D.P.T. versus Chiropractor

[facetguy]

I'll respond to a few of ksem's comments-

>Everything else they do, at least recently, seems to mimic PT. The fact of the matter is that chiros have always, conspiracy?, lacked research or proof behind the pudding. If they dominate so greatly, show it to me. Until then, I believe that anecdotal evidence and sugar pill mentality drives the profession.

Correct. Chiropractic is an alternative non-evidence based profession. This means that it markets treatments without any proof and based solely on subgroups. If you get enough chiropractors to like something it becomes accepted.

Next, yes chiropractors constantly expand into other areas: PT, nutrition, neurology, pediatrics whatever. We want to have our cake and eat it too. We want the primary care scope of practice to treat anything while being able to not take responsibility when the treatments fail. Everybody does this, from the most conservative upper cervical chiropractor treating hypertension to the "wholistic" Applied Kinesiology quack giving you an arm test telling you need to buy liver pills for your weak liver.

>Also, I may be confusing subluxation and manipulation

There really isn't a difference since all of the popular techniques have fatal problems such as invalid biomechanics, failure to treat lower kinematic chain problems first and lack of scope to provide passive stabilization for good long term correction. To be a chiropractic adjustment it would have to be biomechanically accurate and solve the problems. No wonder patients never get better. So why does chiropractic continue to pretend it is an effective spinal treament when all it can do it give temporary palliative relief through nerve stimulation? Because it is an unethical profession. This lie is the core of all the bad will from former chiropractors and disgruntled patients alike. Come visit www.chirotalk.proboards.com if you'd like to learn more.

What ever happened with that Chiropractic Biophysics issue?

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[cdmguy]

Harrison/CBP dropped it against me so they could file an appeal against Dr. Stephen Barrett/Quackwatch however the court ruled the article wasn't defamatory and they lost. They never bothered to inform their CBP supporters of this in their AJCC publication-probably because it looks bad against them.

http://www.chirobase.org/08Legal/cbp/appeal.pdf

In my opinion the whole case was fabricated to try to force more acceptance of CBP from insurance carriers who denied them partly on the basis of that article.

 

[facetguy]

Harrison/CBP dropped it against me so they could file an appeal against Dr. Stephen Barrett/Quackwatch however the court ruled the article wasn't defamatory and they lost. They never bothered to inform their CBP supporters of this in their AJCC publication-probably because it looks bad against them.

http://www.chirobase.org/08Legal/cbp/appeal.pdf

In my opinion the whole case was fabricated to try to force more acceptance of CBP from insurance carriers who denied them partly on the basis of that article.

Having gone through that whole episode, what are your feelings toward CBP today?

 

[cdmguy]

>Having gone through that whole episode, what are your feelings toward CBP today?

The things that I found reprehensible about their behavior were false charges that I fabricated statements about them and their failure to issue a retraction for their false statements despite contradicting themselves in later publications which expose their lies. They continue to keep the article defaming me by charging me with false statements on their American Journal of Clinical Chiropractic website.

Judging from these actions, Chiropractic Biomechanics of Posture is a very untrustworthy organization and I agree with Robert Cooperstein that any research regarding CBP needs to be independently verified by other researchers because they show a strong bias and draw premature, questionable conclusions.(J Can Chiropr Assoc. 2006 June; 50(2): 97–102)

CBP has very sleazy bedfellows politically. CBP supports the International Chiropractors Assocation, an organization which promotes non-evidence based practice, pro-chiropractic propaganda and quackery. They also are connected to Scientology. In 2006 they took money from the Scientology Chiropractic practice management front group the Lori Prescott Group.(CBP® to File Lawsuit Against Quackwatch, Stephen Barrett, MD and Allen Botnick, DC. American Journal of Clinical Chiropractic. July 2006, Vol. 16, No. 3)

Regarding their treatment, judging from the large number of before and after x-rays posted to their website which show an the inability of their methods to have any effect on breaks on the posterior vertebral body line due to ligamentous instability I think it is a false conclusion to expect the spine to be structurally rehabilitated back to even an approximation of normal when the underlying stressors in the lower kinematic chain are still present. CBP has started to address this in a limited way by advocating the use of Sole Supports foot orthotics before commencing treatment and this is an improvement, however I don't think that this is enough. I think that if chiropractors are really to restore normal structure to the spine then they need to expand the scope of the profession to include prolotherapy to restore stability to the injured ligaments.

Two elements suggest bill padding to me. First, CBP's methods are not specific enough because they typically only work on a three point basis around each arc of the spine. This forces abnormal stresses into the spine and draws out the number of treatment sessions. It makes more sense to use multisegmental traction supports but this so far has not been done. CBP treament is analagous to dentists making mouths into beaks rather than nice round arches.

Likewise, I question the necessity of the mirror image adjustments which are believed to be necessary to retrain the spine to hold a new position. There have been no studies comparing treatment with or without them to support this belief so I see possible bill padding here.

Despite their problems, it saddens me to see CBP so dysfunctional. I strongly support biomechanical treatment of the spine and think that rational treatment for these problems has a place in healthcare-perhaps even done by chiropractors if their scope was expanded and they rejected non-evidence based practice. Unfortunately CBP has a long way to go before I can consider it a trustworthy method.

 

[facetguy]

>Having gone through that whole episode, what are your feelings toward CBP today?

The things that I found reprehensible about their behavior were false charges that I fabricated statements about them and their failure to issue a retraction for their false statements despite contradicting themselves in later publications which expose their lies. They continue to keep the article defaming me by charging me with false statements on their American Journal of Clinical Chiropractic website.

Judging from these actions, Chiropractic Biomechanics of Posture is a very untrustworthy organization and I agree with Robert Cooperstein that any research regarding CBP needs to be independently verified by other researchers because they show a strong bias and draw premature, questionable conclusions.(J Can Chiropr Assoc. 2006 June; 50(2): 97–102)

CBP has very sleazy bedfellows politically. CBP supports the International Chiropractors Assocation, an organization which promotes non-evidence based practice, pro-chiropractic propaganda and quackery. They also are connected to Scientology. In 2006 they took money from the Scientology Chiropractic practice management front group the Lori Prescott Group.(CBP® to File Lawsuit Against Quackwatch, Stephen Barrett, MD and Allen Botnick, DC. American Journal of Clinical Chiropractic. July 2006, Vol. 16, No. 3)

Regarding their treatment, judging from the large number of before and after x-rays posted to their website which show an the inability of their methods to have any effect on breaks on the posterior vertebral body line due to ligamentous instability I think it is a false conclusion to expect the spine to be structurally rehabilitated back to even an approximation of normal when the underlying stressors in the lower kinematic chain are still present. CBP has started to address this in a limited way by advocating the use of Sole Supports foot orthotics before commencing treatment and this is an improvement, however I don't think that this is enough. I think that if chiropractors are really to restore normal structure to the spine then they need to expand the scope of the profession to include prolotherapy to restore stability to the injured ligaments.

Two elements suggest bill padding to me. First, CBP's methods are not specific enough because they typically only work on a three point basis around each arc of the spine. This forces abnormal stresses into the spine and draws out the number of treatment sessions. It makes more sense to use multisegmental traction supports but this so far has not been done. CBP treament is analagous to dentists making mouths into beaks rather than nice round arches.

Likewise, I question the necessity of the mirror image adjustments which are believed to be necessary to retrain the spine to hold a new position. There have been no studies comparing treatment with or without them to support this belief so I see possible bill padding here.

Despite their problems, it saddens me to see CBP so dysfunctional. I strongly support biomechanical treatment of the spine and think that rational treatment for these problems has a place in healthcare-perhaps even done by chiropractors if their scope was expanded and they rejected non-evidence based practice. Unfortunately CBP has a long way to go before I can consider it a trustworthy method.

I haven't done any CBP training myself, so I can't add to your comments. I do applaud them, however, for at least taking an objective, research-oriented approach.

Regarding prolotherapy, the evidence isn't all that strong yet. Continuing research should shed more light. But it's not there yet. Either way, I don't ever see DCs adding it to our scope because of its invasive nature. It surprises me a bit that you would be such a strong advocate for prolotherapy, given its scant evidence base.

Since you gave up chiro, what do you do professionally these days? (Just curious; don't feel you need to answer if you don't feel comfortable doing so.)

 

[cdmguy]

Thanks Facet.

There is some research on Prolotherapy showing that it does strengthen ligaments. I suspect that the problem may be with its application. I'm sure that the osteopaths using prolotherapy are unfamiliar with structural rehabilitation concepts so they are probably freezing spines in their position of dysfunction. This of course won't work. Patient selection and having a rational strategy for correction is key. In this case, I would be interested in restoring stabilization to the posterior supportive ligaments to the spine to check excessive anterior translation outside of a normal neutral zone. This is supported by Panjabi's research on how spinal instability occurs so I don't see why it wouldn't work.

Succeeding outside chiropractic is difficult. As you may or may not know, I attended Life University which censored differential diagnosis from its curriculum. This realization forced me to stop practicing and the later realization that the scope of chiropractic was inadequate to accomplish its stated mission discouraged me from remediating and staying in the field. Comments like your comment against scope expansion show me that there is little chance for reform in chiropractic and that it will therefore continue to decline and probably eventually die out when better treatments are developed that actually fix biomechanical problems rather then palliate them. My chest stabilization treatment project (aka asthma) is one such effort.

I went on to earn my CNIM credential in neuromonitoring with the intention of obtaining DABNM but about a year ago contracted Chronic Fatigue Syndrome from a needlestick and am now disabled. Hopefully I can recover sometime in the future.

 

[facetguy]

Thanks Facet.

There is some research on Prolotherapy showing that it does strengthen ligaments. I suspect that the problem may be with its application. I'm sure that the osteopaths using prolotherapy are unfamiliar with structural rehabilitation concepts so they are probably freezing spines in their position of dysfunction. This of course won't work. Patient selection and having a rational strategy for correction is key. In this case, I would be interested in restoring stabilization to the posterior supportive ligaments to the spine to check excessive anterior translation outside of a normal neutral zone. This is supported by Panjabi's research on how spinal instability occurs so I don't see why it wouldn't work.

Succeeding outside chiropractic is difficult. As you may or may not know, I attended Life University which censored differential diagnosis from its curriculum. This realization forced me to stop practicing and the later realization that the scope of chiropractic was inadequate to accomplish its stated mission discouraged me from remediating and staying in the field. Comments like your comment against scope expansion show me that there is little chance for reform in chiropractic and that it will therefore continue to decline and probably eventually die out when better treatments are developed that actually fix biomechanical problems rather then palliate them. My chest stabilization treatment project (aka asthma) is one such effort.

I went on to earn my CNIM credential in neuromonitoring with the intention of obtaining DABNM but about a year ago contracted Chronic Fatigue Syndrome from a needlestick and am now disabled. Hopefully I can recover sometime in the future.

Sorry to hear about your disability, and I too hope you recover soon.

On the issue of scope expansion, I'm not personally opposed. However, getting the whole profession to make a change as significant as adding invasive injections simply won't happen. One state (New Mexico, perhaps?) has just added limited prescribing rights, and I think there is one other state that allows nutritional injectibles, so perhaps there is hope after all.

How did you happen upon Life University? Geography? I had heard about Life prior to entering chiro school, but I guess you hadn't. I went to NYCC and had a good experience overall. You could have, as you said, remediated, but it doesn't sound like you were very happy in chiropractic. Giving it up was probably the best way to spare yourself from a life of professional unhappiness.

 

[cdmguy]

>Sorry to hear about your disability, and I too hope you recover soon.

Thanks.

>On the issue of scope expansion, I'm not personally opposed. However, getting the whole profession to make a change as significant as adding invasive injections simply won't happen. One state (New Mexico, perhaps?) has just added limited prescribing rights, and I think there is one other state that allows nutritional injectibles, so perhaps there is hope after all.

Yes NM lobbied for injectibles and recently got them.

>How did you happen upon Life University? Geography? I had heard about Life prior to entering chiro school, but I guess you hadn't. I went to NYCC and had a good experience overall. You could have, as you said, remediated, but it doesn't sound like you were very happy in chiropractic. Giving it up was probably the best way to spare yourself from a life of professional unhappiness.

It was recommended to me by in-laws and I mistakenly assumed that all chiropractic colleges were similar because they are all accredited by the CCE-big mistake. I didn't even apply at or visit any other schools!

 

[chiropractor]

As chiropractor, I often get this question of studentsasking me if they should go to PT school or Chiropractic school. Sadly I alwaysanswer with go to PT school. I love being chiropractor and get fast results formy patients. Being a chiropractor has so many more challenges the public has noclue about. Of course, people usually want to know about the money and yestypically chiropractors tend to make more. The problem is chiropractic is lesssecure and I know too many chiropractors who are not working anymore becausethey were horrible business people. At least PTs can fall back on working inhospital with benefits if their practice is too tough. 12 years ago PTs were inhorrible shape but nationally they set goals and have grown so much. As with everything in life it is totally up tothe individual. In the end, it does notmatter the initials behind the name it is about the effort they are going toput into the patient. Good luck in your endeavors!