Tuesday, October 10, 2017

Why Your Medical Doctor Loves your Chiropractic Doctor

To some, this title, may sound inconsistent with stories they hear. Myself coming from a family that was not Chiropractically-aligned, I find this title not so much "provocative" as it is actually "true." This context of thought comes with 16 years of practice experience, literally coming from a childhood  instilled with  thinking that Chiropractors were quacks, etc, to being the Primary Health Care Provider for many of my patients as a Chiropractic Doctor.

Since Chiropractic's inception in 1895, there have been periods divisiveness between Medical and Chiropractic perspectives, however not initially as much as many may think as there was actually a good amount of collaborative care with patients as Medical and Chiropractic natural treatment methods and philosophies were initially similar, excepting Adjustive ( Manipulative) therapy of the spine. Chiropractors were cutting edge in the early 1900s with X-ray, respirometery, and more as these new sciences developed. Also, it is a little known fact that "Homeopathic Medical Doctors" used to be very prevalent in the US, which caused in-fighting as 2 factions of Medical Doctors took sides as naturalists or pharmacologists in a sense. As time moved forward and the Medical model approached more of a purely pharmacological model, there came to pass a period from the early 1900's through the 1960's primarily, that the face of Healthcare went through tumultuous changes. Many "variant" (non-pharmacological) forms of healthcare were attacked in an interest to unify Medical care in general. Chiropractors, Homeopaths, Osteopaths, etc were persecuted as "unscientific" and for practicing "medical treatments" with out the proper education or licensing. Over the years, many Osteopaths as well as Homeopaths often got absorbed into the typical Medical practices we see today.

Without getting further into the depths of the "history" of healthcare, how can I make the statement that Medical Doctors love Chiropractic Doctors? Certainly there are many "opinions," so taking on the subject from this perspective is dauntless at best, especially when dealing with so many opinions, often having no technical experience with a subject, creating an in-valid/ non-experienced "perspective" alone. However, when taking into consideration the number of Medical Doctors over the years that have taken pause to understand and evaluate the knowledge base, training and scope of Chiropractic practice, there appears a well-documented favoring. When it comes to the neurophysiologic/ neuropathologic/ neuroplastic basis of the body's functions and the Chiropractic model, we find that with ever-growing volumes of data, that there is overwhelming evidence for "how" Chiropractic works. Essentially, our scientific understanding of the body has come far enough to better understand Chiropractic effects, whereas in the early stages, the science was scant, but it was known to "work." The problem therein lying in any-thing that is known to "work," however without the exact depth of then-current scientific understanding to better explain its dynamic function. Again, this was a problem decades ago, however especially from the realm of MD neurophysiologists, the Medical world at large is gaining a much better grasp of the "why" behind Chiropractic success.

I have personally met a number of neurophysiologists over the years, starting in my Palmer education, that were highly supportive of the Chiropractic Method, and this has always come down to the fact that these specialists deeply understand the nervous system in a way that few others do. These specialists understand the finite workings of the nervous system and how the Chiropractic Adjustment stimulates the intersegmental joint complex, recurrent meningeal nerve pathways, spino-cerebellar pathways, somato-viscero pathways, viscero-somatic pathways, afferent and efferent pathways, proprioceptive input and cortical processing, and much more that have a balanced functional effect on nervous system input and output that create the physiologic/mental/emotional experience of the individual.

In the end, my assertion as to why the Medical community at large over time has come to find a current place of mutual respect, referral, learning and co-care with the Chiropractic community, is in fact based on scientific study and observation. The research performed within the Medical community itself supports and validates the effects of  Chiropractic Care and Treatment. Moreover, there are numerous MD's that are staunch supporters of Chiropractic, such as Joseph Mercola, DO, Jack Wolfson, DO, Andrew Weil, MD, to name only a few. The Following portion of this particular BLOG is a list of articles and research that supports the viewpoint I am asserting. This is done in order to "cite" sources to these claims. All cited references may be largely sourced through PubMed itself or other Medical reference sites via the copy and past method.
As always, we welcome any and all questions and commentary of a positive and constructive nature, therefore please do not hesitate to contact us.
* Disclaimer 1: In healthcare, there are many fields and these may be likened to "tools." whereby different tools are appropriate for different situations. In no way is this piece designed to make the reader feel as though Chiropractic is always the most appropriate course of action. One must always consult appropriate healthcare professionals to determine their best options for treatment and thereby make the best choice for themselves as an individual.
* Disclaimer 2: Within the field of Chiropractic alone, there are literally hundreds of "techniques" and treatment modalities. The research presented has largely been performed via the "biomechanical" treatment methods within Chiropractic. This DOES NOT construe these particular methods to be the only effective methods of treatment and effective patient care. Different methods of Chiropractic treatment are effective for different patients and their personal situation, making many effective  models and no one-size fits all model.
* (~) = my terminology and interpretation given.

Reference Citations: (Basic synopsis in parentheses ( ) )
1.Manga et al. The Manga Report 1993 An Independent Report Commissioned by the Ontario        
   Provincial Government ( Canadian Government Supporting Chiropractic Method/Findings)

2.Risk of Carotid Stroke after Chiropractic Care: A Population Based Study. Journal of Stroke  
   Cerebrovascular Dis. 2017 Apr; 26(4): 842-850. National Stroke Association (No greater risk of  
   Carotid Artery stroke after Chiropractic care than Medical care)

3.Early predictors of lumbar spine surgery after occupational back injury: prospective study of  
   workers in Washington State. Spine 2013 May15;38(11):953-64 (42.7% of workers seeing a   
   Surgeon first had surgery compared to only 1.5% who saw a Chiropractor first prior to surgical    
   consult)

4.Alterations in Cortical and cerebellar motor processing in subclinical neck pain following spinal
  manipulation. Journal of Manipulative Physiol Ther. 2013 Oct;36(8):527-37 (Improvement in       
  cerebellar task performance with 19% decrease mean reaction time in spinal manipulation  
  (~Adjustment)  groups)

5.Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in  
   Chronic Pain Patients.Journal of Manipulative Physiol Ther. 2017 Mar - Apr;40(3):127-138
   (Chiropractic care improving function and decreasing Pain in chronic Pain sufferers via reduction      of somatosensory evoked potentials)

6.British Medical Journal June 1990 p.1431-37
   Canadian Family Physician 1985 ; 31: 535-40
   (Chiropractic Treatment was more effective for low back pain (LBP) than care offered by Medical  
     clinics)

7.The spine as the Causative factor of Disease. Fundamentals of Chiropractic From the Standpoint of
    a Medical Doctor, copyright for the English Language 1959. Friedmut Biedermann, MD
   (Subluxation and Malposition of the vertebrae, and straightening of physiological curves can result 
    in disturbance in function of the gall bladder, kidney, bladder, sex organs, etc.)

8.~Multiple Citations here on Visceral (Organ) reflexes and function~
  A)Neurol Clin 1999;17:91-111.
  B)J Manipulative Physiol Ther 2003;26:108-15
  C)Neville Usher, MD, FACP, “The Visceral Spinal Syndrome a New Concept of Visceral Motor  

      and Sensory Changes in Relation to Deranged Spinal Structures.”
  D)Lewitt MD, Dsc “Manipulative Therapy in rehabilitation of the Locomotor System” (1985)    
  E)Butterworth and Company London and Boston. P. 261-62.
  F)H. Kamieth, “Pathogenic Importance of the Thoracic Portion of the Vertebral Spine,” Journal of 
     the   Am Med Assoc (Nov. 15, 1958), p.1586.
  (Multiple sources citing cases whereby symptoms of appendicitis, gallbladder disease, and other       
  viscera (~organs) were relieved by correction of spinal curvature, associated myositis, and by  
  mechanical correction of posture at the level of the articular facet (~ misalignment/subluxation))

9.The Epidemiology of Low Back Pain in and Adolescent Population. Olson, TL, Anderson RL, et
  al. 1992 American Journal of Public Health
  (In Study of 108 students, 88% had SI dysfunction which further confirms the relationship of SI  
  dysfunction and LBP. There is a common clinical experience of obtaining symptomatic relief by SI
  manipulation (~ Adjustment).)

10.First Interdisciplinary World Congress on Low Back Pain. The Chiropractic Report: Smith,
   Editor,JAN 93, Vol 7 #8 ("We have come to realize that every paient with low back pain also has  
  significant mechanical dysfunction in the cervical and thoracic spine." Joseph Shaw, MD. 
  - significant to the idea of "Full Spine" Chiropractic Care when appropriate.)

11.Menstruation Pain and Sterility
   Butterworth and Company London and Boston. Manipulative Therapy in Rehabilitation of the
   Locomotor System 1985, p263.(Over 75% of women in study having diminished menstrual pain  
   symptoms and favorable results with non-organic infertility issues with manipulative (~Adjustive)
   therapy particularly to pelvic and coccygeal regions.)

12.The effect of sacroiliac joint manipulation on feed-forward activation times of the deep abdominal    musculature.  Marshall P, Murphy B.J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):196-
   202. (Sacro-iliac adjustments improve function and timing of core musculature) 

13.Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation. 
   Yang, Lee & Kim Journal of Phys Ther Sci 2015, 27:795-798. Palmgren et al. JMPT, 2006:29
  (100-106) (Spinal adjusting has been shown to positively influence proprioception function and
  Pain)

14.~ 3 Citations regarding how Chiropractic Adjustments positively change brain control~
   A)Modulation of the flexion-relaxation response by spinal manipulative therapy: a control group
   study. Lalanne, Ufond & Descarreaux JMPT,2009:32 (203-209).
   B)Eduardo et al. Manual Therapy,2010 15(5):469-475.
   C)Murphy, Haavik, Taylor & Marshall JMPT,2010:33(3);168-177
   (All 3 citations show that spinal adjustments positively change the way that the brain controls neck 
   low back musculature)

15. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk
   in Older People: A Randomized Controlled Trial. JMPT 2016 May;39(4):267-78 (Spinal adjusting 
   helps diminish fall risk in the elderly by improving sensory-motor function)

16.RF Gorman DO, (Franz vonKurkel) “Chiropractic for Rejuvenation of the Mind.” Academy of
   Chiropractic Medicine (8 Budgen Street, Darwin Australia 1983).
  “It is not surprising that 
   Chiropractic manipulation lifts depression. It is possible that chiropractic 
   maneuvers will become an important tool in psychiatric treatment.” –  ( Chiropractic care shown
    to help in Depression Disorder)

17.Life Toronto Star: Life section, Peter Rothbart, MD December 28, 1995. "It appears that 
  Chiropractors have been right all along. A team of doctors and Syracuse University have  
  established  with scientific, anatomical proof, that damaged structures in the neck (subluxations) are   the cause of many chronic headaches." (Chiropractic Subluxations can often be the cause of chronic 
  headaches)

18.Australian Case Study :
   “Spinal manipulation was determined for visual disorders by four
   opthamologists independent of the other. Patients were examined before and after manipulative
   treatment. In all cases, the vision improved (in either visual field and/or visual acuity).” – R.F.  
   Gorman DO. “An Observers View of the Treatment of Visual Perception Deficit By Spinal 
   Manipulation.” A Survey of 16 Patients. Sydney, Australia. 1991.(Chiropractic Adjustments 
   appeared to help vision in all individuals)

19.Cranial Trauma and Head Joints (German Medical Weekly), 80, 1503 - G. Guttman, MD
   Many discomforts subsequent to head trauma remain latent for a considerable length of time and 
   were unexplainable until now. They are due to subluxations of atlas and axis. They consist of 
   muscular reflectoric, radicular and sympathetic N.S. symptoms. Chiropractic treatment aimed at 
   realigning cervical vertebrae is the recommended course of action and can relieve all symptoms   
   completely. – G. Gutmann MD, (1955) (Upper cervical Chiropractic shown to be beneficial in 
   cases of head trauma and Neurological symptoms)

20.East Germany Case Study: 
  “In 1970, Vitek showed that these symptoms were linked to the upper cervical spine and not 
   vascular disease. Manual therapy (spinal adjustments) proved successful in 77% of cases.” –  
   "Manual Therapy in Internal Medicine” E.G. Metz @ Bezirkskrankenhaus Postdam, (Formerly 
  East) Germany, 1976. ( Heart Symptoms can be related to Upper Cervical Subluxation)

21.“EMG evidence shows it is clear that manipulation of the upper cervical joints affects overall 
  body  posture” – “Influencing Postural Reflexes by Way of Joints” G. Gutmann MD and Vele, F. 
  (1971) Neurological Clinic of Karlsuniversitat in Prague Zeitschrift fur Physiotherapy 5, 71.
  (EMG study showing that Chiropractic Adjustments directly affect postural musculature)

22.Infantile Head Joint Blckage. Seifert, 1: 1975. Functional Pathology of the Motor System 
   Rehabilitation Suppl. 10-11, p 53. Eds, Lewitt, K. and Guttmann, G Braitslava, Obzor
   (Likely link to birth trauma and upper cervical (C1, C2) blockage)

23. Beal; Myron C, FAAO, July 1983, Journal of AOA, Vol  82 (11), 822/23.
  “The selected findings, muscle tension over the tip of the transverse process and reduction of 
  costovertebral (cardiac) motion in the left upper thoracic region, were accurate in indicating the 
  presence of cardiac or gastrointestinal disease in 76% of cases.” – Beal; Myron C, FAAO, July 1983,
  Journal of AOA, Vol  82 (11), 822/23. (Chiropractic Subluxation in the left upper thoracic Spine 
  has been seen to be consistent with cardiac and GI diseases.)

24.Osteochondrosis of the Cervical Spine and Coronary Infarction. Bruckmann, W. (1956) German 
  Medical Weekly, 81, 1740. “Degenerative disease affecting bone and cartilage of the cervical spine 
  and coronary infarction. Various extensions and mobilization techniques for the cervical spine 
  seems to bear proof of the alleged correction, when they result in prompt elimination of cardiac 
  pain.” (Chiropractic care shown to be beneficial in Heart Pain)

25.Manual Therapy in Internal Medicine. E.G. Metz @ Bezirkskrankenhaus Postdam,
  (Formerly East) Germany, 1976.“According to studies by Rychlikova, Schwartz, and Metz a
  comparison of EKG’s taken before and after manual therapy shows telesystolic changes as well as
  cured heart rhythm disorders.” 
  (Chiropractic Care shown to help with arrhythmia disorders of heart)

26.W. Kunert, 1965 Functional Disorders of Internal Organs Due to Vertebral Lesions, CIBA 
   Symposium 13 (3): 85-96 “Records of numerous cases including myocardial ischemia showed 
  lesions of the spinal column are perfectly capable of simulating, accentuating, or making a major
  contribution to (organic) disorders.There can in fact, be no doubt that the state of the spinal column  
  does have a bearing on the functional status of the internal organs.” (somato-viscero responses;
  Spine issues can and do cause neurologic and therefore organ system issues)

27. Manual Medicine 16:95. F. Becker, MD. 1978 “A Discussion of Dizziness Symptoms with a
  Focus on Manual Therapy Viewpoint.”Vertigo (dizziness) can come from dysfunction of the spinal 
  column. He reports the success of manual therapy (spinal adjustments) in treating vertigo.” 
  ( Chiropractic Care shown to be beneficial in correcting some causes for Vertigo)

28.Manual Therapy In Internal Medicine,  E.G. Metz @ Bezirkskrankenhaus Postdam, (Formerly 
  East) Germany, 1976.
  Patients with peripheral circulatory hypotension and a tendency for asthenia and postural disorders   
  are grouped under the category of vasomotor headaches. Based on our experience I would say that 
  over half of these patients can be helped instantly and lastingly with the means of manual therapy 
  (spinal adjustments). (Chiropractic Care shown to be beneficial in over 50% of Vascular-oriented
  Headaches)

29.Comparative analysis of individuals with and without Chiropractic coverage: patient 
  Characteristics, utilization, and costs. Archives of Internal Medicine, 2004 Oct 11; 164(18):1985-92
  ( Access to Chiropractic Managed Care shown to reduce Health Care Costs and use of Invasive 
  procedures)

30.Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked potential
  study.Clin Neurophysiol. 2007 Feb;118(2):391-402. Epub 2006 Nov 29- Haavik-Taylor et al.
  (Chiropractic neck adjustment seem to alter brain sensory integration, perhaps explaining reduction
  of pain and restoration of function.)

31.Cerebral metabolic changes in men after chiropractic spinal manipulation for neck pain. Altern
  Ther Health Med. 2011 Nov-Dec;17(6):12-7 -Ogura T1, Tashiro M, et al. (Chiropractic
  Adjustments affect regional cerebral glucose metabolism related to sympathetic relaxation and pain
  reduction.)

32.Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain
  intensity in patients with nontraumatic chronic neck pain. J Manipulative Physiol Ther. 2006 Feb;29
  (2):100-6 -Palmgren PJ1, Sandström PJ, et al. (Chiropractic Care has been show to alter chronic 
  neck pain by altering proprioceptive (sensory) input from the neck to the brain.)

33.Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in
  better long-term outcome? Spine (Phila Pa 1976). 2011 Aug 15;36(18):1427-37- Senna MK1
  Machaly ,SA. (Chiropractic Adjustive care is effective for the treatment of chronic nonspecific
  LBP,  also that long-term benefits are attainable with "maintenance care.")  



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