Chiropractic is mainstream.

Did you know that the US Government has been closely looking at complementary and alternative medicine (CAM)? In fact there is an entire department over at the NIH ( national institutes of health) that do nothing but study CAM. The white house has a special commission that has been tasked to Study CAM as well. Chiropractic used to be a part of this conversation, but to my surprise we have been slowly leaving the CAM discussion for the past 7 years. This trend started back in 2001. See below:

Archive
WHITE HOUSE COMMISSION
on
COMPLEMENTARY and ALTERNATIVE MEDICINE POLICY
Meeting Topic I:
CAM: Understanding Coverage and Reimbursement
and
Meeting Topic II:
CAM: Research Challenges
Volume I
Monday, May 14 2001
8:00 a.m.

Excerpt

Dr Alen Korn:" I would like to clarify that the Association does not consider chiropractic services to be complementary or alternative for the purpose of this statement. I believe that chiropractic has become a stakeholder in the politically dominate health system of the United States. The NIH Office of Alternative Medicine defines complementary and alternative medicine as healing resources outside the politically dominant system.”


MR. PIZZORNO**: Dr. Korn, you made a very provocative statement that I would like you to address further. You said you do not consider chiropractic part of CAM anymore, that is part of the dominant health care system at this point. Why do you think that and what was the transition that chiropractic went through?
DR. KORN*: The chiropractors have gone through a very painful transition and one that I would wish none of you would have to do. It is obviously a very complex topic that I will try to summarize at a very, very high level.
What we have observed over the past many years, four or five really, and we have really actually come to understand quite clearly through some direct discussions with the American Chiropractic Association, is the profession has evolved in a way that we find to be quite intriguing.
They have now adopted in large measure a collaborative model of care, in which what the chiropractic community offers is merged with what the allopathic and osteopathic communities offer. And you have a unique opportunity we see here in blending all of the science often rendered by physicians, who sort of stand behind a medical record, it gets between them and the patient, and another body of physicians, and that is how chiropractors are defined in most states, who really are very expert in hands-on care, nutritional counseling, lifestyle things. What we have observed, the data would suggest that with that kind of an approach, patients are far more likely to change their behavior, to not smoke, to lose weight, to exercise, to eat properly than being told to do so by someone sitting on the other side of the desk, writing a progress note in a allopathic office.
So, we could talk a great deal more about it, but we have become impressed with the contribution that that model of care has in the global picture. Again, that is overlaid on a long history and many other things, but that is why, at this point, it probably makes sense to put them outside of the CAM circle.

** Joseph E. Pizzorno, Jr., N.D., appointed by President Clinton in December 2000 to the White House Commission on Complementary and Alternative Medicine Policy and by President Bush¹s administration to the Medicare Coverage Advisory Committee in November 2002, is one of the world¹s leading authorities on science-based natural medicine.

Allan Korn, M.D., is Chief Medical Officer and Senior Vice President for Clinical Affairs for the Blue Cross and Blue Shield Association (BCBSA), a national federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 99 million – nearly one-in-three of all Americans.






So, There you have it according t the chief medical officer of blue cross blue shiel chiropractic is no longer "alternitive" But rather part of the "mainstream."

Blood pressure and Chiropractic

Did you know that getting your neck adjusted and lower your blood pressure. Yes, it's true according to a recent study that is published in the Journal of Clinical Hypertension (volume 8 number 5 May 2006) researchers found that anatomical abnormalities (subluxation if you are a chiropractor) of the cervical spine at the level of the Atlas vertebra are associated with relative ischemia of the brainstem circulation and increased blood pressure. Manual correction of this Mal alignment (subluxation) has been associated with reduced arterial pressure. This pilot study test the hypothesis that correcting Mal alignment of the Atlas vertebra reduces and maintains improved blood pressure. In the study and 50 patients that were not taking medication and suffered from stage I hypertension were evaluated using randomized, double-blind, placebo-controlled study design at a single center. Patients received no medication during the eight week study session. After baseline measurements of their blood pressure were taken they received chiropractic adjustments or a sham procedure. Considering that the technique performed was (NUCCA) it is difficult or impossible for the patient distinguish between a real chiropractic adjustment or the sham procedure. Statistical analysis performed comparing the baseline and eight week visits. The study demonstrated an 8/5 mm reduction in pressure at eight weeks over the placebo (sham adjustment) group. In other words, a patient that had a blood pressure of 147/92 at the end of the week study had a blood pressure of 130/82 and the only treatment received was chiropractic adjustments to the cervical spine.
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In my opinion, this is a landmark study. This proves what we chiropractors have been saying ans seeing in our practice all allong. Chiropractic adjustments transcend neck and back pain and can affect the human physiology at all levels. Traditional medicine has its time and place and can be very useful. This may be the beginning what Thomas Edison stated over 100 years ago: " The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease." This is what chiropractors do everyday all over the world!!

my web site

Check out my web site at www.drpeterbrockman.com

A word on airbags

Global statistics support the overall benefit of airbags when used properly. However, I would like my neighbors here to be aware of certain dangers associated with airbags specifically the injuries that affect the musculoskeletal system. I urge all of my patients to use airbags, but to do so safely. Here are a few pointers:

1. Buckle up: While airbags save lives, there are no substitutes for seatbelts. The two safety devices were designed to work together. Research shows that buckling your seat belt is more important than airbags for overall safety. A study of all passenger vehicle crashes in the United States from 1990 through 2000, which included 51,031 driver passenger pairs in the same vehicle, found that "airbags reduced the risk of death by about 18% when used alone, whearas seat belts reduce the risk of death by 65%." (British medical Journal 2002; 324: 1119. )
2. Keep your distance: "Despite the overall protective effect of airbags, they can cause fatal and nonfatal injuries if the drivers head, neck, chest or arms are too close to the deploying airbags." (British Journal of Ophthalmology 2001; 85:640.) Drivers should have 10 in. (25 cm) of space between the center of the steering column and their chest. A British study found that, "airbags have been advocated as a supplemental restraint system. However, their deployment can cause injury particularly if the driver is of a short stature, unrestrained and out of position within the vehicle." (Ann R Coll Surg Engl 2004;86:149-55.) Tilting the steering wheel down and raising the seat up will allow most drivers, even those under 5 ft., 4 in., to "sit at least 10 in. from the steering wheel and still drive comfortably.” Some cars have telescoping steering wheels or extendors for petals that can help with this." (Medical update 2000; 24:1.)
3. Children: If your child is less than 4 ft. tall, experts warn against placing them in the front seat of the car with airbags: Even when secured by a seat belt. The danger is especially great in the older cars with "first-generation" side airbags. Even the new side airbags pose a risk to children, according to the American Academy of pediatrics. While these new devices improve safety for adults and side-impact crashes, improperly restrained children seated near a side airbag may be at risk for serious injury. On its web site the academy urges parents check their vehicles owner's manual for information on children and side airbags.
4. Hand placement on wheel: Many people were taught to place her hand in the 10 and two o'clock position in their drivers ed class. Unfortunately, this position can result in broken wrists when air bags deploy. If you have an airbag a better position would be nine o'clock and three o'clock on the steering wheel with your fingers resting on top of the wheel. After reviewing the cases of 25,464 accident victims, researchers in Virginia concluded that "an analysis of the cases indicated that occupants exposed to an airbag deployment were statistically more likely to sustained a severe upper extremity injury ,like broken wrists, than those occupants not exposed to an airbag deployment."
5. Protect your eyes: Although airbags reduced deaths, they can also cause injury to the facial skeleton and eye when they suddenly deploy and strike the face and eyes (American Journal of Emergency Medicine 2003; 20: For 90). Injury to the eye from air bags can include the following: abrasions, lacerations of the cornea and retinal hemorrhage or detachment. Research has shown that to wearing glasses helped protect the eyes from airbag chemicals. ( J Craniomaxillofacsurg2004;32;35-7). If you have undergone the radial keratotomy for the correction of moderate myopia there is an increased risk for corneal rupture. (British Journal of Ophthalmology 2001; 85:640).
6. Afterwards: If you or any of the members of your family are involved in a motor vehicle accident, please call your chiropractor immediately. As your partners in health, we will do everything we can do to see you as soon as possible. Many of us have specialized training to deal with car accident victims. Often, we are the best choice for patients that have been injured in a motor vehicle accident. We have the training to diagnose serious conditions and we can refer you to a surgeon if necessary. Otherwise, the most effective treatment for whiplash is chiropractic. Blunt trauma from an airbag to the chest region can result in many types of injuries, including restriction or misalignment of the spinal bones. Early intervention has proven to be the key and avoiding prolonged symptoms. (Spine 2000; 25: 1782-1786.)

Pallitive not Curative?

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.
Arthur Schopenhauer (1788 - 1860)

As you can see by my profile I have been a chiropractor for about seven years. I love my job. Perhaps the thing I love about it the most is when I have a patient say to me "thanks doctor you have changed my life." Ususally after they say that to me I release them out in to the world, often I don't hear from them for several years. I have treated so many infact that I will run into one about once a day outside the office. The most common exchange ususally involves the patient walking up to me and saying " I've been meaning to come in to see you doc but you fixed me and my back no longer hurts anymore." The truth of the mater is hoowever I did not fix them, Chiropractic did.

With this being my experience, you can imagine my frustration when I heard two people, within about 72 hour of eachother, say the exact same statement to me about chiropractic. " Chiropratic is Pallitive but not currative." In other words, it can help the pain but it is just temporary.

Hmmmm. Thats strange. I did not ask but I wondered if either of these people have ever been adjused?

Problably not.


Something deep inside me told me that if I tried to tell them about my personal experience as a chiropractic patient and doctor then they would not belive me. So I decided to do a medline search on the subject. Here is a list of the studies that show that chiropractic is quite curative indeed:


1 THE AGENCY ON HEALTH CARE POLICY AND RESEARCH STUDY
On December 8, 1994, the Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released Clinical Practice Guidelines for the management of acute low back pain. Their guidelines were developed after extensive study of diagnostic and treatment methods for acute low back pain.

The guidelines were created by the AHCPR panel to provide primary care clinicians with information and recommended strategies for the assessment and treatment of acute low back problems. The AHCPR panel was made up of 23 members consisting of medical doctors, chiropractic doctors, nurses, experts in spinal research, physical therapists, an occupational therapist, a psychologist, and a consumer representative.

The following conclusions were made in this landmark study:
• Conservative treatment such as spinal manipulation should be pursued in most before cases considering surgical intervention;
• Prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.
Other interesting finds included:
• The risk of serious complications from lumbar spinal manipulation is rare;
• There is currently no evidence supporting the use of trigger point, ligamentous and facet injections, needle acupuncture or dry needling as treatment for acute back problems;
• The panel found no evidence of benefit from the application of physical agents and modalities such as ice, heat, massage, traction, ultrasound, cutaneous laser treatment, transcutaneous electrical nerve stimulation (T.E.N.S.) and biofeedback techniques.
Acute Low Back Problems in Adults. Clinical Practice Guidelines. Bigos S, et al. Agency for Health Care Policy and Research Publication No. 950642 (U.S. Department of Health and Human Services) -1994.

2. THE AUSTRALIAN STUDY- cost & pain-relief effective with a lower chronicity rate
In this Australian study, 1,996 workers' compensation cases were evaluated in patients who experienced work-related mechanical low back pain. It was found that those individuals who received chiropractic care for their back pain returned to work 4 times faster (6.26 days vs. 25.56 days) and had treatment that cost 4 times less ($392 vs. $1,569) than those who received treatments from medical doctors. Also, in those patients who received chiropractic care there was a significantly lower incidence of progression to a chronic low back pain status.
Mechanical Low-Back Pain: A Comparison of Medical and Chiropractic Management Within the Victorian Work Care Scheme. Ebrall, PS. Chiropractic Journal of Australia - 1992;22:47-53.



3. THE RAND CORPORATION STUDY
Members of the Medical Community Recognize Chiropractic's Effectiveness

This study, conducted by the prestigious RAND Corporation, marks the first time representatives of the U.S. medical community have gone on record stating that chiropractic is an appropriate treatment for certain low back pain conditions. A second, all-chiropractic panel's ratings show agreement with the multidisciplinary panel that spinal manipulation is appropriate for specific kinds of low back pain. A utilization study examining chiropractic patients' charts in multiple geographical locations in the United States is now underway. This will allow investigators to examine actual clinical cases and learn how prevalent each condition is in practice.

The RAND Corporation ("Research and Development") is a nonprofit private corporation in Santa Monica, California. They conduct research and development for the U.S. government and private sector, commanding international respect. It's research programs include classified defense research for the military, applied economics, education, sociology, civil justice and health sciences.

The Appropriateness of Spinal Manipulation for Lower Back Pain. Shekelle PG, et al. RAND Corporation, Santa Monica, California - 1992.


4. THE MANGA REPORT
As the largest existing analysis of scientific literature on low back pain, the 1993 Ontario Ministry of Health commissioned study drew international attention when it recommended the management of low back pain be moved from medical doctors to chiropractic doctors.

Due to serious financial problems with the Canadian governments, the different types of treatments for low back conditions were evaluated in an effort to reduce and contain health care costs. Their findings showed chiropractic manipulation was the most cost effective and efficacious care for low back pain.

The researchers also stated that studies on the prevalence and incidence of low back pain suggest that it is the leading cause of disability and morbidity in middle-aged persons, and is by far the most expensive source of workers' compensation costs North America.

The Canadian Government report concluded with the following findings:
• On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain. Many medical therapies are of questionable validity or are clearly inadequate;
• There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain;
• Indeed, several existing medical therapies of low back pain are generally contraindicated on the basis of the existing clinical trials. There is also some evidence in the literature to suggest that spinal manipulations are less safe and less effective when performed by nonchiropractic professionals;
• There is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management;
• There would be highly significant cost savings if more management of low back pain was transferred from physicians to chiropractors. Evidence from Canada and other countries suggests potential savings of many hundreds of millions annually;
• Workers' compensation studies report that injured workers with the same specific diagnosis of low back pain returned to work much sooner when treated by chiropractors than by medical physicians;
• There is good empirical evidence that patients are very satisfied with chiropractic management of low back pain and considerably less satisfied with medical physician management;
• The use of chiropractic has grown steadily over the years and chiropractors are now accepted as a legitimate healing profession by the public and an increasing number of medical physicians;
• In our view, the following offers an overwhelming case in favor of much greater use of chiropractic services in the management of low back pain:
o the effectiveness and cost effectiveness of chiropractic management of low back pain
o the untested, questionable or harmful nature of many current medical therapies
o the economic efficiency of chiropractic care for low back pain compared with medical care
o the safety of chiropractic care
o the higher satisfaction levels expressed by patients of chiropractors.

The following recommendations were also included in the report:
• There should be a shift in policy to encourage and prefer chiropractic services for most patients with low back pain;
• Chiropractic services should be fully insured under the Ontario Health Insurance Plan;
• Chiropractic services should be fully integrated into the health care system;
• Chiropractors should be employed by tertiary hospitals in Ontario;
• Hospital privileges should be extended to all chiropractors for the purposes of treatment of their own patients who have been hospitalized for other reasons, and for access to diagnostic facilities relevant to their scope of practice and patients' needs;
• Chiropractic should have access to all pertinent patient records and tests from hospitals, physicians, and other health care professionals upon the consent of their patients;
• Since low back pain is of such significant concern to workers' compensation, chiropractors should be engaged at a senior level by Workers' Compensation Board to assess policy, procedures and treatment of workers with low back injuries;
• A very good case can be made for making chiropractors the gatekeepers for management of low back pain in the workers' compensation system in Ontario;
• The government should make the requisite research funds and resources available for further clinical evaluations of chiropractic management of low back pain, and for further socioeconomic and policy research concerning the management of low back pain generally;
• Chiropractic education in Ontario should be in the multidisciplinary atmosphere of a university with appropriate public finding;
• Finally, the government should take all reasonable steps to actively encourage cooperation between providers, particularly the chiropractic, medical and physiotherapy professions.
The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain. Pran Manga and Associates. University of Ottawa, Canada - 1993.
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5. THE AV-MED STUDY
In this study, 80 patients who previously received medical treatment were subsequently referred to the Silverman Chiropractic Center. Of the 80 patients, 21 percent had just been diagnosed with spinal disc problems, 12 percent had been diagnosed as requiring surgery and 5 percent had received emergency room treatment. Following chiropractic treatment, none of the patients were required to have surgery, 86 percent of the patients needed no further care, and the estimated health care savings in the group of 80 was estimated to be $250,000.
The Av-Med Study - 1993.
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6. THE MIDWEST RESEARCH INSTITUTE STUDY
This study examined clinical trials published in the professional literature between 1930 and 1981.

The researchers concluded that:
• manual therapy was superior to placebos,
• there was greater mobility following manipulation,
• the duration of treatment was shorter for the manipulated groups,
• there was improved lateral flexion and rotation after manipulation,
• the numerous case studies throughout the literature report the satisfaction of chiropractic patients with the outcome of treatments.
Chiropractic Evaluation Study Task III Report of the Relevant Literature. MRI Project No. 8533-D. MacDonald MJ, Morton L. For Department of Defense, OCHAMPUS, Aurora, Colorado - 1986.


7. THE ANNALS OF INTERNAL MEDICINE STUDY
The Third Most Widely Read Medical Journal Finds Chiropractic A Winner In Low Back Pain

The use, complications, and efficacy of spinal manipulation for low back pain was reviewed in the Annals of Internal Medicine, the third most widely read medical journal. The article concluded that spinal manipulation clearly helps patients with uncomplicated, acute low back pain.
Spinal Manipulation for Low Back Pain. Shekelle P, et al. Annals of Internal Medicine - 1992;117:590-598.



8. THE UTAH STUDY - fewer costs and days lost
This 1988 Utah workers' compensation board study found a tenfold savings for mean compensation costs in back-related injuries treated by chiropractors as compared with medical doctors ($68.38 vs. $668.39). To ensure accurate and true results, only those back-related injuries with the same diagnostic codes were compared between the two treatment groups. Also, the medical treatments assessed were limited to nonsurgical medical treatments only.
Cost per Case Comparison of Back Injury Claims of Chiropractic versus medical Management for Conditions with Identical Diagnostic Codes. Jarvis KB, et al. Journal of Occupational Medicine - 1991;33:847-52.



9.THE FLORIDA STUDY - shorter disability/lower costs/lower hospitalization rates
This large State of Florida study examined 10,652 patients who sustained back-related injuries on the job. Their findings revealed that individuals who received chiropractic care compared with standard medical care for similar diagnoses experienced had a (i) 51.3 percent shorter temporary total disability duration (ii) lower treatment cost by 58.8 percent ($558 vs. $1,100 per case) (iii) 20.3 percent hospitalization rate in the chiropractic care group vs. 52.2 percent rate in the medical care group.
An Analysis of Florida Workers' Compensation Medical Claims for Back Related Injuries. Wolk S. Foundation for Chiropractic Education and Research, Arlington, VA. - 1988.



10. THE CALIFORNIA STUDY - chiropractic patients get back to work sooner
In this study, Richard Wolf, M.D. followed 500 individuals sent for chiropractic treatments and 500 individuals sent to medical doctors for treatment. Those who received chiropractic treatments returned to work in an average of 15.6 days vs. 32 days in those who received treatments from medical doctors.
Industrial Back Injury. Wolf CR. International Review of Chiropractic - 1974;26:6-7.



11.THE OREGON STUDY- chiropractic gets individuals back to work, and fast!
This Oregon study found that individuals with workers' compensation claims returned to work significantly faster under chiropractic care compared with medical care. In fact, under chiropractic care 82% were able to return to work after one week compared with only 41% in those who received medical care.
A Study of Time Loss Back Claims. Portland, OR. Workers' Compensation Board, State of Oregon, March 1971.




Wow 11 studies!! even more intresting not even one to the contrary!

I wonder if they will belive me now?