Alternative and Complementary Treatments
Harold G. Koenig in Chronic Pain, 2013
Chiropractic is a form of spinal manipulation that chiropractors use most commonly to treat acute lower back pain. Chiropractic manipulations may also be helpful in some cases of chronic pain related to back, neck, or peripheral joint problems, and may be used as a treatment for headaches. There is evidence that spinal manipulation can help many people. Even the U.S. government’s Agency for Health Care Policy and Research (AHCPR) promoted the technique’s use in its Guidelines on Acute Low Back Problems in Adults,* indicating that spinal manipulation is the preferred method of treatment for relief of acute back pain substantiated in part by a recent clinical trial published in the New England Journal of Medicine.24 At least one major clinical trial, however, did not find the technique useful for headache.25 Although no scientific studies confirm its use for anything but low back pain, studies are now being conducted under the sponsorship of the NIH’s Office of Alternative Medicine to see whether other conditions might be treated using this method.
The medical counterculture
Lois N. Magner, Oliver J. Kim in A History of Medicine, 2017
Outside the chiropractic community, the safety, as well as the effectiveness of spinal manipulative therapy remains controversial. Critics warn of increased risk of stroke, bleeding, blood clots, fractures, nerve damage, muscle strains, sprains, spasms, and the risks of postponing conventional treatment for life-threatening diseases. Skeptics note that chiropractors are unlikely to win support from scientists and physicians when they insist that even cancer is caused by nerve blockage, or that manipulation affects the flow of the “life forces” and that germ theory is wrong or irrelevant. The Internet made it possible for chiropractors to reach an international audience via their websites and YouTube videos. In 2016, an Australian chiropractor used these outlets to call attention to his treatment of a four-day-old baby. Australian doctors were shocked to see evidence that infants were subjected to spinal manipulation for problems such as colic, acid reflux, and excessive crying.
Public Health and Free Markets
Ruth E. Groenhout in Care Ethics and Social Structures in Medicine, 2018
The introduction of insurance as part of the economic system changes health care in other ways. One of the ways it changes the system is by setting up an alternative financial power in the system, and that power can be used to determine or influence various aspects of the system. If insurance covers back surgery, but not chiropractic services, for example, we would expect to find many more back surgeons than chiropractors, so insurance coverage will affect what sorts of treatments are available, and also the number of practitioners offering them. One of the ways that HMOs were supposed to lower costs when they were first established was by setting standards of treatment that would be based on best practices research, eliminating ineffective treatments and thus bringing down the cost of health care as a whole.
From (Ontario Ministry of Health and Long-Term Care) policy to implementation: A retrospective look at a community-based patient-centered model of care for chronic pain
Published in Canadian Journal of Pain, 2019
Angela Mailis, S. Fatima Lakha
Currently the PWC staff consists of two physicians (both specialists in physical medicine and rehabilitation), one psychologist and one psychotherapist, a mindfulness meditation facilitator, two naturopathic doctors (NDs), a holistic dietician, two massage therapists, four chiropractors, a community resource facilitator (community navigator), two information technology/management staff, four reception staff, one or two research staff, and a physician assistant. Several rotating trainees such as University of Toronto pain fellows, Royal College pain medicine subspecialty residents, as well as physical medicine and family medicine residents, and chiropractic interns obtain education at the PWC. All of our chiropractors are strength trainers and have additional training and expertise in advanced soft tissue therapy techniques, medical acupuncture, concussion management, and athletic sports injuries. Additionally, all are trained as physician assistants for chronic pain consultations. The massage staff has additional training in lymphatic drainage, and two of the staff are certified life coaches. The NDs and holistic dietitian place emphasis on nutrition, weight management, and life choices. The mindfulness meditation program is offered in a small-group format over an 11-week period, 2 h per week. For patients unable to attend these classes, customized programs are offered with one-to-one mindfulness sessions.
The prevalence of anxiety, stress and depressive symptoms in undergraduate students at the Canadian Memorial Chiropractic College
Published in Journal of American College Health, 2022
Christine Meckamalil, Lydia Brodie, Sheilah Hogg-Johnson, Linda J. Carroll, Craig Jacobs, Pierre Côté
The CMCC chiropractic program is a second entry professional degree consisting of 4,200 hours of training over four years.18 The curriculum integrates practical and theoretical knowledge for clinical practice and is taught over four modules per academic year.18 Years I and II provide foundational courses in basic sciences, chiropractic skills and diagnosis.18 Year III focuses on case-based clinical courses to prepare the students for their fourth year internship.18 Year IV is a 12-month clinical internship where students provide direct care to patients under a licensed chiropractor’s supervision.18 Year IV also consists of laboratory clerkships as well as a clinical midterm and final examination.18 Typically students will also write three licensing examinations during this year.18
Variation in perceived providers of ambulatory physical therapy in the United States, 2009–2012: An analysis using data from the Medical Expenditure Panel Survey
Published in Physiotherapy Theory and Practice, 2019
Gary Brooks, Michelle Dolphin, Adam Rufa
Confusion regarding how PT is defined and who provides PT persists in the US and is reinforced by current realities in healthcare service delivery. Physicians are granted broad authority to practice medicine, which encompasses virtually all facets of care (National Council of State Boards of Nursing, 2009). Thus, physicians may legally provide interventions which are also commonly provided by physical therapists. There is also considerable overlap between interventions used by physical therapists and other healthcare professionals such as chiropractors and massage therapists. For example, in most states, chiropractors may legally provide interventions such as ultrasound, electrical stimulation, traction, massage, heat and cold application, and “rehabilitation” (Chang, 2014). Furthermore, the American Chiropractic Association advocates for insurance reimbursement of PT services provided by chiropractors (American Chiropractic Association, 2016). In addition, the Nursing profession considers complementary and alternative medicine interventions as being within the scope of nursing practice broadly throughout the states. Many of these interventions are shared with physical therapists including massage, biofeedback, relaxation, and exercise (Lindquist, Snyder, and Tracy, 2014; Snyder and Lindquist, 2001). In an informational fact sheet, the US Centers for Medicare and Medicaid services states that, “Doctors and other health care professionals (e.g. nurse practitioners, clinical nurse specialists, and physician assistants) may also offer PT… services” (Centers for Medicare and Medicaid Services, 2016).
Related Knowledge Centers
- Alternative Medicine
- Manual Therapy
- Spinal Manipulation
- Vertebral Column
- Joint
- Soft Tissue
- Physical Disorder
- Spinal Adjustment
- Chiropractic Treatment Techniques
- Chiropractic Education