Chiropractic care and nursing ?

ANSWER:
I do rehab nursing with injured workers. Research shows that chiro for back injury is no better, and sometimes worse, than "traditional" conservative treatment, ie, early mobilization (like walking and resumptionof normal activity), with strengthening and stretching exercises and teaching about prevention, exercise, and mobilization.

That said, I know a few (precious few) chiros who are good therapists, ie, they do not hold themselves out as the only way to treat, and do not let the patient feel that only passive treatments will restore functional capacity. These guys are into exercise and posture and get their pts better by the 'traditional" approach in heavy doses along with the manipulations. They are also good at recognizing more serious problems and referring out prn. I had one guy pick up a set of spinal bone mets from an occult tumor primarily from taking a good history (the lady had night pain and subtle wt loss too)-- a real coup, and god bless him for not blathering on about subluxations and shark cartilage. He turfed her immediately to an ortho for CAT and thence to oncology.

Do I send pts to chiro as a first resort? No, because I get more rapid and reliable response with a good physiatrist and PT. But I cannot tell a pt with whom to treat, and if they insist on a chiro I make sure they go to someone who will keep them active and recognize more serious problems if they are present.

I am a chiropractic student and I would like to disagree with the above statement. First of all, your reference to scientific research is missleading. True, at the present time findings are conflicting, but I can present as much if not more american and international findings that show great benefits of chiropractic care then the ones that don't. There is not enough research done yet to make any serious scientific conclusions. NIH spends billions of dollars every year for medical research, and only resently they offerend a pittifull sum (by research standards) to chiropractic community. Nevertheless, in the past few years, chiropractic research has really picked up and we will see the results relatively soon.

Again, I have to disagree. First of all, I can say that nobody in our chiropractic school is teaching us that "we are the only way", i think it becomes more and more the thing of the past. I agree, that there are some pretty conservative chiropractors, and I , as well as the great majority of chiropractors disagree with them. We believe that that give a bad rap to our profession

Again, I respect your oppinion, and I just felt that I can express my own oppinion here. I believe in chiropractic, that's why I have choosen it as my career. More and more people in US and in the World belive in Chiropractic , what is why medical comunity is a bit confused with how to deal with it. It is funny to see how AMA, medical schools, medical media, and individual M.D.s are toren between deciding to either join in or destroy chiropractic They tryed to destroy us for many years, untill they were found guilty by the Supreme Court of the USA. Now as more and more chiropractic litrature, resereach, international interest, domestic acceptance, and government support becomes available, medical establishment is organizing another compaign thought the press, I am afraid, it's a bit too late

I find it difficult to believe that you are, in fact, a student in a reputable DC program. Your written language is "pittifull" (sic). Nice try, though.

I did not state that chiro care is of no benefit. I said that large-scale studies, in which DC's participated and whose names are on the papers, show that in most back injury DC care is of no more utility than traditional PT and resumption of normal exercise and activity pattern. No less, perhaps, but no more.

I am glad to hear that you feel that chiropractic is no longer taught as a completely passive experience for the patient, and that kinesiology and active therapy (as opposed to passive modalities and adjustments only) are necessary parts of recovery from back injury. There are still, however, far more DC's who practice in this manner than those who do not, in my professional experience.

I also hope they teach better documentation. Most of the stuff I get is garbage, completely in codes and incomprehensible to a reviewer.Even the neurologists can do better than that! And there's too much reliance on the Oswestry questionnaire and hardly ever any Waddell's testing in much of the documentation I get. Makes one wonder how much care is being given for the billing received.

For references on meta-analysis of back care protocols, I refer you to the 'Net. You will find quite a few out there.