Friday, August 04, 2006

CHIROPRACTIC MEDICINE

FYI, "doctors" of chiropractic medicine are not doctors, at least not the kind of doctor that works in a hospital or medical clinic. Chiropractors are not like your family physician, orthopaedic surgeon, neurosurgeon, or emergency doctor. These are all MDs (medical doctors). Chiropractors are simply "doctors of chiropractic medicine", just like some physical therapists are "doctors of physical therapy". Basically, these days anyone can label themselves a "doctor" if they go to some sort of school after college. So in actuality, the term doctor now references many professionals, from doctor of philosophy (PhD) to doctor of junk (JD).

To become a chiropractor one must attend 4 years of school from 1 of 16 chiropractic colleges accredited by the Council of Chiropractic Education (CCE). When finished, they must pass a board exam and aquire state licensure in order to practice legally. Chiropractic's original focus seemed to be on back pain, neck pain, and a thing called malallignment. These days, there are actually chiropractors out there who believe that chiropractic care is the only care and that people should obtain all their medical care from chiropractors. I won't waste time in saying that these people are complete idiots.

To become a medical doctor one must attend 4 years of medical school and pass a series of 3 national board exams. After medical school, they are technically MDs; however, are unable to go practice medicine right away. Instead, MDs who just graduated medical shool must now attend residency. Residency is where a physician learns thier selected specialty. Residencies, such as Family Medicine, Pediatrics, and Emergency Medicine are 3 years long, while surgical specialties last from 5-7 years after medical shool. Plus, after residency, they now have to pass another board exam, sometimes a written and oral exam. So, by the time a medical doctor enters the community and starts practicing medicine, that person has gone through at least 7 years of medical training.

Here's the real difference between the two. In 4 long years of medical school, students learn a lot, but not nearly enough to practice medicine on their own. It is their time in residency that truly makes them a doctor. It is the daily act of seeing patients, learning how to elicit a good history from those patients, think about a differential diagnosis for what may be the problem, and formulate a plan to diagnose the problem. All this is done under the direct supervision of an attending physician, or mentor MD.

A few thoughts:
- In no way can a chiropractor come out of 4 years of school, start working in the community, and be prepared for what may walk through their doors. So many things can cause back pain (some deadly), which I highly doubt they know anything about, i.e. kidney stones, urinary infections, ectopic pregnancy (deadly), ovarian cysts, pancreatitis, numerous forms of cancer (deadly), aortic aneurysms (deadly), ischemic bowel (deadly), aortic dissections (deadly), autoimmune disorders, fractures, trauma, spinal stenosis, ruptured spinal disc, and the list goes on and on. And I didn't even go into things causing neck pain! All of these potentially dangerous conditions can present with simple back pain. A bit scary huh? In no way should anyone with any of these problems go to a chiropractor for help. If a chiropractor says they can treat and fix any of these problems, walk away, because that chiropractor is now more deadly than any disorder I just mentioned.

- I support chiropractic medicine...for those patients with chronic back or neck pain that have not found any relief by medical means. Truthfully, if you have pain and no specific medical diagnosis was found to be causing such pain, chiropractics is for you. Many patients, from fibromyalgia to cancer, have chronic pain. I support any means to help these people, whether it's a chiropractor, masseuse, or accupunturist. But, the big bad medical causes of such pain should be sought FIRST. Once the bad is ruled out, you can then relax and try finding better means to deal with it.

- I think that any MD who says there is no place for chiropractic care in our society is wrong. The reverse of this is also true and potentially deadly.

- Many people seek medical care and are diagnosed, treated, and do not have to deal with that particular problem again secondary to medication, therapy, or surgery. Yes, the medical bills are expensive (a whole other topic of frustration), but the problem is solved. Now, who knows anyone that has visited a chiropractor and never had to go back for continuing care? It doesn't happen. That's the trick, the visit doesn't cost that much, so you keep coming back for more because they really never fix the problem in the first place. What a nice system for them. Patients just keep returning for more and never realize that the problem isn't solved. Hey, whatever works right?

- Concerning X-rays? MDs barely get enough training in 4 years of medical shool to diagnose problems on imaging studies. They'd probably be lucky to put the X-ray up in the correct orientation. MDs even require overreads from trained radiologists (other MDs trained in imaging modalities). How can chiropractors be able to diagnose all problems seen on X-rays, which may show extra problems that they aren't even looking for? Their not. This is a very dangerous game they are playing.

- IMPORTANT NOTE OF INTEREST: Medical practice is scutinized closely and held to a "standard of care" for any patient problem. This means that if a medical doctor deviates from that "standard of care" and there is a bad outcome, you are liable for litigation (will get sued). Chiropractic medicine does not have this kind of scrutiny and there is no standard of care. So, they are fairly protected from litigation since there is no standard to hold them to. Plus, who then corrects their mistakes or holds them accountable when mistakes are made?

18 Comments:

Anonymous Anonymous said...

I don't know if this is true in all states, but chiropractors can be sued for malpractice and are held to a standard of care for their type of practice. It's certainly less than what an MD can be held accountable for, but it does exist.

Just FYI, not criticizing your interesting post.

3:38 PM  
Anonymous Anonymous said...

The main problem with chirofrauders is that there "bread and butter" the "subluxation hypothesis" has never been shown to bear out in terms of a double blind study. If one were to give 100 chirofrauders 100 normal spinal x-rays, one would obtain 100 different readings governing the pressence of "subluxations."

One issue that is the same between both professions. Practitioners of both are happy to whore themselves out to the PI attorneys when it comes to supporting questionable auto accident cases.

6:56 PM  
Anonymous Anonymous said...

I have a family member who is a chiropractor (I am an MD) and he has really convinced the family he is a doctor! I asked him: Did you do pediatrics? ob-gyn? general surgery? psychiatry? ACLS? BLS? internal Medicine? All no answers and yet they think he is a real doctor. At a family picnic someone was choking and he stood there like a useless twit.

7:40 PM  
Blogger Dex said...

IMHO, a *good* chiropractor can be real boon to patients and doctors alike, as a source of referrals for medical problems and for those whose pain has frustrated medical and surgical interventions. Of course, such a good chiropractor would almost need to be trained as a doctor to have real clinical utility in this situation, i.e. the clinician trusts them with basic levels of competence and responsibility. Such "chiropractors" do exist, and they are called "osteopaths".
[/shameless self-promotion]
An osteopath is medically trained, mostly side-by-side with allopathic physicians; indeed, most are indistinguishable from M.D.'s , but a few become manual medicine experts, or neuromuscular medicine specialists. Many family doctors who are D.O.'s fill this role, and are full, board-certified physicians who also do manual medicine. Furthermore, D.O.'s, having been trained in manual medicine, are more familiar with these modalities and are generally better at dealing with low back pain, for instance, even if they don't do the treatment themselves--they're more likely to know someone they trust to work it up. And they will not hesitate to get a neurological or neurosurgical consultation, of course, or send a pt to the ER (lots of D.O.'s work as Emergency Physicians, too) for a suspected kidney stone or occult malignancy. Of course, a "good" chiropractor can be trusted similarly, but how do you judge? And remember, age does not necessarily confer wisdom.

8:28 PM  
Blogger Caduceus said...

Some of the best physicians (real doctors) I know are DOs. To be honest, and somewhat stereotypical, I find that many DOs are much nicer people than some MDs. I respect anyone who has put in their time and training, yet knows their limitations. That's key in medicine.

11:56 PM  
Blogger Caduceus said...

As for the picnic comment by anonymous, I don't know what's worse; a chiropractor that is useless in an emergency, or one that actually think they know what to do. Scary thought. But I still find your story quite funny and even a bit satisfying.

11:59 PM  
Anonymous Anonymous said...

To each in their own opinion, however i thought it might be helpful in your condemnation of chiropractic schools to get the facts correct. A chiropractic student must complete a 5 year program at an accredited college. They must take the board exams which consist of 4 parts taken over a period of 3 years, the last part of which is an oral/practical exam. Students take 270 hours of Radiology (as opposed to the medical counterpart who recieves 30 hours of training). To round it off, chiropractic students take 585 hours of Anatomy, 75 hours of Biochemistry, 345 hours of Physiopathology, 120 hours of microbiology, 525 hours of Diagnosis, 75 hours of Clinical Lab Diagnosis, 1,320 hours of Internship.... and many more not worth mentioning. No, Chiropractors cannot treat pathological problems, but they are taught to recognize them so when the patient comes in complaining of back pain the DC can differentially diagnose if it is or is not an emergency which should be referred out. I would advise not stereotyping a profession in which you obviously have the facts incorrect. Im sure you would agree that there are many MD's out there riding that subtitle for unethical reasons. Dont forget that healthcare is for the patient, and the best thing for the patient is for all health professions to work together.

2:34 PM  
Blogger Caduceus said...

Points well taken. I fully agree with thoughts on unethical MDs, and the team work approach to healthcare. However, your facts, just as mine apparently were, are a bit off. I will address only one here simply for the sake of time and because right now, I don't care.

Concerning your quote on radiology hours in training. It seems to me that an extremely large part of your practice as a chiropractor involves the use of xrays. So, in your 5 years of training, you undergo 270 hours of radiology. Then, you are practicing in the community reading thousands of xrays yearly as a fully functioning chiropractor. Here's the big difference. You were wrong on the idea that MDs only get 30 hours of radiology. To make it simple (like finding a pulmonary nodule on a portable chest xray), I'll break it down for you. Med students go through 4 years of med school, in which they see xrays throughout, but much more their 3rd and 4th years. All typically take a rotation in radiology during their 4th year where they sit with practicing "Radiologists" (those who are professionals in radiology) and learn the basics of how to read the different modalities of imaging, xrays or other. Now the good part, after med school, MDs have to do a residency! That's another 3 to 5 to 10 years depending on how crazy they are. No matter what field or subspecialty they go into, they will be reading xrays, CT, and maybe an MRI or two the entire time on all their patients. Plus these are over read by professional radiologists so that things aren't missed.

So the breakdown stands as such,
Chiropractors:
Practice practically revolves around the use of xrays and they get 270 hours of radiology. Then they're reading them on their own.

MDs:
Little formal radiology training, but spend nearly 4-8 years reading xrays every day and having them over read by professionals before they are out in the community.

You do the math.

2:15 AM  
Anonymous Foot Bath Array said...

This is a neat blog with lots of interesting stuff in it.

Sincerely,

June
Foot Bath Array

5:18 AM  
Anonymous Anonymous said...

I go to a chiropractor for lower back pain, and I don't think they always take xrays... Maybe since they are just looking at one kind of diagnostic imaging (just xrays) and only one part of the body (spine) they don't need more than 270 hours? Also... I'd have to guess chiropractic students see xrays of backs everyday too and even, possibly with radiologists teaching them? Just wanted to throw that out there.
I hope you have time to answer two questions, mostly because I don't understand your problem with this kind of healthcare and I would like to know more.
If everything you are saying is true, Caduceus, why is it that chiropracticors are liscened and allowed to practice?
Also, would you be more comfortable with chiropractics if they didn't have the title of doctor in front of their names?

9:47 PM  
Anonymous Colin said...

Well, I am glad to see some people on here willing to challenge the accepted. To begin with, I am a graduating undergrad and on my way to chiropractic school this coming year. I am the president of a pre-chiropractic club at my university, and currently am working in my second chiropractic office. This said, I do NOT know everything there is to know about either chiropractic or medicine (allopathic).
Before I go any further, I want to quell the angry tirades I will most likely receive from this post by saying that there is a time and place for all health professions. I will make it perfectly clear, however, that I feel that the course of modern medicine (allopathic) has overstepped its bounds of safe use, and has begun to cause more problems than it can deal with (see the end for more facts on this).
The problem I am seeing on this page is not simply the anti-chiro sentiments, but more so the ignorance about chiropractic that feeds the attacks. I am going to try to clear this up (but am not expecting to convince anyone). The purpose of any healthcare system is to make a patient as healthy and whole as possible through the methods of that given system. In allopathic medicine (the current accepted form of western medicine), those tools are prescription drugs, surgery, and on the fringes lay physical therapy and other assisting types of techniques. In Chiropractic, the tools are merely the body's innate power (the body's natural ability to heal itself with the toolset it was designed with) and the adjustment. The adjustment is a physical movement of any or all of the vertebre in the spinal column by a quick and pointed force, allowing the bones to move either for a resonance or for a shift, causing a pressure on the nerves to be released or to stimulate the nervous system. The adjustment has also begun to find new partners as it were in the toolbox through other methods of reshaping, strengthening, and aiding the nervous system and spinal column/spinal muscles.
The focus of either perspective can be seen in that allopathic medicine has the emphasis placed on diagnosing an existing pathology or symptom and then treating that problem accordingly with a prescription (in most cases) that seeks to inhibit or illicit certain biochemical reactions in order to alleviate the symptom. Secondly is surgery to alter, remove, or add things to the body (changing not only the problem area, but affecting the entire body and changing the functionality of the body as a whole). This is one of the biggest philosophical discrepancies between chiro and allo. Medicine is often solely focused on the symptom (and if not the doctor, then the patient certainly is, and is rarely educated and guided otherwise). There is usually little effort to locate and correct the actual cause of the symptom. To counter this, the perspective of chiropractic is not only to locate and alleviate the cause of an issue, most commonly believed to be a "subluxation" at some point in the nervous system, but also to aid in prevention of disease to begin with. I can find the citation if you want, but it was said in the mid to late 90’s by the head of Blue Cross and Blue Shield at a presidential hearing (Clinton), that of the three systems of healthcare in America (allopathic, chiropractic, and alternative), that chiropractic was the ONLY system that worked with prevention. This makes sense too if you think about it…shouldn’t you get your car’s oil changed regularly, make sure the tires have pressure, etc? Why not keep your body at its best potential to deal with life’s little problems? The idea is not just to crack a back, it is to allow everyone to have a healthy life and lifestyle by correcting or maintaining the central nervous system and its protective bones.
I do want to clarify right now that Chiropractors are NOT back doctors, we are neurologically focused doctors that seek to allow the body to take care of itself by relieving any and all inhibitions or conflict in the body's major control system (the nervous system). As is the nature of (most) chiropractors, prescription drugs are not to be taken and surgery is a LAST ditch effort because these techniques cause adverse affects in the body along with their intended purposes (as I said earlier, there are times and places for all treatments, but not as a primary solution).
Also, this being said, I want to reply to the poster who mentioned in invalidity of chiropractic based on its lack of ability to substantiate the “subluxation” through double-blind study. To this I say that there are many things beyond the comprehension of modern science and medicine. Can anyone explain how from simple cells we can create thought, art, and the very science we study? Can someone please tell me how consciousness and free thought are functions of cellular activities? No. This is not possible yet because it is not known. In this we also have to accept the fact that the body DOES know how to heal itself. A live person can watch a cut heal on their arm independent of their own desires or an MD’s intervention. This natural ability shows that the body is capable of taking care of itself in most general situations (in cases of trauma and extreme accidents where emergency intervention is necessary and is not within the scope of chiropractic care). If you wish to debate the innate, let me know and we can talk more later, in the idea of keeping this shorter than a novel, I will move on.
As for schooling differences, yes medical school students do have residency on top of their classroom learning, but you have to keep in mind that during this time, MD students are working to learn all the hundreds of drugs that they will be using on a daily basis (not to mention their surgical techniques if that is their specialty), the composition of the drugs, the effects, side-effects, interactions with other drugs, and dosages. These are all things that chiropractors do not deal with, thus eliminating a great deal of time that is necessary for training. Also, a little tidbit for you, the first year and a half to two years of either chiro or MD schools are nearly identical. It is only after they both learn the basics of the body that they separate paths. The attacks on chiropractors for not being educated enough to practice directly out of school are a misconception. The scope of chiropractic is a bit smaller in comparison to allopathic in that they don’t use drugs or surgery, not to mention that most chiropractors upon exiting school intern under another chiropractor for a year or so and then open their own practice.
Now, if you get riled up easily, buckle up, because now I am going to challenge the common acceptance. If chiropractic is a hack science, and of little to no value, why is it that there has been only 1, let me repeat that, ONE case where a court has linked chiropractic to being the cause of a problem (I believe it was a stroke case, but don’t quote me). The point being, chiropractic has no side-effects, no negative effects, few to no malpractice suits, and absolutely no deaths associated with it. On the other hand, take a look at our wonderful modern medicine system…now, as of 2004, being the #1, and I will repeat this too, NUMBER ONE killer of Americans (Gary Null, PhD, et al, “Death By Medicine”). The combination of prescription interactions, wrongful prescriptions, unnecessary surgeries, botched surgeries, and other medical malpractices account for more than 750,000 deaths per year in America. These are only those that are noted, there are bound to be many more issues that cause death and are not recorded, putting this number somewhere closer to 1million deaths per year. This is more than heart disease (#2), and cancer (#3). How is it that a system designed to provide the best possible life quality for its patients is the number one reason they die? Why are we giving people drugs that cause more problems than they fix? Why are we performing unnecessary surgeries on a regular basis. To validate this I give you an example of a patient I know from my current office. Let’s call the gentleman Joe. Joe had two colonoscopies, both confirming a cancerous tumor in his colon (both confirmed the same location). Between the times of the colonoscopies and the surgery he was scheduled for, Joe continued the chiropractic care that he had begun, and come time for surgery, the surgeon could not find the tumor. After searching for more than thirty minutes and looking back at the colonoscopies, he could not find the tumor, but instead of pulling out and saying that nothing could be done, this genius proceeded to REMOVE 2ft of Joe’s colon and intestines. To this day Joe cannot leave the house because of his digestive and excretion problems stemming from this surgery. There are many, many more cases of the atrocities that happen within our medical system, and not to say that the doctors hold all the blame, but they are the connection between the system and the patients and implement the care.
One final comment I would like to make (if you have read this far) is that, to the anonymous poster who has a chiropractor as a relative and still stands ignorant to chiropractic, first aid is something everyone should know (Heimlich maneuver included), and that yes, chiropractors should know first aid as far as that, but that it is not within the normal practicing scope of a DC as we do not deal with trauma or emergency situations of that capacity. So, please rag on him for that, but do not question his merit as a doctor because of it. Also, I would appreciate any challenging posts or debates, but please keep unproductive and uninformed posts or flames to a minimum.

8:25 PM  
Anonymous Anonymous said...

I have been a practicing chiropractor since 1992. I am quite proud of the help I give my patients. Last month, I referred a new patient from my office to our local ER with a script stating diagnosed bacterial menningitis. The admitting nurse threw it in the trash and said that "they" would take care of it... 4 hours later, I received a call from the head of the ER stating that they had sent her out by helicopter to a larger hospital as she had a rare epidural abscess. The fact is that I see back pain every day. It is much easier for me to find rare, dangerous and unusual conditions when compared to a family practice doctor. They treat runny noses, coughs and athletes foot.

I have found brain tumors missed by my medical buddies. AAA's, MS, RA, TIA's CVA's have all walked in my office and been referred out to the proper specialist.

In fact, I felt quite gratified when that patient (who I had to threaten to go to the ER) came back to my office after 3 weeks of hospitalization and thanked me for saving her life.

I pay $900 per year for 3 million in medical malpractice. That alone suggests that most chiropractors are more than able to safely treat patients and recognize serious illness that need referral. I would compare my rates for malpractice to anyone....

Bash DC's all you want. But the numbers don't lie and my personal experience suggests that most of what you say is way off base..

PS Have you ever seen a dentist or a podiatrist? I guess they aren't real doctors either....

7:54 PM  
Anonymous Anonymous said...

I have now worked for a Chiropractor for more than a year and must tell you that I see many of your views as close minded. Many Chiropractors do mention that Chiropractic Care should come high on your list of physicians you choose to see on a regular basis..maybe even more so than your "regular" doctor.
This is because Chiropractors treat the very root of many things that cause ailments. A chiropractor releases tension on the nerves in your spine.... the same nerves that control each and every function of your body. If you were to have simply a pinched nerve somewhere in your upper back...the symptoms would present themselves as if you had anything from dizziness, headeaches, trouble sleeping... and you go to your MD and he presctibes something for each... never treating the underlying cause and never fixing the problem.
When you go to the dentist... he doesn't do bloodwork- when you see your medical doctor..he's not checking your teeth...no doctor is completely thorough with regards to every aspect of your health but a Chiropractor is definately one to include in yours and your family's HEALTH care.

10:32 AM  
Anonymous Anonymous said...

Chiropractors also have the ability to specialize in specific areas of study. There are Chiropractic radiologists, which receive additional training (min 4 years). There are also studies that have shown Chiropractors outperform Medical counterparts in the diagnosis of standard xray. Furthermore the most proficient in this field was not the Medical radiologist but the Chiropractic radiologist. This in by no means to demean the Medical profession, I simply believe that this is due to the drive for Chiropractors to become accepted. Much in the same way other ostracized minorities strive for excellence to prove themselves. I would only wish the medical community would embrace the value that Chiropractors can bring the health of the people, and to remember Chiropractors are people just as they are.

11:19 AM  
Blogger dre said...

The very same can be said about the early rifts between medicine and dentistry; medicine and podiatry; medicine and pharmacy; medicine and osteopathy; medicine and nursing; and so on. The MD is always touted among his or her peers as being the ultimate authority on health. Do not forget the Flexner report. Do not forget where organized medicine came from. It appears that the only argument that comes to the table when an intellectual harping on MD superiority is the amount of education they receive. Why don't you discuss the ongoing dissemination of this enormous amount of information to countless people who need it? Is it a major part of the average post-graduate MDs career? Certainly not! Why aren't more and more MDs educating the public about real public health? Why don't real patients benefit from frank discussions from MDs? Why are patients treated with such disrespect by MDs? Who anointed MDs to be the anointed leader of healthcare? Please do not get it twisted, natural healthcare and the prevention/wellness model are much more appropriate educational pursuits than the "after-the-fact" pathological model. If you can prevent it you shouldn't have to treat it, right? Get a clue medicine head.

7:05 AM  
Blogger Jon said...

As a second year chiropractic student, I'd also have to disagree with many of the things mentioned in this post.

We are constantly reminded that there are a multitude of things that present as back pain and when to recognize a serious event that's causing that pain. Murphy's punch for kidney stones/pyelonephritis, Kernig's for meningitis, etc etc, we get plenty of that, so many of the negative statements about chiropractic are unfounded.

Secondly, why is the double blinded RCT used as a reason that chiropractic is unscientific when medicine isn't held to the same standard. Where's the RCT that shows statins in patients without heart disease increase longevity? Where's the RCT showing the efficacy on most of the major surgical procedures performed? Where's the chemical assesment to measure chemical imbalances that are treated with drugs for ADHD?

I'm not saying that surgery is bad or ADHD isn't real, but if you want to hold us to a standard for the subluxation, shouldn't medicine hold itself to the standard for some of it's most common treatments?

As far as subluxation goes, it's pretty simple. If you have a joint that's not functioning properly, does that not affect the proprioceptive input into the cerebellum? Is the cerebellum not an integral sensory integrator into the entire brain? If the proprioceptive/nociceptive balance has been shifted towards nociception, does that not predispose the brain into a chronic stress response? Does a chronic stress response affect the entire body as a whole?

Regardless of what you may think about chiropractic, there are DC's doing incredible things and stretching the boudaries of how chiropractic affects the entire body. Dr. Ted Kerrick has a 3 year waiting list to take care of patients with hopeless neurological cases with video evidence of waking people from comas with consistency. Clarence Gonstead saw thousands of patients and had to have an air strip and hotel to for the people who came to see him and got well. A new clinic in China had Chinese MD's baffled because chiropractic was the only thing they had ever seen that helped the patient relieve a symptom, and had side benefits.

So say what you will about chiropractic and the lack of scientific credibility there is.I see people come in where every other option has failed them and got well. If RCT's are the driving force of a pharmaceutically run industry that injures and kills hundreds of thousands every year, then I'll take happily be labeled as pseudo-scientific while all my patients get well with my anecdotal evidence.

1:19 AM  
Blogger Caduceus said...

Regarding the comments made by the 2nd year chiropractic student above...

Good attempt at making some decent points, but I have a couple follow up questions/comments for you.

First, what is "Murphy's punch"? I've heard of Murphy's sign which is used to depict the pain elicited from palpation of the right upper quadrant in a patient suspected to have cholecystitis, but never heard of a punch, please clarify for the sake of my ignorance.

Second, your comments, "If you have a joint that's not functioning properly, does that not affect the proprioceptive input into the cerebellum? Is the cerebellum not an integral sensory integrator into the entire brain? If the proprioceptive/nociceptive balance has been shifted towards nociception, does that not predispose the brain into a chronic stress response? Does a chronic stress response affect the entire body as a whole?" are interesting to say the least.

What anatomy, neurology, or neurosurgery book are you reading? I ask only because what you're saying sounds like a lot of nice big words strung together at an attempt at logic.

If a vertebral facet joint is not working properly, or your foraminal canals are truly narrowed to the point of impingement, you'll have a lot more that simply proprioceptive loss. Spinal nerves carry everything - both dorsal and anterior horn fibers, which for those that have read the books contain motor and sensory fibers. If you have impingement of a spinal nerve you won't have selective loss of proprioceptive function alone.

Then we get to the comment "If the proprioceptive/nociceptive balance has been shifted towards nociception, does that not predispose the brain into a chronic stress response?" This made me giggle a bit. Call it ignorance, but again, what book are you reading? Please tell me more about the "chronic stress response of the brain" and how it relates to the "shift in the proprioceptive/nociceptive balance". Also, for the sake of not being laughed at, please don't repeat this comment to any other medical professionals - they won't take you seriously.

Lastly, it sounds like chiropractic medicine focuses a whole lot on neuro-science. In chiropractic training, do you ever use a true neurology or neuroanatomy textbook?

3:08 PM  
Anonymous Anonymous said...

As a matter of fact, we do use real neuroanatomy textbooks and neurophysiology text books. Heck the hundreds of hours in lecture I sat through in the subject were even tought by a real live neurobiologist..with a PhD even! Wow...you really think that chiropractors don't learn anything don't you. What do you think we do in school that long?

4:21 PM  

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