Paradigms
Raymond Downing in Suffering and Healing in America, 2018
But if we step back and look more dispassionately at these other paradigms, are they reallv so foreign to us? Doesn’t some disease result from bony pressure on spinal nerves? Doesn’t chiropractic manipulation sometimes give at least as much temporary relief as our treatment for back pain? And doesn’t our practice of vaccination to prevent disease fit almost exactly into the homeopathic paradigm? In other words, our problem with chiropractic and homeopathy is not the paradigm itself, but the attempt to apply it to all disease. Our ‘scientific’ paradigm is built on verifiable pragmatism and includes such disparate approaches to therapv as drugs, surgery, vaccinations, physical therapy, counseling – as long as they can be ‘proven’ to work.
Modalities
Michael Weir in Law and Ethics in Complementary Medicine, 2023
Although chiropractic has an impressive safety record, there is a perception by some that one risk of chiropractic is the possibility of stroke caused by cervical spine manipulation.7 On many occasions, what is portrayed as a stroke or cerebrovascular injury caused by chiropractic manipulation is in fact the result of manipulation by a medical practitioner, untrained manipulator or family member.8 Despite this apparent distortion, there is evidence that on very rare occasions chiropractic cervical spine manipulation may cause strokes and other less serious results.9
Complementary and Alternative Medicine Use in Rheumatic Disease
Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide in Clinical Innovation in Rheumatology, 2023
Chiropractic manipulation originated in the late 1800s and is a technique that involves spinal manipulation to improve pain and mobility.29 Chiropractic techniques and approaches vary widely.30 The use of chiropractic care has risen in the United States in recent decades especially among individuals aged forty-five to sixty-four years old for various pain syndromes.31 However, very little quality evidence exists regarding use for people living with rheumatic disease.
Cervical spondylotic myelopathy: A two decade experience
Published in The Journal of Spinal Cord Medicine, 2019
Robert F. Heary, Anna MacDowall, Nitin Agarwal
In patients presenting with progressive cervical myelopathy with moderate or significant deficits, one would be hard pressed to not recommend intervening surgically. Aside from severe medical comorbidities preventing a safe operation, the most appropriate therapy would be surgical intervention. Myelopathy tends to progress, and as such, non-surgical management tends to be futile for this condition. Sadasvian et al. followed 22 patients to delineate the natural history of CSM. All 22 patients deteriorated over time using the Nurick classification.11 Moreover, alternative non-surgical approaches such as physical therapy, diagnostic or therapeutic injections, weight control, acupuncture, biofeedback, or chiropractic manipulation may not provide any proven, sustained benefits. As such, the passage of time without surgical intervention predisposes the patient to further problems rather than a therapeutic solution. Of note, mixed results have been reported in prior studies. In 2000, Kadanka et al. compared surgical versus non-operative treatment for CSM in a randomized control trial of 48 patients. Using the modified Japenese Orthopedic Association (mJOA) classification of disability, this study reported no difference between patients treated with surgery versus no surgery on long-term follow-up of 2 years.12 Still, more recent prospective studies indicate a benefit to surgical intervention. For example, Fehlings et al. demonstrated improved health-related outcome measures in a prospective study of 278 patients undergoing surgical intervention for CSM.13,14
Treating patients with pain: how to make it less painful
Published in Postgraduate Medicine, 2019
In elaborating upon what we can/should do for patients with pain, while I started discussing pharmacotherapy, I cannot emphasize the importance of incorporating non-pharmacologic therapies, such as patient education with respect to chronic pain, improving patient self-efficacy and self-management, and involvement of a multi-disciplinary team, which may include a pharmacist with expertise in pain management, and practitioners of psychology, pain management, physiatry, physical therapy, social work, chiropractic medicine, acupuncture, and psychiatry. In fact, sometimes effective use of these modalities may obviate the need for attendant pharmacotherapy. There is ample evidence that acupuncture (including both whole body and auricular acupuncture), chiropractic manipulation, tai chi, yoga, aquatherapy, physical therapy, low-intensity exercise, and behavioral treatments such as cognitive behavioral therapy, mindfulness, meditation, deep breathing exercises, and progressive muscle relaxation can also be beneficial in pain [7]. Personally, I have been astonished by the success of an early learned form of auricular acupuncture, battlefield acupuncture, which is easy both to learn and use in practice [8,9]. Additionally, chronic pain can be influenced by a multitude of biopsychosocial factors, including poor sleep, poor nutrition, stress, depression, and environmental exposures [10] and these factors should also be addressed. Sometimes devices or more invasive techniques including trigger point injections, targeted corticosteroid injections, transcutaneous electrical nerve stimulation units, Botox injections, and others can also be beneficial.
Patterns of Nutritional Supplement Use in Children with Tourette Syndrome
Published in Journal of Dietary Supplements, 2023
Bobbie L. Smith, Amanda K. Ludlow
Across the general population, there has been an increase in the use of alternative, non-westernised medicines primarily due to the increased accessibility and advocacy of methods via the Internet. For example, data from 2003 to 2006 showed that pediatric supplement use in various conditions ranged from 26% to 43% depending on age (6), and this is expected to have increased in recent years. Complementary and Alternative Medicines (CAM) are “diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional Western medicine” (7), p. V). However, due to the lack of standardized measures and a universal definition of CAM, there are no clear prevalence rates for CAM use. It is also essential to consider the results within the context of possible response bias of surveys in this field. A review found the average one-year prevalence of CAM use was 41.1% and the average lifetime prevalence was 51.8% in the UK with herbal medicine being the most commonly used CAM (8). However, these figures reduced when studies with poor methodology were excluded. CAM were found to be prevalent in 17.7% of children (n=1134) in a UK sample (9). More specifically, CAM is more frequently used by children with a chronic illness, with increased prevalence for those who take medication regularly (10). For instance, CAM is increasingly being used by children with neurodevelopmental disorders (e.g. Autism Spectrum Disorder [ASD]; 11), and a study in a pediatric neurology clinic reported 44% of patients (n=105) used CAM (12). The most reported types were chiropractic manipulation (15%) and dietary therapy (12%), and it has been reported that the majority of individuals who use CAM pay for the treatment themselves (13).
Related Knowledge Centers
- Chiropractic
- Craniosacral Therapy
- Manipulation Under Anesthesia
- Randomized Controlled Trial
- Spinal Manipulation
- Osteopathy
- Vertebral Subluxation
- X-Ray
- Joint Manipulation
- Activator Technique