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(The Atlantic)   A look at the increasing popularity in CPR shows the overall issue of "medical creep," which also explains the whole rise in chiropractic "care"   (theatlantic.com) divider line 57
    More: Interesting, CPR, defibrillators, elective surgery, Stephen Jay Gould, surgical team, mesothelioma, permanent brain  
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5288 clicks; posted to Main » on 05 Nov 2013 at 12:13 PM (51 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-11-05 12:12:50 PM  
Oddly, 'Medical Creep' reminds a lot of my general practitioner, Doctor Coldfinger.
 
2013-11-05 12:17:49 PM  
thefridgemedia.com
"What the hell are you doing in there?  You don't belong there..."
 
2013-11-05 12:18:08 PM  
Ha ha! Chiropractors are all fake!!!
 
2013-11-05 12:18:47 PM  
Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.
 
2013-11-05 12:19:08 PM  
Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.
 
2013-11-05 12:21:03 PM  
images.wikia.com

Approves of medical creep.
 
2013-11-05 12:21:34 PM  
CPR started being taught to laymen after the popularity of Emergency! Showed the public was aware of it and trying on their own.

Why yes, I read Tvtropes, not Fark articles.
 
2013-11-05 12:23:17 PM  
What a medical creep might look like:


theprodigalguide.files.wordpress.com
 
2013-11-05 12:23:35 PM  
ones with no future

crunching bones sound like branches

I go home saddened
 
2013-11-05 12:23:45 PM  
My life was saved from misery by a chiropractor. Saying all chiropractors are ineffective is akin to saying all MDs are pill pushers.

Some DCs get better results than others due to skill, technique, and proper evaluation of issues.

Educate yourself on what a chiropractor does (and doesn't) do rather than blather on with an opinion you heard from some guy that had never actually been to one.
 
2013-11-05 12:26:30 PM  
Hmm. Baltimore was such an important place for emergency medicine back then. This and of course the mythical golden hour which suffers from the same issue as CPR: the long term studies don't bear it out about an hour to the surgical table. It all depends on the specifics of an injury.

But yes, doing CPR on some one very old is very disturbing when you hear and feel their ribs crack off the sternum.

/had to do CPR on the FD chaplain. Very sad
 
2013-11-05 12:26:49 PM  

kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.


I'll help your back feel better by applying high risk violent rotations to your neck.
 
2013-11-05 12:27:40 PM  

Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.


When I took first aid last year they kept telling me that I wasn't pushing down hard enough. I'm not exactly brimming with upper body strength but I found that comment a little odd given how dangerous I heard it could be.

I guess if you're forced to use CPR the person is already in dire straights anyway, so a broken sternum is a least of their worries.
 
2013-11-05 12:29:34 PM  
Just because chiropractic was founded by a crackpot with no scientific basis doesn't necessarily mean it's bullsh*t. It just probably is.

/still feels good to get your back popped
 
2013-11-05 12:31:52 PM  
I pop my own back; I'll give myself CPR too.
 
2013-11-05 12:32:13 PM  

Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.


I once was involved in taking care of a patient with a terminal diagnosis who was old and frail.  They had no advance directives and the family was divided so the DNR was revoked and reinstated depending on who was visiting that day.  Much of the staff tried to explain how traumatic a full code could be on their loved one but there were a lot of holdouts.

Long story short- the patient died when his ribs punctured his heart as a result of compressions.  Not that he would have lived a lot longer, but still.

The moral of the story is to take the responsibility (and the guilt) away from your loved ones and make your preferences known through a living will, advance directives, etc.
 
2013-11-05 12:32:49 PM  

Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.


Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.
 
2013-11-05 12:33:50 PM  

kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.


In other words, a physical therapist wearing a lab coat, with a glorified title, wrapped in a mantle of pseudoscientific bullshiat about energy flows of a mystical vitalistic force that cannot be measured.

Oh, sign me up!
 
2013-11-05 12:35:20 PM  

Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.


Sort of like getting you oil changed in your car?

/Maintenance, how do it work?
 
2013-11-05 12:35:31 PM  

miss diminutive: Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.

When I took first aid last year they kept telling me that I wasn't pushing down hard enough. I'm not exactly brimming with upper body strength but I found that comment a little odd given how dangerous I heard it could be.

I guess if you're forced to use CPR the person is already in dire straights anyway, so a broken sternum is a least of their worries.



Having done CPR on many folks who had pressure lines which show pressure waveforms and measurements to provide direct feedback, I can assure you that it's not odd.  One has to literally be compressing the shape of victim's rib cage against a hard surface to get pressure up enough to be useful.  CPR isn't about pushing 'on the chest', it's about compressing the chest down against the spine and hoping to squeeze blood out of the heart.

It's not pleasant, and if your victim is brought back to life (they were already clinically dead) there will be injuries.
 
2013-11-05 12:38:53 PM  
so subby, if you were smashed in to on the freeway while riding a motorcycle, resulting in what orthopedic and GP MDs say is quite a lot of misalignment of your spine, just exactly what do you suggest?  Because the GP said I should go to a chiro, and the ortho guy seems to agree with you; his assessment was that I was just going to have to deal with it, and that physical therapy might help.

/as above, it's not to heal your liver or mediate allergies...
 
2013-11-05 12:39:21 PM  
I was thinking of having DNR tattooed on my chest. Now it seems it belongs on my forehead. And my T-shirt. And my medical-alert bracelet.

And I need to update my Final Directive or whatever it's called to more strongly stress that in case I become even more like a cauliflower they're supposed to give me as much pain medication as they can squeeze into my carcass and let me die in peace.

But they're welcome to crack my neck. And massage my feet any time they feel like it. And give me coffee enemas while wearing Hello Kitty costumes.
 
2013-11-05 12:39:56 PM  
JonZoidberg: "....make your preferences known through a living will, advance directives, etc."


I'll take the Joe Diffie:

1. Fill my boots up with sand
2. Put a stiff drink in my hand
3. Prop me up against a jukebox
 
2013-11-05 12:43:11 PM  

Mose: That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.


and why on earth can't there be a bit of both?  I'd walk away from any chiro who said I needed to go to them long-term/permanently anyway; help get me back to the right place, then I'll just do physical activity (yoga is teh bomb for spine alignment...and lots of nice views, too) to take it from there.
 
2013-11-05 12:43:21 PM  
"You've got diphtheria?, I'm gonna crack yer bones!"

i763.photobucket.com
 
2013-11-05 12:44:50 PM  

fappomatic: JonZoidberg: "....make your preferences known through a living will, advance directives, etc."


I'll take the Joe Diffie:

1. Fill my boots up with sand
2. Put a stiff drink in my hand
3. Prop me up against a jukebox


That's all well and good until Bubba shoots the jukebox.

/It played a sad song and made him cry
 
2013-11-05 12:48:58 PM  

InfamousG: My life was saved from misery by a chiropractor. Saying all chiropractors are ineffective is akin to saying all MDs are pill pushers.

Some DCs get better results than others due to skill, technique, and proper evaluation of issues.

Educate yourself on what a chiropractor does (and doesn't) do rather than blather on with an opinion you heard from some guy that had never actually been to one.


Same goes for many people talking shiat about some other state or country. Farking armchair tourists who never made it past the county line should keep their stupid to themselves.
 
2013-11-05 12:55:03 PM  

Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.


The only time you should do it is if someone's heart has stopped, which is generally a very imminent case of life or death.
 
2013-11-05 01:01:39 PM  

InfamousG: My life was saved from misery by a chiropractor. Saying all chiropractors are ineffective is akin to saying all MDs are pill pushers.

Some DCs get better results than others due to skill, technique, and proper evaluation of issues.

Educate yourself on what a chiropractor does (and doesn't) do rather than blather on with an opinion you heard from some guy that had never actually been to one.


Thank you. I was forming my view of chiropractors based off of scientific studies that proved how ineffective they were, but with your anecdotal evidence, I may have to reformulate my opinion.
 
2013-11-05 01:02:09 PM  

Target Builder: The only time you should do it is if someone's heart has stopped, which is generally a very imminent case of life or death.


For laypeople, it's any time someone has signs of cardiac arrest. They are no longer taught to assess for a pulse. However, after a successful defibrillation, even through organized cardiac activity may be present, the heart muscle may not be squeezing hard enough to get blood out to the rest of the body in adequate amounts - meaning you're doing your two minutes of CPR with the heart still beating.

In the infant/neonate population, it's quite common for them to receive chest compressions due to bradycardia.
 
2013-11-05 01:06:39 PM  

kendelrio: Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.

Sort of like getting you oil changed in your car?

/Maintenance, how do it work?


No.  Not at all like getting the oil changed in your car, actually.  A better analogy is this: you have an oil seal leak somewhere and you're burning oil.  You can go to the mechanic once a month who adds a quart of oil with each visit and charges an hour of labor, or you can go to the mechanic that replaces the faulty gasket.  Chiropractic vs. PT.
 
2013-11-05 01:11:38 PM  

miss diminutive: Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.

When I took first aid last year they kept telling me that I wasn't pushing down hard enough. I'm not exactly brimming with upper body strength but I found that comment a little odd given how dangerous I heard it could be.

I guess if you're forced to use CPR the person is already in dire straights anyway, so a broken sternum is a least of their worries.


Yep. (trained medic)

If you have to perform CPR, they have no pulse -- the odds they are walking out of the hospital are somewhere around 1% to 1.5%. If you perform CPR perfectly, those odds can double -- to 2 or 3%. So from really shiatty to just plain old shiatty.

(This is assuming that they're not already in a well staffed ER, in which case the odds might be a little bit better, but not all that much.)

/Had to perform CPR a number of times.
//None of them walked out of the hospital.
///Nobody I know has performed CPR and had the person get out alive.

(Sometimes you get vitals back, but the person still does not live to see the outside of a hospital -- there was a reason the heart stopped working, and CPR does nothing to fix that.)
 
2013-11-05 01:11:58 PM  

IamAwake: Mose: That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

and why on earth can't there be a bit of both?  I'd walk away from any chiro who said I needed to go to them long-term/permanently anyway; help get me back to the right place, then I'll just do physical activity (yoga is teh bomb for spine alignment...and lots of nice views, too) to take it from there.


You're free to go to whomever you like, but PT is the evidence based practice.  If I have a problem that I want to get better, I'd rather go to someone practicing evidence based medicine, that's just personal preference though.  Comes with being rational, i guess.

I hear the L. Ron Hubbard people are always willing to take your money too, though.
 
2013-11-05 01:15:31 PM  

kermit_the_frog: miss diminutive: Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.

When I took first aid last year they kept telling me that I wasn't pushing down hard enough. I'm not exactly brimming with upper body strength but I found that comment a little odd given how dangerous I heard it could be.

I guess if you're forced to use CPR the person is already in dire straights anyway, so a broken sternum is a least of their worries.

Yep. (trained medic)

If you have to perform CPR, they have no pulse -- the odds they are walking out of the hospital are somewhere around 1% to 1.5%. If you perform CPR perfectly, those odds can double -- to 2 or 3%. So from really shiatty to just plain old shiatty.

(This is assuming that they're not already in a well staffed ER, in which case the odds might be a little bit better, but not all that much.)

/Had to perform CPR a number of times.
//None of them walked out of the hospital.
///Nobody I know has performed CPR and had the person get out alive.

(Sometimes you get vitals back, but the person still does not live to see the outside of a hospital -- there was a reason the heart stopped working, and CPR does nothing to fix that.)


And despite those odds I was mocked at a monthly meeting when I brought up the idea of brining back the pre-cordial thump as a way to make everyone who's going to live feel a little better anyway.

/I at least had the courtesy to follow up with an idea to get more AEDs across town
 
2013-11-05 01:22:54 PM  

kendelrio: Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.

Sort of like getting you oil changed in your car?

/Maintenance, how do it work?


Chiropractors sell what doctors can't - the ability to always have something they can "do". Nobody wants to be told by a doctor that it will get better on its own, or in the case of sore backs that the best cure is losing weight, exercise and other hard lifestyle choices; they want a magic feather that fixes it.

Sore lower backs are "cured" by six weeks of manipulations and taking care of it, or six weeks of taking take of it. One of them makes the patient feel better, and the practitioner richer.

Nobody wants to be told "there's nothing wrong with you" or "there's nothing we can do besides wait", and all the quack treatment, chiropractors included, home in on those problems for a reason.
 
2013-11-05 01:27:23 PM  

Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.


Just like those damn dentists.... making you come in for a cleaning every 6 months.  Because we all know that schedule is evidence-based, yet no one ever comments about that...
 
2013-11-05 01:36:20 PM  

kermit_the_frog: If you have to perform CPR, they have no pulse -- the odds they are walking out of the hospital are somewhere around 1% to 1.5%. If you perform CPR perfectly, those odds can double -- to 2 or 3%. So from really shiatty to just plain old shiatty.


The Memphis area ROSC rate is 18 to 24%, depending on what department in the county you use. Seattle and Wake County have a 52% ROSC rate for primarily cardiac-causes for arrest, and lead the nation.

Anecdotally, a lot of that is being seen by using mechanical CPR assists, such as the LUCAS 2 and the Zoll Autopulse.

Of those, the odds of walking out of a hospital with a CPC score bellow 2 is about half the ROSC rate.
 
2013-11-05 01:41:16 PM  

Enigmamf: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

In other words, a physical therapist wearing a lab coat, with a glorified title, wrapped in a mantle of pseudoscientific bullshiat about energy flows of a mystical vitalistic force that cannot be measured.

Oh, sign me up!


WTF kind of chiropractor do you see? I've never heard of one spoutig that sort of BS.
 
2013-11-05 01:46:52 PM  

kittyhas1000legs: WTF kind of chiropractor do you see? I've never heard of one spoutig that sort of BS.


The entire basis of Chiropractic Medicine's inception is that "vertebral subluxations" are the One True Cause (TM) of disease.
 
2013-11-05 01:50:36 PM  

kermit_the_frog: miss diminutive: Prophet of Loss: Done correctly, CPR can easily break someone's sternum. Not an activity to screw around with unless its life or death. Done incorrectly, it can actually do more harm than good.

When I took first aid last year they kept telling me that I wasn't pushing down hard enough. I'm not exactly brimming with upper body strength but I found that comment a little odd given how dangerous I heard it could be.

I guess if you're forced to use CPR the person is already in dire straights anyway, so a broken sternum is a least of their worries.

Yep. (trained medic)

If you have to perform CPR, they have no pulse -- the odds they are walking out of the hospital are somewhere around 1% to 1.5%. If you perform CPR perfectly, those odds can double -- to 2 or 3%. So from really shiatty to just plain old shiatty.

(This is assuming that they're not already in a well staffed ER, in which case the odds might be a little bit better, but not all that much.)

/Had to perform CPR a number of times.
//None of them walked out of the hospital.
///Nobody I know has performed CPR and had the person get out alive.

(Sometimes you get vitals back, but the person still does not live to see the outside of a hospital -- there was a reason the heart stopped working, and CPR does nothing to fix that.)


I work in a hospital and end up doing compressions once every 4 or 6 weeks.  I've had plenty of people survive... but it is a highly controlled situation (hospital ER or ICU), and surviving sometimes isn't a good thing depending on how long they've been down and the amount of damage to their brain from lack of oxygen.

You get some situations where the factor causing their heart to stop is temporary (like an O.D.) and can be negated/controlled by drugs until it passes.  A lot of others are just not savable.  I don't know the percentage of survivors off the top of my head, but I'd guess 10 or maybe 20%, with half of those having major brain damage.
 
2013-11-05 01:58:38 PM  

kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.


THIS
I go to an eye doctor when my eyes have issues, and a chiropractor when my bones don't line up the way they are supposed to.

Mose:
I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.


I have been sing a physical Therapist for a couple years and this addresses a problem that she can't seem to find an effective solution for. (She's done magic for a number of other problems.) I made my appointment because I got my back to crack one day and all the pain in my back moved around - as muscles that weren't used to working had to pick up a load. It isn't always a rest-of-your life thing - just long enough to retrain your muscles so they don't keep pulling your bones out of alignment. I had treatment in my 20s for whip-lash and quit when that problem was fixed. I fully expect this one to be fixed within 6 months to 1 year.
 
2013-11-05 02:00:07 PM  
I used to have some heated arguments with my mother about her visiting a chiropractor for her neck, because that can be so dangerous. I feared for her life/health. I printed out a shiat ton of articles and studies and histories of chiropractic with their sources (I couldn't expect her to find and read them online because she has no idea how to use a computer or any other internet-accessible device). She barely acknowledged what I'd given her and never read a single bit. She doesn't care that it's largely ineffective at helping her with her pain and could potentially literally KILL her. In her head it's just what you do if you have neck or back pain. (Her mother used to see one too.) She even tried to talk me into seeing one when I had a bad bout of sciatica. No.

I haven't brought it up lately since she hasn't gone to her chiropractor in a while. I'm bracing myself for the next battle.
 
2013-11-05 02:21:50 PM  
Anecdotal only, but I've had a fairly high success rate with CPR, I'd say somewhere around 60%. This probably can be attributed to the fact that our average time from 911 call to ambulance on-scene is below four minutes and a transport time to the ER of under four minutes. However, I'm counting "success" as anyone who was in arrest on scene and either had a beating heart on arrival at the hospital or was resuscitated at the hospital. If you consider 7-day survival, my number goes down significantly.

The real consideration comes from what an individual wants, his views on life, quality of life, and death. I'm not in a position to decide whether someone deserves a low-percentage shot to live versus certain death, or to evaluate quality of life implications. Me? I'm having DNR tattooed across my chest when I turn 50. The 55 year old quadrapelegic living in the nursing home? She wanted to live. And she made it, and a year later is still alive as far as I know. The old man who we brought back, but never regained consciousness and died two days later? His family genuinely appreciated that they had time to get everyone together and say goodbye; their last memory of him was laying peacefully in a hospital bed instead of on the bathroom floor of his business with his pants around his ankles. On the other hand, watching CPR done on a family member is traumatic and I've had family members object to it, though I have a legal and professional obligation to do it if no DNR paperwork is present.

The default, with no other information available, must be to try to preserve life. Planning ahead is the only way to be certain that your wishes are adhered to.
 
2013-11-05 02:41:17 PM  
"No evidence?"
The results of this trial suggest that CMT in conjunction with SMC (standard medical care) offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP. (Spine (Phila Pa 1976). 2013 Apr 15;38(8):627-34)

or...

As much or more evidence exists for the use of spinal manipulation to reduce symptoms and improve function in patients with chronic LBP as for use in acute and subacute LBP. Use of exercise in conjunction with manipulation is likely to speed and improve outcomes as well as minimize episodic recurrence (
J Manipulative Physiol Ther. 2000 Feb;23(2):91-5.)

or...

VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care. (Spine. 2008 Feb 15;33(4 Suppl):S176-83)

or...

Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal. (J Manipulative Physiol Ther. 2011 Jun;34(5):274-89. doi: 10.1016/j.jmpt.2011.04.008. Review.)

or...

For patients with low back pain, the McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs (N Engl J Med. 1998 Oct 8;339(15):1021-9.)

Evidence based practice (bit of a side note here: some schools don't like the EBP term, favoring evidence informed care because they feel it disregards the institution of clinical experience) is becoming the norm. I know most people like to think that M.D.'s only practice that, but in reality, the entire field of medicine is undergoing a sea change that is causing a lot of friction on all sides."This is the way I've always practiced and I know it works." has been the rallying cry of those who are too set in their ways to yeild to what they see as a cabal researchers, statisticians, and general snooty academics. But with electronic medical records and systems that can track patient response to treatment becoming more and more common, it's clear (to me, at least) that EBP is the future. There are many chiropractors who don't like this. (Yes, the origins of chiropractic are fairly steeped in quackery, but hey... Psychology started with trephaning! Newton was an alchemist! Where we've come from is not nearly as important as where we're going.) The vast majority of them, however, are committed, as all good providers of health care are, to the well-being of their patients. Anyone who says otherwise is just trolling.

That being said (purely in response to the quotation marks around "care" in the headline)... The preponderance of medical creep is real. Insurance companies don't want to pay for superfluous treatment or tests, and they'll put pressure on everyone involved to prevent paying out a single penny more than they have to. But philosophically (and chiros are all about the philosophy, amirite?) the problem lies deeper, in the black stinking heart of capitalism which says it's fair game to make a profit in all areas, including patient care. That's why, in the inevitable post-money utopian socialist society, everyone will get free chiropractic care, whether they want it or not. Suck it, ye subluxed.
 
2013-11-05 02:50:32 PM  

SenoreVurm: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care. (Spine. 2008 Feb 15;33(4 Suppl):S176-83)


blogs.name.com 

Doctors Mark Crislip and Harriet Hall tore this paper apart after it was published in 2008.
 
2013-11-05 02:51:41 PM  

Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.


Most of those I know who go to chiropractors don't go because they believe in some magic.  The chiropractor charges $30 a visit, and they feel better for a little while after.  The physical therapy often says they'll still need to go forever, or that they do not know if they can help, costs several hundred or more a visit and often doesn't fall under their insurance, and makes them tired and sore afterwards.  I think at that point they are just desperate due to chronic pain and will gladly pay forever for that little relief.

I'd rather see a real fix for them, but sometimes it just doesn't seem practical.  I can empathize with the making do... a lot of people will rely on questionable remedies if nothing better is available.
 
2013-11-05 03:15:51 PM  

ErinPac: Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.

Most of those I know who go to chiropractors don't go because they believe in some magic.  The chiropractor charges $30 a visit, and they feel better for a little while after.  The physical therapy often says they'll still need to go forever, or that they do not know if they can help, costs several hundred or more a visit and often doesn't fall under their insurance, and makes them tired and sore afterwards.  I think at that point they are just desperate due to chronic pain and will gladly pay forever for that little relief.

I'd rather see a real fix for them, but sometimes it just doesn't seem practical.  I can empathize with the making do... a lot of people will rely on questionable remedies if nothing better is available.


That's a whole lot of words to say "legalize it."
 
2013-11-05 03:32:12 PM  

UrukHaiGuyz: ErinPac: Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.

Most of those I know who go to chiropractors don't go because they believe in some magic.  The chiropractor charges $30 a visit, and they feel better for a little while after.  The physical therapy often says they'll still need to go forever, or that they do not know if they can help, costs several hundred or more a visit and often doesn't fall under their insurance, and makes them tired and sore afterwards.  I think at that point they are just desperate due to chronic pain and will gladly pay forever for that little relief.

I'd rather see a real fix for them, but sometimes it just doesn't seem practical.  I can empathize with the making do... a lot of people will rely on questionable remedies if nothing better is available.

That's a whole lot of words to say "legalize it."


Except that it really wasn't.  One of the several people I was thinking of did think along those lines... and still also went to the Chiropractor for pain relief.  It may not be permanent, but it isn't quite THAT short term.
 
2013-11-05 04:16:45 PM  
www.journoblog.com
 
2013-11-05 04:23:58 PM  
One thing I will give chiros credit for: they have the highest rate of patient satisfaction in all of medicine (or pseudomedicine, depending on your thoughts.) Just the mere act of placing hands on patients can "cure" disease. That being said, it's very very clear that their philosophy (linked above) has no basis in science/Western medicine. Doesn't mean it doesn't "work." The mind is a very powerful thing, and the placebo effect is very real.
 
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