Wanted for back cracking: 400 Dachshunds

Who is overseeing this? Are there protections in place for the vertebrates? And their vertebrae? HJ

What did those poor Dachshunds do to deserve this kind of treatment?

Well, a wiener dog is nothing but a life support system for a spine, so I guess it makes some sort of sense. As much sense as chiropractic at any rate.

Does anyone see a problem with this? No controls, no randomization, no nothing. That's a start.

Not to mention, their coding schema sucks. How are they going to differentiate between FidoJS and FidoJS?

And, yeah, what IACUC approved this study?

Given the shortness of this post, does Orac have a dog in this fight?

Does anyone see a problem with this? No controls, no randomization, no nothing. That's a start.

Bah! Orac, don't you accept by now that there are other "wags of knowing" besides science?

What about other long, short-legged breeds like corgis or basset hounds? They get off scot-free, only the Dachshunds suffer!

On a side note, my corgi-chow mix doesn't have "uneven leg length" but her front paws point off in opposite directions. :)

http://files.dogster.com/pix/dogs/53/236953/236953_1134970388.jpg

My dog Oscar was the first one signed up for this study!

So their bologna has it's first name!

Yawn....

Patients will be identified by animal's name followed by owner's initials. Max owned by Jessica Ormston will be MaxJO for the study.

Thus clarifying that "MaxJO" is not, as one might first think, a sex toy.

Thus clarifying that "MaxJO" is not, as one might first think, a sex toy.

It may still be both. These New Age types are very open minded about things like that.

We can only hope that the dachshund back-cracking (with before-and-after videos) winds up on YouTube, or World's Funniest Videos.

I do feel sorry for the poor beasts* though.

*the dachshunds.

Orac, you should have just linked their "about us" page:
Amy Hayek DVM finished her certificate in veterinary acupuncture with the Chi Institute. Not feeling her education complete, she continued with a certificate in spinal manipulative therapy from the State of Wisconsin at the Healing Oasis Wellness Center and was certified by the American Veterinarian Chiropractic Association, and in 2007 completed the program for Advanced Chiropractic in Neurology at the Healing Oasis.
Bill Ormston DVM In 1998 he attended Options For Animals and became certified in animal chiropractic care by the American Veterinary Chiropractic Assoc. In 2004 he completed his degree in Veterinary Homeopathy from the British Institute of Homeopathy.

I'm just curious- exactly what animals do these chriopractors think have subluxations? Which species are subluxation-free? And how do they explain sickness in animals that don't have subluxations?

Chiropractors don't like dachshunds for the same reason Darwin didn't like the eye--except Darwin didn't poke animals in the eye and claim he was doing "research". :-P

Can I send my sea-sponge to a chiropractor? he doesn't seem to be as absorbent as he used to be. poor guy.

If an arthropod is sick, does that mean it has subluxations in its exoskeleton?

Doesn't look like they are studying subluxations to me. Looks like they are studying neuromuscular and musculoskeletal components which should be fair game to either a Vet or Chiro. What if an Vet ortho or a Vet PT was doing the same thing? Would all of you have your panties all knotted up in a bunch? It looks like this is basic physical medicine research.

Also, this is sort of interesting, no? These dogs have back problems and I can't imagine your beloved placebo effect/excuse/escape hatch is at play here. Also, of note the term "chiropractic veterinarian" can be a bit confusing. Not sure if you know this but Veterinarian Chiropractic is taught at Tufts Veterinary school...to DVM's. It is a term I have seen used by both Vets and Chiro's who perform chiropractic analysis and treatment of the musculoskeletal system of animals. A lot of DVM's embrace this. A good friend of mine travels the world treating thoroughbred horses for musculoskeletal injuries.

But please do not let the facts again get in the way of a good conspired smear campaign. Your assumptions and very narrow minds continue to confuse you. Carry on it's entertaining.

Darwin didn't like the eye

Ahh, so nice to see a creationist distortion become just a part of the fabric.

I can't imagine your beloved placebo effect/excuse/escape hatch is at play here.

And yet, it does. See here for a discussion about placebo effects in animals, notably dogs.

Funny. Everybody know that dogs are identifying us as supreme beings and almighty providers, and yet some people assert that same dogs are unable to realize that we are taking care of them. They certainly know who is feeding them.
Not to mention that the placebo effects could be on the caregiver's side. Sure, taking care of our pet colors in no way our perception of its well-being.
It amazes me.

DocWonderful says: "Doesn't look like they are studying subluxations to me. Looks like they are studying neuromuscular and musculoskeletal components which should be fair game to either a Vet or Chiro."

So what will they be doing with their "adjustments", if not treating subluxations? From the link:

"The certified doctor will adjust only the atlas and occiput until leg length is corrected and will then video the leg length after the adjustment."

Veery interesting - a little neck/head cracking and les voila! the dog's leg length is "corrected". That sure sounds like Real Science/standard chiro nonsense to me.

DocWonderful is correct in one thing - there are elements of quackery in veterinary medicine, just as you can find quackery practiced by some people with M.D. degrees.

"...it's entertaining"

To us, yes - less so for the poor dogs.

I wonder if there's good money in chiropractic veterinary treatments, and if subspecialization is working out. "Practice Limited to Subluxed Toy Dogs". :)

My dog prefers aromatherapy.

So, Cuttlefish, does your dog prefer Essence of Garbage or Oil of Rancid Roadkill? Both inspire "rolling" behaviors in mine.

If they're seriously studying leg lengths then why just video? Shouldn't someone actually measure legs? Before, after, 10 days later...

"2) The doctor will video tape leg length before the adjustment and show how it is influenced by lateral movement of the neck. Video will be labeled as Pre adjustment."

Each of these things should be quantifiable and some sort of measure of significance made. But, not without controls or some method of unbiasing the measurement itself. Beyond that, the only "measures" being done are questionnaires. No problem with perception and placebo there huh? /sarcasm

Kathryn, a word of advice: keep your dog away from livestock pastures. Apparently dogs love to roll in the piles of poo left by large herbivores (horses and cattle, don't know about sheep). A family friend's poodle was especially fond of cow patties.

Damn you! Cuttlefish, OM !
I was getting my wiener set up for Rieki.

When we first took our miniature dachshund Sniff (this is what happens when you let a 5yo name your pet) to the vet, we were told that they "get a lot of problems with their spine". Given their comical proportions, as a simple, single-species doctor this made sense to me.

We have a saying in Australia that, if something is of particularly poor quality: "I wouldn't give it to my dog." This principle fits perfectly for chiropractic.

Some countries require an authorisation from an ethics committee to make all animal testing or even using human patient data for research. Wonder how's the matter with this study.

I'm going to submit my dog 'Qua' for this.

Bacon- It seems they are treating musculoskeletal issues when they are performing the adjustment as they have described, to me. The evidence is right in front of you but you have chosen to ignore it, again.

The adjustment is legit phy med procedure and is also referred to as a Grade 5 mobilization. It was developed by chiro's but now is frequently done by DC's, DO's, MD's, PT's and DVM's to treat musculoskeletal issues. Just because the procedure is being done does not mean it is intended to reduce disease causing subluxation. Most, almost all, chiropractic adjustments are performed to treat a musculoskeletal issue. This is a narrow assumption on your part, again.

Yes, treating animals can be very lucrative. My friend who travels the globe treating the worlds greatest race horses is paid $3,000-$5,000 per day plus expenses. His house in San Diego looks over a cliff and is extraordinary. Sorry, strange but true.

No controls, no randomization, no nothing.

Sounds like standard practice in the social sciences.

Or for bigPharma where they hire ghost writers to produce their "science".

http://tpmlivewire.talkingpointsmemo.com/2010/12/drug-company-used-ghos…

Looks like a job for the ASPCA and Humane Society. Maybe even PETA (cranks vs. cranks).

No doubt vet chiros think they're treating "musculoskeletal issues" by doing neck/back cracking on pets - but the central focus, as always, is on those mysterious invisible "subluxations". A typical animal chiro site says:

"A standard test taught in all chiropractic colleges is the short leg analysis. This test successfully locates subluxations in the neck, lower back and hip. A vertebral or hip misalignment results in a muscle imbalance, producing the appearance of a shorter leg. When a chiropractor extends a catâs legs, and the neck is gently turned toward the shorter leg side, the leg will lengthen if there is a neck subluxation on that side."

Sounds an awful lot like the wiener dog study, where they're announcing plans to normalize leg length in the beasts by doing neck/head cracking.

I'm sure they'll do rigorous, rigorous reproducible measurements to show just how the dachshund legs become normal length again.

Since poor DrWonderful feels compelled to defend this nonsense, we should ask if he also believes that the dogs' legs will return to "normal" length, if his own chiro (and/or animal) patients see similar results, and what evidence supports this.

No doubt vet chiros think they're treating "musculoskeletal issues" by doing neck/back cracking on pets - but the central focus, as always, is on those mysterious invisible "subluxations". A typical animal chiro site (first one that comes up on a Google search) says:

"A standard test taught in all chiropractic colleges is the short leg analysis. This test successfully locates subluxations in the neck, lower back and hip. A vertebral or hip misalignment results in a muscle imbalance, producing the appearance of a shorter leg. When a chiropractor extends a catâs legs, and the neck is gently turned toward the shorter leg side, the leg will lengthen if there is a neck subluxation on that side."

Sounds an awful lot like the wiener dog study, where they're announcing plans to normalize leg length in the beasts by doing neck/head cracking.

I'm sure they'll do rigorous, rigorous reproducible measurements to show just how the dachshund legs become normal length again.

Since poor DrWonderful feels compelled to defend this nonsense, we should ask if he also believes that the dogs' legs will return to "normal" length, if his own chiro (and/or animal) patients see similar results, and what evidence supports this.

I'm sure they'll do rigorous, rigorous reproducible measurements to show just how the dachshund legs become normal length again.

Not arguing with your snark or Orac's general argument but this isn't all that much different from what Pharma does all the time. Look at the licensing of psychiatric drugs, many of which don't do much but make you more depressed and suicidal.

I am not totally surprised by this woo in veterinary medicine. My own place of occupation, a private, non-for-profit research company focused on basic scientific research in immunology using the laboratory mouse, has recently approved the use of "Cothivet" for treatment of skin lesions caused by cage mate aggression with the mice. Look up "Cothivet" and you will see that it is a hydrocotyl tincture with horse chestnut tincture, rosemary volatile oil, cypress volatile oil, thyme volatile oil, lavender volatile oil, foenugreek tincture, carlina tincture. Yikes! Oh yea, and it is IACUC approved usage. And I thought we were actually doing real science here. Next thing that will be approved will be spine adjustments on the mice to normalize their leg lengths along with laying on of hands to equalize their spiritual equilibriums. Woo.

Bacon- yes, leg lengths can change with upper cervical manipulation. Not the actual length of the leg, mind you. But the relative length to the other. Any musculoskeletal distortion in the spine (or lower extremities?)can lead to increased or decreased muscle activity along the kinetic chain which ultimately settles into the center of gravity (upright humans it's pelvis, SI joints, about S2 segment).

In humans that distortion can be seen in the form of pelvic obliquity...a shift in the pelvis, typically extension and rotation to one side. This pulls one leg up and pushes the other one down creating a relative difference. No one cares (or shouldn't care)about the leg length deficiency itself, it's just a way of determining how much distortion may or may not be there. Of course it is non specific and hardly a worthy tool and I do not use it myself. I'm just translating what they are saying when they talk about leg length and "subluxation" here.

It has long been known that these distortions lead to other musculoskeletal issues along the kinetic chain so dealing with things beyond where the boo boo pain might be is prudent. For example when treating a patello femoral syndrome I look at the hip flexor complex first and foremost which begin at the T12-L1 area with the psoas muscle. Omg a knee cap issue can start at the thoracolumbar junction? The scandal.

A musculoskeletal distortion, be it joint or muscle, can be treated via numerous manual techniques. One of which is an adjustment (aka Grade 5 mobilization). We call it adjustment, others call it Grade 5 mobs. We/I/DO's/PT's/MD's call the lesion a musculoskeletal distortion, some chiro's still call even this a subluxation (complex). Even fewer still think they can cure visceral diseases by reducing this lesion.

You're hung up on semantics here and are more obsessed with subluxations than most chiro's.

I also am not speaking to the validity or design of the study. I trust it is inadequate and would rely on people who do research for a living to make that determination. I was, again, clarifying that you are so myopically focused on terms that have multiple definitions and uses that your own assumptions and biases are clouding the discussion. I do this because you are worth saving, Bacon. I also enjoy it.

"yes, leg lengths can change with upper cervical manipulation."

Again, the evidence for this is what?

"You're hung up on semantics here and are more obsessed with subluxations than most chiro's."

Um, chiros are the ones who keep bringing up subluxations and how fixing them treats disease. The vet chiros do this as commonly as the ones who address alleged human subluxations.

I realize this embarasses those chiros who have view themselves as reformist (or at least minimally evidence-based). I once participated in an e-mail list on health quackery featuring a chiro college faculty member who kept insisting that subluxation theory was on the way out. He could never explain how not only practicing chiros insist on heavily promoting the idea of subluxations, but major chiro organizations continue to validate the theory, which is essentially unchanged from way back when Daniel Palmer invented it (and magically cured a janitor's deafness despite the fact that Palmer's manipulation could not have affected hearing).

It's like homeopathy - the principle is ludicrous, but practitioners and "researchers" who've convinced themselves that their practices are effective are constantly searching for mechanisms to explain why this should be so and churning out jargon-filled justifications for what they do. In the case of chiropractic, "subluxations" are what separate you from physical therapists, massage therapists and other layers on of hands who achieve similar results. You'll never give them up.

And the winner of the funniest comment when taken out of context award goes to Harbo @25

I was getting my wiener set up for Rieki

Ahh, so nice to see a creationist distortion become just a part of the fabric.

Sorry, CW (and others). I later realized that what I posted could be misunderstood. I was being facetious, but LIT (lost in translation). My error. (for the record, NOT a creationist as in Dawkins is NOT a theist). :)

@Bacon- all I can say is that it is changing and has been for about 25 years. The disease causing subluxation is not the cornerstone of the profession and is not the primary focus of most practices. The nomenclature has changed even more slowly so you can still commonly find the written words rather easily, especially if you are focused on it like a laser guided ill tempered sea bass. Truth be told, you guys are about the only ones who really care about the semantics anymore.

Over the last 10 years we've seen this evolution speed up quite a bit. Most graduates today do not subscribe to previously held beliefs and are practicing at a very high level. If all you're going to do is show me internet ads, again, I really can't tell you much more in response. A major problem is that several state scopes and Medicare require that chiro's use the subluxation nomenclature (and only the nomenclature)...doesn't mean the practices themselves haven't not been evolving.

I would LOVE for some chiro vet to try this with my cat (grins evilly)

These people (operating out of Dallas and Myrtle Beach, respectively) are actually vets who have gone off-the-rails into doggie-woo!

Guess what? They sell "products".

Is there any ethics group in vet medicine that might question this "study"?

I hope all 400 weenies bite the hand that "cracks" them!

@ DrWonderful

Care to explain to me why animals are not susceptible to placebo effects?
(which you asserted in your post #17)

@Seb30- Do you really think you could perform manual therapy, including manipulation, on a horses pelvis and it would run faster and with more stamina because of a placebo effect? Does that even sound reasonable? Maybe I'm wrong but cognitively the horse really has no clue what the expected outcomes may or may not be when being treated. If there is something that says otherwise be please enlighten me.

DrWonderful: "The disease causing subluxation is not the cornerstone of the profession and is not the primary focus of most practices."

Hmm, puzzling then that subluxations are still recognized by leading chiropractic organizations, chiro colleges, and promoted heavily by chiros as the prime reason for their adjustments.

It's hilarious that DrWonderful blames Medicare for keeping the term alive, when it was chiros who in the early '70s successfully lobbied the government to get Medicare payment for treatment of "subluxations", developing a laundry list of supposed objective signs of subluxations (but which, anatomically speaking, are nonsense). And of course Medicare has since relaxed its requirements so you don't have to show evidence of subluxations on x-ray, which is nice since x-rays (beloved of the chiro profession) don't actually show them.

Speaking of "evolving", it's noteworthy that when the Council for Chiropractic Education recently proposed removing the word subluxation from the lexicon of schools getting accreditation, there's been a tirade of opposition from the schools and practicing chiropractors, like this one:

"You want to take subluxation out of chiropractic? Let me guess⦠hmm. Now why would you want to do that? You think this is some kind of freaky cult phrase that relegates chiropractors to the Stone Age and stigmatizes them as faith healers, or something like that."

Well, yes. :)

It'd be amazing if chiropractic took a first step towards evidence-based respectability by dumping the phantom subluxation, but we shouldn't hold our breath.

Speaking of "freaky cult" stuff, I'm still waiting for DrWonderful to provide evidence of successful leg lengthening of patients getting neck cracking (or other forms of chiro adjustments).

Bacon- honestly, who cares? You guys are the only ones who care about this level of a picayune ninny-ninny argument. CCE had no choice but to keep the nomenclature in place because of the reasons I outlined above...ignore it if you want. That does not mean the profession isn't evolving.

The term subluxation is multi-faceted. It is a musculoskeletal lesion that causes pain and/or dysfunction and is coupled with soft tissues distortion as well. It typically involves and is part of a kinetic chain extending several joints and overlapping muscle systems. The issue here is whether it can cause disease and no longer believe it can. Most chiro's use the term when discussing the exact same musculoskeletal or neuromuscular lesion as an MD (typically PMR), PT or DO. It's just semantics now.

To be honest, no one cares what you guys think. I wish they did and I even tried showing them what you think. No one cared. Even the guys who know you from your Quackbusting life simply do not care. They think this is all about nothing and y'all just like to masturbate mentally.

@ Dr Wonderful some posts above

Ah, horses' pelvic manipulation. Nice choice.

Are you telling me horses have no clue we expect them to run fast? I would think that all the whipping and spurring tell them we expect something.
It's actually the basic of animal training. Rewards for good behavior, punition for bad behavior.

As for the horse's ability to figure out what's the human expected objective, please read the story of Clever Hans.

As pointed in the SBM article linked in my previous post (#19), animals do not need to understand what's being done to them, or what we expect. All they need is to know that we are doing something. Our behavior around vets could condition the animal to 'feel better' after a visit.
Heck, this conditionning applies to humans, too. A lot of us feel better after visiting a physician, if for no other reason it's over and we are going back to normal life.

Also, an existing placebo effect does not necessarily arise in the animal; it could be in the eye of the beholder. Are the horses running faster, or are we making them running faster (are they even running faster?)

It would be nice to have a study displaying your horses' pelvic manipulation's results. Double-blinded, with speed measured before and after. And the control horses should receive a good petting or similar calming interaction.

Finally, stay classy. I just read your last answer to Dangerous Bacon and I'm not impressed by your arguments.

@DrWonderful

Re: Placebo effect in animals

Just to clarify something that Seb30 mentioned, when conducting studies on animals, it is very important for the researchers to be blinded to the treatment the animals receive. Otherwise, the researchers may behave differently depending on which treatment the animal received, even without being aware of it. Animals can pick up on these subtle cues.

For instance, say you manipulate a horse's pelvis. Knowing that the horse received manipulation, your attitude toward the horse may change (more encouraging or energetic), your perceptions of the horse's behavior may change, leading you to see improvement even when there is none. Conversely, suppose you have a control animal that you know did not receive manipulation. Your attitude may be less encouraging or energetic and you may perceive no improvement or worsening, when there is no change or even slight improvement.

As another example, someone here mentioned (can't recall the thread) about how their SO other was worried about their dog's health. Every time the SO would enter the room, the dog would pick up on the worry and start behaving in a "worried" or "unhealthy" manner. As soon as the SO left, the dog was back to its normal, lively self.

The placebo effect most certainly can occur in animals, and observer biases also play a role in skewing observations. To assume that the placebo effect cannot, under any circumstances, occur in animals (or babies, for that matter) is to invite error into your data.

DrWonderful: "Bacon - honestly, who cares?"

Says the guy who's been harping on the idea that the 400 Wiener Dog study has nothing to do with subluxations and that chiropractic is phasing out the term, but who then tries to redefine it as "a musculoskeletal lesion that causes pain and/or dysfunction and is coupled with soft tissues distortion as well." (in other words, anything we think we can treat and get paid for).

Obviously lots of people care about subluxations - most notably the CCE which has tried to dump the term (did they give up on this? I thought the proposal was still at least technically under consideration) and the outraged chiropractors who've deluged them with complaints.

Here's a dynamic article from Dynamic Chiropractic discussing how the profession can take chiro education away from the "left-wing fringe" types on the CCE and substitute lots of nifty things for the outmoded basic science curriculum. This makes fascinating reading. Out with biochemistry, in with metaphysics! And you've gotta love the "clinical paradigms" he wants to teach, notably:

Salutogenesis
Eu-stress vs. Dis-stress
Ease vs. Dis-ease

It doesn't get any woo-ier than that.

Relax, folks, despite the would-be chiro reformers, chiropractic will be providing us with lots of choice lunacy to poke fun at for many, many years to come.

When I read the title of the post, I thought Orac wanted 400 dachshunds to crack his back.

I wonder how many of those poor dogs they're going to paralyze before they realize what an especially terrible idea it is to apply force to a dachshund's spine?

@trepto- who said anything about applying force?

@Bacon- per the norm you have done your best to cherry pick certain quotes and citations from isolated individuals and try to imagine that it represents the profession as a whole. Did you read the thousands of pages of comments supporting the proposed changes? I know, I know. Posting that wouldn't help support your bias and imaginary crusade. Leaving out the truth is like lying, you do realize that don't you? Then again, with no soul, who cares?

Anyway, I have no idea what CCE will end up doing, their report is not out yet as far as I know. I do assume they will not be able to change the nomenclature, yet, because of the scope issues in a few states and Medicare. I and many others do wish we can get to that point

A little history (I'll do my best to correct your revisionist history) when Medicare was passed for chiro's the bill simply authorized HHS to write rules about chiro scope in Medicare. They handed us the scope, it is not what was lobbied for. What they came up with is what we got and few were happy about it then and most everyone remains disappointed to this day. I know that does not fit your pre-determined and well imagined position but, again, some truth for you to ponder.

@Dr Wonderful

@trepto- who said anything about applying force?

You mean chiropractors don't exert any force in their manipulations? First, from what my dad went through when he was consulting a chiropractor, I doubt it. But OK, it's just my n=1, so let's accept your version.
Then, pray tell, how do chiropractors have any effect on their patients?
If you meant that only minimal forces are applied, how do you know they are minimal? And how whatever chiropractors do is different from a soft massage or a vigorous brushing?

BTW, what do you think of Clever Hans?

@Seb30- A chiropractic adjustment is the same thing as a Grade 5 mobilization of the joint (as done by PT's, MD's, DO's and DVM's but developed by chiro's). Just different nomenclature. Semantics again.

It is a high velocity/very low amplitude (force)thrust and only takes the joint into the paraphysiological range of motion. For structural damage to occur the joint must be taken into the pathological range of motion with a high amplitude (force). This happens more frequently in poorly trained providers and very rarely with chiro's. It's simple. We are trained to use very little force but some speed and only at a specific point in the range of motion.

I didn't say adjusting a dog like this wouldn't be tricky but if the provider is trained properly it would be very low amplitude and well within the joints physiological range of motion. In this case it may even be instrument assisted.

The goal of an adjustment, or Grade 5 joint mobilization, is to free the joint space thereby returning the joint to it's normal full active and passive range of motion. This reduces mechanical stress on the joint and surrounding supportive and active tissues. Neurologically during the thrust the mechanoreceptors are stimulated which has been shown to reduce nociceptor output and help normalize proprioceptor balance.

When compared to long lever/low speed Grade 4 mobilization (PT of old) the amount of neurological activity in the joint is incredibly higher in a grade 5. The speed thrust involved in a Grade 5 mobs is what seems to make the greatest difference in stimulating mechanoreceptors, dampening nociceptors, and enhancing proprioceptors.

Certainly quite different than massage which only mechanically breaks adhesion in soft tissue.

I hope this helps.

@Charles King: ROFL...

McCarthy, comment #30: You, sir, are an idiot:
Threats to science-based medicine: Pharma ghostwriting (revisited).

Learn to use the handy dandy search box on the upper left part of this page.

[Chris: McCarthy, comment #30: You, sir, are an idiot:
Threats to science-based medicine: Pharma ghostwriting (revisited).

Learn to use the handy dandy search box on the upper left part of this page.]

Are you DEFENDING Big Pharma Ghostwriting? Or.. are you saying SBMs lip service given to Big Pharma ghostwriting is a defense of SBM?

Meaning, "we almost always side with pharma and we almost never critically analyze pharma policy." ("mainly because we are obsessed with 'woo peddlers' and their atrocities against our ideology")

Also, in your library studies, have you ever known of a doctor falling for these pharma ghost writing tactics? Or are they all too smart to fall for marketing and psychological techniques.

Has a doctor actually written a vioxx or avandia prescription that resulted in the death of their client based on a ghost written article? Do you think no prescriptions were written that resulted in harm because of ghost written article? Were they written in the name of woo or the name of science?

DrWonderful speaks of "revisionist history" and claims the following:

"when Medicare was passed for chiro's the bill simply authorized HHS to write rules about chiro scope in Medicare. They handed us the scope, it is not what was lobbied for."

The truth is a different matter. From Quackwatch's useful reference on "subluxations".

"In 1973, Congress authorized payment under Medicare for chiropractic treatment of "subluxations demonstrated by x-rays to exist." In 1972, to enable payment, chiropractors held a consensus conference that redefined "subluxations" to include common findings that others could see. The document, several pages long, described the supposed x-ray manifestations of 18 types of "subluxations," including "flexion malposition," "extension malposition," "lateral flexion malposition," "rotational malposition," "hypomobility" (also called "fixation subluxation"), "hypermobility," "aberrant motion," "altered interosseous spacing," "foraminal occlusion," scoliosis, and several conditions in which "gross displacements" are evident [4]. I have been unable to determine how many billions of dollars chiropractors have received from Medicare since the law took effect."

Billions and billions, as Carl Sagan would say. :)

DrWonderful earlier claimed that the "subluxations" favored by chiros describe the same lesions termed subluxations by MDs and other health professionals. This is nonsense, as medical subluxation describes a specific, imaging-detectable lesion defined as a partial dislocation, i.e. of a bone within a joint. For chiros on the other hand (as DocWonderful has shown us) "subluxation" means a myriad of things, vague and non-reproducible, which have in common a "boo-boo" (to use DocWonderful's term) that can be adjusted to get a fee for the chiropractor.

But to DrWonderful these inconvenient facts are just "cherry-picking" and "smear" tactics, and every example provided of chiros clinging to the old nonsense (sometimes dressed up with sciency-sounding woo like the "grade 5 mobilization") must be false since there are hordes of invisible, earnest science-based chiros out there, or at least that's what DrWonderful would have us believe.

Won't somebody speak for the dachshunds?

Bacon- again mixing some truth with misleading falsehoods to create an alternate reality. Stuck mentally masturbating on semantics...and the distant past. There is nothing more masturbatory than quoting Quackwatch's slanted, biased and heavily ommitted garbage. Just like Ernst constantly quoting himself...no credibility and is laughable. I thought you were evidence based, which usually means peer reviewed?

The medical use of the term subluxation is not the same as the chiropractic use of the same term. Admitted. Main reason why I want the term discontinued in my profession. However, what an MD (PMR), DO, PT and DVM commonly treats with manipulation, soft tissue release, physiotherapeutic modalities, lifestyle/ergonomic counseling and rehab is not very well defined. Not our fault they have no idea what they are doing or why they are doing it. But they are doing it (and not so well). They are not treating medical subluxations and neither are we.

But they are treating basic joint and soft tissue distortions/kinetic chain disruptions that some chiropractors still call subluxations. Mostly everyone is just treating musculoskeletal diagnosis' with standard physical medicine procedures, including Grade 5 mobilization, and are not so obsessed with the semantics and ninny-ninny arguments like many of you here. The camp has moved on and no one really cares. You've done your best, it failed. Get over it and move on.

Collectively, by now sharing the same scientific journals, the various disciplines are forming a common nomenclature so that we can communicate better and are getting along very well. The medical use of the term subluxation is not in play here, never was and I have been pretty clear about that. More revision Bacon? It's you that seems to be rearranging the truth to fit a certain agenda. You only throw junk now. Remember even if you have no soul, lying, cheating and stealing is still wrong. Unless you're on a crusade, of course.

DrWonderful says -

yes, leg lengths can change with upper cervical manipulation. Not the actual length of the leg, mind you. But the relative length to the other.

I've read this about 10 times, and I just can't crowbar this into my head. The leg length relative to what? It seems that cracking the spine won't change the distance from the heel to the ankle to the knee to the hip, will it? If so, how? If not, where is leg length measured? From where to where? How is the measurement done? Can I get a picture?

Or is it some sort of carnival trick? By laying on the floor, with my legs together, and very slightly moving them from side to side, I can make them appear to change length relative to each other. But chiropractors wouldn't do that, would they? They have to have a better way to measure than that, right?

Subluxation is still a term used by Chiro in Canada. No medicare definitions here. Yet here it is......Sounds like Physical Therapy envy by Dr. Wonderful.

Johnny and Agashaem- You'll both need to go back and read what wrote a little more carefully. I know it's a lot of words and will require that you think outside the little biased box you've put yourself in but the answers are already there.

Leg lengths can changes relative to each other if there is obliquity in the pelvis. That obliquity in the pelvis can be the result of kinetic chain distortions anywhere in the musculoskeletal system, even extremities. This is not controversial and accepted across all disciplines of physical medicine.

Yes, the term subluxation is still prevalent as a way to describe the musculoskeletal lesion chiropractors treat. It is changing. However, it can be used without the intent to say that lesion can cause visceral disease. For such smarties you guys do not read very well.

And Agashem, it is the PT's who are trying to copy chiro's. They are trying emulate just about everything we do. It's quite flattering. In the past 5 years I have had more PT students shadowing me on rounds than chiro interns.

@ DrWonderful

I hope this helps.

Not really. You just buried us under professional jargon.

Since I have no clue what you are talking about, I have to declare forfeit and let people who are more medically educated than me continue the discussion.

However, I take note that you recognized that chiropractors are applying force. I hope that you know that you are doing.

And I reiterate my previous wish. A published study of your horses' pelvis' manipulation and the subsequent increase in their performance would go a long way in convincing us.

Sorry, but I don't believe you re: PT students. But then I am in Canada and things, believe it or not, are different here. As for jargon, feel free to keep using it. I will continue to ignore it. Show us double blinded animal studies that don't rely on the owners subjective interpretation of the results. And before you think I am being unfair, parents of children with CP are also very poor at measuring outcomes of interventions but at least the people studying that group acknowledge that as a serious shortcoming.

Seb30- sorry, I wrote the explanation in basic neurologic, physiologic and anatomic terms used across all disciplines of physical medicine.

Essentially when a joint is distorted in it's position and movement (because the joint is fouled up or because the soft tissues controlling the joint are fouled up, or both) this obviously causes the articulation to lose mechanical advantage and can lead to pain, dysfunction, swelling, muscle spasm, structural damage/ acute injury and if left for too long, presumably, advanced and accelerated degeneration. This is sort of obvious. Correcting that distortion relieves pain and restores function and in itself is a worthy pursuit.

What's more interesting is that the neurologic components of the joint and soft tissues (which vary slightly based on where they are on the body) have an overarching connection to other articulations up and down the kinetic chain and can influence movement, position and function of other articulations. In other words the musculoskeletal system is increasingly being viewed as one interlocked system comprised of multiple separate but interdependent and overlapping structures.

For example this is how a complex of joint and soft tissue dysfunciton at let's say the T12-L1 area can, but not always, cause the knee cap to move inappropriately causing a patellofemoral syndrome. The strongest and most integral hip flexor in the human body is the psaos muscle and it's upper most origin is at T12-L1. If too tight or overworked itself or hypertonic due to joint dysfunction anywhere from T12-L5 to the hip itself the psoas can lose mechanical advantage and that will cause the paralumbar muscles, hip rotators and hip extenders to distort in function. This can, and often will, cause articulations along the chain from T12 down to the knee to also distort and can cause the patella to turn slightly in it's groove roughening it's under surface causing pain and inflammation.

In that distortion pattern you may find the pelvis is tilted and/or rotated because of the resultant asymmetry in the two psoas muscles. This can alter the relative leg length length if you are interested in measuring such a thing. I rarely do.

To treat this effectively we now look at the entire involved kinetic chain and find the problem and attempt to fix the whole thing including the lifestyle issues that caused the distortion in the first place (sitting on wallet, bad chair, sleep posture, etc).

At a deeper level the actual neurologic components of the joint seem to be coordinating much of the choas and correction. The joint mechanoreceptors measure and influence mechanical movement of a joint. The nociceptors measure pain and chemical irritation. The proprioceptors link joints together in essentially a neurologic chain allowing for coordinated movement and balance of all joints and keeping you ambulating upright. Each component is hard wired to the central nervous system where the big picture is monitored, coordinated and influenced.

The chiropractic adjustment, aka Grade 5 mobilization, is a high velocity/low force mechanical impulse into the articulation that stimulates the mechanoreceptors. This causes nociceptors (pain) to dampen and proprioceptors to reset and search for normalcy and reconnect with other points in the chain. CNS modulated.

Other factors include soft tissues release and exercise to reduce that kinetic chain distortion. I hope this is clearer.

Yes, we know what we are doing when it comes to manipulation and musculoskeleatal injuries.

@Agashem- I guess I should have mentioned that I work with professional athletes and there is a long line of PT students and chiro interns waiting to work with our group.

Chris @30

Your assumption that I care about your opinion of me proves you are mistaken.

I see DrWonderful has been reduced to name-calling and flailing around with jargon, rather than acknowledging the evidence provided (i.e. regarding chiropractors being instrumental in getting Medicare to pay for treatment of subluxations, rather than the ludicrous claim that the terminology was forced on the poor chiros by Medicare). And he still hasn't responded to the request for evidence that chiropractic neck-cracking can normalize leg length.

There is one telling quote from DrWonderful:

"Mostly everyone is just treating musculoskeletal diagnosis' with standard physical medicine procedures".

This has a degree of truth if one includes chiropractors in "mostly everyone". A lot of it comes back to the laying on of hands being therapeutic in certain instances, and chiros who know their limitations may be effective in cases where others are not (and vice versa). The problem is that chiros have invented an encyclopedia of gibberish jargon to explain their alleged uniqueness/superiority (see DrWonderful's explanations and the list of woo in the Dynamic Chiropractic article I linked to in comment #49) and an array of gadgets and machines that are supposed to impress the marks clientele into forking over their dough. Worse yet, this hocus-pocus is used to justify back/neck cracking to treat internal medical complaints.

Chiropractic can dump the term "subluxation" if it wants (not very likely) but it's left with a clinical paradigm based on a limited scope which has been expanded by many practitioners into a deceitful model of overall primary care. Until it addresses that problem, it will still be synonymous with quackery in many people's minds.

Bacon- I do find it intriguing, and a little creepy, that you have such strong and forceful opinions while at the same time knowing absolutely nothing about your subject matter.

Leg lengths can changes relative to each other if there is obliquity in the pelvis.

So.... carnival trick, right? The actual legs, from "heel bone" to "hip bone" may be equal, but if the pelvis is tilted, the tilt can be added and subtracted to each leg, right?

How do you, Dr Wonderful, measure this on a routine basis?

My anecdotal evidence is that athletes are notorious for wanting all manner of woo. That you happen to be attached to a sports team does nothing to improve your credibility. I will say I am sorry that you think that you really are teaching anything to PTs; in Canada to become a PT you need an A+ average. Not so to enter chiro school. Who would you want working on your body.....

It's almost comical. If Johnny could read he would know I do not measure this and do not consider it an accurate assessment tool. Most chiro's and PT's barely care.

This is like red meat for you guys and I love it because we can make y'all chew on anything if it has the right seasoning. Ask yourself why you should give a shit first before munching down on any word that is hanging out there! Like crazed scripture throwing fundamentalists. It's literally nuts watching you guys go round and round chewing on any meat you can get your teeth in. A lot of people come in here and just to watch me throw meat on the floor and watch you climb over yourselves to see who is snarkier. It's awesome and entertaining beyond belief. Yes, we sometimes mock you too, sorry.

Anyway, if I notice a leg length differential I really don't even mention it to the patient. I am merely stating here that distortions along the kinetic chain can cause obliquity of the pelvis which will push one leg down and pull one leg up causing a relative difference between the two...and that's what the leg length guru's are talking about. I'm just translating the nomenclature for you and barely care about the validity of the test or your opinion of it.

This has nothing to do with the anatomic length of the leg. It is all about kinetic chain distortions and trying to find a way to measure it. If these blokes find a way to quantify it then more power to them. I have never used it as a tool myself. There is no carnival act with me. You'll have to get over yourself.

Yawn...ok guys I had fun. We'll do this again sometime. I believe I have answered everything above and really am not interested in fighting off the inevitable word distortion, scripture hurling game y'all play.

I could not find the study I thought demonstrated that upper cervical manip changed leg length...admitted mistake. Sorry Bacon, my firend, I failed you there.

It is an observed phenomenon and in my opinion it's somewhat useless anyway unless we can quantify it and demonstrate it adds anything to the standard ortho/neuro/kinetic chain exam (see Janda, Lewitt, Liebenson, Leahy etc for more seasoning). I do think leg length discrepancy is a superficial result of the kinetic chain distortions I was discussing above, we see it all the time, but it's not a good tool. See ya.

No, you did not answer any question. You just buried us under pseudoscientific garble, without anything to back up your claims, despite us asking you repeatedly.

why you should give a shit first before munching down on any word that is hanging out there!

Because we don't have to believe whatever you say just on your good word. And because not everybody is a self-centered douche bag and some of us try to be honest while interacting with their fellow human beings.

Shorter DrWonderful # 72- I'm just here to bullsh* you.

So all you told me was just lies and red herrings?

Duly noted troll.

I was trying, dammit.

Ok I peeked, I admit it.

@Agashem- professional athletes seeks treatment with chiropractors because of the outstanding results they get. We're very highly respected and very competent in the sports medicine world. Did you know the Medical Director for the US Olympic program is a chirorpactic physician? Shocking, huh? The medical administration of the US Olympic program is in no way in love with woo, is it? They hired a chiropractor as their top dog (no pun).

@Seb30- What I provided you is a brief tutorial on the analysis and treatment of kinetic chain distortions as applied by DC's, MD's, DO's, PT's and DVM's. There is nothing I can about the fact that you do not understand it. It is rather pathetic, however, that your arrogance allows to call something pseudoscience just because you know nothing about it.

This is basic contemporary physical medicine and not only are chiropractic physicians part of it, we are leaders within in.

I remain unimpressed. A chiropractor was (maybe still is) science minister for the federal government of Canada. Does not make him in any way shape or form a scientist. Having a chiropractor as head of Olympic medicine does not make it credible for evidence. Would a chiropractor be head of a medical school that would be shocking, not that it will ever happen in our time.

@agashem- I will agree that having a chiro as the head of a medical school would be shocking...and inappropriate. The same could be said if it were either a podiatrist or optometrist too!

Weiner dog chiropractic practically screams "you tube parody video".

The sad thing is that while DrWonderful is deep into some kinds of chiropractic woo, he's actually fairly evidence-based compared to many of his colleagues - particulary on the subject of vaccination, which he has stated here that he supports.

A high percentage of chiros (half or more by some polls) are antivax and discourage patients from taking advantage of immunization. The most respected (?!) chiro organization, the American Chiropractic Association, currently has an article up on its website deriding immunization against flu. It suggests that the best protection against flu may be getting the flu itself (handy unless you happen to get gravely ill or die in the process of acquiring immunity) and urges "natural" protections instead, in the form of such preventatives as garlic, tea and echinacea.

Further, the A.C.A. sets out in its current policies opposition to mandatory public immunization and the idea of "opting out" of vaccination:

"Resolved, that the American Chiropractic Association (ACA) recognize and advise the public that:
Since the scientific community acknowledges that the use of vaccines is not without risk, the American Chiropractic Association supports each individual's right to freedom of choice in his/her own health care based on an informed awareness of the benefits and possible adverse effects of vaccination. The ACA is supportive of a conscience clause or waiver in compulsory vaccination laws thereby maintaining an individual's right to freedom of choice in health care matters and providing an alternative elective course of action regarding vaccination. (Ratified by the House of Delegates, July 1993, Revised and Ratified June 1998)."

It's a disgrace that the A.C.A. gives aid and comfort to antivaxers including the many chiros who damage public health efforts through their antivax activities. I would happily give chiropractic a blank check to advertise all they want about their alleged superiority in healing the "kinetic chain" if they'd just stop the anti-immunization propaganda.

Seriously, this website is just a big circle-jerk for a bunch of close-minded people masquerading as intellectuals. Have any of you BEEN to a chiropractor? I've been going on and off since I was in a car accident when I was 12 years old. I am now 29. Never, ever, EVER have any of the various DCs I've been to, in multiple US states, EVER told me that they were going to cure some disease caused by subluxation. They treat back pain. By assuming all DCs are promising to cure blindness, you're throwing the baby out with the bathwater. Similarly, an earlier commenter mocked Cothivet for containing a small percentage of plant oils - 'cause, it's just CRAZY to think that plants might contain chemical compounds that could have medical effects. I mean, we all now that salicin just a big hoax, right? Menthol? Total bunk! You only THINK your opioid receptors are being activated. No, adding plant oils is obviously to channel some natural spirit, not to take advantage of naturally occurring chemicals like pinenes and terpines. And who needs phytochemicals anyway? Even plants just have them for fun - they certainly aren't part of an evolutionary progression that enables plants to fend off destructive fungal, bacterial, and viral infections, or to ward off damaging insects.
Fortunately, much like the quacks you bemoan, ya'll are mostly harmless: I don't see chiropractors disappearing any time soon.

The accusation of being "close-minded" is common among supporters of woo. Being dubious of health claims made solely on the basis of testimonials, appeals to the succesful status of quackery promoters and impressive-sounding but nonsensical jargon does not mean being "close-minded" - it's a hallmark of rational thinking.

" By assuming all DCs are promising to cure blindness, you're throwing the baby out with the bathwater."

No one has said any such thing. Those chiropractors who know their limitations and stick to treating musculoskeletal complaints can do some good, comparable to what's achieved with physical and massage therapy (for example). It remains true that a depressingly high percentage of chiros go beyond those boundaries into useless, potentially dangerous (but lucrative) forms of woo.

Pointing this out often leads to personal attacks by chiros (as in this discussion) or lawsuits.

As to whether one must sample woo before criticizing it - sorry, I'd rather save time and money. I've had back issues on occasion; when my back has gone out I find that rest and heat resolve the problem within 7 days or so. I could have gone to a chiropractor and been better in a week, but the expense doesn't seem justifiable (wonder what's been spent for Natasha's treatments and "maintenance" over the last 17 years).

I just want to say that my first thought on reading the title of this post was that it would be about a new treatment for lower back pain that involved having dachshunds walk over the patient's back until the pain went away...It sounds at least as plausible as the actual study...Hey, I wonder if NCAAM would be interested in funding...

I wrote a petition and posted it on change.org, click animals, then search for '400 Dachsunds Wanted For Back Cracking'. In two days we got 113 signatures. Thanks for caring enough to bring it to the public's attention.

Those poor wiener dogs are getting their back re-aligned.
What did they do to deserve,.... Wait,... That's not so bad.
In fact, alot of people pay good money to have their spine re-aligned. Now that I think about it, they're getting the special treatment. So why is this artical making it out to be so terrible?
Even if it was bad, god gave man kind supremecy of all creation. So it doesn't really matter anyway.

To me, this just seems like a naive moron just looking to give some company a hard time.
Like enviromental exremists telling us the earth is running out of water(Tards, like 70% of the earth is covered in water. Trust me, it's not going anywhere). Or saying that melting the polar ice caps will flood the earth(Fill a glass with as much ice as you want, then fill it to the brim with water. Then, leave it out till it melts. Does the water RISE & overflow? Or Does the water go DOWN? It goes Down)

Ahhh a thread necro who is chock full'o'fail....