No, it isn’t a placebo. There is real benefit to be had from improving your posture.

I for one have received better treatment from a chiro or physio compared to any of the numerous GPs I’ve dealt with.

Did he try to cure any migraines by realigning your arse muscles?

Best site ever: http://www.quackwatch.org/

I have to refrain myself from lashing out and murdering chiropractors or homeopathy practitioners with the nearest blunt object whenever I meet them.

Oooooh, there’s some cynicism on here tonight! I won’t argue … due to my nervous disposition. 😉

No, it isn’t a placebo. There is real benefit to be had from improving your posture.

I was referring to your second sentence. I don’t disagree with the first (largely because I’m physically broken because of poor posture).

Now they are idiots … I have a lump Dr: “so what do you think it is?” mmmm why the f*** am I hear? Cancer, blood clot, bruise?? give me a clue..

Generally this is because GP’s are concerned with allaying any anxiety you have about something in particular…eg cancer….diagnosing lumps is difficult and GP’s are there as your primary port of call to refer you onwards if there are red flag symptoms that cause them concern.

GP’s are not walking House MD’s who can tell you on the spot if you have cancer, they effectively think in terms of probabilities.

Lastly, if your doctors a jerk off ask to move to a different GP.

I was referring to your second sentence.

Ah, fair enough then!

Did he try to cure any migraines by realigning your arse muscles?

Who said anything about migraine??

Just the arse manipulation, then.

Ah, fair enough then!

My bad TBF, I wasn’t clear.

that what a friend’s GP did. She died of it 6 months later.

Here’s the deal….

Statistically this is going to happen because there are people who will get various things that do not throw up red flags….I had a lump in my arm once….cyst….lumps in my ear lobes….cyst….the doctor could tell what they were from experience.

BUT there will on occasion be someone that has something that resembles what I had but then ends up dying 6 months later from it.

Now do you want to pay for hundreds more MRI/CT scanners, pathology staff, medical staff that can take biopsies etc….because if you don’t then there is a limit to the amount of people that are sent for testing…..patients have to be prioritized….and someone like me with my 98 percent certain cyst is not deemed a high enough risk to go ahead of other people on a waiting list.

And to compound things further…. if we started scanning/biopsying every single complaint that patients had then the risks associated with testing them might start outweighing the chances of finding something…..so you end up with more ill/dead patients than you had before.

I have to refrain myself from lashing out and murdering chiropractors or homeopathy practitioners with the nearest blunt object whenever I meet them.

Lol. Some anger issues perhaps?

Would you care to cite some in particular?

I have copied these from the discussion I mentioned. Bear with me – I’ve tried to do it on my phone and its a bit awkward:

“Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.”? Journal of Manipulative and Physiological Therapeutics, Nyiendo et al (2000).

“In a Randomised controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counselling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.” ?British Medical Journal, Korthals-de Bos et al (2003).

“There is strong evidence that manipulation is more effective than a placebo treatment for chronic low-back pain or than the usual care offered by general practitioners of bed rest, analgesics and massage.” ?Spine, Van Tulder and Bouter et al. (1997).

“…improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear.” ?British Medical Journal, Meade et al. (1995).

“Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after 12 months.” ?British Medical Journal, Koes et al. (1992).

“…patients suffering from back and/or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments, thus reinforcing previous results showing the benefits of chiropractic treatment for back and neck pain.”? Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997).

“Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.”?Duke Evidence Report, McCrory et al. (2001).
The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.”? Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995).

“[Elderly] chiropractic users were less likely to have been hospitalised, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs.”? Topics in Clinical Chiropractic, Coulter et al. (1996).

“Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.”?Journal of Manipulative and Physiological Therapeutics , Haas et al. (2005).

First contact chiropractic care for common low back conditions costs substantially less than traditional medical treatment and “deserves careful consideration” by managed care executives concerned with controlling health care spending.”?Medical Care, Stano and Smith (1996).

“The overwhelming body of evidence shows that chiropractic management of low-back pain is more cost-effective than medical management, and that “many medical therapies are of questionable validity or are clearly inadequate.” ?The Manga Report (1993).

Bronfort; A report into the effectiveness of manual therapy, as practiced by chiropractors, manipulative physiotherapists and osteopaths for various common musculoskeletal disorders such as back pain and other health problems Effectiveness of Manual Therapies: the UK Evidence Report was published in February 2010. This found evidence that spinal manipulation/mobilisation is an effective treatment for acute, subacture and chronic low back pain; migraine and cerviocogenic headache; cervicogenic dizziness; manipulation/mobilisation is effective for several extremity joint conditions; and thoracic manipulation/mobilisation is effective for acute/subacute neck pain. The conclusions were based on the results of systematic reviews of randomised clinical trials, widely accepted and primarily UK and US evidenced-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories.

NICE Guidelines; In May 2009, The National Institute for Health and Clinical Excellence (NICE) published new guidelines to improve the early management of persistent non-specific low back pain. The guidelines recommend what care and advice the NHS should offer to people affected by low back pain. NICE assessed the effectiveness, safety and cost-effectiveness of available treatments and one recommendation is to offer a course of manual therapy, including spinal manipulation, spinal mobilisation and massage. This treatment may be provided by a range of health professionals, including chiropractors as spinal manipulation is part of the package of care that chiropractors can offer.

UK Beam Trial; Back pain, exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal Nov 2004; 329; 1377 (doi: 10.1136 /bmj. 38282. 669225.AE)

Medical Research Council; ‘Low Back pain of mechanical origin: randomised comparison of Chiropractic from hospital outpatient treatment’; Meade et al.

Medical Research Council (Follow-up-study) Trial ‘Randomised comparison of Chiropractic and hospital outpatient management for low back pain; results from extended follow up’; Meade et al.

RCGP – Clinical Guidelines for the Management of Acute Low Back Pain (1996, 1999, 2001)

Clinical Standards Advisory Group; Backpain Report 1994.

Acute Back Pain – Primary Care Project; The Wiltshire and Bath Health Commission.

Carter JT, Birrell LN (Editors) 2000. Occupational health guidelines for the management of low back pain at work – principal recommendations. Faculty of Occupational Medicine. London. Occupational health guidelines for the management of low back pain at work – leaflet for practitioners. Faculty of Occupational Medicine. London. 2000. Waddell G, Burton AK 2000. Occupational health guidelines for the management of low back pain at work – evidence review. Faculty of Occupational Medicine. London.

Chiropractic Treatment in Workers with Musculoskeletal Complaints; Mark P Blokland DC et al;Journal of the Neuromusculoskeletal System vol 8 No 1, Spring 2000

Musculoskeletal Services Framework – Department of Health July 2006
The main treatment interventions, as recommended by the current evidence review and that of clinical guidelines is a biopsychosocial approach: a) Guidance on activity, lifestyle, prognosis and prevention. b) Physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercise. c) Advice about pain control, including non-prescription medication. d) Psychosocial interventions aimed at resolving cognitive barriers to recovery.

Non-rigid stabilisation procedures for the treatment of low back pain – National Institute for Health and Clinical Excellence. June 2006 States that chiropractic intervention can be used in the treatment of acute low back pain.

European guidelines for the management of acute nonspecific low back pain in primary care. 2005 Recommends the consideration of spinal manipulation for patients failing to return to normal activities.

My knowledge of chiropractic is from reading the leaflets at my mother’s chiropractor while I was waiting for her treatment session to finish. The emphasis was all about “energy flow” and such mysticism – it put me right off it. But from what you say, mulv1976, there’s some medical science behind it? In that case I might reconsider.

If you do a search on physiological or neurophysiological effects of manipulation (or high velocity low amplitude thrusts) you should find some interesting reading

OK, here goes so licence to scoff!

I had a foot op (used to run lots) involving bone being broken and reset. Ended up with painful foot months after the op. GP said go back to hospital so had foot x-rayed. Didn’t show anything and consultant couldn’t offer any explanation.

Went to chiro who diagnosed that my body was lop-sided and, indeed, when I looked in a full-length mirror I could see that it was.

Basically the operation had altered the way that my foot pronated so effectively I was now standing square.

Quackwatch – OK I admit that someone I consult with is on one of those lists. I’m an extremely cynical person, probably due to my age, but I consider that medicine does not yet have all the answers. Once again, I come back to Big Pharma.

I do read a fair amount of papers from various medical people all over the world. There’s some very interesting stuff and I keep an open mind. It’s helped me enormously.

Time for a good old moron-baiting session.

If you do a search on physiological or neurophysiological effects of manipulation (or high velocity low amplitude thrusts) you should find some interesting reading

Someone quick for the love of god put him out of my misery before I go on a 3 hour Pubmed binge

Journal of Manipulative and Physiological Therapeutics
…
Topics in Clinical Chiropractic,

Biased in favour of chiropractic. we can discount these.

low back conditions

Established, the one area where chiropractic may be effective above placebo (though not necessarily better than other treatments).

The rest I need to be a bit more awake to research. In the meantime, would you care to field my other questions?

If you don’t claim to treat ‘subluxations’ and ignore all that vitalistic nonsense (which I applaud, incidentally), surely what you’ve got left isn’t actually chiropractic? You’re basically offering, what, therapeutic massage and physiotherapy under the guise of chiropractic? Isn’t that a little misleading?

We’ve had this discussion on here before. One of your colleagues made the assertion that historical chiro is, and I quote, “about as relevant as pre-antibiotic era medical practice is to todays level of allopathic medicine.” I asked what defines a chiropractor in modern day as opposed to similar practices, and never got a reply. Perhaps you could clear this up?

If you don’t treat anything that isn’t backed up by evidence, ie anything where efficacy of chiropractic isn’t proven beyond placebo, then presumably you only treat lower back pain? What other “musculoskeletal complaints” are you treating?

I had a foot op (used to run lots) involving bone being broken and reset. Ended up with painful foot months after the op. GP said go back to hospital so had foot x-rayed. Didn’t show anything and consultant couldn’t offer any explanation.

http://saveyourself.ca/articles/structuralism.php

Because I can’t be arsed to trawl pubmed.

Also before you rant about how this is obviously all a big pharma conspiracy to put these quacks out of business… many of the researchers kicking off at chiropractors are also the ones kicking off at pharmaceutical companies….eg Ben Goldacre and his merry band of affiliates.

The rest I need to be a bit more awake to research. In the meantime, would you care to field my other questions?

No not really its late. Look at bronfort report. Chiropractors differ from physios because we learn manipulation at undergraduate level and that is our main treatment method (although our training also encompass many of the functional and soft tissue techniques they would use to compliment it).

No not really its late. Look at bronfort report. Chiropractors differ from physios because we learn manipulation at undergraduate level and that is our main treatment method.

Yeah change that to the main way you injure patients for cash.

No not really its late.

Agreed. ‘s cool, I’ll wait, you can answer me tomorrow.

Yeah change that to the main way you injure patients for cash.

I suppose you’d do if for free if they were a Chiro or homeopath?

Look at bronfort report

From that text, Bronfort is “A report into the effectiveness of manual therapy, as practiced by chiropractors, manipulative physiotherapists and osteopaths”

So it’s nothing to do with Chiropractic, it’s discussing one technique used by several different disciplines. To wit, doesn’t answer my questions at all.

I don’t really understand why “what do you do” should be a particularly tricky question.

THis thread is steamrolling way out of control, far far away from the op……
However….

Just to look at one point:

“Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients.

Now, chronic pain no longer conforms to the typical pain pathways and nocioceptive receptor involvement – its almost fair to say that chronic pain is a state of the mind, rather than the physical body….
Chronic pain teams focus on this point with counselling, mood management etc etc.
Often what these people require is regular help and support though their situation.

Back to the point above – I’m not saying spinal manipulation doesn’t work (it’s the area of ailment where I believe benefit > harm, as opposed to neck where harm > benefit…), however what I will say is that of all the patients I see who have confronted a chiropractor, the one bit of advice that is never missed is “come back next week”….
If I were to regularly review my ‘non red flag’ low back pains at a weekly/fortnightly basis, I would a)help them think they are getting better more effectively, and b)fail to manage the countless other illnesses and conditions that would be on my books.
This simply isn’t feasible primary care practice….

DrP

Hi yunki how are you . What you described is an exact match to my kidney stone incident . Mine came in two episodes a couple of days apart . If you go to casualty they can push some class a pain killers up you bum which help no end.

Thanks for the concern crankboy.. I had another restless night but feeling a bit more chipper this arvo..

Turns out it’s probably just a bit of a spazzy muscle that I don’t really use unless I’m laying down..

I always get a bit paranoid about my kidneys though..
My uncle was last in the queue when they were handing them out and got given an out of date tin of Tesco value mince and kidneys instead..

Chiropractors differ from physios because we learn manipulation at undergraduate level and that is our main treatment method

Physios get taught manipulations at pre-reg level too, but we differ in that it is not our main treatment method.

A patent I had a while back was complaining of tennis elbow. We were getting nowhere treating his tennis elbow and his neck was absolutely fine (those who know their way about the body will understand the link). Eventually they gave up a wee mugget of information which once they were advised to stop doing what it was they were doing made thier tennis elbow go away. The bit of info – they were going to a chiropractor once a week to get their neck manipulated.

The quackery cost the patient aroun £200/month and the NHS god knows how much in treatment and diagnostic costs.