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Chiropractors?
Posted: 12 October 2011 05:02 AM   [ Ignore ]   [ # 91 ]
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Um, yeah, that’s the study that you just linked to. I’ve shortened it because it’s obviously under copyright.

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Posted: 12 October 2011 03:41 PM   [ Ignore ]   [ # 92 ]
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dougsmith - 12 October 2011 03:57 AM

Did you read the abstract? So your final word is a single, 92 patient study that shows that massage, acetaminophen and 8 weeks’ rest is better than ‘usual care’ on low back pain. 

The ‘8 weeks rest’ policy alone has been scientifically disproved at least 2 decades ago.

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Posted: 12 October 2011 06:15 PM   [ Ignore ]   [ # 93 ]
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asanta - 12 October 2011 03:41 PM
dougsmith - 12 October 2011 03:57 AM

Did you read the abstract? So your final word is a single, 92 patient study that shows that massage, acetaminophen and 8 weeks’ rest is better than ‘usual care’ on low back pain. 

The ‘8 weeks rest’ policy alone has been scientifically disproved at least 2 decades ago.

... I should perhaps have written ‘8 weeks vacation from work’ ...

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Posted: 12 October 2011 08:23 PM   [ Ignore ]   [ # 94 ]
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dougsmith - 12 October 2011 06:15 PM
asanta - 12 October 2011 03:41 PM
dougsmith - 12 October 2011 03:57 AM

Did you read the abstract? So your final word is a single, 92 patient study that shows that massage, acetaminophen and 8 weeks’ rest is better than ‘usual care’ on low back pain. 

The ‘8 weeks rest’ policy alone has been scientifically disproved at least 2 decades ago.

... I should perhaps have written ‘8 weeks vacation from work’ ...

...Oh, okay. I still don’t think you get 8 weeks off of work, unless you’ve had surgery. Usually, physical therapy is recommended.

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Posted: 13 October 2011 04:03 AM   [ Ignore ]   [ # 95 ]
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asanta - 12 October 2011 08:23 PM

...Oh, okay. I still don’t think you get 8 weeks off of work, unless you’ve had surgery. Usually, physical therapy is recommended.

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Not sure I understand. This was the experimental protocol: “METHODS: Patients were assessed by a spine physician, then randomized to SC (reassurance and avoidance of passive treatments, acetaminophen, 4 weeks of lumbar CSMT, and return to work within 8 weeks), or family physician-directed UC [usual care]”.

Most back pain is stress related. Eight weeks vacation from work would certainly reduce stress for most people. I doubt that family physician directed usual care would include eight weeks’ vacation. (Perhaps that was your point?)

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Posted: 14 October 2011 10:09 AM   [ Ignore ]   [ # 96 ]
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dougsmith - 13 October 2011 04:03 AM
asanta - 12 October 2011 08:23 PM

...Oh, okay. I still don’t think you get 8 weeks off of work, unless you’ve had surgery. Usually, physical therapy is recommended.

question

Not sure I understand. This was the experimental protocol: “METHODS: Patients were assessed by a spine physician, then randomized to SC (reassurance and avoidance of passive treatments, acetaminophen, 4 weeks of lumbar CSMT, and return to work within 8 weeks), or family physician-directed UC [usual care]”.

Most back pain is stress related. Eight weeks vacation from work would certainly reduce stress for most people. I doubt that family physician directed usual care would include eight weeks’ vacation. (Perhaps that was your point?)


As I thougth!    Heres a link to the WHOLE study. http://www.worksafebc.com/contact_us/research/funding_decisions/assets/pdf/RS2004/RS2003_04_007.pdf

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Posted: 14 October 2011 10:37 AM   [ Ignore ]   [ # 97 ]
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Helge - 14 October 2011 10:09 AM

As I thougth!    Heres a link to the WHOLE study. http://www.worksafebc.com/contact_us/research/funding_decisions/assets/pdf/RS2004/RS2003_04_007.pdf

OK, there’s no mention of work loss here at all, so I’m not sure where that sentence came from. But the rest is exactly as I’d feared. The link demonstrates why this is a worthless study, even setting aside that it’s a very small sample size. Quoting from the paper (pp. 6-7):

Patients randomized to received GCT then received reassurance regarding the natural history of acute mechanical lower back pain; advice to avoid certain passive treatments (e.g. bed rest, heat or the use of back supports/corsets/braces), advice to participate in mild aerobic exercise (e.g. carry out a progressive walking program comprised of two walks a day, each with an initial duration set to the patient’s tolerance, starting with between five and 15 minutes, and adding two minutes a week to each walk); acetaminophen 650 mg every six to eight hours when required for pain for a period of two to four weeks, except when medically contraindicated (e.g. allergy, compromised liver function, acute porphyria); and a maximum four week course of lumbar spinal manipulative therapy using conventional side posture, high velocity, low amplitude techniques (i.e. no other areas of the spine were treated and specifically the patients did not receive any manipulation of the cervical spine). Spinal manipulation was administered two to three times per week at the discretion of the attending Chiropractor for a maximum of eight weeks. GCT group patients were also advised to avoid guideline-discordant treatments including the use of muscle relaxant and opioid-class medications, passive physiotherapy modalities, bed rest and “special” back exercise programs (e.g. “core stability” or extension exercises).

Patients randomized to the usual care / GDT treatment arm were advised of their diagnosis (i.e. acute mechanical lower back pain) and referred back to their referring family physician with a letter that explained the protocol of the current study. No specific treatment recommendations were made by the CNOSP physician.

So, in the first case the patients were given:

(1) Reassurance about the history of their symptoms
(2) Advice to avoid bed rest (which is known to be bad for lower back pain).
(3) Advice to do aerobic exercise (which is known to be good for reducing stress).
(4) Continual use of Acetaminophen (which is known to reduce pain generally).
(5) Back massage 2-3 times a week for 8 weeks (which is known to reduce stress).
(6) Advice to avoid certain other techniques

vs. in the second case the patients were given:

(1) Referral to family physician. (Which tells us precisely nothing).

There was no followup or tracking of what the family physicians did or did not do with their patients. No attempt to control for variables having nothing to do with supposed chiropractic care (reassurance, exercise, acetaminophen, etc.) And no apparent awareness that massage is good for reducing stress levels and lower back pain is typically stress related, something that is consistent with normal medical practice and that has nothing to do with the whole rigmarole of chiropractic quackery.

This study appears designed for marketing purposes rather than to actually elucidate anything. They might as well have termed it, “Acetaminophen and Aerobic Exercise Hospital Based Research Outcomes”, but that wouldn’t get them the headline they were looking for when they thought up this regime.

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Posted: 21 March 2012 07:33 AM   [ Ignore ]   [ # 98 ]
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The thread starter asked what chiropractors are. I have had many dealings with them on a personal and more so in a professional capacity.
The most reduced answer I can come up with is that they are all sizzle and no steak. SOME call themselves “evidence based” but there is no evidence at the base. While others are practicing things like this:

http://www.youtube.com/watch?v=75786xG7pJ8

The latter group that do this “KST” among other things (applied kinesiology etc.) that exploit the ideamotor effect are dubious at best and make up the majority. The interesting thing about chiropractic is that they recieve a doctorate in determining what and where a “chiropractic subluxation” (differs from a medical subluxation) is and what to do to about it. YET, none can agree on what it is, what caused it, where it is, or what it looks like. Seems strange to me that if you are a group of experts in a given field of study that there is absolutely no consensus whatsoever on the “chiroptractic subluxation” and yet they run clinics all over the world to treat this very thing.

Largest public duping I have ever seen. The only thing they have to back up anything they do is testimonial. That level of evidence is well, you know.

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Posted: 21 March 2012 07:52 AM   [ Ignore ]   [ # 99 ]
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orthican - 21 March 2012 07:33 AM

The thread starter asked what chiropractors are. I have had many dealings with them on a personal and more so in a professional capacity.
The most reduced answer I can come up with is that they are all sizzle and no steak. SOME call themselves “evidence based” but there is no evidence at the base. While others are practicing things like this:

http://www.youtube.com/watch?v=75786xG7pJ8

The latter group that do this “KST” among other things (applied kinesiology etc.) that exploit the ideamotor effect are dubious at best and make up the majority. The interesting thing about chiropractic is that they recieve a doctorate in determining what and where a “chiropractic subluxation” (differs from a medical subluxation) is and what to do to about it. YET, none can agree on what it is, what caused it, where it is, or what it looks like. Seems strange to me that if you are a group of experts in a given field of study that there is absolutely no consensus whatsoever on the “chiroptractic subluxation” and yet they run clinics all over the world to treat this very thing.

Largest public duping I have ever seen. The only thing they have to back up anything they do is testimonial. That level of evidence is well, you know.

But how can that be? Dr. Phil says his chiropractor has changed his life and that chiropractors are key parts of orthopedic surgical teams.  cheese
Just more proof that the more cameras you put on someone, the dumber they become.LINK

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Posted: 21 March 2012 11:27 AM   [ Ignore ]   [ # 100 ]
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A word that fits chiropractic is venality. A word that fits Dr. Phil is venality.

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Posted: 21 March 2012 11:39 AM   [ Ignore ]   [ # 101 ]
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orthican - 21 March 2012 11:27 AM

A word that fits chiropractic is venality. A word that fits Dr. Phil is venality.

Hmmm, the word I would have chosen is dumb.

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Posted: 21 March 2012 12:57 PM   [ Ignore ]   [ # 102 ]
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traveler - 21 March 2012 11:39 AM
orthican - 21 March 2012 11:27 AM

A word that fits chiropractic is venality. A word that fits Dr. Phil is venality.

Hmmm, the word I would have chosen is dumb.

Well, You do make a compelling argument… LOL ...agreed then. Dumb it is.

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