Speaking of quackery. This is fearmongering of the lowest sort.
All medical care has possible complications.
Why not?
You didn’t read the article, did you?
Yes I did. 1.3 out of 100,000 people is probably less than the statistic for how many people become suicidal after taking Zoloft. And that’s the most extreme statistic in that whole article from the Canadian study. The German study said that this was a lot more common from manipulations done by people who were not chiropractors. There are a whole lot of assumptions here.
The dangers of taking anti-depressants.
Next up: acupuncture!
When do we get to the people who think that all alternative medicines are precisely equivalent? Do we get to take a shot at those people at any time? The people who like to dismiss stuff because Penn and Teller told them to?
They’ll be way down on the list of people who believe goofy shit like this.
The difference is that responsible medicine has benefits to offset the possible complications. Neck-cracking for deafness does not.
Regards,
Shodan
Are you really in some kind of argument with the 19th century when that was current or what?
I am quite well-versed in the actions of actin and myosin, thank you. Also how calcium ions help regulate muscle contraction too.
However, that’s a far cry from your equating actin-myosin fiber contraction with muscle spasm, which is a whole different phenomenon, frankly. Same for the so-called “calcium deposits”. Your cite talks about the importance of calcium ions, and says nothing about any such deposits.
In fact, the best theory of ‘muscle knots’ implies that it is cross-linking of the actin and myosin fibers with neighboring strands of muscle instead of the fiber next in the length of the chain. Rather like a knot in a long tress of hair. Fibers get cross-linked, and normal contraction is thus painful.
Since it is normal contraction and not spasm, they they don’t respond to muscle relaxers, nor do they respond well to injections with steroids. Local injections with lidocaine help relieve pain for a few hours, but not for much longer than that. Local massage seems to break up some of the cross-links temporarily, but they tend to reform. Local nerves remodel after sending pain signals repeatedly over time, and then tend to send pain signals in response to any stimulus. This plays a big role in myofascial pain syndrome, too. I see these patients regularly, I treat them, I keep up with the legitimate literature. Stretching and exercise is a big role in that treatment, as are forms of physical therapy, including therapy provided by some of the more rational DCs.
So in short, none of your cites say what you seem to think they say, nor are they in conflict with what I’ve said about muscle knots.
And you must run with a different bunch of chiros, then. I had a good friend who was a scientific chiropractor, and he was at constant war with 90% of other DCs due to his emphasis on scientific method being applied to manipulation, and his refusal to blame all symptoms and diseases on ‘subluxation’. He was my preferred consultant for many of my chronic muscle pain patients, as his skills were equal to or exceeded that of most physical therapists available to my patients.
Here’s a very handy guide for those practitioners treating muscle knots, myofascial pain syndrome, and fibromyalgia: Treatment of Fibromyalgia.
Note the illustration on page 496, labeled B. You can see regions of contraction in a fiber with its effect illustrated on adjacent fibers. The text expands on the theory of such tangled and contracted areas being aggravated by resultant ischemia.
Also note that actual muscle spasm has a minor to non-existent role in the overall picture of myofascial pain.
Well thank you for providing some info on knots.
The point I was making is that calcium deposits might be wrong, but it’s not ‘quackery’, it’s just a plausible theory that happens to be wrong. If you’re a Doctor, I certainly would believe you to know more about it than I would.
It’s the pithy dismissal with nothing to back it up shit that bugs me.
One of my best friends is a chiropractor. He doesn’t go to ‘war’ with other chiros so much but his manner is from the scientific viewpoint. I’ve heard him talk about subluxations when talking about the original theory of chiropractic, but generally how he approaches it is from a more scientific standpoint. I think that where there is quackery it’s important to point out the non-quacks.
Do you think the work on Trigger Point therapy that Travell and Simons did is still current? Has it become outdated?
When I was trained in massage school basically the way to work out knots was simply through finger pressure techniques, and it was generally regarded not as something you could immediately solve, but something that could be allayed over time. The actin and myosin getting ‘stuck’ thing that you describe is more or less the way I was taught it minus claiming poor circulation of calcium locally as the etiology.
The article linked to above is from 1992.
ETA: I was involved in a thread a few years ago on the E-budo boards about chiropractic where some of the spine crackers were claiming to treat vision and hearing problems with spinal manipulation.
Regards,
Shodan
I meant “next up for impassioned and opinionated argument”. I keep forgetting to use smiley faces for the humor-impaired.
Ahh well I’ve heard of that but never experienced it personally in my interactions with chiros. I had one guy claim that a food allergy caused my poor posture. Other than that, that’s about as Woo as it got.
Chiropractic supposedly started when a guy cracked a deaf guy’s back and he suddenly heard again. Doesn’t make any sense as the sense of hearing doesn’t go through the spine, but whatever.
The only vision things I’ve heard of is not correcting vision, but correcting posture by some sort of method of eye movement exercises, focusing on things and such. This though was something he was checking into and sounded interesting not, “I believe this to be the gospel truth.”, but as I hear that vision problems can affect one’s posture it doesn’t seem completely baseless. Like I’ve heard people with poor depth perception have a tendency to slouch.
Not necessarily. In the US and some other countries it could also mean a DO (http://en.wikipedia.org/wiki/Doctor_of_Osteopathic_Medicine).
Qtm said (paraphrased):
“QtM, who once shared an office with a self-described “scientific chiropractor” who gave me the inside scoop on D. D. Palmer’s little program. (An) Office-mate was very good at cracking my neck. It felt wonderful, and was more pleasant than popping ibuprofen, but the effects were always temporary.”
I worked as an administrator (continuing education) at Cleveland Chiropractor College in LA.for a few years.
The requirements for students were quite rigid, ending with a Doctor’s Degree (DC) in California at a cost (then) of about $80.000. (Then: 1997)
This is physical therapy. Massages, concern for the patient, more massages. Not once anyone, student or instructor, could tell me exactly, in scientific terms, what a “Subluxation of the Spine” is. Because there is no such thing, and this is what Chiropractic is based upon.
Most of the students were caring, intelligent people, who wanted to help others, as I’m sure they did after graduation. Just don’t let them stick a needle in you.
I was going to add my views on going to a chiropractor, but Qadgop has said it very well.
As for neck cracking/manipulation, the bottom line here according to neurologists and other practitioners of evidence based medicine, is that the purported benefits of neck cracking do not justify even the small associated risk of neck artery tears that cause strokes. When strokes occur in younger people (i.e. under age 45), cervical arterial dissections are a common cause, and it’s especially tragic when someone is disabled permanently or killed because a chiropractor cracked their neck. This type of injury is also likely underreported, as people can have vague or delayed symptoms and never connect their stroke with previous chiropractic manipulation.
If it wasn’t for the neck injury problem and the continued association of many chiros with quack modalities and attempts to treat internal medical problems, I’d say that seeing one in general was as acceptable as being treated by a physical therapist or massage specialist. But chiropractic still carries too much negative baggage for me to recommend it.
Travell and Simons advocate passive stretching of the affected muscle after application of sprayed coolant to be the “single most effective treatment” for trigger point pain. This surely has not become outdated, and remains crucial to treatment of myofascial pain and trigger points/knots.
Many other hypotheses have come to the fore since they last updated their book, but their description of where the trigger points are often found, where they tend to cause pain, and the most important ways of dealing with them haven’t changed much. Yet.
I still prefer a good trigger point massage for acute relief of my very significant muscle knots in the upper back. It hurts so good, and relieves the symptoms for a while. But my massage therapist and I both know she’ll never rid me of them. Nor do hers ever fully resolve, despite the fact that her massage therapist husband works on them regularly.
And if the chiros in your area are moving away from their ‘science’ and using manipulation to treat dysfunction of the spine and shoulders, more power to them. Those types were rarities in my area of the Midwest (where D. D. Palmer’s influence is still strong). The professional journals of the DCs are still laden with articles talking about subluxations, obstruction of nerve impulses, and treatment of all diseases via the “miracle of manipulation”.