Here it is 7:20AM on Monday morning, April 12th, 2010. Today is the first day in my new office. As I look back on my many years in chiropractic I realize that every office i have had (4) has been a new and exciting endeavor. This one is no different, and I look forward to seeing what will become of my new space. One thing is for sure, I needed a new space. As I moved out of the old space i realized I saw about 20,000 patient visit there, and the carpet was never replaced, and it was never repainted. the dust was thick under the equipment and I was really glad on move on from that space. So it’s out with the old and in with the new!
I recently had a student at one of the Karate Dojo’s that I do sports care demonstrations for, ask me for an interview, for an upcoming ‘Spotlight on health’ article for the Portland News Science Examiner.Her name is Halley DeLay, and she is the Science News Examiner.Here’s the interview we had.
Dr. Watson
Question 1: What is chiropractic and how does it work? Can you run me through the various treatment modalities in chiropractic and the physiological mechanisms that they utilize for treatment? Also, what are the different disorders that chiropractic would be a viable treatment for?
Chiropractic is a healthcare system, which utilizes methods to detect and correct spinal subluxations. A spinal subluxation is defined, most succinctly, as a misalignment of a vertebra, which causes interference to the function of the nervous system. The nervous system is the main controlling and coordinating system of the body; therefore correction of interference to this system can only result in a normalization of the function of the nervous system. It is not accurate to think of chiropractic care as a treatment, or cure, for a specific symptom. Chiropractic care does not treat or cure disease, infirmity, or maladies. Rather, chiropractic assists the body to heal itself naturally, by removing interference to the main controlling and coordinating system of the body - the nervous system.
Question 2: In your presentation you mentioned research a number of times, what research supports the different chiropractic treatments that you use in your practice? Just the citation is fine for most journals as I can access quite a few journals through the PSU information system.
There is an enormous body of research involving chiropractic care that can be read and disseminated. Below are a few various articles I found on short notice. To obtain further research studies please contact the Palmer Center for Chiropractic Research at http://www.palmer.edu/research.aspxand use their “How to Conduct Searches” page at http://www.palmer.edu/research_content.aspx?id=4276
However, if your inquiry is to attempt to better understand the simple concept of chiropractic, I recommend you read Grays Anatomy and Guyton’s Physiology, which can easily be found in most college libraries. Read the chapters on the nervous system and the spinal column.
Various research and abstracts:
Effects of Chiropractic Care on Athletic Performance in Baseball Players. Schwartzbauer J, Kolber J, Schwartzbauer, DC, Hart, JDC, Zhang J. Paper Presented at the National Subluxation Conference, October 12-13, 1996 Phoenix, Arizona, Sponsored by Sherman College of Straight Chiropractic. Published in the J of Vertebral Subluxation Research Vol. 1 No. 4. 1997 as Athletic performance and physiological measures in baseball players following upper cervical chiropractic care: a pilot study.
Abstract:The athletic performance of university baseball player was assessed before, during and after chiropractic care. Each athlete’s performance was evaluated by athletic abilities, such as the vertical jump, standing road jump. Linear space (specified), broad jump (speci172
fled), muscles strength; and physiological tests such as electrical cardiogram, blood pressure, pulse rate and treadmill stress testing. 28 players were recruited for the study. Twenty players completed the entire experiment with usable data. All players were randomly divided into control and experimental groups. Every player was required to complete three sessions of athletic ability and physiological tests. The first test was administered before any chiropractic care was given. The second test was given after six weeks of chiropractic care. The third test was given after fourteen weeks of chiropractic care. Only the subjects in the experimental group received chiropractic adjustments to remove/reduce vertebral subluxation. The results showed a positive correlation between chiropractic adjustments and athletic performance.
Note:In addition to the above improvements, the chiropractic group showed significant improvement in capillary count at five and fourteen weeks of chiropractic care. Since healthy oxygenation of tissues is dependent up blood supply, this physiologic parameter may be the most important one of all.
Chiropractic effects on athletic ability. Lauro A. Mouch B. Chiropractic: The Journal of Chiropractic Research and Clinical Investigation. 1991; 6:84-87.
Fifty athletes were tested. They were divided into two groups. One group received chiropractic adjustments, the other served as controls. Eleven tests were used to measure aspects of athletic ability including: agility, balance, kinesthetic perception, power, and reaction time. After 6 weeks, the control group exhibited minor improvement in eight of the 11 tests while the chiropractic group improved significantly in all 11 tests.
In a hand reaction test measuring the speed of reaction with the hand in response to a visual stimulus, the control group exhibited less than a 1% response while the chiropractic group exhibited more than an 18% response after 6 weeks. After 12 weeks the chiropractic group exhibited more than 30% improvement.
Improvements Following the Combination of Chiropractic Adjustments, Diet, and Exercise therapy. GS, Sauer AD, Wahl DR, Kessinger J. Chiropractic. The Journal of Chiropractic Research and Clinical Investigation 1990; 5:37-39.
Author’s abstract: Case reports of four individuals and the effects of chiropractic adjustments on their cardiac dysfunctions as monitored by ECG are presented. Patients with varying symptoms had a baseline ECG taken. A treatment plan was implemented consisting of adjustments combined with exercise and diet recommendations. At the end of the treatment period, a follow-up ECG was performed and three of the four patients showed improvement.
Chiropractic management of a hypertensive patient: a case study. Plaugher G, Bachman TR. JMPL 1993: accepted for publication.
A case study of a 38-year-old male presented with a complaint of hypertension of 14 years duration and side effects of medication (Minipress and Corgard) which included bloating sensations, depression, fatigue, and impotency. Chiropractic analysis revealed vertebral subluxation complex at levels C6-7, T3-4, and T7-8 motion units; adjusted using Gonstead technique. After three visits patient’s M.D. stopped the Minipress and reduced the Corgard. After six adjustments Corgard was reduced again. All medications were stopped after seven adjustments. Medication side effects had abated as well. After 18 months patient’s blood pressure remained at normal levels.
The management of hypertensive disease: a review of spinal manipulation and the efficacy of conservative therapeutics’. Crawford JP, Hickson GS, Wiles MR. JMPT 1986; 9:27-32.This is a discussion of the literature relating high blood pressure to various factors, including stress and how that relates to the autonomic nervous system. As the author writes (from the abstract) “Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regiments, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice.”
Question 3: In your presentation you did a series of tests on people’s arms and legs to see where there are problems. What exactly is this test and how does it work? Is there research to support your treatment method?
The majority of the “tests” you saw demonstrated at the dojo are common orthopedic exams known as muscle testing and grading. I believe these are the “tests” you are referring to.Chiropractors, Neurologists, and Orthopedists commonly use this examination protocol regularly. The examiner asks the patient to contract against the examiners resistance.Strength and amplitude of muscular contraction are evaluated. The clinician can use the tests to assess the function of the peripheral nervous system, and the musculosketal system. The patient’s ability and effort are graded as follows.
Grade 5: Muscle contracts normally against full resistance.
Grade 4: Muscle strength is reduced but muscle contraction can still move joint against resistance.
Grade 3: Muscle strength is further reduced such that the joint can be moved only against gravity with the examiner’s resistance completely removed. As an example, the elbow can be moved from full extension to full flexion starting with the arm hanging down at the side.
Grade 2: Muscle can move only if the resistance of gravity is removed. As an example, the elbow can be fully flexed only if the arm is maintained in a horizontal plane.
Grade 1: Only a trace or flicker of movement is seen or felt in the muscle or fasciculations are observed in the muscle.
Question 4: Also during that test series I noticed the procedure looked a lot like applied kinesiology. Some of the problems with kinesiology were; patients and practitioner falling prey to the ideomotor effect, placebo effect and confirmation bias. It seems that your test would also have these same problems, how do you control for these effects in your practice?
Applied Kinesiolgy (AK) is a method of evaluation and treatment originated by George Goodheart, D.C., and iscurrently updated and regulated by The International College of Applied Kinesiologyhttp://www.icak.com/.
AK is a method I utilize in my practice. AK does have its detractors, however I feel it is a good method to assist in completing the patient examination experience, in some, although not all cases. AK, in and of itself, in my opinion, is not entirely sufficient in determining total patient status. AK is a tool in the examiners toolbox. One tool, weather it something as empirical as a blood test, or as abstract as the most speculative AK test, is merely a piece of the puzzle of human examination. Some of the AK tests are exactly the same as the Muscle Testing and Grading tests. Therefore, they look the same - because they are.
Question 5: In your presentation you mentioned that chiropractors do not treat deafness. I noticed in a quick web search that one of the conditions that Frank M. Painter, D.C. says responds well to chiropractic is deafness (http://www.chiro.org/research/ABSTRACTS/Conditions.shtml#Conditions) Also there are other conditions, like blindness, colic, asthma/allergies that defy logic in using spinal manipulation as treatment. Also disorders like autism and ADD/ADHD are psychological conditions that have a neuro-chemical basis for most treatment options. Can chiropractic treat these conditions? If not, how would you address people in your field claiming to be able to treat these conditions?
Chiropractic’s Founder, Daniel David Palmer discovered chiropractic on Sept 18th 1895, when he “racked” his janitor’s spine into place.The next day the janitor reported his hearing was restored.This is the first recorded chiropractic adjustment.
Once again, chiropractic care does not treat conditions, or cure diseases. Patient’s, as well as some chiropractors,misunderstand this very important concept. Chiropractic adjustments that correct spinal subluxations, allow the innate potential of the body to function without nervous system interference, via spinal misalignment. This allows the main controlling and coordinating system, to function without interference, thereby restoring homeostasis (balance). Generally speaking chiropractors that claim they “treat” certain conditions with chiropractic care, are attempting to advertise to an uneducated public. Most people have the concept of “disease care” in place, when it comes to personal healthcare paradigms. In other words, why go to the doctor unless you have a problem? Chiropractors can address potential patients at their level of understanding. Please see my website to see how most chiropractors, including myself, do this, without making the claim that they treat or cure conditions. http://www.watsonchiropractic.com/conditions.htm
Question 6: Finally, there have been a number of studies looking at the safety of chiropractic manipulation, a concern that has been raised is in regards to the manipulation of the spine and an increased risk of stroke. What information do you have regarding the safety of chiropractic manipulation in general and to the neck in particular? Do you brief your patients on the risks associated with chiropractic care and if so what do you tell them?
Spinal adjustments (manipulations) have a very low risk of associated iatrogenic (physician or procedure induced) disease. The incidence of stroke from chiropractic adjustment (manipulation) is 1 to 3 incidents per million treatments. One can merely compare malpractice rates of chiropractors, with any other physician, and determine the risk is very low. In addition, there have been numerous “stroke” type studies. Of the studies performed that I am aware of, all have found the incidence of stroke to be extraordinarily low - however not, non-existent. All health care does have a risk associated with it, even chiropractic care, albeit extremely low.
There is population of patients that have a higher risk of stoke secondary to chiropractic adjustment (manipulation). Those with diabetes, over 60, a history of arteriosclerosis, or heart disease, need to be screened with George’s Cerebrovascular Test, to determine the patency, and possible hardening of the cervical vertebral arteries. For those with signs associated with vertebral artery hardening, chiropractic adjustments need to modified to include procedures with less amplitude, and less rotation, of the cervical spine
Relevant to your question, is the understanding that there was a campaign to destroy the chiropractic profession launched by the American Medical Association (AMA) in the 70’s. The AMA implemented a campaign to eliminate the chiropractic profession. In their attempt to do so, they disseminated false information to their members, as well as informed their members that if they would refer to a chiropractor they would loose their membership within the AMA. In 1976 chester Wilk, D.C. as well as four other chiropractors filed suit against the AMA and won. Whereas, the 7th US Circuit Court of Appeals found the AMA guilty of conspiracy against the chiropractic profession. http://www.chiro.org/Wilk/
Office news:
Well I’m still here.I had more than a few patients wonder if I moved away when Dr. Campbell moved out next door. And again, when Farmers Insurance agency moved from across the hall to downstairs. And one more time, when the landlord put the building up for sale and sold to a new investor. It’s been quite eventful around here lately. I’m the only business upstairs now. Hopefully we’ll get some new tenants soon. However, it’s not so bad, because unlike last year, we have no parking problems. I’m still operating solo, without employees. This took some getting used to after having employees for many years. However, I am really liking it now. I’m not sure I will go back to the employee thing, as it was frankly more stressful to operate that way. For those who have not heard, Nina, my wife and previous office manager, has been battling breast cancer once again. She has been treating for it since last March, and is doing well.
This hockey season, I am the team chiropractor for the Portland State Vikings. It’s been a pleasure working with this team. They are a bunch of great young men who work their butts off on the ice, and hit the books all week, and weekends too. They just Swept the Idaho Vandals last weekend. Come out and see them sometime at Valley Ice Arena. It’s great action and makes for a fun night. http://psuvikingshockey.com/schedule/schedule.html
As you may know, I had spent much effort and time on a redesigned website and launched it last June. Well, sometimes life can teach you a lesson or two, and that was one of them. It was a disappointment really. The darn thing looked good but was slow as a snail, and did not come up on phone browsers worth a dang. I finally said good-bye to the website and killed it in cyberspace, along with my disappointment. I came up with a new website in about an hour, and it’s simply effective, and it’s fairly good on a phone browser. A lot of my patients are now using their phones to make appointments - crazy huh?. I also loaded a Twitter widget onto the home page, and if I’m running late to the office, or traffic is bad for patients getting to the office, I can update it. This way you can have a current update on anything that may seem pertinent to the office. Ain’t technology amazing! Oh yes, you can follow me on Twitter if you like, however you might be quite bored doing so. I’m also on Facebook, things are much more exciting there. At first I thought I would not use Facebook for patients since it’s all about “friends”. However, after some patient’s “friend requested” me, I said what the heck.
Holiday Hours:
I will be on a limited office schedule the week before Christmas, and New Years. I will be here Monday’s and Wednesday’s from 10AM to 6PM, only for those two weeks. For those who may not know, my standard office hours are 10AM to 6PM Monday through Friday.
High Heels:
It’s official, high heels cause pain. Oh yes, there’s a study now to prove it. American Orthopaedic Foot and Ankle Society published it, and in a nutshell, they hurt the feet. Recommendations include heels under two inches, and try to save high heels for special occasions.
Erectile Dysfunction: Oh no! E.D.? Bummer - you need Viagra. At least that’s what Pfizer Pharmaceutical would like you to think if you are a male over 40. When I graduated in 94′, “erectile dysfunction” or “E.D.” was not even in the medical nomenclature. The term back then was “impotency”. Dysfunction was not associated with occasional impotency over 40, it was just part of the normal aging process. Testosterone levels start dropping at 40. It’s NORMAL! Thank goodness too. Having a kid at 40 means you would be raising them until your 58. Now I’m not saying that’s a bad thing at all, but I am saying that it is harder to take care of those youngins, the older you get. Mother Nature has a way of working things out. E.D. is a marketing term created by the pharmaceutical companies to make you think there is something wrong with you, so you buy their stuff. Of course if your looking to have a good time, that’s different. . But the reality is…sexual activity can lead to children. Can you imaging having a kid when your 50 or 60? Holly macrel! Poor kid, who’s he/she going to snowboard with.
Responsible Healthcare: Oh boy, here’s my two cents, on this really hot topic. I’ll draw from personal experience. My wife Nina went through cancer treatment several years back, we had insurance. The cost was amazing, we paid a lot out-of-pocket. This time we do not have insurance, we pay cash, negotiate all the fees, and it costs less then our out-of-pocket expenses, when we had insurance. When you leave it up to the doctor’s and insurance companies to determine fees, your portion of payment being 20 to 40 percent, depending on the plan, can be a very expensive thing. You can even end up paying more than your ‘agreed to’, percentage, as many times an insurance company determines a procedure or service is not a covered benefit. They also like the term “medically unnecessary”. Now if your medical doctor thought it was necessary for you to have the procedure, then how can it be medically unnecessary? That term needs to be changed to something more accurate, maybe “greedy insurance company profit”, or “careless managed care kickback”, yea both are more fitting. I guess the old adage is true, “When you are not at the table, you are on the menu”.
Today I see in the Oregonian, that the Senate has now dropped the public option portion of the drafted health care bill they are working on. That’s not good, not at all. We need fees to be exposed to all. Patients need to be at the negotiation table. We need a public option. Insurance companies need to be regulated. Hospitals and doctors need to be regulated. We need tort reform. It’s way out of hand, believe me, waaay out of hand. Fixing this thing by making the current insurance system mandatory for all citizens, is not going to fix the problem. It will exacerbate it. The current insurance industry will have a boon upon tax payers dollars. They already do quite well. Have you noticed the tallest buildings in nearly each and every city in the United States are owned by insurance companies. Essential what’s largely on the table in Washington is a tax to pay for a system that is based on corporate greed promulgated mostly by the insurance companies. Sure doctor’s and hospitals are part of the problem as well. I’ll give it this ratio, 80% Insurance Company Problem, 20% Hospital/Doctor Problem, and I add this - it’s 100% a problem of each and every citizen of this country.
What can you do? Next time you go to the doctor ask what it will cost you. Find out what will your insurance company will pay for. If you can, negotiate your fees and pay cash. Contact your US Senators, and US Representative, with your concerns and opinions. Most of all take personal responsibility.
Office Specials:
All offers good thru January 15th, 2010, and you must present this newsletter to receive discount.
All first day services including X-ray (if necessary) for $96.00.
Two adjustments with examination for $56.00, for returning patients who have not been in the office within the last three months.
20% discount on all supplements and supplies.
Gift certificates can be purchased for $56.00 for new patients, to include an exam and treatment (not including x-ray), and $28.00 for returning patient adjustments. Limited to only one new patient certificate, and two returning patient certificates per purchaser. This offer may not be redeemed by the purchaser.