Chiropractic

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Proposed changes to long-standing consensus version of the lede

Here is the long-standing consensus version of the lede. Let's discuss. For any editors who are just now joining this discussion, see this talk-page section for context.

"'Chiropractic"' is a form of alternative medicine mostly concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine.cite book|vauthors=Chapman-Smith DA, ((Cleveland CS III)) |chapter= International status, standards, and education of the chiropractic profession|pages=111–34|title= Principles and Practice of Chiropractic|edition=3rd|veditors=Haldeman S, Dagenais S, Budgell B |publisher=McGraw-Hill|year=2005|isbn=978-0-07-137534-4|display-editors=etal Some proponents, especially those in the field's early history, have claimed that such disorders affect general health via the nervous system,cite journal |vauthors=Nelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T | title = Chiropractic as spine care: a model for the profession | journal = Chiropractic Osteopathy| volume = 13 | issue = 1 | page = 9 | year = 2005 | pmid = 16000175 | pmc = 1185558 | doi = 10.1186/1746-1340-13-9 through vertebral subluxation, claims which are demonstrably false. The main chiropractic treatment technique involves manual therapy, especially spinal manipulation therapy (SMT), manipulations of other joints and soft tissues.cite book|chapterurl=http://chiroweb.com/archives/ahcpr/chapter3.htm|chapter= Content of practice|vauthors=Mootz RD, Shekelle PG |year=1997|title= Chiropractic in the United States: Training, Practice, and Research|pages=67–91|veditors=Cherkin DC, Mootz RD |location= Rockville, MD|publisher= Agency for Health Care Policy and Research|oclc=39856366 AHCPR Pub No. 98-N002. Its foundation is at odds with mainstream medicine, and chiropractic is sustained by pseudoscientific ideas such as subluxation and "innate intelligence" that reject science. Chiropractors are not medical doctors.Salzberg, Steven (April 20, 2014). https://www.forbes.com/sites/stevensalzberg/2014/04/20/new-medicare-data-reveal-startling-496-million-wasted-on-chiropractors/4498507368c8 New Medicare Data Reveal Startling $496 Million Wasted On Chiropractors. "Forbes." Retrieved: September 12, 2018.

Numerous controlled clinical studies of treatments used by chiropractors have been conducted, with conflicting results. Systematic reviews of this research have not found evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.cite journal | author = Ernst E | title = Chiropractic: a critical evaluation | journal = Journal of Pain and Symptom Management| volume = 35 | issue = 5 | pages = 544–62 | date = May 2008 | pmid = 18280103 | doi = 10.1016/j.jpainsymman.2007.07.004 A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition.cite journal |vauthors=Posadzki P, Ernst E | title = Spinal manipulation: an update of a systematic review of systematic reviews | journal = The New Zealand Medical Journal| volume = 124 | issue = 1340 | pages = 55–71 | year = 2011 | pmid = 21952385 Spinal manipulation may be cost-effective for sub-acute or chronic low back pain but the results for acute low back pain were insufficient. The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.cite journal |vauthors=Leboeuf-Yde C, Hestbaek L | title = Maintenance care in chiropracticnbsp;– what do we know? | journal = Chiropractic Osteopathy| volume = 16 | issue = | page = 3 | year = 2008 | pmid = 18466623 | pmc = 2396648 | doi = 10.1186/1746-1340-16-3 There is not sufficient data to establish the safety of chiropractic manipulations. It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.cite journal | author = Ernst E | title = Adverse effects of spinal manipulation: a systematic review | journal = Journal of the Royal Society of Medicine| volume = 100 | issue = 7 | pages = 330–38 | year = 2007 | pmid = 17606755 | pmc = 1905885 | doi = 10.1258/jrsm.100.7.330 | url = http://jrsm.rsmjournals.com/cgi/content/full/100/7/330 | laysummary = http://www.medicalnewstoday.com/articles/75754.php | laydate = 2007-07-02 | laysource = Med News Today | deadurl = bot: unknown | archiveurl = https://web.archive.org/web/20100516074554/http://jrsm.rsmjournals.com/cgi/content/full/100/7/330 | archivedate = 2010-05-16 | df = There is controversy regarding the degree of risk of vertebral artery dissection, which can lead to stroke and death, from cervical manipulation. Several deaths have been associated with this technique and it has been suggested that the relationship is causative, a claim which is disputed by many chiropractors.cite journal | author = Ernst E | title = Deaths after chiropractic: a review of published cases | journal = International Journal of Clinical Practice| volume = 64 | issue = 8 | pages = 1162–65 | year = 2010 | pmid = 20642715 | doi = 10.1111/j.1742-1241.2010.02352.x | url= https://www.researchgate.net/publication/45273915

Chiropractic is well established in the United States, Canada, and Australia. It overlaps with other manual-therapy professions such as osteopathy and physical therapy. Most who seek chiropractic care do so for low back pain.cite journal |vauthors=Hurwitz EL, Chiang LM | title = A comparative analysis of chiropractic and general practitioner patients in North America: findings from the joint Canada/United States Survey of Health, 2002-03 | journal = BMC Health Services Research| volume = 6 | page = 49 | year = 2006 | pmc = 1458338 | doi = 10.1186/1472-6963-6-49 | pmid = 16600038 Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues. Many chiropractors describe themselves as primary care providers, but the chiropractic clinical training does not support the requirements to be considered primary care providers, so their role on primary care is limited and disputed. Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "innate intelligence", and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.

D. D. Palmer founded chiropractic in the 1890s, after saying he received it from "the other world", and his son B. J. Palmer helped to expand it in the early 20th century.cite journal | author = Martin SC | title = Chiropractic and the social context of medical technology, 1895-1925 | journal = Technology and Culture| volume = 34 | issue = 4 | pages = 808–34 | date = October 1993 | pmid = 11623404 | doi = 10.2307/3106416 | jstor = 3106416 Throughout its history, chiropractic has been controversial.cite journal | author = DeVocht JW | title = History and overview of theories and methods of chiropractic: a counterpoint | journal = Clinical Orthopaedics and Related Research| volume = 444 | pages = 243–49 | year = 2006 | pmid = 16523145 | doi = 10.1097/01.blo.0000203460.89887.8d cite journal | author = Homola S | title = Chiropractic: history and overview of theories and methods | journal = Clinical Orthopaedics and Related Research| volume = 444 | pages = 236–42 | year = 2006 | pmid = 16446588 | doi = 10.1097/01.blo.0000200258.95865.87 Despite the overwhelming evidence that vaccination is an effective public health intervention, among chiropractors there are significant disagreements over the subject,cite journal |vauthors=Busse JW, Morgan L, Campbell JB | title = Chiropractic antivaccination arguments | journal = Journal of Manipulative and Physiological Therapeutics| volume = 28 | issue = 5 | pages = 367–73 | year = 2005 | pmid = 15965414 | doi = 10.1016/j.jmpt.2005.04.011 | url = http://jmptonline.org/article/S0161-4754(05)00111-9/fulltext which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic.cite journal |vauthors=Campbell JB, Busse JW, Injeyan HS | title = Chiropractors and vaccination: a historical perspective | journal = Pediatrics| volume = 105 | issue = 4 | page = e43 | year = 2000 | pmid = 10742364 | doi = 10.1542/peds.105.4.e43 | url = http://pediatrics.aappublications.org/cgi/content/full/105/4/e43 The American Medical Association called chiropractic an "unscientific cult" in 1966 and boycotted it until losing an antitrust case in 1987.cite journal |vauthors=Cooper RA, McKee HJ | title = Chiropractic in the United States: trends and issues | journal = Milbank Quarterly| volume = 81 | issue = 1 | pages = 107–38, table of contents | year = 2003 | pmid = 12669653 | pmc = 2690192 | doi = 10.1111/1468-0009.00040 Chiropractic has had a strong political base and sustained demand for services; in recent decades, it has gained more legitimacy and greater acceptance among conventional physicians and health plans in the United States.

Suggestion for change #1

"'1st paragraph, 2nd sentence"': I suggest we remove ""claims which are demonstrably false"" unless appropriate sourcing is provided. -- Somedifferentstuff11:22, 13 May 2019 (UTC)

I just took a look at this RS https://www.sciencedirect.com/science/article/pii/S088539240700783X?via%3Dihub which is currently used in the article; it states, ""The core concepts of chiropractic, subluxation and spinal manipulation, are not based on sound science"" and ""With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition."" -- Somedifferentstuff11:36, 13 May 2019 (UTC)

Let's replace that "demonstrably" phrasing with an adaptaptation of that first sentence. This article, "Chiropractic: A Critical Evaluation", is a review article which more than 100 other papers have cited, so this seems like solid sourcing to back that idea. I like linking to what the wiki calls concepts, so I prefer saying "not based on scientific evidence" rather than "demonstrably false" or "sound science". Bluerasberry "' Blue Rasberry "' 12:36, 13 May 2019 (UTC)

Hi x "' Blue Rasberry "', would you support ""... through vertebral subluxation, claims which are not based on scientific evidence."" -- Somedifferentstuff12:41, 13 May 2019 (UTC)

Somedifferentstuff Yes great! Bluerasberry "' Blue Rasberry "' 13:33, 13 May 2019 (UTC)

Done https://en.wikipedia.org/w/index.php?title=Chiropractictype=revisiondiff=896889593oldid=896515578 -- Somedifferentstuff16:35, 13 May 2019 (UTC)

Suggestion for change #2

"'1st paragraph, 5th sentence"': Shall we remove ""Chiropractors are not medical doctors""? - Even though I disagree with this removal (it is undisputed that Chiropractors are not MD's (they don't go to medical school, they go to an accredited chiropractic school in order to earn a D.C. (Doctor of Chiropractic) degree) which is why they can't use the MD title anywhere in the world. This statement also doesn't violate MEDRS because when you read through that policy, it simply doesn't apply to general information that is separate from medical claims. In other words, there is no policy violation in regards to stating this information with its current source, according to Wikipedia's rules - have a look at MEDRS if you think I'm mistaken.) With that said, if consensus is to remove it, then we will. -- Somedifferentstuff14:09, 13 May 2019 (UTC)

I agree it should be worded differently, since although not medical doctors, most chiropractors are still doctors in one field or another. (Bit hard not to be after 6-8 years of education). That said, I still think it should be pointed out that they are decidedly Not medical doctors, so perhaps a little tag on end pointing out typical education levels? Sry if I'm doing this wrong, usually never suggest anything in these talk pages. —nbsp;Preceding 01:29, 7 July 2019 (UTC)

It is perfectly possible not to be a doctor after 6-8 years of education. Especially if the education was in a field which has only a flimsy relation to reality, such as chiropractic.

That said: Wikipedia articles are supposed to be about what is the case, not about what is not the case. --Hob Gadling04:17, 10 July 2019 (UTC)

Suggestion for change #3

"'4th paragraph, 1st sentence"': Another editor had previously suggested removing the part of the sentence that states, ""after saying he received it from "the other world"" - The material is sourced and I personally find it to be interesting; it also provides the reader an opportunity to see where D. D. Palmer was coming from. -- Somedifferentstuff18:23, 14 May 2019 (UTC)

Headers

I claim no expertise on this topic. I am therefore here for information, not to join the fray. That said, I have wikified the topic headers to facilitate copy-editing and so that the automatic TOC will be created. Having edited several hundred articles, I have not previously seen the headers designated as they were here. That does not make them wrong, but w/o sections and subsections, every minor edit involves the hypertext of the entire article.

I did not differentiate between topics and subtopics. That may have advantages of clarity, but I'll leave it to the next reader, who is very likely more familiar with chiropractic than I. If I have gone against a perceived consensus, sorry, but I will not wade thru 39 archives to be sure. We are all volunteers, but I value my time more than that. FWIW, I believe robot archiving after only 20 days lends a false sense of resolution to an obviously contentious topic. Just sayin'.

--the Ragityman. 20July2019 This keyboard doesn't offer the 'tilde' so I am forced to sign manually.