-sectional studies of patients clinically suspected of harbouring the relevant disorder, not a randomised trial. For a question about prognosis, we need proper follow-up studies of patients assembled at a uniform, early point in the clinical course of their disease. And sometimes the evidence we need will come from the basic sciences such as genetics or immunology. It is when asking questions about therapy that we should try to avoid the non-experimental approaches, since these routinely lead to false-positive conclusions about efficacy. Because the randomised trial, and especially the systematic review of several randomised trials, is so much more likely to inform us and so much less likely to mislead us, it has become the “gold standard” for judging whether a treatment does more good than harm. However, some questions about therapy do not require randomised trials (successful interventions for otherwise fatal conditions) or cannot wait for the trials to be conducted. And if no randomised trial has been carried out for our patient’s predicament, we follow the trail to the next best external evidence and work from there.

Despite its ancient origins, evidence-based medicine remains a relatively young discipline whose positive impacts are just beginning to be validated [12, 13], and it will continue to evolve. This evolution will be enhanced as seve ral undergraduate, post-graduate, and continuing medical education programmes adopt and adapt it to their learners’ needs. These programmes, and their evaluation, will provide further information and understanding about what evidence-based medicine is, and what it is not. [3]

Links

Federation of Chiropractic Licensing Boards FCLB History of Chiropractic Schools

ChiroTalk

I noticed recently that Chirotalk has started its own self-promoting article on WP. I nominated it for deletion. I thought you might want to chime in with your thoughts here. TheDoctorIsIn 23:00, 7 June 2006 (UTC)

Dematt, I started a page for Chirotalk and the chiropractic zealots are rallying to censor it. Can you please make a comment to its articles for deletion page in support of improving and keeping it? Abotnick 00:49, 8 June 2006 (UTC)

Commons:Image:Ddpalmer.gif

Hi, I saw you uploaded Commons:Image:Ddpalmer.gif, showing that you have permission from the webmaster of http://www.aucco.org/ to use images from that website. I have bad news and I have good news.

1. The bad news is, Wikipedia can't use images "by permission". Because Wikipedia consists of free content, if an image is copyrighted, we can't use it except under a claim of fair use, regardless of whether the copyright owner gives Wikipedia permission. Wikipedia content has to be free for other "downstream" users, including commercial ones.
2. The good news is, this particular image is almost certainly in the public domain. Works are in the public domain if the author (in this case, the photographer) died more than 70 whole years ago (since this is 2006, that means before Dec. 31, 1935). In addition, works first published in the United States before January 1, 1923 are also in the public domain regardless of when their author died. If you can find out (1) who the photographer is and when he died, and (2) when the photograph was first published (not necessarily when it was taken), please add that information to Commons:Image:Ddpalmer.gif. I have already provisionally marked it as published prior to 1923, but this still needs confirmation.

Angr (talk) 20:46, 9 June 2006 (UTC)

Thanks! This was my first download and I have certainly learned some things since:) Apparently this picture is all over the net with public domain because of the 1923 issue. DDPalmer died in 1913, ao I'm pretty sure we're safe! I will make the note on the talk page of the image as well. --Dematt 03:06, 10 June 2006 (UTC)

My Barnstar

I am truly grateful and humbled. Thank you. Levine2112 04:01, 15 June 2006 (UTC)

You more than earned it. Thank You. --Dematt 12:23, 15 June 2006 (UTC)

Thanks for....

Thanks for all your help when I've been deferring to you when I don't know how do to something.  :) Maybe when you get a chance, you could hop over to the vs page and help :) by adding some pics (mostly from WP) to help. Also, I haven't taken the time yet to add references but they are coming. That page was such a hatchet job, I couldn't help but start editing...I've been trying to keep what seemed relevent and from looking at that (vs) talk page, going by what they were discussing...we'll see what happens! Cheers and keep up the hard work! --Hughgr 18:04, 23 June 2006 (UTC)

PS-I've done even more editing on the vs page, check it out and let me know what you think. I'm starting to get the hang of this, so maybe I won't have to rely on your expertise as much ;) BTW, the pics were from other articles here on WP so copyright should be a problem, right?--Hughgr 23:51, 23 June 2006 (UTC)

That quote was from: "TEXT-BOOK OF THE SCIENCE, ART AND PHILOSOPHY OF CHIROPRACTIC", D.D. PALMER, PORTLAND, OREGON PORTLAND PRINTING HOUSE COMPANY[1910]

I'm having trouble with adding links to resources, and this is fun, but not making links to resources :)--Hughgr 01:49, 24 June 2006 (UTC)

okay, we already have this reference on the chiro page. Click to edit this section and then copy the reference under this and paste it at the end of the sentence that you want it. I fixed the Strang reference for you, so see if you can see how I did it and just do the same thing. You don't have to do anything in the references section - it does it by itself.

--Dematt 02:20, 24 June 2006 (UTC)

Coooool, thanks Dematt, YOU are the man! Hope you have a great weekend! --Hughgr 16:52, 25 June 2006 (UTC)

Universal Intelligence

Universal Intelligence I've started this page, perhaps you could check it with your editing expertise :)--Hughgr 00:05, 8 July 2006 (UTC)

For an interesting take on DNA, check out a paper written by Bruce H. Lipton, Ph.D. [4] --Hughgr 19:21, 14 July 2006 (UTC)

Sorry for your loss, odd timing though eh. ;)--Hughgr 05:58, 15 July 2006 (UTC)

I suppose it could just be a random role of the dice:)--Dematt 13:41, 15 July 2006 (UTC)

Some people say things happen for a reason, but who really knows. We're all just living, loving, breathing clay. :)--Hughgr 22:13, 15 July 2006 (UTC)

Images

I wonder if some of the images on the chiro page should be a bit smaller. They dominate too much. I don't think they should be bigger than the DD Palmer image, which is about right. Also alternating them from side to side would provide some interesting variety on the page. Just a suggestion.... Otherwise it's a great looking article. -- Fyslee 20:51, 18 July 2006 (UTC)

Okay, I'll switch them and you let me know what you think. I have three different computers and they look different depending on which screen resolution I am using so I am not sure what everybody else is seeing. This computer at the office makes them look big (800X600)and I don't like it either, but my laptop(1260X800) looks better. Feel free to switch them around, too. My wife tells me I have no taste in decorating and I think she might be right:]--Dematt 21:00, 18 July 2006 (UTC)

Right now DD is missing. We've got to have him present! -- Fyslee 21:16, 18 July 2006 (UTC)

I moved him down to history! You don't think I would put BJ in without DD:) I'll stop here and let you make some fine tuning, too - I know you want to:) I like the middle section better, but I still don't like the beginning. --Dematt 21:19, 18 July 2006 (UTC)

Okay. I don't know if it improved things, but I tried pushing the minister around.....;-) -- Fyslee 10:35, 19 July 2006 (UTC)

AfD

You forgot to sign your vote on the Quackpotwatch AfD. Also, I want to thank you for your superb work throughout Wikipedia, but especially on the chiropractic article. TheDoctorIsIn 20:46, 21 July 2006 (UTC)

Hi Dematt. I think you misunderstood the issue. This comment might help you understand it better. You can still change your vote. -- Fyslee 20:56, 21 July 2006 (UTC)

Coulter study

Hi Dematt,

Thanks for the reversion of Mccready's very bold edits. Unfortunately he doesn't seem to be much of a team player.

I just noticed the latest edits in the chiropractic article, especially regarding the Coulter study. I strongly suspect a misinterpretation is going on:[5][6]

The summary only makes sense if the indications named are indications commonly used to justify cervical manipulation:

• "Only 11.1% of 736 indications for cervical manipulation were judged appropriate."[7]

Since only chiropractors have so many indications for cervical manipulation, and PTs and MDs have almost no indications for cervical manipulation (many, many contraindications!).......you see where I'm going? It's quite telling that the DCs themselves (in this case they were a majority, since the DC/MD is firstly a DC - unless speaking to MDs....;-) came to this conclusion, when they had to make an NPOV decision together with MDs. If it had only been a group of DCs, the decision would have been entirely different, maybe only 11% INappropriate.

What we really need is the original study, but until then we'll have to just use what we've got.

Also Levine's edits are very strong spin to undermine a simple fact, that chiropractors perform by far the most manipulations(adjustments), so his edit is a very POV way of downplaying that fact, and it needs to be revised or simply left out: [8]

He vastly overrates (well, all of chiropractic does it) the impact of Terrett's findings. While it did point out misreporting, underreporting is still a huge problem, so the study didn't make that much difference.

A most significant study has been done, the best I've ever seen, on the safety of cervical manipulation. I would encourage you to read it:

Manipulation of the cervical spine: risks and benefits

In a study to identify cases of injury involving treatment by physical therapists.... Any study would unavoidably also turn up the involvement of chiropractors, so they ended up also being part of the study's statistics.

The graphs are interesting, especially Figure 2, where the type of practitioner was adjusted according to the findings by Terrett.

DCs were involved in a little more than 60% of all cases of injuries and deaths, and PTs were involved in less than 2% of all cases, with no deaths caused by PTs. Death occurred in 32 cases.

Before adjusting the numbers according to the findings by Terrett, it looked like DCs were involved in more cases than was actually the case. The revised figures made DCs look a very little bit better, but were still far too high. A casual glance at these numbers could lead to the partially incorrect conclusion, that manipulation, when performed by a chiropractor, is much more dangerous than when performed by other practitioners. No, that would not be entirely correct. They should be seen more as a reflexion of the fact that manipulation is most often performed by DCs.

Regardless of who performs the manipulation - the more it gets done, the greater the risk. Sooner or later someone is going to get hurt. It needs to be used much more judiciously, by whoever it is that uses it, than most DCs use it today. If a PT or MD were to use spinal manipulation in precisely the same way, extent and frequency that DCs do, they would be exposing their patients to the same risks that chiropractic patients are exposed to every day. The statistics would then reveal more injuries from PTs and MDs.

While the technique itself is potentially problematic, the attitude of most chiropractors towards it makes it doubly so when applied by them.

Here is a conclusion from the summary of the article above:

"The literature does not demonstrate that the benefits of MCS outweigh the risks."

Here's another verifiable source - from a chiropractor:

Rand Finds Little Justification for Neck Manipulation

"A 1996 Rand report on The Appropriateness of Manipulation and Mobilization of the Cervical Spine (Coulter 1996) . . . concluded that only 11.1 percent of reported indications for cervical manipulation could be labeled appropriate. A patient who receives regular, frequent, and totally unnecessary neck manipulation is subjected to greater risk." -- Dr. Samuel Homola, DC., Skeptical Inquirer, Jan./Feb. 2001.

-- Fyslee 22:29, 24 July 2006 (UTC)

Hey Fyslee! Thanks for keeping involved. You can see I've been trying to deal with this paragraph for a few days now. I can see the problem, but I can't seem to get it into the right words. Ultimately, there is a risk of stroke, it is small, but the number of adjustments that DC's give means that more strokes are caused than would otherwise occur had no treatment been given. Abotnicks point is that DC's that use cervical manipulation for say, halitosis, are placing the patient at an increased risk of stroke for no perceivable benefit other than to "adjust the cause". And of course there's the contention that there is no scientifically proven benefit for spinal manipulation so all cases are putting the patient at unacceptable risk.

I agree with your assessment of MDs and DCs on the panel including the notion that, were there only DCs on the panel, the number would be 11% INappropriate. In that case, we would be having a much different conversation right now. That is the reason I felt that it was necessary to place that fact in the body of the discussion, because it does mean something (not necessarily the same thing to everybody). To the uneducated reader and skeptic, it adds credibility. To the DC and Alternative medicine believer it takes away credibility.

The real problem is - can you think of 736 cervical conditions that would normally indicate cervical manipulation? That list has to include non chiropractic conditions. If I saw the list, I might agree with only 11%, too. Then again, I might not, but without seeing the list, the sentence really means nothing to anybody.

To me, the numbers for other practitioners basically don't matter. I think that the problem is that we're trying to use the wrong study to prove it. The Coulter study has too many holes in it.

I still think that the point can be made, but it needs to be made using rational data.

We really do need the original study. -- Fyslee 21:43, 25 July 2006 (UTC)

Let's keep looking. We might find it somewhere, or something similar. Also keep in mind that the next counterpoint is that the risks of medications may outweigh the risk of manipulation. I don't know if there is data on that, but we should look at that, too. So much work, so little time! :) --Dematt 22:08, 25 July 2006 (UTC)

I found this [9]--Dematt 01:01, 26 July 2006 (UTC)

I saw your message and decided to answer here. That's an interesting study, with predictable conclusions. Nice to see it in print.

Your point about medication or manipulation (risk/benefit ratio) is of course valid. Whether to mention it or not is another matter. It depends whether it's on-topic or not. If it's only a knee-jerk way to move the focus of attention, then it's inappropriate (the old inappropriate comparison of apples to oranges fallacy), but if the subject is "what is the best way to deal with bla, bla problem," then the various options can be discussed and their advantages and disadvantages weighed in the balances.

Here is where the difference between manipulation of the upper cervical region and manipulation of the rest of the spine is significant. It's an entirely different risk/benefit ratio. Although I've seen multiple fractured vertebrae after chiropractic manipulation of the lumbar spine (it can happen to anyone, not just to DCs), the consequences are still nothing compared to the consequences of a properly performed cervical adjustment that causes a stroke, even though the risk is very small. So the risk is very different.

Next is the benefit factor, which is highly disputed by non-DCs. We just don't see any benefit that is worth or requires keeping cervical manipulation. As a PT I quit manipulating the upper cervical area a few years ago, and have honed my skills at dealing with those problems without doing it, with good results. Since there are others ways to deal with the same problems without manipulating, what excuse is there for doing it at all? That makes any benefit pointless, when other less risky methods are available for achieving those benefits. I know that this is controversial, and don't expect full agreement, even from some of my own colleagues, but that's just where I'm coming from as a clinician.

BTW, I am not one of those who holds the viewpoint you wrote about above, just to make sure you know:

"And of course there's the contention that there is no scientifically proven benefit for spinal manipulation so all cases are putting the patient at unacceptable risk."

I do consider spinal manipulation as having some value in certain situations, and I don't believe that it's only a placebo effect, as some people claim. My beef is primarily with cervical manipulation, and of course with overly broad claims for myriad miraculous benefits and effects of adjustments. -- Fyslee 15:31, 26 July 2006 (UTC)

Alleged

I would like to invite to you add your comments here. -- Fyslee 08:56, 30 July 2006 (UTC)

Request

Hi Dematt, I thank you for your very admirable and skilled edits, and cool demeanor, however, the idea of mainstreaming the 'pseudoscience' label by placing a new heading in the article, (Pseudoscientific aspects of chiropractic) IMO is not a good idea.

Like most fields, there is sincere, genuine research and there are also areas that need further research. Giving 'pseudoscience' the spotlight paints everything with too wide a brush.

All it is, is an opinion of the anti-chiropractic fundamentalist extremists aka 'skeptics' whose purpose is to denigrate that which they hate, and therefore IMO, not a factual, legitimate description. Hope you take this into strong consideration and would consider removing it. Thanks Steth 22:55, 1 August 2006 (UTC)

Steth, I respect your stalwart defense of chiropractic and I need you to remain that way. Hopefully, we won't have too much to worry about. When the facts are on the table, chiropractic should be okay. If it is not factual or legitimate, I expect to hear from you. Just keep it clean and accurate. Hang in there;) --Dematt 00:27, 2 August 2006 (UTC)

OK, you are right. I will remain calm. So how about removing it anyway? There are already enough things to keep us busy. Steth 01:51, 2 August 2006 (UTC)

From what I'm seeing, chiropractic may be a lot of things, but pseudoscience is not it. Apparently no-one was willing or able to put up. Oh well, I tried. --Dematt 21:43, 2 August 2006 (UTC)

Whats up Dematt

After parusing the chiro article, it struck me that the history section goes from ~1910 to Wilk. That's leaving out a lot. I know you had said you were working on more for this section, but its getting pretty long. I don't know how much we should add or consolidate, but on the other hand, maybe I'm just rambling. :)

Also, you may find this interesting for the BJ Palmer re-develops chiropractic section. I'd seen a history ouline in the July edition, but haven't seen it on the net but this puts a little twist on how its worded in the article. ;)[10]--Hughgr 00:51, 4 August 2006 (UTC)

Howdy Hughgr! Yeah, He's talking about the lerner report. I got a lot of my stuff for the history from the lerner report. It took me weeks to work through, you should read it! Every chiropractor should read it. Also, here is my timeline for everything I've read. By putting it in order of time, it all makes more sense why DD and BJ did what they did. Just scroll through it and you'll be blown away when you see the battles in and outside the profession between the mixers and straights and AMA. All very interesting. You'll see that Fyslee really has a good feel for what has happened.

I agree on the length of the history. I could have written a book. You have no idea how hard it was to narrow down what to write and still be able to get the timeline to tell the story. There is so much stuff. There is so much stuff that I couldn't put in, but really wanted to!!!! Let me know what you think. --Dematt 01:18, 4 August 2006 (UTC)

Yea, that is a ton of stuff. Maybe we should start a page of just chiro history...and in the main article, have a link of course but cover some of the main highlights. I don't know how we'd decide what highlights to include though. Some would seem obvious, ie. Wilk, but other points maybe more important to some people over others...We've seen what happens when we try and reach a concensus around here:)--Hughgr 04:04, 4 August 2006 (UTC)

That's exactly what I was thinking. When I started the history, it was because DD and BJ quotes were just being thrown out there all out of context and it made DCs sound like lunatics, but when you see that they said them in response to the times, you realize they weren't that radical. So if we take out too much, we might lose that again. --Dematt 11:23, 4 August 2006 (UTC)

I think you've been doing an excellent job with the history section. Yes, length is a problem, so it needs to be summarized, but keep at it. -- Fyslee 16:05, 4 August 2006 (UTC)

Thanks, but I hope you both know none of it would be there without your help. This is our history! You can edit it however you think will work to make this an accurate and awesome article --Dematt 03:00, 5 August 2006 (UTC)

Keating a "reformer"?

Good call here. Keating is the foremost expert on chiropractic history and has been immersed in, and employed by, the profession for many years. He understands it extremely well, but I'm quite certain from my few email contacts with him that he wouldn't appreciate being called a reformer, although he certainly provides documentation for many of their viewpoints. He's not stupid. If he ever openly professed to support them, he'd lose his job!

He has a different viewpoint than chiropractors who have become reformers. He hasn't been personally threatened in the same way, as far as I know. Some of them have been physically assaulted, their families threatened, etc. That creates some pretty hard feelings. Keating has been criticized alot. Whenever he has written articles that weren't totally full of praise, the letters to the editor have sometimes been rough, but he was still employed and wasn't getting the same treatment that chiropractic reformers have gotten. How Homola, who amounts to the Luther of chiropractic, has kept practicing is a wonder to me. That he is still alive is a wonder! (Steth's "messages" to me are water compared to the vile threats I get, and I haven't even written any books, like Homola has done!) Yet he has always defended chiropractors who practiced sensibly, only criticizing the dubious aspects. -- Fyslee 09:11, 4 August 2006 (UTC)

Good to hear your input on that one; that's what I thought, too. With all the reading I've been able to do (and I realize that it's just the tip of the iceberg), Keating declares himself as an "inside outsider". He is a psychologist and it seems his interest lie in the mentality of chiropractic as a whole. He also presents his arguments from both sides and his tone is nonjudgemental, or at least he backs up his judgements from a well informed POV, making him appear more sympathetic and thus his critiques are accepted as constructive. It's interesting how we both can read his work and see our POVs in it. That must be the sign of a very good scientific journalistic psychologist:)

I haven't read much from Homola, other than the article on one of your pages and I get the impression that he was never happy. You get the feeling that if he were a medical student, he would have hated it, too, and then we would be posting his writings on our web sites:) He might be a reformer, but I would think he would state it outright if he were. I get the impression that, though there may be a lot of "reform minded" DCs, very few would want their names posted (yet). Back in my school days, I was able to attend a lecture by Robert Mendehlson and he talked about his fear as a result of death threats from the medical profession and I got the impression that these were very real possibilities. You could see the fear in his face and the tremble in his voice when he described his concern for his family. You knew it was real. So I don't doubt that the same thing happens from the other side. It's a shame, because all that does is force people to choose sides and closes their minds to the possibility that they could be wrong. Both sides are at fault. --Dematt 11:18, 4 August 2006 (UTC)

Homola

Sam is a very gracious and eloquent person. He is very helpful and I've gotten plenty of good advice and help from him. He actually sent me a hardback copy of his first book, which is out of print. It's a classic and is available for free on Chirobase. It's well worth reading:

• Bonesetting, Chiropractic, and Cultism

I still firmly believe that one cannot truly understand chiropractic without having read that book.

An excellent review of the book:

• A Guest Review by Joseph C. Keating, Jr., Ph.D.

A few more links:

• Biographical Sketch: Samuel Homola, DC

• Inside Chiropractic: A Patient's Guide I purchased it from Amazon.com and read it. Excellent.

He has written a number of other books and many articles. The articles are interesting reading, and especially the Letters to the Editor.

• Seven articles on Dynamic Chiropractic that mention him.

• Google search of DC for Homola

• Several other articles

-- Fyslee 16:02, 4 August 2006 (UTC)

Pseudoscientific elements

This heading of yours on the Pseudoscience article was especially good. It would have solved a lot of problems:

"Fields with pseudoscientific elements"

This edit of yours is (also!) right on the money. I fully agree:

"Beyerstein(1996:7), Keating (1997:40), and Homola (2002:311) consider chiropractic to have pseudoscientific characteristics. These include:...."

There is a difference between saying "is pseudoscience" and "has pseudoscientific characteristics." It's not an either/or situation. Keating's observations are quite astute. He sees both sides of the story and tells it.

I have been torn about what to do with the inclusion of chiropractic (as a whole) in the list of pseudosciences. Several months ago I happened upon the article and noticed that chiropractic had been removed from the existing list, so I put I back in. Then I refined it to be more specific: chiropractic vertebral subluxation. Of course Levine2112 immediately started a revert war and the battle has been on and off ever since, although I only frequent the article occasionally. There are just too many interesting articles here, and so little time! Wikipedia is huge!

I think Keating's analysis and your heading are the most accurate way to view chiropractic. It contains pseudoscientific and scientific elements. To skeptics the pseudoscientific ones are too many, too dominant, and too fundamentally a part of the profession to be considered a minor blip or exception. Most chiropractors naturally disagree.....;-)

Among all the hate mails I get, and comments on my blog, I also get some heart wrenching ones. About two years ago I got a long email from a chiro in Texas. He had four or five children (I'm retelling this from memory, so don't crucify me....) He had read something or other on my blog and was really upset. By the time I finished reading the mail I was nearly in tears. He plead with me to stop criticizing his profession. He agreed that there were problems, but he made it clear that it wasn't his fault. He felt trapped, his income was dropping for various reasons, and now his reading of my thoughts had just ruined his day, because he felt such viewpoints would only contribute to ruining him. He was genuinely worried for his income and family, and I truly did feel sorry for the guy, because he was an innocent victim. He explained that he hadn't realized what he was getting into, and far too late did he realize that the only way for him to achieve the kind of success he had been promised was to do like the other chiros in his town, and that was to engage in some unethical forms of marketing and practice building, and he didn't want to go there. I have had contact with a number of chiros who shared his concerns, and I fear that there are many more. These people are really trying to help people and are honest. They aren't crooks or quacks. They do help alot of people. They often contact the NACM, and their mails are shared with the mailing list or discussion forum (I'm a moderator), and members can individually contact them and give them advice. Hopefully they get some direction and figure out what to do. Some drop out totally, others change careers. Several have become MDs or DOs. Some battle on for years attempting to practice ethically. Some survive, others don't. -- Fyslee 15:37, 4 August 2006 (UTC)

Thanks for the kudos on the edits. Apparently, not everyone agrees:) I read your post earlier, but got myself in deep on the PS page and have to admit, I really tried to be a positive force, but I think I may have only added fuel to the fire. Its pretty obvious that the term pseudoscience has no real definition(kinda sounds like subluxation doesn't it:). Its hard to hit a moving target:) I'm sure its just as hard to defend from the other side, too. It is fun to be on the offense for once, though! If they would just hold still!

Thanks for the stuff on Homola. He certainly sounds reasonable. There is something different about his style that has an angry tone for me, but it may be that he tends to bring out a defensive posture in me:) It's always interesting to read these things that are written from this POV. It makes me wonder what I would write if I didn't have to worry about somebody editing my work:) It's not like I haven't heard all this before, just with a totally different spin on it. It takes me a little while to settle the two in my own mind. I wonder what it must be like for you to read this from your POV. I think I would have given up on chiropractic a long time ago. I see why you "lose it" occasionally and spout out all that antichiroburpup:) Maybe one day it will all come together. --Dematt 04:08, 5 August 2006 (UTC)

I guess know I do get fed up sometimes and overreact. (I don't speak that way to you.) Extremist deletism and overprotection irritates me. Suppression of opposing viewpoints shouldn't be our job here. All the hateful language and personal attacks are counterproductive. I find it much easier to discuss things with guys like yourself, who seek to get all viewpoints out into the open, and get them presented properly. Cooperation is so much nicer! I may be a skeptic, but I have nothing against positive facts about chiropractic being presented, as long as they are accurate and sourced, which they can be. I only ask for the same treatment, but Levine2112 and Steth don't have the same intentions, and certainly don't assume good faith, so I hope that other editors of all persuasions will attempt to ensure that fairness prevails. The Golden Rule and being our "brother's keeper" would do wonders here. -- Fyslee 19:36, 5 August 2006 (UTC)

I'm beginning to understand what you're talking about. I've been spending most of my time in the protection of the chiro page where you guys have really treated me well. After venturing out yesterday, I can see why you guys get gruff. Nobody likes to be shut down without good reason. If I wanted that I would talk to my wife!!!! (That's really not true,, sorta:) I am getting a better feel for the situation, just finding it hard to put it into words. I think the "combat" between you and Levine is very important. It helps me to understand both sides and try to put it into words. Steth is just the defender,(like FeloniusMonk on the PS page). He balances Mccready (who is the antichrist:). And then there's Hughgr who is our compass and keeps us smiling and going in the right direction. As for the "do unto others.." the rest of the sentence is supposed to be "as you would have done unto you", not "as you just had done to you." I think it's more of a "shoot the messenger." --Dematt 20:33, 5 August 2006 (UTC)

You understand the situation perfectly, and the Golden Rule! -- Fyslee 21:10, 5 August 2006 (UTC)

Well, it's so nice to see everyone enjoying each other's company. It's just one big happy family. Thank you Dematt for your kind words and for being the voice of reason.

I have no grudge against Fyslee. I am just skeptical when he claims that he is being attacked because no one understands him. Being a 'chiroskeptic' is one thing, but actively planning, coordinating and engaging in activities designed to damage another profession like chiropractic and ensuring chiropractors are dehumanized and depicting them as murdering crooks and lunatics who want to give you a stroke and steal your wallet, is something else.

Isn't this curious behaviour for a physical therapist? Example: Why would a physical therapist in Denmark lead the charge to stop a school from opening when it was OK with the school? Stop FSU School of Chiropractic

It seems that he has devoted a huge portion of his life and energy to anti-chiropractic activities to ensure that good folks like Dematt are out of a career and driving a bus. Why is that? Curious. All of his edits at WP always seem to have a denigrating tone to them. Have you noticed?

Are we creating websites and blogs against physical therapy? It is one thing to be skeptical but another entirely to be hateful.

Dematt understands the Golden Rule. Does Fyslee? Steth 05:50, 6 August 2006 (UTC)

PS Have you read this: No justification for the existence of chiropractic Would like to know your thoughts. Thanks Steth 05:56, 6 August 2006 (UTC)

I hear ya Steth, and thanks for the compliment Dematt. :) When I first started editing here, I didn't know what to think about the other editors motives. Is Fylsee a part of some conspiricy by the PT world to denigrate chiropractic to increase their portion of the market? :) I don't know, but I do know that if the all powerful AMA couldn't do it after many years, I doubt the PT's will either. These "battles" have been going on forever. BJ once said, "If medicine wants to get rid of chiropractic, all it has to do is get sick people well." Thats as true now as it was then. Peace.--Hughgr 07:20, 6 August 2006 (UTC)

Steth, once again you engage in personal attacks. Not only are they a violation of Wiki policies on many levels, they are directly false. You are lying, twisting things, and doing all you can to demean me and to poison the well. (Are you really Tim Bolen pretending to be a chiro? He does this kind of thing.) You make some pretty serious charges above, and you know full well you've just made them up. You're reading far too much into my writings, and this is very telling of your own thoughts and motives. You write the following:

• "I have no grudge against Fyslee."

I'd sure like to see you convince someone else of that. No one who reads your track record here would believe you. Your contributions history is quite revealing!

• "I am just skeptical when he claims that he is being attacked because no one understands him."

???? That "you" fail to understand, or "you" misunderstand, is another matter entirely.

"I" shouldn't be attacked at all, especially by the likes of you! If you would calmly and professionally debunk my entries (which is where you and Levine2112 differ - he actually attempts to do that), it would be a different matter. BUT you don't do that. You attack me personally and don't deal with the content at all. You don't merely misunderstand me, you don't even try to understand, and you deliberately misrepresent me! That's precisely what Tim Bolen does. He has no medical credentials or qualifications of any type, and knows only one method of defense - offense. He has no understanding of how medical and scientific debates are carried on, and you pattern after him so much it's scary! I wonder sometimes if you're not even a chiro, but just someone who knows enough to fool some people some of the time. If you knew more, you'd be able to use it in the discussions, but you fail to do so, at least when you attack me. Usually such ad hominem attacks are a sign that the attacker has no good answer, and is getting desperate. Maybe that's what's happening. Please start to prove me wrong. I'd love to have normal discussions with you.

• "dehumanized and depicting them as murdering crooks and lunatics who want to give you a stroke and steal your wallet"

Please provide the quotes that do such a thing. I don't even think that way, so I don't see how you can interpret anything I've written in that way, unless you really want me to fit your demonizing thought patterns.

• "lead the charge to stop a school from opening"

Far from it. I was one of the last players and had little if any effect. Most of my effort was simply to reprint what others had already written. I have never had any contact with Dr. Bellamy or the professors who threatened to resign, and I've only had a contact with Dr. Kinsinger, in connection with attempting to find out who was behind the Neck911USA site. It turned out he was. Otherwise I have no contact with him. After that he copied a bunch of links to my sites and added them to his site. I wish he had asked me, so I could have formatted and arranged them differently. Whatever. I guess he liked what he read.

• "All of his edits at WP always seem to have a denigrating tone to them."

If you've ever sensed that, it would be on talk pages, and especially in response to your personal attacks (which are far more than just denigrating). What you interpret as "denigrating" is typical skepticism. True believers will usually interpret skepticism as such. When one, like I do, deal with outright crooks who lie about these things all the time, it's kind of hard to avoid it when coming into contact with someone who speaks the same way and defends the same nonsense.

I sometimes do come across with statements that reveal my disgust with nonsensical or dangerous practices and ideas. That's a very different matter, as is as it should be. Chiropractors should also react with disgust when encountering such nonsense from fellow DCs. As a PT in private practice my point of view is not the same as the general public’s. I’m surrounded by chiropractors and treat chiropractic patients every day. If the occasional results of unsatisfactory care were the only thing I met, I'd have no special interest in pursuing this matter, since that works both ways for all professions. That can and does happen to any practitioner in any profession. If it were only the unavoidable side effects of legitimate treatment, it would be expected, and therefore somewhat acceptable. But such is not the case with chiropractic. There is uniquely more to it.

After years of observing chiropractors and investigating chiropractic - as well as daily seeing the results of chiropractic misinformation, dependence, and multiple serious injuries - righteous indignation has removed some of my inhibitions. Therefore I speak freely (sometimes sarcastically) and may not always be able to hide my indignation. It is not directed at sensible chiropractors. They still get my support and encouragement.

• "hateful"

It seems to me you are the one expressing personal hatred towards me nearly every time you respond "after" (not "on") something I've written. Keep in mind that your personal attacks nearly always come in reponse to my normal discussions, where I discuss the topic at hand, and don't attack persons. Any personal response of mine thereafter is in response to your personal attacks. Otherwise I like to stick to the issues under discussion.

You're always playing the hate card. Read this very carefully -- I do not hate chiropractic or chiropractors!!! I do get disgusted with types like yourself who defend nonsensical practices, and who can't carry on a decent discussion. You nearly always attack the man, instead of discussing the content. Your default mode seems to be permanently set at "straw man attack using ad hominem diversionary tactics". I'd sure like to see you act professionally and start dealing with the issues, rather than attacking persons, but I doubt you're man enough to do it. Your track record here speaks too loudly.

BTW, are you the chiro that regularly sends me threatening emails and plays the hate card? Your language and attack patterns are very similar to his. He too seems to get some kind of erotic kick from reading all my writings and then misinterpreting them. Why the obsession with me? (Try Pamela instead.) Of course all your efforts only bring more attention to my writings, and give me more "air time." Is that what you want? I doubt it. You and chiropractic would do well if you never commented on my entries. Just ignore them. One of these days I'll have to take the time to make a whole blog devoted to all your hateful messages here. What should be its title? "Steth, the chiro, plays the hate card"? That wouldn't place chiropractic in a good light. People like you are a shameful spot on the profession, and cast a shadow over good people like Dematt, who practices sensibly and conducts himself with a professional demeanor that speaks well for him. He is one who makes me think positively about chiropractic. You don't do that.

-- Fyslee 09:11, 6 August 2006 (UTC)

You know, I am trying to believe you, Fyslee, but when I read your websites/blogs/so-called Forums, devoted to chiropractic, there isn't one ounce of respect demonstrated. From the 'Beware of Chiropractors' sign, to the links to Stephen Barrett Enterprises, to your own huge volume of musings, it clearly indicates how you feel about chiropractic despite your protestations to the contrary. You see everything as a personal attack. I am not attacking you. I even provide links to your 'sites' backing up what I what I am talking about. I am merely questioning your ability to edit from a neutral POV. You may question my ability too, and that is fair.

I haven't memorized your 'writings'. I do a Google search and am surprised to see how easily I can find stuff you had your hand in. I have never and would never send anyone a threatening email. I feel my talk entries here raise important questions in a professional yet hard-hitting way.

So why don't you take down the 'Beware of Chiropractor' sign, perhaps we can all get along better. Steth 11:32, 6 August 2006 (UTC)

Good morning guys! It's nice to have everybody here:) And Steth and Fyslee, be nice. You both know it doesn't matter who each of you are. We are not people here. We are ideas. This is the only place where all we ideas can come together without spending a whole lot of money on hotels for months and years. Thomas Jefferson and John Adams were polar opposites all their lives and were in constant discourse all their lives about things such as slavery and land ownership. They had to communicate by horse mail! Can you imagine writing down your thoughts and then having to wait 2 weeks or more before you heard a response? I would forget what I wrote!

My point is, this is the 21st century. Unless there is a world war and all electricity is shut off. This is the way of the future. If, as a profession, we say something stupid, it won't take months or years before we hear it on the news. It will only take hours, or even minutes and potentially everyone knows. We all become politicians for our causes. And we will be judged by our words and ideas. Not by what we look like, but what we say. It's like newspaper on TV. The world is at a threshold and we are right in the middle of it writing it down. Our audience is not ourselves, but the children of the future, and they will be far savvier than we are. They will have seen and heard it all. They know how to deceive someone online, they were taught to lie about who they were to keep away from strangers. They aren't going to trust anything they read without proof. They will have so much information available to them, it won't matter what any one of us say, it will be about what "everyone as a whole says." WP needs to reflect what "everyone as a whole says." That's why all of us are here. But we are not people. We are the ideas that are floating out there. And there are ideas that are rational, ideas that are philosophical, ideas that accept everything and everyone, and ideas that hate and want to destroy it all. If any of our professions are going to make it, we'll need to be able to respond to the new environment. But first, we'll need to understand it.

As far as I'm concerned, I would rather work with all of you. At least we're getting somewhere (unlike the pseudoscience page:) Nobody said we couldn't be a dysfunctional family:) --Dematt 12:54, 6 August 2006 (UTC)

Dematt, thanks a bunch for your comments over at Category Talk:Pseudoscience. I'm mucho impressed by the editorial comity and objectivity at Talk:Chiropractic that you and others bring. I only realized you were a DC now when I stopped by your user page; I couldn't tell from your edits. (Similarly with Fyslee as well.) So one "blinded" reviewer has hereby verified your NPOV; well-done! cheers, Jim Butler^(talk) 06:31, 8 August 2006 (UTC)

Thanks for the compliment, Jim. But it is I that am impressed with your demeanor. If it weren't for your well documented and elequantly expressed POV, I'm afraid NPOV would be much further to the right:) I have been watching your edits for months on the acupuncture page and you should know that that page has improved 100% since you've been here. I'm sure Pseudoscience will benefit from your influence as well. You pick the valiant fights! Give your son a hug for me:) You are truly blessed;) --Dematt 18:39, 8 August 2006 (UTC)

My son would hug you back in a heartbeat, that's for sure. He's a great kid, picks up on the "vibes" of kind people instantly, and is my best teacher. I truly appreciate your encouragement, both here and in the real world. All the best to you! Jim Butler^(talk) 21:28, 9 August 2006 (UTC)

You win! Please support this

You guys should be very pleased at my latest entry. Please help support this effort. I think it will not only strengthen the documentation of dubious concepts, but also help to defuse the efforts of deletionists and suppressors. Revert wars are a huge waste of time! -- Fyslee 22:04, 9 August 2006 (UTC)

I don't know, Fyslee, you have more faith in the pseudoscience editors than I do. What would keep them from deleting any edits I make? Right now they don't seem to see any other POV but their own, I'm not sure I can trust them with mine. --Dematt 01:38, 10 August 2006 (UTC)

Pat on the back

After a busy day, I come home to see that you are doing your exemplary best at the chiropractic article. You walk the fine line quite well. I also agree with your solution to the category issue at the bottom there. For now it seems to be working. Keep it up! -- Fyslee 16:36, 11 August 2006 (UTC)

Pseudoscience article

Dematt, I would appreciate it if you could provide a summary-list (or for that matter a comprehensive one if you want) of the contemporary empirical research on chriropractic. I don't have the time to research this myself, though it's my definite understanding that there are plenty of studies out showing significant correlations between treatment and measurable benefits (range of motion, pain indices, etc. etc.). For instance, I understand there was a study entered into evidence in the Wilk v. AMA case showing major correlations between use of chiropractic and rate/time of return to work after injury in comparison to treatment by MD's. I'd appreciate it if you'd also throw in any relevant references to studies which assert no correlation or negative correlation as well, just to be objective. Please email via the "E-mail this user" link on my talk page, or easier yet, it may be posted at User talk:Kenosis/Research. Thanks. ... Kenosis 17:21, 15 August 2006 (UTC)

Great images

There are some great images in these documents:

• The Meanings of Innate
• Chiropractic History: a Primer

Some could be used in the chiropractic article, others in the Innate intelligence article. -- Fyslee 17:47, 16 August 2006 (UTC)

Great diagrams

For chiropractic concepts in diagram form (at least organized systematically), try this:

• Faulty Logic & Non-skeptical Arguments in Chiropractic -- Joseph C. Keating, Jr., Ph.D., Professor

-- Fyslee 18:06, 16 August 2006 (UTC)

Metaphor

Re your comment on my talk page[11]: Interesting; thanks! So it may not have started out as metaphor. I know that TCM theory is valued for its clinical utility but not taken literally, cf. Kaptchuk's quote here. That's what I meant by "metaphorical". I gather some DC's think similarly, but don't have a feel for the range of views held by chiros. What is your sense on this? best, Jim Butler^(talk) 21:33, 17 August 2006 (UTC)

Yo Yo Dematt

Hi, saw your picture change in sci section of the chiro article. Looking good, but I was thinking they'd look good if they were side by side...whatdathink? Have a great weekend Doc!--Hughgr 05:43, 19 August 2006 (UTC)

I'll try it, and you can check it out. I have a feeling it won't fit or we would have to shrink it so much, we won't be able to read it. See what you think. --Dematt 13:49, 19 August 2006 (UTC)

Okay, I did it then reverted it so you could look. I'm going to see if I can find out how to change the font to something smaller in the first chart so I can shink it some and grow the other. When I figure that out, I'll try that, too. --Dematt 14:00, 19 August 2006 (UTC)

I see what you mean, but I think it can work. We'd need to re-do the early development one so the points are side by side. I'll require a little photoshop work though. And I suppose we don't have to do it, I was just being artsy :)--Hughgr 22:49, 19 August 2006 (UTC)

migraine

Sounds to me like a logically argued differential diagnosis, and an interesting case report. One reason I'm (cautiously) sympathetic to chiropractic is that it's easy to say you need controlled trials and more research, but very difficult to design good studies and then they come expensive; case reports and natural experiments like this can be very helpful in moving towards defining an experimental or trial protocol. In this area, which is outside my expertise by a long way, I'd suggest looking into the possibility of PET/fMRI studies of migraine to see if manipulation altered cerebral blood flow in brain areas affected by migraine. There's quite a lot of this type of study being done these days, if you can find a friendly imager. Gleng 14:15, 23 August 2006 (UTC)

Excellent - Thanks, I hadn't thought of that. Before I started, I wanted to make sure I was thinking correctly first. After the court case, I plan to contact the neurologist and anesthesiologist and see how they feel about it as well. I suppose money is the problem. If you have any input on that matter, it would be helpful! It would be nice to have a teaching institute involved. --Dematt 16:17, 23 August 2006 (UTC)

Just to make sure we know what you're talking about, I'll place the last part of what you wrote right here.

The anesthesiologist is stating that the migraines were the result of the facet injuries in the accident as is the neurologist, based on what they are calling "the experiment" that the other medications did not work, but the injections did. They are basically backing me up that the segmental dysfunction (vertebral subluxation) resulted in the exacerbations of the migraines.

My question to you is; do you think an "experiment" such as this has some value in the research efforts for vertebral subluxation? And if so, who does this type of thing? --Dematt 13:25, 23 August 2006 (UTC)

The idea of using injections in specific spots as a differential diagnostic tool is far from new. The work of Janet Travell and David Simons on trigger points was done in this manner, with excellent results. Their work contributed to a valuable increase in our knowledge of referred pain syndromes. The two volume work is one of the best textbooks I've ever seen, chock-full of valuable information, with every conceivable differential diagnostic possibility discussed in depth. Fortunately their suggested method of treatment (stretch and spray) is not the only method to deal with these pain syndromes. Good old (uncomfortable) massage works just fine.....;-)

Now just what can this method do for your experiment? First of all you're going to have to drop the chiropractic definition of "subluxation," which includes myriad conditions and symptoms (that have real names understood by MDs and PTs) that have nothing to do with the definition of an orthopedic subluxation. Just use the proper words to describe the symptoms. The injections can help to support hypotheses regarding the regional source of the pain. That's about it. It's not a specific enough method to ensure any certainty about exactly what condition in the area is causing the pain or symptoms. It can still be a useful tool, and the results might form the basis for a more specific pilot study. Just my two cents.... -- Fyslee 18:17, 23 August 2006 (UTC)

Absolutely on Janet Travell and trigger points. She used them a lot on JFK when he was almost disabled with back pain. The old chiros used to call them acupressure points. I'm pretty convinced thats what nerve tracing was finding. But it doesn't really matter what you call them. I use ischemic pressure and a regional nimmo type deep muscle "massage" and seem to get good responses (i.e. referred pain patterns goes away and tenderness decreases over a period of follow-through visits). I never liked the spray and stretch, mostly because the chemicals were expensive and may have been toxic to breathe. They also didn't really work as well as the manual techniques.

I don't think anyone argues the somato/somato referral patterns that have already been satisfactorily shown to exist. Even the visceral/somatic relationship is understood as organ conditions refer to predictable somatic regions. The theory is that there is a somato/visceral relationship where the somatic tissue, specifically the facet capsule which is innervated by the recurrent spinal nerve that returns to the spinal cord synapsing in the 2nd and/or 5th laminal layers of the dorsal horn of the spinal cord where afferent and efferent interneurons from the sympathetic nervous system communicate with the central nervous system (I'm not sure if that's the terminology MDs and PTs use). If this theory is true, we should be able to "numb" or "irritate" this region and see an effect. There ought to be a vascular change somewhere. In the case of migraine, the brain.

Apparently the neurologist and anesthesiologist have no trouble saying that because the migraines did not respond to anything else, they were convinced the migraines were the result of facet irritation which I will have already described prior to their testimony. I don't think the terminology of subluxation really matters as this is just one more test of another link in the chain. If it does show change, it supports, if it doesn't show change, it detracts. What I am looking to consider is a way to test the theory that visceral conditions can be related to the elusive subluxation. I am quite sure that most researchers today don't really care whether the word subluxation is involved or not. It certainly would not say "chiropractic works!" as it says nothing about whether anything a chiropractor does would have a similar effect, but it does lend some credibility to the claim that "vertebral subluxation" may exist. Then I imagine even PTs could treat them because they would no longer be alternative medicine:) --Dematt 20:49, 23 August 2006 (UTC)

Osteopathy and chiropractic

The sentences you removed did need documentation:

"There is evidence that Mr. Palmer's theories of chiropractic were taken from Dr. Still as Mr. Palmer was a student of Dr. Still's at the American School of Osteopathy. He left Dr. Still's school and founded his own school of chiropractic medicine in Iowa."

That idea has been around for a long time, and can be found in many books and websites, but I still would like to see better documentation. (It can be presented as "a poorly documented legend.") Here's an interesting version:

Osteopathy was “discovered” in 1872 by Dr Andrew Taylor Still, an American doctor who grew disillusioned with orthodox medicine after his wife and three children died from spinal meningitis.

Many accounts of the history of osteopathy mention that one of Dr Still's early students was Daniel David Palmer (D D Palmer), who founded chiropractic in 1895. Palmer reportedly studied with Dr Still for only about six weeks.

However, the association between Dr Still and Palmer is usually not mentioned in accounts of the history of chiropractic. [12]

The answer to the mystery might be found in this book being auctioned at eBay:

VERY RARE AND VALUABLE VINTAGE OSTEOPATHIC BOOK

This happens to be one of the only Osteopathic books that I know of that refers to DD Palmer - the discoverer of Chiropractic. According to the author - Dr. A.T. Still had relations with DD Palmer - you will have to WIN THIS BOOK to find out WHAT?????

Did DD Palmer copy AT Still's technique?

Did DD Palmer attend Osteopathic College at ASO?

So many questions.......

BUY-IT-NOW DISAPPEARS once a bid is placed.

VERY-RARE-SIGNED-Osteopathy-PALMER-Chiropractic-Book

Another interesting quote:

"For instance, Daniel David Palmer, a magnetic healer from Davenport, Iowa came to Kirksville in 1893 to be treated by Still. After several treatments he returned home and two years later announced his discovery of a manipulative healing method called chiropractic." [13]

And yet another:

"D.D. Palmer was a self-educated healer who founded chiropractic (in Davenport, Iowa) on the belief that spinal dysfunction was the basis of all disease and its correction could cure all. There is speculation that D.D. Palmer visited Kirksville, Missouri, shortly after the ASO was founded. It is rumored that he was treated by Still with his “new” technique, and may even have spent time at his home. Consequently he returned to Davenport with an acute memory of his experience and began to practice what he had learned from Still. Shortly thereafter, he “cured” a deaf man by spinal manipulation, and chiropractic was born." [14]

And another....:

"D.D. Palmer, the founder of Chiropractic, had studied for a time in Kirsville, Missouri at the American School of Osteopathy, but was dismissed because of his drinking problems." [15]

I wish I knew the setting for the following strong denial by DD Palmer:

"...Langworthy, O.G. Smith and this boy [BJ] have tried hard to lie me out of of Chiropractic...

-DD says (p. 19):

...I will say that D.D. “Palmer from Iowa” was never in Kirksville, Mo., therefore never was in “The American School of Osteopathy.” That I, D.D. Palmer, never took Osteopath treatment of, in or at “The American School of Osteopathy,” or elsewhere. That I, D.D. Palmer, will be pleased to give space to J.A. Quintal or anyone else, who will inform the public the date on which D.D. Palmer took treatment in “The American School of Osteopathy.” I will pay for a photograph of my signature with the date, copied from the register of patients in “The American School of Osteopathy”; will make a cut of the same and publish it in 1000 copies of The Chiropractor Adjuster. This monthly is for the purpose of adjusting just such misrepresentations as the above...

The above statment made by J.A. Quintal is false. he purposely or ignorantly states what is not true. It is up to him to either prove himself a man of truth and veracity, for which space will be given freely in this journal, or he owes me an apology for slander and misrepresentation." [16]

He certainly didn't want to give Still any credit, but instead claimed to have received chiropractic from the "other world," from the spirit of Dr. Jim Atkinson. This essentially meant that Palmer was in touch with the gods....., or, if you believe the Bible, in touch with the Devil....;--) -- Fyslee 18:21, 24 August 2006 (UTC)

There is certainly doubt in the descriptions from all those concerned, isn't there. When reading through Keating's work and Lerner's report and putting together the timing of all the factors, it doesn't take much to see (IOW, this is my totally conjectured assumption) that Palmer was at least aware of what Still was doing, simply because he was doing it ten years prior. Palmer was just starting to practice magnetic healing when Still opened his school. Apparently he was very successful for nine years, then the first adjustment. By this time Still's school was open ten years and they were what, 100 miles apart?. That certainly meant they were aware of the same people in the field and probably went to the same "workshops", or at least read the same books. They both were charismatic and arrogant, probably a prerequisite to success in those day. As far as we know, they both could have borrowed the whole idea from the same bonesetter. Atkinson was an MD; Palmer said he learned from him, where did Atkinson learn. Lots of questions. The waters are to clouded to tell where the truth lies.

I don't doubt there is a link. We just don't know what it is.. and we probably never will. This was a heated debate in those days and it is quite likely that so many lies may have been told on both sides (we can't just assume the osteopaths were truthful, anymore than we can the chiros), nobody but DD knows. That's really why I wrote that section the way I did; basically to try and leave it up to the reader to decide what they thought might have happened. Ultimately, I'm not sure it is going to matter as the osteopaths have pretty much disowned Still. If something more solid comes up, I'm open to it. --Dematt 19:48, 24 August 2006 (UTC)

I think the "evidence" is too weak at present to be sure of what actually happened. There is an interesting article from DC that describes a debate between Palmer and Still. It's the only place I've ever heard the story, and I suspect it's some kind of script for a play, or something like that. A bit of historical docufiction. I doubt it actually happened, but it still makes interesting reading. BTW, I just left a message for you on the "new article" page. -- ~~

I'd be willing to bet it would go a lot like that! --Dematt 20:17, 24 August 2006 (UTC)

Another resource

A very interesting resource here:

http://www.jcca-online.org/client/cca/JCCA.nsf/objects/Chiropractic+History/$file/p113-136.pdf

-- Fyslee 15:06, 27 August 2006 (UTC)

Your right. The scary thing is I met several of those guys:) I took seminars from John Fay. Vic Nickson was a nice old guy, I always wondered why he was hanging around:) I remember wondering why anyone would want to collect things about chiropractic history! The names didn't seem to matter then, they were just people teaching us. --Dematt 19:05, 27 August 2006 (UTC)

Terrett

Do you know of a source for Terrett's study? -- Fyslee 15:40, 27 August 2006 (UTC)

I found this. Does it help? It looks like it has the quotes that were refenced on the chiro page. I'll see if I can find the full version. --Dematt 19:17, 27 August 2006 (UTC)

Great. I've added it to the reference. When we find the full version we can link to it. NCMIC used to have it on their site, but then it disappeared totally. Weird, if it's really so important. The Di Fabio study seems to indicate that it doesn't really make a very big difference, so its use - in the way Levine2112 uses it - is rather dubious whitewashing, to the detriment of patient safety, but (by his own admission a long time ago) for the protection of the profession's reputation. That's rather unethical prioritizing:

In a study of the risks and benefits of cervical spine manipulation (MCS), 177 cases that were reported in 116 articles published between 1925 and 1997, were analyzed.

When the type of practitioner was determined using Terrett's modifications, the number of chiropractors involved in cases of MCS injury decreased slightly, and the numbers of cases attributed to physicians, physical therapists, and other individuals (ie, a barber, a kung-fu practitioner, and a masseur) increased (Fig. 2). In addition, the number of cases where the practitioner was later reported (by the original authors of the case report) to be unknown increased slightly (Fig. 2). The overall pattern of practitioners involved in MCS-related injuries, however, did not change with Terrett's adjustments.

I find the misuse of Terrett's discovery of minor "misattributions" (not the same as the nearly 100% rate of "underreporting") to be disingenuous, and it undermines the credibility of those who do it. I hope you can help to combat this prioritizing of a profession at the expense of patient safety. The risk is indeed low, but it shouldn't be hidden or denied, especially since other methods of treating the upper cervical spine are available, and since most adjustments of this area are totally unnecessary.

The issue applies to all who use upper cervical manipulation, and not just chiropractors. It just happens to be more of an issue with them, because they are the ones who do it most, and they are the ones who deny the risks. Other groups are documenting their injuries and requiring informed consent.

You have previously expressed a desire to cover the subject properly:

Levine, the safety issue is a POV that needs to be handled. People have heard about it and are interested in the chiropractic response to it. This is the opportunity to state the chiropractors position. The discussion above was very thorough in descibing both POV's. The fact that the problem is relatively small suggests that the article space given to it should be small as well, but thorough. We should be able to get Abotnick's (and other's) POV in two or three sentences and then (since this is the chiropractic article) there should be a rebuttal in defense of chiropractic. The end result should be NPOV within the relative weight of the evidence. Once this subject is handled, it should not be mentioned in the article again. IMO to continue to mention it would give it more weight than it deserves. --Dematt 03:20, 27 May 2006 (UTC)

-- Fyslee 21:10, 27 August 2006 (UTC)

I still feel the same. When I made that statement, I also did some research and every article I found related to spinal manipulation and CVA's noted that "chiropractic" manipulation was considered one cause, but they always noted some sort of "bias" in the claim and then seemed to dismiss it and were more interested in the "genetic predisposition" or "underlying connective tissue disorder." The net result was that Ernst was correct in saying that to try and determine a number was "nonsensical". To me that means that it could be a lot of strokes are caused by SMT or it could be none. At this point, nobody knows. What this means to me as an editor is that I shouldn't "decide" either way. As I read the article, that is pretty much the way it ends up, though I think we could have said it in far fewer words. That's pretty much why I haven't joined in the discussion. I can't tell from what I am seeing whether the information is real. That is not to say that it won't be more obvious as more research surfaces. I am willing to bet, this is just the tip of the iceberg as far as the research that is going to given to this subject:) --Dematt 21:56, 27 August 2006 (UTC)

References

Science and other stuff

Stuff I've seen: Brennan PC, Triano JJ, et al. Enhanced neutrophil respiratory burst as a biological marker for manipulation forces: Duration of the effect and association with Substance P and tumor necrosis factor. J Manip Physiol Ther 1992; 15:83-89.

• Sympathetic nervous system response to mechanical stress of the spinal column in rats.
• Degenerative changes following spinal fixation in a small animal model.
• Response of muscle proprioceptors to spinal manipulative-like loads in the anesthetized cat.
• Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry.
• Can chiropractic maim and kill?
• "Dysafferentation: A Novel Term to Describe the Neuropathophysiological Effects of Joint Complex Dysfunction. A Look at Likely Mechanisms of Symptom Generation" - David R. Seaman, D.C. and James F. Winterstein, D.C., [PubMed ID 9608382]
• Response to school brochure information
• The Meanings of Innate Keating

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22. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Spine. 2002;27(20):2193-2204.
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24. Chiropractic regulatory boards. Federation of Chiropractic Licensing Boards Web site. Accessed at www.fclb.org/boards.htm on June 16, 2003.
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27. Bronfort G, Goldsmith CH, Nelson CF, et al. Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: a randomized, observer-blinded clinical trial. Journal of Manipulative and Physiological Therapeutics. 1996;19(9):570-582.
28. Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. New England Journal of Medicine. 1995;333(14):913-917.
29. Pope MH, Phillips RB, Haugh LD, et al. A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain. Spine. 1994;19(22):2571-2577.
30. Triano JJ, McGregor M, Hondras MA, et al. Manipulative therapy versus education programs in chronic low back pain. Spine. 1995;20(8):948-955.
31. Meade TW, Dyer S, Browne W, et al. Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up. BMJ. 1995;311(7001):349-351.
32. Assendelft WJ, Koes BW, van der Heijden GJ, et al. The effectiveness of chiropractic for treatment of low back pain: an update and attempt at statistical pooling. Journal of Manipulative and Physiological Therapeutics. 1996;19(8):499-507.
33. Ernst E. Chiropractic spinal manipulation for back pain. British Journal of Sports Medicine. 2003;37(3):195-196.
34. Ernst E. Chiropractic care: attempting a risk-benefit analysis. American Journal of Public Health. 2002;92(10):1603-1604.
35. Hurwitz EL, Morgenstern H, Harber P, et al. A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study. American Journal of Public Health. 2002;92(10):1634-1641.
36. Sran MM. Commentary on "Chiropractic spinal manipulation for back pain." British Journal of Sports Medicine. 2003;37:196.

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11. Nansel D, Szlazak M. Somatic dysfunction and the phenomenon of visceral disease simulation: A probable explanation for the apparent effectiveness of somatic therapy in patients presumed to be suffering from true visceral disease. J Manipulative Physiol Ther 1995;18:379-397.

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14. McDonald W, Durkin K, Iseman S, Pfefer M, Randall B, Smoke L, Wilson K. How Chiropractors Think and Practice. Ada, OH: Institute for Social Research, Ohio Northern University, 2003.

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18. Ernst E, Assendelft WJ. Chiropractic for low back pain: We don’t know if it does more good than harm. BMJ 1998;317:160.

19. Ernst E. Spinal manipulation: Its safety is uncertain. Can Med chiropractors, who can participate in joint-manipulation research that is free of bias and dogma. Assoc J 2002;166:40.

20. Assendelft WJJ, Morton SC, YuEmily I, Suttorp MJ, Shekelle PG. Spinal manipulative therapy for low-back pain. The Cochrane Database of Systematic Reviews 2004; Issue 1. Art. No.: CD000447. Pub 2. DOI: 10.1002/14651858. CD000447.pub 2.

21. Assendelft WJ, Bouter LM, Knipschild PG. Complications of spinal manipulation: A comprehensive review of the literature. J Fam Pract 1996;42:475-480.

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24. Goetzel RA, Hawkins K, Ozminkowski RJ, Wang S. The health and productivity cost burden of the top 10 physical and mental conditions affecting six large US employers. J Occup Environ Med 2003;45:5-14.

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Science table from NCCAM

Citation	Description	Findings
Hurwitz et al., 2002	Randomized clinical trial (RCT) of patients in a managed care organization compared chiropractic cared (with and without any of the following added: heat or cold therapy, ultrasound, electrical muscle stimulation) with conventional medical care (with and without physical therapy added). Participants (652) had acute, subacute, or chronic low-back pain with or without leg pain. Back-pain intensity and back-related disability were measured.	After 6 months of followup, the conventional medical care and chiropractic regimens were found to be comparably effective
Hsieh et al., 200225	RCT compared four treatments for subacute low-back pain (LBP): "joint manipulation" by a chiropractor, back school (program of counseling and exercises), myofascial therapy, and joint manipulation plus myofascial therapy. Participants (178) had LBP for either >3 weeks but <6 months in a current episode or >2 months within the preceding 8 months for recurrent LBP, and were evaluated 3 weeks and 6 months after treatment.	No statistically significant differences were found between groups at 3 weeks or 6 months.
Cherkin et al., 199826	RCT in an HMO setting of 321 adults aged 20-64 with low-back pain. Patients received either chiropractic manipulation, physical therapy (PT), or a booklet on self-managing back pain. They were monitored for 2 years and evaluated for bothersomeness of symptoms and level of dysfunction.	The outcomes for those who received manipulation or PT were better than those who received the booklet, but "only marginally better." There were no significant differences between the manipulation and PT groups. Authors note that manipulation and PT "may slightly reduce symptoms."
Bronfort et al., 199627	For chronic low-back pain, prospective RCT compared (1) chiropractic spinal manipulation therapy (SMT) plus trunk-strengthening exercises with (2) chiropractic SMT plus trunk-stretching exercises and (3) trunk-strengthening exercises combined with an NSAID (drug). Enrollees (174) were measured for low-back pain, disability, and functional health status at 5 and 11 weeks.	Each of the 3 regimens yielded a "similar and clinically important improvement over time that was considered superior to the expected natural history of long-standing chronic low back pain."
Carey et al., 199528	Prospective observational study on the outcomes of care for acute low-back pain by chiropractors, primary care practitioners, and orthopedic surgeons, including how long it took to return to functional status. Participants (1,633) had acute pain of less than 10 weeks' duration.	Time to recovery was "essentially the same," regardless of which provider provided the care.
Meade et al., 199531	RCT of 741 patients who came to chiropractic and hospital outpatient clinics in 11 centers, for low-back pain. Participants were randomized to receive either chiropractic or hospital-outpatient management. Outcomes were measured mainly with a pain disability questionnaire, at 6 weeks, 6 months, and 1, 2, and 3 years.	Chiropractic was found to be more effective, especially for those with "short current episodes, a history of back pain, and initially high [pain scale] scores." Benefit was less evident at 2 and 3 years than earlier. Authors noted that further trials are needed, e.g., on specific components of chiropractic.
Triano et al., 199530	RCT comparing chiropractic spinal manipulation, sham manipulation, and a back education program. Participants (170) had low-back pain (lasting 7 weeks or longer or consisting of at least 6 episodes in 12 months) and were evaluated for pain and activity tolerance at enrollment, after 2 weeks of treatment, and after 2 weeks of no treatment.	Greater improvement was found in the manipulation group than in other groups. Pain relief continued to end of evaluation period.
Pope et al., 199429	Prospective RCT compared chiropractic spinal manipulation for treatment of subacute low-back pain to massage, use of a corset, and TMS (electrical muscle stimulation). Patients (164) were treated for 3 weeks and evaluated through various standardized instruments and examinations.	Various improvements were seen in all 4 groups. The manipulation group had the most improvement in flexion and pain. However, authors concluded overall that none of the changes in physical outcomes measured was significantly different between groups.
Assendelft et al., 2003	Meta-analysis of 39 randomized clinical trials of treatments for acute or chronic low-back pain in adults. The trials compared spinal manipulation (by chiropractors and other health care providers) with another treatment or control condition (including no treatment, conventional medical care, pain-relieving drugs, physical therapy, exercise, and back school)	Spinal manipulation was more effective than sham therapy, but no more or no less effective than other treatments. Authors found that the specific profession of the manipulators (including chiropractors) did not affect these results.
Ernst, 2003	General review of the scientific evidence for the effectiveness of chiropractic spinal manipulation for back pain (this review is not limited to low-back pain studies).	Author noted there has been only one systematic review of chiropractic spinal manipulation exclusively (Assendelft et al., 1996, see below), and that, since that study, emerging trial data "have not tended to be encouraging…. The effectiveness of chiropractic spinal manipulation for back pain is thus at best uncertain."
Assendelft et al., 1996	Systematic review of 8 RCTs of chiropractic for acute or chronic low-back pain.	Authors stated that all studies analyzed had serious flaws in design, execution, and reporting. Studies could not be pooled to reach statistical conclusions because of insufficient data and data quality problems. Authors summarized the available data narratively; concluded they "did not provide convincing evidence for the effectiveness of chiropractic for acute or chronic low back pain"; and noted that better-executed trials are needed in future.

Changed meaning

This edit changes the meaning of the sentence. It clarifies the fact that manipulation is a part of the adjustment, but the fact that the adjustment is still the primary technique gets lost. -- Fyslee 05:28, 28 August 2006 (UTC)

• The initial chiropractic technique was manipulation of the spine and remains the primary technique used in the adjustment .

How about:

• Palmer's initial chiropractic treatment consisted solely of the use of manipulation of the spine and this procedure remains the primary technique included in today's chiropractic adjustment.

--Dematt 12:28, 28 August 2006 (UTC)

Wow! You really can do it when necessary. That's an excellent choice of words. It presents the facts very well. -- Fyslee 12:55, 28 August 2006 (UTC)

Yeah, but you don't know how deep I have to dig. Sometimes it takes hours of staring at the screen! Not to mention watching you and Levine for days on end argue each side. Then one day it just "burps" out:) Sometimes it's actually painful! --Dematt 13:03, 28 August 2006 (UTC)

Somatic simulation of visceral disease

Are you familiar with this work? I have read the whole study. Very interesting.

When Dale Nansel, PhD and Mark Szlazak, DC (at the time both professors at Palmer College of Chiropractic-West, San Jose, CA.), in 1995 published their monumentally important (for the chiropractic community) report on the phenomenon of somatic simulation of visceral disease, it was largely ignored, and has had little impact on the profession. It was published in JMPT 1995 Jul-Aug;18(6):379-97

-- Fyslee 20:29, 28 August 2006 (UTC)

I think you turned me on to something by Nansel a few months ago. Go ahead and give it to me again to refresh my memory. --Dematt 20:50, 28 August 2006 (UTC)

Have access to the original articles in JRSM but not the correspondence; I'll see if anyone close by is a memberGleng 08:56, 29 August 2006 (UTC)

Thanks, Gleng. I haven't been successful yet, either. --Dematt 12:22, 29 August 2006 (UTC)

To my surprise I haven't got anywhere (though I don't mingle a lot with clinicians); I was surprised that the library here doesn't take it but it seems that JRSM is not considered a particularly noteworthy journal - its impact factor (as I've just discovered) is only 0.65. This is a study to note, but not one to be bowled over by. There should be some hierarchy of sources, I guess; this is not Lancet/BMJ/NEJM class by a long way.Gleng 14:41, 30 August 2006 (UTC)

Okay, that says a lot; the Royal word got me:) Saved me a lot of time barking up the wrong tree;) Thanks! --Dematt 14:52, 30 August 2006 (UTC)

[17]:)Gleng 19:02, 4 September 2006 (UTC)

Hi Dematt; I looked only at the quality of the source, deliberately haven't looked at the content of the link. The source seems unimpeachable as a strong, authoritative secondary source; the site is an NHS site, centrally funded and managed, deseminating information collated and reviewed by a properly funded academic research centre [18]; their reviews, like Cochrane etc are stated to be peer reviewed etc. Can't fault it. Gleng 08:19, 2 September 2006 (UTC)

Excellent, thanks again. --Dematt 16:51, 2 September 2006 (UTC)

Perspective on safety

I have been troubled by the safety section as a whole, and now by the paragraph involved in this edit:

"In contrast, cervical spine surgery, an alternative to spinal manipulation for neck pain and radiating arm pain, has a 3-4% rate of complication and 4,000-10,000 deaths per million neck surgeries." [19]

It needs to be put into perspective:

Chiropractic as a profession treating mild conditions vs. medicine and surgery treating serious conditions.

I don't see surgery being used as an alternative to the ordinary neck-related conditions that are being treated with upper cervical manipulation. Even when it does happen in exceptional cases, the fact that most upper cervical manipulations are unnecessary, and for conditions in which an MD wouldn't consider any treatment as necessary - much less surgery - is being ignored. It is only in very exceptional situations that there would be any serious discussion about which was appropriate.

The Safety section was originally specifically about the safety risks involved in upper cervical manipulation, but has been watered down by numerous inclusions of POV defenses of chiropractic as a whole that are unrelated to that issue.

Starting the section with this about chiropractic as a whole detracts from patient safety as related to high cervical manipulation specifically, and prioritizes protection of chiropractics reputation above individual patient safety:

"Chiropractic continues to be one of the safest health professions and chiropractors have some of the lowest malpractice insurance premiums in the health care industry." [20]

-- Fyslee 05:42, 5 September 2006 (UTC)

Let me take another look at it. It's a work in progress! --Dematt 14:31, 5 September 2006 (UTC)

The Safety section should be in at least two parts:

• Chiropractic as a whole: generally quite safe, since most conditions treated aren't even worthy of a trip to the ER.

• Upper cervical manipulation: risk is very low, but is real and serious, and is very relevant to chiropractic, since chiropractors perform 95%(?) of them. The problem is not exclusively related to chiropractic, but to the technique and region, and thus all practitioners who do it are exposing their patients to an avoidable risk.

Here's an interesting one:

• Spinal manipulation versus mobilization - Edzard Ernst

Of course di Fabio's research:

• Manipulation of the Cervical Spine: Risks and Benefits - Richard P Di Fabio

Now if we could only get hold of the Terrett study, which I believe is misused. -- Fyslee 15:46, 5 September 2006 (UTC)

I see you just added the reference from the Danish study. Keep an eye on the Danish chiros. Some of them do excellent research, especially Charlotte (with the exception of where she claimed "overreporting," instead of misreporting. They aren't the same thing):

• Overreporting: Actually reporting more cases than are actually the case. This is virtually impossible. (Result: 110%)

• Misreporting: Misattribution error where the wrong practitioner is blamed for another one's error. This modifies the statistics and thus "shifts the blame." (di Fabio used Terrett's study to correct for this error.) (Result: just a shift within the 100%)

• Underreporting: Failure to report actual cases, which then never figure in the statistics. (Result: reporting 15%, instead of 100%. Ernst actually discovered 100% underreporting in England, which means we're talking about a large iceberg, with very little showing above water. We know it happens, but just how much "ice" is under the water?)

(The statistics above are just examples, not proven ones.) -- Fyslee 16:00, 5 September 2006 (UTC)

Yes, the editing I did that first night was more just "pruning". I wasn't sure what was put in from memory and what really had resources. I tired to qualify the surgery edit by adding the "neck pain with radiating arm pain" because I agree that is misleading. I'm still thinking about that one. On the other hand, if we are going to put it all into perspective, we have to consider it somehow. Maybe throwing in the NSAIDS for the lessor vs surgery for the more complicated.

I think over-reporting is really meant for when numbers are derived from an estimation based on reported percentages. --Dematt 16:38, 5 September 2006 (UTC)

Neuroimmunology

Hi Dematt, I have to take a break now, real life getting too busy. See the link I found above? Last Sunday went fishing on the North Sea and one of the others was an immunologist; we got chatting and he asked me what I did etc; he said he was using microarrays to study gene expression in macrophages and he asked me " These have lots of mRNA for GABA receptors - what's that doing in macrophages". (GABA is a neurotransmitter). I shrugged and said the kind of standard thing - Neuroimmunology is an exploding field, we know that the immune system is regulated extensively by the nervous system but really don't know very much yet about how that happens. Funnily enough, chiropractic never even crossed my mind. :)Gleng 09:20, 5 September 2006 (UTC)

That is very exciting to me. Don't feel bad, you're not the only one that didn't immediately think of it. Neither did the Neuroimmunologist! I should go fishing more often:) There was a documentary on PBS about ten to fifteen years ago (I can't remember the name) but it was discussing macrophages and showed a graphic animation of it traveling through a maze of fluid filled tissues and every once in awhile it made contact with a nerve ending. The narration actually stated that the macrophage was receiving information from the nerve ending (of course the animation showed the nerve ending reaching out to the macrophage - assumably directing its behavior). At the time, I was not able to decide if this was some author's conjecture or if it was a known phenomenon. Either way, maybe that is whats happening. It is all exciting. I am sure we are getting closer all the time. Especially when scientific minds start getting involved. Thanks Gleng. --Dematt 14:22, 5 September 2006 (UTC)

Hi Dematt - many thanks for the star - just noticed it, and much appreciated...  :)Gleng 18:03, 6 September 2006 (UTC)

And so are you! --Dematt 20:36, 6 September 2006 (UTC)

Our disc article

You should take a look at this!

• What links here

That article is a good addition to Wikipedia, and we can be proud of it. -- Fyslee 13:23, 7 September 2006 (UTC)

I agree! No-one has changed anything either.. I guess that means we covered all the bases pretty accurately. Does the MRI look dark on your computer? It's really dark on mine. I can barely see the disc. --Dematt 13:46, 7 September 2006 (UTC)

Yes, the image is a bit dark, and it might be better with one that focuses on the local area more, with larger detail. The idea is a good one. Such an image speaks a thousand words. I have a whole MRI series on my PC that I can turn and zoom in on. It's of one of my former patients whom I suspected had a herniation in his neck. It turned out that he had three, with massive osteoarthrosis, foraminal occlusions, root impingements, etc.. If anyone ever had subluxations.....;-) A cervical adjustment could have paralyzed him or severed nerves to his arms. -- Fyslee 14:00, 7 September 2006 (UTC)

That sounds like a good one! But, you might want to leave off the severed nerves part, that would be OR and I would have to argue it with you;)LOL --Dematt 14:07, 7 September 2006 (UTC)

Okay,.... permanently damaged. I've seen cases where manipulations have caused osteophytes to tear nerves. Not a very good prognosis. -- Fyslee 14:15, 7 September 2006 (UTC)

There is a lesson to be learned from our collaborative effort. Even though this wasn't a controversial article, I think it's good for editors with different POV to collaborate in making articles. As long as we accept each other's good intentions and fallibilities, and both seek to ensure that all significant POV are included, the end result meets NPOV criteria and covers the subject much more thoroughly than when editors battle for control of an article. Of course that also means that they aren't thin skinned and religiously attached to some pet idea. When religious feelings get aroused, irrational behavior can dominate the editing process, and that screws things up. We have to be willing to allow edits and inclusions that express and expose the ideas we'd rather not see directly in the eye. The truth often lies precisely there where we don't want to look. If we can surmount and conquer those feelings, we come out of the editing process with a better understanding of all sides of the issue than we had when we started. When the chiropractic article is more finished, you will be expert enough to write a book! Let me know when it's published. I'd love to read it. (I don't know if you'd like to read the one I've already written. Over 200 pages and sitting unpublished on my PCs. It's far too imperfect at present to be viewed by others. I need about two months undisturbed to get it ready for publication, and those months never come....) -- Fyslee 14:13, 7 September 2006 (UTC)

Rewarding personal attacks

Your comment here should be tempered by trying to set yourself in the shoes of those whom Steth attacks. I've endured quite a bit, and it's not at all funny, and he doesn't deserve barn stars for doing it. -- Fyslee 14:20, 7 September 2006 (UTC)

That was the tempered comment. I wouldn't wish the wrath of Steth on anyone!

Early political tactics, with modern counterparts

This paragraph, which you deleted, is very interesting:

John F. A Howard, D.C, the 1906 Palmer alumnus who founded the National School of Chiropractic, noted that, "In the early days it was necessary to protect the “child” (chiropractic)... by evasive terminology in order to avoid the chill and ice of the law and “analysis” was used for diagnosis, “adjustment” was employed for treatment, “pressure on nerves” was used for a reflex stimulation or inhibition, etc. These terms were garments to protect the child until legal clothing could be secured.

I have read a very similar, but even more clearly expressed, statement, but I can't find it right now. I believe it might be in some of Keating's historical stuff.

This early strategic thinking, clearly designed to avoid prosecution (a very real danger), is still evident in the statements and writings of some chiros, especially the F.A.C.E. group and other ultra straight chiros.

The statement above, and the one I'm thinking of, could be made into a nice and short section regarding this type of strategic thinking, past and present. -- Fyslee 07:31, 9 September 2006 (UTC)

I agree, I tried to fit it in, but I think we have to get a section that starts to show the developement of the science with John Howard and Joe Janse at National, then we can show their POV as well. I still have not seen anything that makes me change my mind that DD was the original "mixer" and was in the middle of developing a science, but because of the AMA's threat to absorb everything into themselves (and because DD was not an MD), BJ decided to cloak it while DD wanted it to be scientific, but finally gave in to the fact that it had to go religious to avoid being called a science and absorbed by medicine (then getting arrested for practicing without a license). Once the threat was gone, it was too late, BJ had created his flock and they would defend it to the death. I want to avoid anything that would be OR, though, not because it would be wrong, but because I want to get it right. We don't need to point fingers at any group, though. I think they all think they are doing the right thing, they all just have different information. --Dematt

Interesting theory about DD Palmer being more scientific than his river-rat, high school drop out (nope, he got booted out!) son. It wouldn't surprise me, because BJ was anti-scientific, and primarily a businessman, salesman, and a pioneer in mass marketing (of chiropractic). I've never gotten an impression that he had any moral scruples about using any method to sell his "product." Here's an interesting quote showing his attitude:

“Our school is on a business, not a professional basis. . . . We manufacture chiropractors. . . . Give me a simple mind that thinks along single tracts, give me 30 days to instruct him, and that individual can go forth on the highways and by ways and get more sick people well than the best, most complete, all around, unlimited medical education of any medical man who ever lived.” Fountain Head News, Nov. 1, 1919.

What have you read that gives a clue about DD Palmer's "scientific" attitude? Always ready to learn more about those early days! -- Fyslee 20:27, 9 September 2006 (UTC)

A few links that might shed light on the early legal defense tactics: [21] (you have this one) [22] [23] [24] [25] Happy reading! -- Fyslee 21:02, 9 September 2006 (UTC)

The most comprehensive article ever written

You know that my dream is that the chiropractic article be the best and most comprehensive one ever written. It should be our goal to preempt all other articles, by making it possible for a reader to say: "No article or source outside of Wikipedia really provides significantly new information, because it was already covered in that article. It covers every angle, so there are no surprises waiting for me outside of Wikipedia." -- Fyslee 07:31, 9 September 2006 (UTC)

Megalomania and other thoughts

Palmer's grandson has described his technique:

“He would develop a sense of being positive within his own body; sickness being negative. He would draw his hands over the area of the pain and with a sweeping motion stand aside, shaking his hands and fingers vigorously, taking away the pain as if it were drops of water.”

“Palmer began speculating that the flow of animal magnetism may become blocked by obstructions along the spine. Palmer taught that chiropractic was "an educational, scientific, religious system" that "associates its practice, belief and knowledge with that of religion" and "imparts instruction relating both to this world and the world to come." "Chiropractic," Palmer stated, "sheds enlightenment upon physical life and spiritual existence, the latter being only a continuation of the former." [26]

The religious/metaphysical basis for chiropractic philosophy and biotheology is expressed quite clearly in the following quotes by a sensible, non-vitalist chiropractor, and also by a historian of chiropractic:

"It is my perception that the chiropractic profession and the practice of chiropractic lacks a sound philosophical foundation, and that this exists in part because we do not appropriately and consistently examine our beliefs, dogmas and supposed axioms.

". . . philosophy in chiropractic typically echoes that of mysticism, rather than critical thinking. . .

“In their words, according to most chiropractors, so called chiropractic philosophy constitutes a type of religion or metaphysical theology.

"BJ proposes that mental impulses are godly or spiritual impulses, and that subluxations can interfere with or block, the transmission of these spiritual impulses. In essence . . . this explanation offers a "spiritual disconnection theory" of subluxation, such that subluxations disconnect one from the consciousness of God and his healing forces. Within this belief system it is held that the chiropractor, through spinal adjustments, is directly responsible for releasing God's healing forces that were previously blocked by subluxations. With good reason, this explanation is unacceptable to many chiropractors." - David Seaman, DC. Science Vs Dogmatism. Journal of Chiropractic Humanities. Vol. 8. No. 1.

“Armed with “pure, straight and unadulterated chiropractic philosophy,” B.J. expounded at length upon the “Innate Intelligence,” and placed the concept center stage in his theories. He proposed this Vital Force as an explanation (not merely a description) for the life processes, and offered this Spirit as a source of knowledge for individual chiropractors. B.J. gave us “Innate Intelligence” not as metaphor, but as a physico-spiritual or theosophical reality. Chiropractic, it was suggested, was superior to godless medicine because its “science” united the material with the immaterial. Palmer’s unique chiropractic rhetoric also drew liberally from business and marketing metaphors; he developed chiropractic science, as he said, “with printer’s ink.” The neurocalometer, he proclaimed, was “THE MOST VALUABLE INVENTION OF THE AGE BECAUSE IT PICKS, PROVES AND LOCATES THE CAUSE OF ALL DIS-EASES OF THE HUMAN RACE” (Palmer, 1924).” - A Brief History of Chiropractic Belief and Values: The "Therapeutic Approach," Joseph C Keating Jr PhD [27]

As with all megalomaniacs, DD had grand thoughts of himself, at one point even stating:

“I am the originator, the Fountain Head of the essential principle that disease is the result of too much or not enough functionating [sic]. I created the art of adjusting vertebrae, using the spinous and transverse processes as levers, and named the mental act of accumulating knowledge, the cumulative function, corresponding to the physical vegetative function-growth of intellectual and physical-together, with the science, art and philosophy-Chiropractic. . . . It was I who combined the science and art and developed the principles thereof. I have answered the time-worn question -- what is life?“ [28]

Another time B.J. Palmer quoted his father:

“There is a vast difference between treating effects and adjusting the causes. I was the first to adjust the cause of disease. . . . The man who had the intellectual capacity to comprehend the displacement of vertebrae; the mental ability to grasp the significance of nerve impingement; the power to conceive and discriminate between normal and abnormal positions; the foresight and wisdom to discern the outcome; the genius of originality to create such a unique science; the judgment needed for the occasion; the brain caliber capable of reasoning on this heretofore perplexing question--the cause of disease; the sense of touch required to discover a racked vertebra and the skill and tact to replace it, was the one destined to discover the science which he named chiropractic.” Shall Chiropractic Survive?, 1958

The following account of B.J. Palmer's attitude is likewise quite astounding:

"While attending a meeting at the Hotel Sam Peck (Legacy now) my thoughts drifted back to over a third of a century ago when as a new doctor in this state, I was privileged to be seated at a table with many of the pioneer chiropractors in this state. Dr. Yoder was present, along with Dr. Tina Murphy, Dr. Carl Lindquist and others. They told the story of going to clinic in the early nineteen hundreds at Palmer College in Davenport, Iowa and passing through a door with two pictures above it, one of Jesus Christ and one of B.J. Palmer. Under Christ's picture were the words "HE HEALED FEW". Under B.J. Palmer's were the words "I HEALED MANY". I expressed my disbelief but they all swore it was true." Dr. Conrad Kaelin [29]

Just a bit of info from my unpublished book .....;-) -- Fyslee 20:42, 9 September 2006 (UTC)

AMA and chiro

A good new section on the AMA's attempts to eliminate chiropractic. Good going. There is more information

• here,

• here,

• here, and

• here.

-- Fyslee 05:27, 11 September 2006 (UTC)

Thanks, I never know when I've gone overboard. I'll let everybody digest what I've got first. You can add stuff, too. --Dematt 15:58, 12 September 2006 (UTC)

KV

Hey, Dematt, see this. •Jim62sch• 10:25, 11 September 2006 (UTC)

Suggesting an one month community ban for Mccready on all pseudoscience articles

I'm suggesting a one month community ban of Mccready from all pseudoscience articles. [30] He could edit the talk pages but not the article. Please make your thoughts known on AN/I. FloNight 16:46, 12 September 2006 (UTC)

You might want to weigh in your thoughts here, if you haven't already. TheDoctorIsIn 18:37, 12 September 2006 (UTC)

Take a look

If you wouldn't mind checking out National Board of Chiropractic Examiners to check for any errors and offer improvements. Also, and only if you have the time, I've yet to master the reference making part of WP. ;)--Hughgr 20:57, 12 September 2006 (UTC)

Roger that, thanks for the compliment. It'd be cool if we could add the logo or something to "spice" up these new pages. Maybe Dr. Rick knows who to ask? :)--Hughgr 23:17, 12 September 2006 (UTC)

Maybe I could make some drawings with ms-paint? HAHA that's a good point about the copyright. They'd never allow WP to use it under their GFDL. Oh well, it was just a thought...--Hughgr 23:26, 12 September 2006 (UTC)

References

(Please keep this section at the bottom.)

Spinal disc herniation plus hydrotherapy, or other therapy

Tuesday, 9-12-05 Portland, OR 5pm Pacific time

To: Dematt

From: MyPresentCPUisTooSlow registered user, and PC end-user

This is my first time using this "user talk" function so please bear with me. It will be a miracle if you see this message, and more so if you can answer my question. but first, I tried to send a private email to you, but apparently there was a glitch somewhere in my loggin.

Until I get an upgrade, my PC's present CPU is way to slow; so what you read here is only a result of my own persistence. So for now I'm posing a subject to you in this user talk function.

The following wikipedia page address is an entry on spinal disc herniation:

1) http://en.wikipedia.org/wiki/Spinal_disc_herniation

This page entry describes a herniated disc and what it looks like. I wish to know if Hydrotherapy facilitates healing a herniated disc? And if so, then between the "annulus fibrosus" and the "nucleus pulposus" which heals first?

I suspect that I have a few herniated discs. But I don't have the money to get a physican's medical examination, thusly the number of herniated discs that I have and there location on my spine is unknown.

Can you provide an answer to my question on hydrotherapy?

My personal email address is:

celetials@aim.com

Or you can reply to my question in your "user talk:Dematt" function.

MyPresentCPUisTooSlow, without knowing specific details about your condition, it is not possible and would not be proper for me to make a diagnosis over the internet. I would hate to think something would happen to you because of something I said without examining you. As you can imagine, there are several conditions that can mimic spinal disc herniations that are dangerous. In extremely rare cases, some can leave permanent damage or can even be life threatening such as tumors or metastasis that should not be overlooked. The only advise I can safely give you is to see your MD or DC. Once you are sure of the diagnosis or cause of your pain, then you can make more educated choices about how to treat it at home, which may certainly be appropriate.

I certainly wish I could help you further. Please keep me informed of your progress. I'll be thinking about you until I hear from you again! --Dematt 02:20, 13 September 2006 (UTC)Dematt

Hi Dematt Thanks (:/) for the Sludge paper, I think it's given me a headache. How can I put it, I wouldn't like my life to depend on this as a case. However, as always, I can see things within it that indicate that there is a case to be heard, if only it could be put clearly. Of course it's written for insiders who might grasp the meaning without any trouble, but if you're asking an outsider to take this as a reasoned case, then I personally don't think it reads like one.

BTW you should be aware that I've mentioned chiropractic in this [ http://en.wikipedia.org/wiki/Wikipedia_talk:Tendentious_editors]Gleng 14:33, 13 September 2006 (UTC)

Hi, Thanks for putting in the details on regulation, and yes I think it's very important addition.

If you send me an e-mail I've a pdf I'd like to send you.Gleng 11:08, 14 September 2006 (UTC)

Orgs

So far we haven't solved this dilemma mentioned by Botnick:

• "This is ridiculous. WCA is allowed as a group but NACM is censored off for the reform chiropractors? This is unfair to the readers." [31]

He has a point, but one editor in particular seems to have been born for only one purpose - to prevent this improvement to the article, and particularly this section:

• Practice styles and schools of thought

Right now each group is described, and information about tendencies towards organisational affiliation are provided, which is a good service to readers:

• Traditional Straight chiropractors: "The most popular national association for traditional straight chiropractors is the International Chiropractors Association (ICA)."

• Mixing chiropractors: "They tend to be members of the American Chiropractors Association, and all the major groups in Europe are also in membership of the European Chiropractors Union."

• Objective Straight chiropractors: "Objective Straight chiropractors tend to be members of the Federation of Straight Chiropractic Organization (FSCO) and the World Chiropractic Alliance (WCA)."

• Reform chiropractors: (description conspicuously lacking, thanks to one editor, who would like to keep Wikipedia free from mention of anything that smells like "reform")

Most chiropractors are not members of any national or state organisation, which is a fact that the organisations often lament, but there are tendencies that are clearly based on philosophy.

I have earlier made a very neutral and factual description, which that editor has repeatedly deleted, based on his hatred for the organisation and the very idea of reform. Here was my version:

• "Reform chiropractors tend to be members of the NACM, but are allowed simultaneous membership in other organizations."

That version is more factual than this one:

• Most reform chiropractors belong to the National Association for Chiropractic Medicine (NACM).

That is not true. My version is just as factual as the descriptions for the other groups, and those descriptions are allowed.

I would like to see this situation resolved, but if I do it, the result will be immediate and predictable, and with no opposition from other editors, who should be sympathetic to improving the article, and to actively opposing any suppression of opposing POV. -- Fyslee 22:14, 15 September 2006 (UTC)

Fyslee, I think I may be the editor you are trying not to mention. You make a statement implying that I don’t like reform. I am all for reform. There are many chiropractors that are members of the American Chiropractic Association (a REAL organization). They may have only a portion of chiropractors as members but it is still, I think it is around 10,000(?) Your org may have only 10 or 20. Who knows?

I just don’t see how adding information about your so-called ‘organization’ will improve the article in any way shape or form, as you contend. I am curious though, as a physical therapist, why are you so interested in this organization? Are you connected with it?

I have asked both you and Abotnick to give us something to verify, and have yet to see it. There are just too many Red Flags.

Please verify your statement "Reform chiropractors tend to be members of the NACM, but are allowed simultaneous membership in other organizations."

They won’t reveal how many members there are or who they are. 10, 20, 100? Who knows? No way to verify. No way to find out who the officers are, when elections are held, where are they headquartered, what seminars have they sponsored, what research have they conducted, sponsored, funded, etc. etc. What exactly have they done for the chiropractic profession? You have told us things that appear to be on more of a subjective level, but what is there to verify? REAL organizations like the ACA, ICA, FCER have all funded large research projects at school research departments. The hold elections, sponsor seminars, meetings, etc.

I have asked Abotnick, who I think is connected with them, if he was a member. No answer. Correct me if I am wrong, but I think you may be connected with them as well. If so, could you please provide some of the many missing blanks in the application to appear in Wikipedia, like notability, verifiability and how reliable a source is it? I and the other editors would appreciate it.

The biggest Red Flag is the fact that at the bottom of the one-page website are four links, three of which are hotlines to Stephen Barrett Enterprises (Donations gladly accepted!) which has nothing to do with chiropractic. Now if that doesn’t fail the smell test, I don’t know what does! Steth 23:28, 15 September 2006 (UTC)

I am trying to sort through some of this with my own reading as well. I appreciate both of your inputs on this, because I think you both have valid points. The net effect of the things I am reading seem to be that(I'm not going to give links yet as it would take me longer than necessary to get the point across):

1. The ICA and ACA are actively discussing merger.
2. Duvals and Slaughter are asked by Barrett or Jarvis(NCAHF) to write up something about what they think the scientific practice of chiropractic would look like.
3. They do it. They may have even been the ones that decided to suggest renouncing subluxation (or it could have been NCAHF's idea).
4. Afterward, Barrett writes his guidelines for the "ethical" practice of chiropractic. Duval et al create the NACM and set guidelines to match NCAHF requirements for practice.
5. Somewhere in there Murray Katz, MD starts orthopractic (1994)
6. NACM and McKenzie support orthopractic (May 1994)
7. NACM comes out in the news as wanting to prescribe drugs. The profession immediately goes into a dialogue of whether this is appropriate.
8. Katz and NACM dominate Consumer Reports negative chiropractic piece (Jun 1994)
9. NACM (Nov 1994)and McKenzie (Feb 1995) pull out of orthopractic. McKenzie cites not wanting to be involved with an organization that seems to only want to destroy chiropractic
10. The ICA/ACA merger falls through(again). Nobody is prescribing drugs. Nobody is telling who is part of what. Homola is a NACM member. Slaughter, DuVals of course are NACM.

(I'm not sure what order all this happened and that is why I haven't added any of it yet).

I am still trying to find V RS for some of this. I would love to have something that is written that we could use as a source for anything we say about any of these organizations, because these are organizations that still exist and would take offense to anything that we said that was not verifiable. To use information from one organization about the other organization may not be reliable. I am also having some difficulty with the term reform and the use of the the category "Reform group". I haven't seen any group called that anywhere in my research. Did we just decide to call them that before I got here, or is there a group called that. Any links would really be helpful.

So that is where we are at so far. Any input?--Dematt 00:31, 16 September 2006 (UTC)

Okay guys, this is what I have after spending several hours searching. If we look at this V RS, I have is the two pages from the NACM website with Ron Slaughters explanation about who and what they say they are about. Then we have a some sources that link it with Katz and orthopractic and Barrett and NCAHF. Is there anything else out there that would make them more than just a few fringe DC' working with MDs?--Dematt 05:54, 17 September 2006 (UTC)

I did further research on Spinal Disc Herniation

Saturday, 9-16-06 Portland, OR 2:27pm Pacific Time

User Talk: Dematt

From; MyComputersCPUisWayTooSlow

(I've got to shorten my username, ugh!) I'm back! and at this time I'm pressed for time. I have to get ready for work A.S.A.P. I'm not a Business Owner, and as such I'm not always in front of my PC, so as i have the chance I log on. I did some research on Spinal cord impingement, and I found that there are several origins of impingement. I'm a caucassian male, age 45, and slim build, and a non-smoker (just to give you an idea of my demographics.).

http://www.spine-health.com/dir/hern.html

The above web address contains an animation sequence of a disc herniation, but it doesn't illustrate how the protrusion retracts in the process of self-healing. I don't know what parameters that your profession of chiropractic medicine actually entails, but speaking from the perspective of a Layman, I wish to know how a Disc herniation retracts its protrusion and facilitates self-healing? Does hydrotherapy or gravity inversion facilitate this retraction healing process. If you do not know the answer to this then can you recommend someone who does?

From User: MyComputersCPUisWayTooSlow, PC end-user

MyCPUWTS;) - That is a very good question. The advent of MRI imaging has helped a lot in studying the disc in the last 20 or so years. As of yet, I am not aware of one good answer. At this point there are a few hypotheses for this process. I would refer you to these studies:

• Spontaneous regression of a large lumbar disc herniation: report of an illustrative case.

This study suggests retraction, dehydration, and resorption as three possible reasons

• Spontaneous regression of lumbar hernia of the nucleus pulposus. Follow-up study of 4 cases by repeated magnetic resonance imaging

This case suggests that it is through resorption rather than dehydration

• Natural history of extruded lumbar intervertebral disc herniation.

This study suggests that the nucleus pulposus hydrates directly after herniating, then dehydrates causing it to shrink. So it considers dehydration as the cause of the size of the disc herniation.

If we consider retraction (or that the disc is "sucked" back under the vertebra), then inversion therapy would be a potential intervention that could create a "vacuum" effect on the disc and hopefully facilitate this process. Keep in mind that there may be side effects of inversion, i.e. too much traction on a injured disc may damage it more or result in a reflex muscle contraction as the body responds to the traction. Also, the veins have valves in them that are meant for upright posture, there are no valves for upside down posture, so theoretically, too much pressure could build in the brain causing stroke. I do not use this therapy in my office for this reason alone, but am aware of equipment that is available for this purpose. Most do not allow full inversion.

If we consider dehydration (or the body "absorbing" the fluid out of the tissue), this is a chemical and immune type reaction. According to the study, it suggests that the body hydrates the disc initially. This may be a normal reaction to the injury (such as inflammation that allows for infiltration of white blood cells and fibrocytes to enter the area and clean up and rebuild the injured tissues) and then dehydration is part of the natural healing process that does not need much help other than being careful not to reinjure yourself with lifting or bending, etc.

If we consider resorption (or that the disc fragment or bulge is "digested" or "dissolved" by chemicals factors secreted by specialized cells in the inflammatory stage or macrophages/white blood cells), this too is a self healing process that would not need much help to heal. Again, the most important factor is not to re-injure.

I am not sure what type of hydrotherapy you are asking about. The name suggests water, perhaps similar to a whirlpool or spa type bath. This would help decrease the muscle spasm pain, but I would advise against prolonged use of heat during the acute stage of the injury (similar to using heat on a sprained ankle - you'll make it swell more). Otherwise, judicious use may not be bad. Mostly it will feel better. I generally suggest ice during the acute stage, though others use other methods as well.

Remember, prolonged nerve root pressure will eventually create permanent damage to the nerve, so if that disc is causing radiating pain, seek help. If you are unable to void your bowel or have lost the urgency to urinate, seek help immediately. Also, there are other conditions that can cause symptoms similar to disc herniation that are life threatening, so be mindful to seek help. I don't know where you live, but there may be financial assistance programs out there for you. Your doctor would know how to set you up if that is the case.

Does this help? --Dematt 01:14, 17 September 2006 (UTC)

Mccready is issued a 30 day community probation related to Pseudoscience articles

Hello

Based on the comments left on AN/I, I issued a 30 day topic ban to Mccready. (see Community probation log [32]) Discussion on talk pages is encouraged. Admins can enforce the ban if needed. Crosspost from AN:

Based on this discussion on AN/I [33] and the numerous comments on Mccready's talk page, Mccready (talk · contribs · deleted contribs · page moves · block user · block log) is issued a 30 day ban from editing all articles related to the Pseudoscience. Mccready is encouraged to discuss his ideas on the talk pages of these articles. The the suggested sanction for disregarding the article ban is a 24 hour block with the block time adjusted up or down according to Mccready's response. Admins are encouraged to monitor the ongoing effectiveness of this article topic ban and make appropriate adjustments if needed. FloNight 23:26, 16 September 2006 (UTC)

Further discussion about the ban or request for enforcement can be made at AN/I or AN. FloNight 00:44, 17 September 2006 (UTC)

Suggested sequence of steps to document VS

I have just submitted a suggested sequence of steps to document VS here. Please add your comments and suggestions. -- Fyslee 08:14, 17 September 2006 (UTC)

Chiropractic as spine care: a model for the profession

Have you read this?:

Chiropractic as spine care: a model for the profession. Craig F Nelson, Dana J Lawrence, John J Triano, Gert Bronfort, Stephen M Perle, R Douglas Metz, Kurt Hegetschweiler and Thomas LaBrot

• PubMed abstract
• Full text

It has an excellent set of references.

You should read what they say about "internal confusion," the "chiropractic hypothesis," and "Palmer's Postulates."

This part is especially relevant to the "Practice styles and schools of thought" section in the chiropractic article:

Internal Confusion

The chiropractic profession is not currently prepared to effectively meet these challenges. More than 100 years after its origins, the chiropractic profession remains focused on the internal debate "What is chiropractic?" – a quandary shared by many other stakeholders in the healthcare system. Perhaps as testimony to some underlying strength of chiropractic, the profession has managed to survive in spite of its confused self-vision. The more important issue is the profound organizational weakness suggested by the century-old debate on fundamental identity. It is difficult to fault decision-makers within the healthcare industry for any reluctance to embrace chiropractic when they do not know what it is they are asked to embrace.

There is a lack of uniformity and consensus within the profession about the proper role of chiropractic. Depending upon whose point of view is solicited; chiropractors are subluxation-correctors, primary care physicians (PCP), neuromusculoskeletal (NMS) specialists, wellness practitioners, or holistic health specialists. Within each of these models there are many competing factions. While the many professional subgroups of medicine (pediatrics versus cosmetic surgery, for example) converge, at least in theory, on broad but common ideology and professional attributes, the same is not true among the more divergent chiropractic factions. The differing chiropractic schools of thought form competing professional models that are not mutually compatible. Moreover, the disparities are indefensible in the context of the scientific, regulatory, political and economic criteria under which healthcare delivery is expected to operate. A number of models are impractical, implausible or even indefensible from a purely scientific point of view (e.g., subluxation-based healthcare), from a professional practice perspective (e.g., the primary care model), or simply from common sense (e.g. Innate Intelligence as an operational system for influencing health).

Happy reading. -- Fyslee 19:58, 17 September 2006 (UTC)

Yes, I found this earlier. These are all respected researchers within the profession. I was thinking of adding some of this article to the chiropractic article somewhere in the scientific "reform". It could possibly be useful at the end of the subluxation section, too. Kind of a last word from them. It's good to see it's on your mind as well. --Dematt 21:20, 17 September 2006 (UTC) As an afterthought, it is certainly an internal chiropractic proposal so it could go into the internal criticisms, though I wouldn't call it a criticism as much as a proposal. It represents an opinion from a set of very influential DCs at least to the mixer group. Dr. Coy didn't think much of them. We might have to use some of his stuff to illustrate the straight POV. I wish I could really tell how most of the ICA members and those who aren't members feel about this proposal (if they've read it). --Dematt 23:56, 17 September 2006 (UTC)

Along this same line, were you aware of this. --Dematt 00:00, 18 September 2006 (UTC)

No, I wasn't aware of it. Perle is a professor at Bridgeport, and a frequent participant on the Healthfraud Discussion List. He claims to be a reformer, but some of the most anti-chiro list members still attack him for not being reformer enough! They point to the discrepancy between his claims about the existence of a reform movement in the profession, and its lack of visibility or effect. I usually just let them discuss without getting involved. -- Fyslee 20:40, 18 September 2006 (UTC)

You did notice that he is one that put himself on the line in the "model for the profession" paper that you sent me. I think you can let everybody know that he is trying. You just have to keep in mind that your talking about a 70,000 lb gorilla with deep roots. It's going to be hard to move, but I think it may be showing signs of budging;) --Dematt 00:05, 19 September 2006 (UTC)