Talk:Chiropractic/Archive 6

message: The short mention is important to the history of chiropractic. -- Fyslee 22:52, 2 January 2006 (UTC)
thread_title:  Mention of B.J. Palmer in History section 

message: I believe they should stay in the history section, especially since they deal with origins. .. Fyslee 22:52, 2 January 2006 (UTC)
thread_title:  Religious views of DD Palmer 

message: Some of the History section seems to be copied verbatim from Bradley Chiropractic Clinic: Brief History of Chiropractic.—203.173.11.75 07:52, 19 January 2006 (UTC)
thread_title: Copyright problem?

message: As soon as the the supporters of chiropractic want to cite peer-reviewed studies supporting their claims--studies in reputable journals that meet the same criteria for validity that the sciences require in their studies--the sooner this mess can be resolved.  Until then, the  claims made by the supporters of chiropractic are no better than those made by supporters of magnetic healing or Scientology. [Unsigned]
::Indeed, I note that the vast dump of references put in the usage paragraph are all case studies.  None of them are double-blind studies nor population based and further the vast majority of them are published  in chiropractic journals - not generally accepted medical journals such as the BMj.  Homeopaths are really good at promoting their research in homeopathic journals, but for some reason can't get into any mainstream peer reviewed journals.  I wonder why not?  A big scientific conspiracy to stop good science being published?  Or is the science simply poor or lacking. Maustrauser 04:26, 12 January 2006 (UTC)
replies: text: Is PubMed not a generally accepted journal? Is JVSR not a peer-reviewed scientific journal? And Elsevier, is it not gloabally the most respected collection of science, technology and medicine full text and bibliographic information? I made sure to vary the sources to show that these studies are not coming from just any one organization with a specific agenda. These are legitimate scientific studies from various disciplines of independent researchers from around the globe. Levine2112 06:39, 12 January 2006 (UTC)
replies: text:  You are obviously not aware that anybody can go to Elsevier and set up a journal.  All Elsevier asks to publish a journal is your money.  A colleague of mine who is a CEO of a medical profession has just made a deal with Elsevier to publish its journal.  It costs $18,000 a year.  Elsevier made no inquiries regarding the science in the journal, simply that the association was willing to pay.   When I have time I shall look at the publishing policies of the other journals you mention.  You claim they are legitimate studies reported.  They may or may not be legitimate case studies, but that's all they are - case studies.  Case studies are generally no more useful than anecdotal evidence.  Show me the double blind population based studies and then I may consider that chiropractic is more than a fringe exercise in removing money from people's pockets — oh and showing me the physical evidence for a subluxion might help too . Maustrauser 07:02, 12 January 2006 (UTC)
replies: text: I look forward to you letting us know about the publishing policies of the other journals. The case studies certainly support the claim, but certainly more research is always needed. That's the wonderful thing about science. Knowledge is always expanding and growing. What was once considered quackery is now science. What was once considered heresy is now the gospel. I can point to dozens and dozens of other case studies and scientific research on the Internet supporting more chiropractic claims if you'd like. I thought the 13 I put up there was a generous supply, but there is so much scientific evidence out there. For me, I was convinced by actually experiencing it and I'm more and more convinced with evey adjustment and my continuing health. Then there's the basic logic of how the nervous system functions and how neural message interferance to and from the brain can cause health problems. To me, it just makes logical sense. Step on a garden hose and the flower at the other end will dry up. If you haven't already, I whole-heartedly encourage you to get adjusted by a straight chiropractor (one who is interested in health and not just pain relief...the pain relief ones tend to be the ambulance chasers). Experience it for yourself. To your health and to your peace. Levine2112 07:56, 12 January 2006 (UTC)
replies: text:  Anecdotal evidence does not science make.  And case studies are anecdotal evidence.  Population-based double-blind studies prove that modalities work - not one off miraculous cures (even if the cures are your own).   My father attended a so-called holistic chiropractor and the chiropractor fractured my father's back.  And at age 61 a fractured spine is not the best position to be in.  But rest assured, I am not allowing my personal experiences to prejudice my view of chiropractic, I was skeptical of it before my father's 'accident'.  Indeed, I urged him not to attend.  But it's not somethng one goes and says "I told you so," later.  I shall research the other publications when Ihave some time.  Cheers, Henry. Maustrauser 09:29, 12 January 2006 (UTC)
replies: text:  I think there is a problem in what you are asking for: a double-blind study of chiropractic. Double-blind would mean neither the subject nor the practitioner would know whether a real chiropracitc adjustment has taken place or just a placebo adjustment. I don't think this is possible, espeicially from the practitioners stand-point. I think a chiropractic practitioner would know whether or not they are applying an actual or a placebo adjustment. There have been single-blind studies where the practitioner knew if they were giving a real or fake adjustment, but the subject did not know nor did the third-party researcher. Many of these studies have been in favor of chiropractic's claims to promote general health. As far as I know, a double-blind study would be impossible. Just like a double-blind study of a surgery. The surgeon is going to know whether or not they removed an organ, repaired an artery, implemented an artificial device, et cetera. A double-blind study would be impossible in these scenarios too. So for now, all we have are single-blind studies, case studies, and anecdotal evidence to rely on... I'm sorry about your father. But please understand - with the utmost respect to your father's suffering - that there is malpractice in virtually every form of medicine. Statistically, chiropractic's malpractice rate is miniscule compared to conventional medicine. Levine2112 22:53, 12 January 2006 (UTC)
thread_title:  The problem is the lack of peer reviewed evidence supporting chiropractic 

message: http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=34541932&oldid=34503778
http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=next&oldid=34541932
http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=next&oldid=34545717
http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=next&oldid=34549361
http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=next&oldid=34592883
current version, with corrections:
http://en.wikipedia.org/w/index.php?title=Chiropractic&diff=next&oldid=34653974
-- Fyslee 23:54, 10 January 2006 (UTC)
thread_title:  Here are the key revision attempts: 

message: I am curious. Why do you hate chiropractic? Please be specific. I seriously want to know your grievances. Please list them here. Levine2112 23:57, 10 January 2006 (UTC)
replies: text: No hate at all. Only skepticism of the quackery aspects of chiropractic. If you'll just stay honest and civil, we can have some interesting discussions here. If you continue getting nasty, you'll get nowhere, other than revealing the nasty side of your motives. -- Fyslee 00:13, 11 January 2006 (UTC)
replies: text: The same goes for you. I fight fire with fire. Just my nature. You seem highly motivated to hurting the profession. There must be a reason. I just want to know why. Levine2112 00:15, 11 January 2006 (UTC)
replies: text: Where is the fire? You repeatedly attempted to improperly revise accurate information. I simply exposed your attempts and corrected them. You can stop anytime. -- Fyslee 00:18, 11 January 2006 (UTC)
replies: text: I say your information is not accurate and I show exactly why. Here's some fire: "Levine, grow up". Or "If this keeps up, we have to get administration to block his IP address." And "Come on with your life". And "a little second grade math". Now to be fair, I never got this personal until you did. I understand that Wiki has strict guideline against this and I will refrain from make furthere juvenile comments as it doesn't help what we are trying to do, which is create and honest non-biased article. Now please, answer my question... Why do you hate chiropractic? Levine2112 00:27, 11 January 2006 (UTC)
replies: text: I have answered it. I don't hate chiropractic. I oppose the quackery found in chiropractic. If you don't identify yourself with it, then you need not be defensive. That's all. I'm interested in accurate information, just as many chiropractors are. I get my information from them, and they agree with me. -- Fyslee 00:33, 11 January 2006 (UTC)
replies: text:  It has been settled on the "quackery" page that chiropractic is not considered "quackery". If you want to address the certain aspects of chiropractic that you deem to be quackery then please do it on a more specific page and not the general chiropractic article. The agreement is that "quackery" is a pejorative term. Using it incites anger. Using it to blindly label a profession is hateful and typically inaccurate. Levine2112 00:36, 11 January 2006 (UTC)

text: I'm pretty happy with the "Chiropractic" article as it is. As long as the core scientific belief of the profession is there and most prominent - Removal of subluxations allows for better communication between the brain and all of the body's systems, thus promoting health. Levine2112 00:51, 11 January 2006 (UTC)
thread_title:  Why all the Anti-Chiropractic Hate? 

message: You (Fyslee) are saying that there is no way of telling that Palmer made the distinction between subluxations and joint displacement in the quote. You are referring to this quote that you added to the article, right? - "A subluxated vertebrae . . . is the cause of 95 percent of all diseases. . . . The other five percent is caused by displaced joints other than those of the vertebral column". Clearly, he made a distinction, otherwise he would have said 100%, no? Levine2112 01:56, 11 January 2006 (UTC)
replies: text: Levine, you may be needlessly confusing the information; DD Palmer said that the cause of every disease (100%) is disrupted nerve supply, and this disrupted nerve supply is due 95% to spinal subluxations and 5% to other joints.  I don't know how much clearer that could be.  --CDN99 02:11, 11 January 2006 (UTC)
replies: text: Then please reword this "the original chiropractic hypothesis that subluxations are the cause of 100% of all diseases". Because, as you said DD said that 100% of disease is caused by disrupted nerve supply...not subluxation. Is that clear? Levine2112 02:20, 11 January 2006 (UTC)

text: Look up subluxation in a dictionary.  From dictionary.com, the first definition is "Incomplete or partial dislocation of a bone in a joint."  In other words, DD claimed that disease is due 95% to spinal dislocations (or subluxations), and due 5% to other dislocations (or subluxations), and that subluxations disrupted nerve supply, no matter where the subluxations were; thus DD did claim that disease was due 100% to subluxations (95% spinal, 5% other), and this is what Fyslee is saying in the section "During this time he tried to find a single cause for 100% of all diseases. He reached a point ....." --CDN99 02:34, 11 January 2006 (UTC)
replies: text: Then why the distinction the quote? "A subluxated vertebrae . . . is the cause of 95 percent of all diseases. . . . The other five percent is caused by displaced joints other than those of the vertebral column".Levine2112 03:01, 11 January 2006 (UTC)
replies: text: You know what? It doesn't even bother me that much. Leave it. NACM doesn't hold much water with anyone anyhow. Just yet another face of Stephen Barrett. Levine2112 03:04, 11 January 2006 (UTC)

text: Huh? I'm the one under attack here. Levine2112 06:47, 11 January 2006 (UTC)
thread_title: 95 or 100

message: After a reversion after vandalism, caught by User:Steinsky, I have tidied up the External Links section with better headings and plenty of good links on both sides of the issues. I have used the alt. med. page as a model, since it's a common way to do it here at Wikipedia. The NPOV is best preserved by including both sides. I can't be accused of not being fair.....;-)
Several of the links under "Critiques" are from chiropractic's foremost historian, chiro professor Joseph C. Keating, Jr., PhD. He has been employed by the profession for ages, and is so knowledgeable and important for them, that he can get away with telling the truth. Subluxation based chiros hate him, but he has support from many teachers, researchers, and some in the very top (who don't dare to identify themselves publicly, but who participate at Chirotalk under pseudonyms. Very interesting phenomenon! -- Fyslee 10:41, 14 January 2006 (UTC)
thread_title: External links improvement

message: I am calling into question the NPOV status of the following statement currently in the article:
To date there is limited scientific evidence of the existence of "subluxations", in terms of quantifiable measures. Nerve conduction studies of human spinal nerves identified as being subluxed by chiropractors were shown to be normal by conventional scientific measures. Studies involving X-ray and CT scanning of the human spine before and after chiropractic manipulation show no changes in joint position as identified by radiologists. This lack of a clear definition of "subluxation", supported by scientific evidence, is one of the major sources of chiropractic's struggle for acceptance within the traditional medical community.
I feel this is extremely slanted. There is a tremendous amount of respected scientific research that does show the existence AND the effect of the vertebral subluxation. Granted, a lot of this research is by chiropractors and chiropractic organizations, I can also point to a number of researchers and doctors from other professions that have documented the existence of the vertebral subluxation and its consequences. Sir Sidney Sunderland, MD in  "Nerve and Nerve Injuries" documented:
Narrowing of the lumbar intervertebral distance, whatever the cause, results in the subluxation of the apophyseal joints in which the facet of the vertebra above is displaced inferiorly across the surface of the facet of the vertebra below. As a result of this displacement, the medical branch of the lumbar dorsal ramus, which is fixed in this region, is involved in two ways:
#Inflammatory swelling of the joint reduces the lumen of the tunnel containing the neurovascular bundle.
#The inferior articular pedicel comes to press directly on the nerve.
Similar finding come to us from Rene Cailliet, M.D in his textbook "Neck and Arm Pain", "Scoliosis Diagnosis and Management" and "Tissue Pain and Disability". Dr. Cailliet also found that evidence that chiropractic care can reverse osteoarthritis—something previously considered impossible. According to Dr. Cailliet - a respected authority on orthopedic disorders - Surgery "should only be considered as a last resort". More evidentiary research showing the existence and effect of verrtebral subluxation comes to us from "The Cervical Syndrome" by Ruth Jackson, M.D. who reported that an analysis of more than five thousand patients who had symptoms referable to the cervical spine revealed that over 90% of these patients had one or more injuries to the cervical spine, either recent or remote. A study by Von Torklas and Gehle of the University Hospital, Hamburg, Germany, has found that even in the “healthy” children, the age group under eight years shows a 40% subluxation tendency. Gutmann, a German M.D., concluded in a paper published in 1987 in “Manuelle Medizun” that blocked nerve impulses at the upper neck cause many clinical features from central motor impairment to lower resistance infections, especially ear, nose and throat infections. He states, “Chiropractic and radiological examinations are of decisive importance for diagnosis of the syndrome.” He further states that chiropractic can often bring about amazingly successful results. Maigne, the eminent French orthopedist, states that “trauma to the cervical spine and head can cause irritation to the sympathetic fibers in the cervical spine, causing such problems as headaches, vestibular troubles, auditory problems, visual disturbances, pharyngolaryngeal disturbances, vasomotor and secretional problems.” Maigne adds that manipulation of the neck achieves excellent results with many of the conditions. And it goes on and on. I keep doing Google searches and I keep finding more well-documented, published independent studies supporting the existence of the vertebral subluxation.
Therefore, I feel it is a POV statement to write:
To date there is limited scientific evidence of the existence of "subluxations".
Depending on your definition of "limited", this statement would seem to be an opinion (and a false one at that).
As for the next sentence:
Nerve conduction studies of human spinal nerves identified as being subluxed by chiropractors were shown to be normal by conventional scientific measures.
Perhaps this is true sometimes. What studies? Who did these studies? I have cited and can cite much more that says just the opposite.
The same goes for the next sentence:
Studies involving X-ray and CT scanning of the human spine before and after chiropractic manipulation show no changes in joint position as identified by radiologists.
What studies? Please cite them.
Finally:
This lack of a clear definition of "subluxation", supported by scientific evidence, is one of the major sources of chiropractic's struggle for acceptance within the traditional medical community.
Vertebral subluxation is clearly defined by chiropractors today basically as a misalignment of the vertebra. You'd be hard-pressed to find legitimate chiropractors who say anything else. The spiritual definition was D.D. Palmer's rudimentary ideas over a 100 years ago before x-rays, CT scans, and a whole lot of other medical advancements and chiropractic research. I don't think it is fair to cite that and say that there is still confusion about the definition of subluxation. As for the rest of that sentence, clearly there is scientific evidence that supports subluxation, and while chiropractic does continue to struggle to gain acceptance in the traditional health community, I don't think it is because of a semantic debate over the word "subluxation".
Given the mixed opinions on this subject, I would like to suggest that we do one of two things.
#Strike the paragraph completely, as it stands now it is mostly representive of the opinion that subluxations do not exist OR
#Revise the paragraph to be more NPOV
A revised paragraph would note that there have been scientific studies that show the existence of vertebral subluxations and scientific studies that show the non-existence (of course, those studies would also need to be cited - as it stands now, it is just a blanket statement with no reference to anything).
Thoughts? Suggestions? Anyone want to take a shot a reworking this paragraph with me? Levine2112 04:16, 17 January 2006 (UTC)
thread_title:  A plan to delete or revise passage for NPOV 

message: User:Levine2112 wrote: I just NPOVified it. I think you'll agree with my edits. Maybe?
User:Fyslee replies here:
Fair enough. Let's fine tune it a bit more.
I understand your viewpoint very well, and also understand why this section needs to be kept as balanced as possible (as with all other Wikipedia articles).
Since this is an area with great disagreement, not only among chiropractors (the majority seeking to downplay the risks), but within the medical and scientific community (basically no attempts at downplaying, but more about just how great the risks really are), we should not consider this an area that is finally "proven" or conclusively "documented" as yet. More and more research is uncovering a serious underreporting problem.
To aid our discussion, I'll place the "before" and "after" versions below, with the keys words highlighted and numbered for ease of reference:
==== My version, before Levine2112's editing ====
:*Many chiropractors report that these serious complications due to manipulation of the cervical spine remain rare, having been estimated (1) at 1 in 3 or 4 million manipulations or fewer. Such estimates are considered (2) to be highly unreliable because (3) of vast (up to 100%) underreporting problems. While still rare, the true incidence must (4) be much higher, and further research should (5) shed more light on this situation.
==== Levine2112's edited version ====
:*Many chiropractors report that these serious complications due to manipulation of the cervical spine remain rare, having been documented (6)  at 1 in 3 or 4 million manipulations or fewer . (7)  Such estimates are believed (8)  to be highly unreliable based on the possibility (9) of vast (up to 100%) underreporting of problems. While still rare, the true incidence could (10) be much higher, and further research may (11) shed more light on this situation.
To start with, please explain why you felt these changes were necessary. Were they made from a concern for 
*(1) accuracy, 
*(2) patient safety and protection, or  
*(3) to protect chiropractic's reputation (by downplaying the risks and - as earlier done - to compare "apples and oranges" regarding other risks that aren't comparable)?
I fear that you are prioritizing chiropractic's reputation, to the detriment of accuracy and patient safety.
-- Fyslee 12:45, 19 January 2006 (UTC)
thread_title:  Editorial changes 

message: :*Many chiropractors report that these serious complications due to manipulation of the cervical spine remain rare, having been documented (6)  at 1 in 3 or 4 million manipulations or fewer . (7)  Such estimates are believed (8)  to be highly unreliable based on the possibility (9) of vast (up to 100%) underreporting of problems. While still rare, the true incidence could (10) be much higher, and further research may (11) shed more light on this situation.
To start with, please explain why you felt these changes were necessary. Were they made from a concern for 
*(1) accuracy, 
*(2) patient safety and protection, or  
*(3) to protect chiropractic's reputation (by downplaying the risks and - as earlier done - to compare "apples and oranges" regarding other risks that aren't comparable)?
I fear that you are prioritizing chiropractic's reputation, to the detriment of accuracy and patient safety.
-- Fyslee 12:45, 19 January 2006 (UTC)
thread_title:  Levine2112's edited version 

message: :Yes for accuracy.
:Changing words such as "considered" to "believed" more accurately depicts that this statement is not a fact but an opinion. The same goes for changing "because" to "based on the possibility". "Because" refers to definite causality. But as this belief is just a debated theory, the belief is only a possibility. That would go for the word "must" which insists that there is "vast underreporting" - but again that is just a theory with little proof. "Should" again suggests a definite result; whereas "may" defines only the possibility that research will shed more light on vast underreporting.
:Yes for patient safety and protection.
:Now this is just an opinion, but it is as relevant and valid as your opinion on this matter: I feel that by scaring possible patients away from chiropractic, you are putting their health in jeopardy. I beleive this because I believe that chiropractic promotes health.
:Yes to protect chiropractic's reputation.
:As a knowledgeable advocate of chiropractic, I felt that the way the paragraph was worded, it was stating as fact that chiropractic is gravely dangerous. Without any documentation, your theory supposes that chiropractors must be vastly underreporting cervical neck trauma. I take offense to this not only as a chiropractic advocate but as a truth seeker. I found the paragraph POV and manipulative against chiropractic. But I am not trying to downplay the truth - that chiropractic has one of the lowest malpractice rates of any legitimate health profession - I was merely downplaying a supposition that was being presented as fact.
:Now please read a paragraph that I added a while back:
:Philosophy of the Subluxation
:Chiropractic philosophy holds that much of the body is controlled by messages sent to and from the brain along the nervous system. The medical community agrees that all messages - whether it is the brain commanding the foot to move or an organ telling the brain it is in need of repair - pass through the spinal cord; which acts as a kind of cerebral router. An outgoing message from the brain passes down the spinal cord and through the appropriate spinal nerve branch held between the vertebrae on either side of the spinal cord. There are 31 pairs of spinal nerves that emerge from the spinal cord; all of which are housed by vertebrae. If the vertebrae are misaligned (subluxated), chiropractors believe that a spinal nerve can be squeezed or pinched and therefore message flow can be compromised. By aligning the vertebrae and removing restrictions on the spinal nerves, chiropractic claims to allow the spinal cord to more effectively relay messages to and from the brain; thus promoting better health.
:Even though I truly believe in my heart of hearts that correcting subluxations does promote health, you'll notice that I was sure to point out that this is just a belief, not a fact. I used words such as "claim" and "believe". I even called it a "philosophy" rather than "science". I did this because I wanted to keep this article fair but at the same time educate a possible Wikipedian on what is at the core of chiropractic philosophy. I'm not trying to sway a researcher or possible chiropractic patient into believing anything. I am simply presenting them with information and clearly letting them know what is fact and what is theory. I feel that this paragraph exemplies what Wikipedia means by NPOV.
:I took this very same approach when editing the paragraph in question in the Criticism section. Regardless of it being pro or anti chiropractic, I applied the very same standards of NPOV that I applied to my paragraph. I truly feel that I am acting resonably and completely fair considering the equal but opposite passions that we both have for this issue. Levine2112 21:58, 19 January 2006 (UTC)
thread_title:  Levine2112's reply 

message: Good catch! This guy works fast. I have written a warning on his User and Talk pages. -- Fyslee 22:49, 21 January 2006 (UTC)
thread_title:  removal of argumentative vandalism 

message: I beg to differ, and the following should show my reasons.....
Here is an expanded view with my suggestions and comments, just for this talk page.
The choice of support here is a real mixed bag. Much better quality research is needed here (and it exists for manipulation). It takes typical chiropractic thinking to accept some of these as valid at all. No one but chiropractors and their supporters would interpret them so positively, or even consider them as good research. For example, single case studies of idiosyncratic situations can't be used as proof of anything.
===== Scientific support for chiropractic =====
*Survey (not scientific) support for chiropractic popularity. In this case it could be interpreted negatively, since CAM therapies are generally without evidence of effectiveness. This says more about people's ignorance and gullibility.
:- According to a survey released in 2004 by the National Center for Complementary and Alternative Medicine, chiropractic was the fourth most commonly used complementary and alternative medicine therapy among adults in the United States (7.5%).,
*Improper confusion of chiropractic with manipulation, plus political POV conclusion in conflict with the judge's decision in the trial. She agreed that the AMA was justified in its skepticism and concern for the well-being of the public, but was forced to judge them for an illegal boycott. 
:- Chiropractic has gained general acceptance in the last 40 years as an appropriate treatment for certain back and neck problems.  This was partly a result of the prolonged litigation between the powerful American Medical Association (AMA) and various chiropractors over the legitimacy of the field (see Wilk v. American Medical Association). The AMA is politically opposed to chiropractic as a healing discipline and disputes the concept of subluxation.
*Scientific support for manipulation in acute (not chronic LBP or maintenance care), but not for the chiropractic profession (needs a reference).
:- According to Harrison's Principles of Internal Medicine, a meta-analysis of nine studies found spinal manipulation to be effective in improving uncomplicated, acute back pain. The studies found no benefit to treating chronic pain or sciatic nerve irritation.
*Presumably scientific support for manipulation, but not necessarily for chiropractic alone, since other professions can also provide manipulation  Needs references so we can see what it was compared to. For it to be a valid comparison, it needs to have compared it with comparable treatment methods.
:- However, more recent studies have found chiropractic to be cost effective in the treatment of chronic back pain.
*Study that blends manipulation results with chiropractic satisfaction, when compared to a totally different type of care, (apples and oranges problem) therefore hard to analyze the difference here. We could still try classifying it this way:
::*Scientific support for manipulation and for relative cost-effectiveness of chiropractic care
:::- A new study in the October 2005 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) 
:::- Chiropractic care appeared relatively cost-effective for the treatment of chronic LBP. Chiropractic and medical care performed comparably for acute patients. For chiropractic, clinically important differences in pain and disability improvement were found for chronic patients only. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulation efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.
*Poorly designed study, comparing manipulation with basically nothing comparable. It was a stacked deck. No other result could be expected. Doing something will always be better than nothing!
:- A 2002 investigation supports that spinal manipulation may benefit patients afflicted with asthma . 
*Single case study proves nothing, although interesting. In this one case, it could well be that constant pain caused abnormal behavior, that was incorrectly diagnosed as ADHD. So we have a false diagnosis, meaning that ADHD wasn't treated or cured, but it was a pain syndrome that was treated.
:- A 2004 study showed that spinal manipulation may benefit ADHD patients .
*These need to be analyzed individually, since this is a wastebasket including some questionable to absurd studies and single case histories. Erin Elster's study is one of the worst ever printed by the Journal for Vertebrally Subluxed Rxtxrds..... That has got to be one of the worst journals around. (The so-called "peers" are other subluxation-based chiros.) Even in chiropractic circles there are chiros who use it, along with Dynamic Chiropractic, to line their bird cages. Matt McCoy's way of putting "scientific" and "subluxation" in the same sentence is simply an expression of extremely conservative, but normative, chiropractic pseudoscience. It's an oxymoron.
:- Other recent case studies and research support chiropractic's claim to be effective with a range of conditions including Autism, Irritable Bowel Syndrome, Bell's Palsy, Glaucoma, Crohn's Disease, Colic, Ulcers and Parkinson's Disease.
I suggest that the section be purged and rebuilt more carefully. It should be there, but should be limited to manipulation. (But that should be in a "manipulation article.....) -- Fyslee 01:45, 22 January 2006 (UTC)
thread_title:  My analysis 

message: *Survey (not scientific) support for chiropractic popularity. In this case it could be interpreted negatively, since CAM therapies are generally without evidence of effectiveness. This says more about people's ignorance and gullibility.
:- According to a survey released in 2004 by the National Center for Complementary and Alternative Medicine, chiropractic was the fourth most commonly used complementary and alternative medicine therapy among adults in the United States (7.5%).,
*Improper confusion of chiropractic with manipulation, plus political POV conclusion in conflict with the judge's decision in the trial. She agreed that the AMA was justified in its skepticism and concern for the well-being of the public, but was forced to judge them for an illegal boycott. 
:- Chiropractic has gained general acceptance in the last 40 years as an appropriate treatment for certain back and neck problems.  This was partly a result of the prolonged litigation between the powerful American Medical Association (AMA) and various chiropractors over the legitimacy of the field (see Wilk v. American Medical Association). The AMA is politically opposed to chiropractic as a healing discipline and disputes the concept of subluxation.
*Scientific support for manipulation in acute (not chronic LBP or maintenance care), but not for the chiropractic profession (needs a reference).
:- According to Harrison's Principles of Internal Medicine, a meta-analysis of nine studies found spinal manipulation to be effective in improving uncomplicated, acute back pain. The studies found no benefit to treating chronic pain or sciatic nerve irritation.
*Presumably scientific support for manipulation, but not necessarily for chiropractic alone, since other professions can also provide manipulation  Needs references so we can see what it was compared to. For it to be a valid comparison, it needs to have compared it with comparable treatment methods.
:- However, more recent studies have found chiropractic to be cost effective in the treatment of chronic back pain.
*Study that blends manipulation results with chiropractic satisfaction, when compared to a totally different type of care, (apples and oranges problem) therefore hard to analyze the difference here. We could still try classifying it this way:
::*Scientific support for manipulation and for relative cost-effectiveness of chiropractic care
:::- A new study in the October 2005 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) 
:::- Chiropractic care appeared relatively cost-effective for the treatment of chronic LBP. Chiropractic and medical care performed comparably for acute patients. For chiropractic, clinically important differences in pain and disability improvement were found for chronic patients only. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulation efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.
*Poorly designed study, comparing manipulation with basically nothing comparable. It was a stacked deck. No other result could be expected. Doing something will always be better than nothing!
:- A 2002 investigation supports that spinal manipulation may benefit patients afflicted with asthma . 
*Single case study proves nothing, although interesting. In this one case, it could well be that constant pain caused abnormal behavior, that was incorrectly diagnosed as ADHD. So we have a false diagnosis, meaning that ADHD wasn't treated or cured, but it was a pain syndrome that was treated.
:- A 2004 study showed that spinal manipulation may benefit ADHD patients .
*These need to be analyzed individually, since this is a wastebasket including some questionable to absurd studies and single case histories. Erin Elster's study is one of the worst ever printed by the Journal for Vertebrally Subluxed Rxtxrds..... That has got to be one of the worst journals around. (The so-called "peers" are other subluxation-based chiros.) Even in chiropractic circles there are chiros who use it, along with Dynamic Chiropractic, to line their bird cages. Matt McCoy's way of putting "scientific" and "subluxation" in the same sentence is simply an expression of extremely conservative, but normative, chiropractic pseudoscience. It's an oxymoron.
:- Other recent case studies and research support chiropractic's claim to be effective with a range of conditions including Autism, Irritable Bowel Syndrome, Bell's Palsy, Glaucoma, Crohn's Disease, Colic, Ulcers and Parkinson's Disease.
I suggest that the section be purged and rebuilt more carefully. It should be there, but should be limited to manipulation. (But that should be in a "manipulation article.....) -- Fyslee 01:45, 22 January 2006 (UTC)
thread_title:  Scientific support for chiropractic 

message: This article seems to be very biased towards chiropractic care.  We're over 1000 words into the article before we are informed for the first time that "The use of manipulative therapy — especially as practiced by chiropractors — is regarded with controversy by medical authorities in many nations."
Then when we get to the part about the American Medical Association's position on chiropractic care we are told "Chiropractic has gained general acceptance in the last 40 years as an appropriate treatment for certain back and neck problems. This was partly a result of the prolonged litigation between the powerful American Medical Association (AMA) and various chiropractors over the legitimacy of the field (see Wilk v. American Medical Association). The AMA is politically opposed to chiropractic as a healing discipline and disputes the concept of subluxation."  
That whoever wrote this wanted to qualify AMA with the adjective "powerful" does not bely POV as much as saying the "AMA is politically opposed to chiropractic".  Politically opposed?  That doesn't make much sense to me - they are medically opposed to it, or at least, after the lawsuit, adverse to it.
I have no desire to make a statement that since the mainstream AMA, doctors with medical degrees and so forth, consider chiropractic care to be a quack medicine, that it is so.  But I do think this article does need to display more prominently and straightforwardly what the position of the AMA was and is on chiropractic care.  The view of chiropractors and their supporters can be represented as well, and the reader can decide.  But the AMA case presented here is buried deep in the article, and is not made well at all. Mr. Know-It-All 23:38, 26 January 2006 (UTC)
replies: text: I think adding that to the overview as you have done is all right. But the fact that there is an entire Criticism section, should also help balance out this article. Levine2112 03:21, 27 January 2006 (UTC)
thread_title:  POV in article 

message: 1. "Still, the safety of manipulation, ..."
:The very first word ("still") is a biased POV, that sets the stage for the rest, which is designed to undermine the intent of the whole section (safety concerns about possible risks) and downplay the known risks. It is therefore unnecessary and counterproductive to the paragraph and to the sentence itself.
2. "..., by all accounts in current literature, ..." 
:The next phrase - "by all accounts..." - is an absolute (never say "never"....;-) and broad (it couldn't be broader!) statement, without any documentation (impossible to list it all), and is in fact untrue as regards cervical manipulation, the object of the "safety concerns." If it is to be kept at all, one could substitute "many" for "all." One cannot really claim "all", when cervical manipulation has been shown to have rare, but very serious, risks. The phrase simply ignores all the literature dealing with the risks of cervical manipulation.
3. "..., appear to be superior to many non-steroidal anti-inflammatory drugs, ..."
:The rest of the sentence is a misleading apples and oranges comparison on several counts:
::*Many NSAIDs are self-administered for a myriad of conditions, many of which are not for problems comparable to those treated by chiropractors using spinal manipulation. (Okay, there are plenty of chiros who treat literally everything using "adjustments!") Therefore one cannot, in all fairness, compare the risks.
::*Self-administered treatments should not be compared with treatments very carefully and deliberately administered by a practitioner.
::*Since this section is about "safety concerns" involving cervical manipulation, the comparisons should be with methods used to treat the cervical spine, not all kinds of other things. (Ironically, the most (in number) serious chiropractic injuries I have actually seen in our clinic have been fractured lumbar vertebrae....! Of course the dead patients didn't come to me at all, but some strokes have been suspect....)
::*Chiropractors regularly manipulate the cervical spine for problems that have no relation to it. Thus these "adjustments" are a totally unnecessary risk factor, and therefore should not be compared with other procedures with even greater risks, where there can at least be some excuse for their use.
4. "..., and spinal surgical procedures."
::*To compare unnecessary and avoidable cervical "adjustments", often used for totally unrelated problems - or even when used for innocent neck problems - with complicated, risky and necessary "spinal surgical procedures," which are reserved for absolutely necessary and unavoidable situations, is one of the worst examples of typical chiropractic POV propaganda arguments around. One hears it all the time, and those who use it are either incredibly stupid, or are unethically and deliberately attempting to brainwash people. It violates a number of the rules of logic by making unfair comparisons ("apples and oranges"). The risks are extremely different, because the situations are totally different, so claiming that "the safety of manipulation, ......appear to be superior" is a bunch of crap.
::::I agree that the sentence is POV and could be reworked a bit. However, you can't call people "stupid" or "unethical" or accuse them of deliberatley brainwashing people. Your vitriolic attacks are uncalled for here. It is only your opinion that cervical adjustments are "unnecessary and avoidable". I happen to disagree and so do a lot of doctors, scientists and a large and growing portion of the general population. There is a lot of science out there that shows that chiropractic cervical adjustments are extrememly beneficial for more than just neck aches - but also for systems that you deem "completely unrelated" such as the immune, respitory, digestive and ciculatory. I know that there is also science that you point to that says just the opposite and cites the risks, but that doesn't excuse your use of opinionated, hate-inspired terms like "a bunch of crap". Please try to be more sensitive and rational when stating your case.
::::Furthermore, given chiropractic's strong anti-drug / anti-surgical stance, making comparisons to drug treatments and sugeory is completely warranted. Bear in mind, that generally chiropractors do believe that drugs and surgery are necessary at times; it's just that drugs and risky surgeory are massively over-prescribed. Chiropractors opt for more natural, less invasive routes to help their patients heal and help prevent futher illness. However, chiropractors are certainly aware of their own limitations and therefore it is of no surprise that chiropractors quite commonly have one of the highest referral rates of any health practitioners. Levine2112 18:41, 27 January 2006 (UTC)
thread_title:  Sentence 1 

message: Simply drop those two sentences. They are inaccurate and don't apply, plus their only purpose is a strongly biased POV attempt to downplay the risks by making invalid comparisons. This is a typical chiropractic attempt to distract attention from the issue at hand. The fact that the risks are "rare" is mentioned twice should be enough to place things in their proper perspective. -- Fyslee 07:33, 27 January 2006 (UTC)
thread_title:  Suggested improvements 

message: What is this section about anyhow? The usage of chiropractic in what respect? The text that is there doesn't really provide a clear answer. Should that section just be deleted? Levine2112 03:54, 17 February 2006 (UTC)
replies: text: I say merge the first paragraph into history, and the last two paragraphs into scientific support (it explains how joint manipulation works). --CDN99 13:03, 17 February 2006 (UTC)
replies: text: I don't see any history in the first paragraph that isn't already mentioned and the rest is about the popping sound bones make occasionally during an adjustment. Doesn't seem all that important here. I'm just going to remove the section... maybe preserve a line or two. Levine2112 00:12, 19 February 2006 (UTC)
thread_title: Usage section

message: The section entitled "Philosophy of the subluxation" states: "Both chiropractic and medical care hold that much of the body is controlled by messages sent to and from the brain along the nervous system. It is generally agreed that most messages - whether it is the brain commanding the foot to move or an organ telling the brain it is in need of repair - pass through the spinal cord, which acts as a kind of cerebral router." Given that the brain IS part of the nervous system and that "messages" is a bit ambiguous when talking about biology or physiology, the first sentence should read: "Both chiropractic and medical care hold that much of the body is controlled by nerve impulses sent to and from the brain along the spinal cord." AED 00:22, 21 February 2006 (UTC)
thread_title: Section entitled "Philosophy of the subluxation"

message: Previously the "scientific evidence" section contained the following with a "citation needed" marker.
"According to Harrison's Principles of Internal Medicine, a meta-analysis of nine studies found spinal manipulation to be effective in improving uncomplicated, acute back pain. The studies found no benefit to treating chronic pain or sciatic nerve irritation. However, more recent studies have found chiropractic to be cost effective in the treatment of chronic back pain"
I dragged out our copy of the 14th Edition and the index doesn't mention Chiropractic at all.  So trucking out to the online 16th Edition.  There is only one mention of the term 'Chiropractic' in Chapter 10 - essentially a miro-history, no mention of this analysis.  Searching on "spinal manipulation" brings back an article on Osteopathic Spinal Manipulation vs. Standard Care for Low Back Pain in Chapter 15 but the conclusion was "There were not statistically significant differences between the two groups for any of the outcome measures.".  So certianly not a meta-analysis and hardly supportive.
Searching on 'chiropractor' gets four hits one is the Osteopathic study, one in the history in Chapter 10, one is a study entitled "Lack of Efficacy of Spinal Manipulation for Tension-Type Headache" probably not supportive but I will read it later and add it to the criticism part if necessary and another hit in Ch 15 marked 'Further reading' which cites a number of studies, some of which may be useful.
So I have removed this citation.  Until someone provides a cite from the proper source - and I will be checking ;-) it should remain that way.
24.141.146.87Jonathan Graham
===NPOV===
:"However, chiropractic care is not always synonymous with manipulation. Not all chiropractors even manipulate, and a manipulation still remains safer than the best surgical intervention."
The first part that chriopractic isn't always synonymous with manipulation is needless in a paragraph discussing the safety of manipulation.  It belongs closer to "The primary therapeutic technique used by chiropractors is joint manipulation"
The last part is biased.  It doesn't limit it's scope (if you're going to say that something is safer in every and all cases then you better present evidence for every and all cases).  It doesn't provide a cite supporting the position and it uses 'sales talk' instead of science.  Instead of saying (and providing a study) that says where and when the manipulation is better it uses non-specific words like 'best'. Jonathan Graham 20:18, 24 February 2006 
::I noticed that, but hadn't gotten around to doing anything about it. It's a very careless comment from someone who doesn't seem to know much about the subject matter, and who wrote off-topic. In the context (safety concerns about cervical manipulation) the comment was irrelevant, inaccurate, and an apples and oranges comparison with a twist of straw man on the side. -- Fyslee 21:31, 24 February 2006 (UTC)
thread_title: Removed Citation for Harrisons Internal Medicine

message: :"However, chiropractic care is not always synonymous with manipulation. Not all chiropractors even manipulate, and a manipulation still remains safer than the best surgical intervention."
The first part that chriopractic isn't always synonymous with manipulation is needless in a paragraph discussing the safety of manipulation.  It belongs closer to "The primary therapeutic technique used by chiropractors is joint manipulation"
The last part is biased.  It doesn't limit it's scope (if you're going to say that something is safer in every and all cases then you better present evidence for every and all cases).  It doesn't provide a cite supporting the position and it uses 'sales talk' instead of science.  Instead of saying (and providing a study) that says where and when the manipulation is better it uses non-specific words like 'best'. Jonathan Graham 20:18, 24 February 2006 
::I noticed that, but hadn't gotten around to doing anything about it. It's a very careless comment from someone who doesn't seem to know much about the subject matter, and who wrote off-topic. In the context (safety concerns about cervical manipulation) the comment was irrelevant, inaccurate, and an apples and oranges comparison with a twist of straw man on the side. -- Fyslee 21:31, 24 February 2006 (UTC)
thread_title: NPOV

message: I have added a Disputed tag to the article, as the previous tag did not reflect the actual facts of the matter. The long history of these discussions should make it clear why such a tag is necessary. -- Fyslee 11:41, 25 February 2006 (UTC)
thread_title: Disputed tag

message: I have long considered this to possibly be the only option to resolve many of these disputes.
Let's discuss the possibilities of splitting the article. -- Fyslee 11:41, 25 February 2006 (UTC)
thread_title: Article splitting

message: :Well, I really don’t know much about “organization” NACM, particularly since they aren’t very forthcoming with just WHO is in their membership rolls and HOW MANY DCs are actually members.  Who are its officers?  Have they ever changed?  When do they nominate new ones?  Do they have elections like a proper organization should?  Do they sponsor seminars like the ACA and ICA?  It seems the ACA and ICA all have this information readily available.  Do you have ‘special’ knowledge about this ‘group’?  Yes?  Then please answer the above questions so we can find out if this is a legitimate organization?
:You said:
::“Keep in mind that there are far more reform chiropractors outside of the NACM than in it…”.  
:So it looks like we agree on this point, so what’s the problem?  Why recognize an organization that’s not any sort of an organization?   A link at the bottom of the article is more than generous in an encyclopedia.  They shouldn’t even be acknowledged here at all, and may not be in the future.
:You said:
::“NACM members claim to receive mainstream approval more so than practitioners of straight or mixing chiropractic.”  And pharaohs claimed to receive their power from the gods.  Who cares what nameless members “claim” to receive.  Do you have anything better than sales jargon?
:Qualifiers: "some," "minority," "claim," "guess,", etc.  are sales talk more than anything else and attempt to proclaim headlines out of weasle words.  Very non-specific as Jonathan stated in a previous post.
:I also feel that there are enough links to sites that you participate in or are connected with and you shouldn’t keep placing them in there at your whim.  This particularly holds true of sites owned and privately operated by former psychiatrist Stephen Barrett with whom you quote with regularity.
:In my opinion, you are claiming expertise in an area OUTSIDE of your area of expertise, adding a PTPOV (physical therpist’s point-of-view) to this, not an NPOV, hindering all of our efforts at creating a NPOV article for readers. Steth 12:50, 25 February 2006 (UTC)
thread_title: Steth's reply