Friday, August 9, 2013

The Journal of the American Medical Association suggests Chiropractic care for lower back pain

The AMA has recently released an article finally determining Chiropractic care to be patient's first decision in dealing with back pain over other convention methods, namely Drugs and surgery. For years the American Medical Association was the sole force attempting to demonize and do away with Chiropractic and alternative care. Now in 2013, an article has been published in their Medical journal suggesting otherwise. For half a century, the American Medical Association waged war against chiropractic, an intervention that relies on spinal adjustments to treat health problems. Chiropractors were regarded as the modern-day equivalent of snake-oil salesmen. Today, chiropractors are the third largest group of health care providers, after physicians and dentists, who treat patients directly. AMA policy now states that it is ethical for physicians not only to associate professionally with chiropractors but also to refer patients to them for diagnostic or therapeutic services. "In the last decade of the 20th century, chiropractic has begun to shed its status as a marginal or deviant approach to care and is becoming more mainstream," said Paul Shekelle, M.D. and director of RAND's Southern California Evidence-Based Practice Center. He played a key role in RAND's landmark investigations of chiropractic that stimulated a national reappraisal of this and other nontraditional health care approaches. What led to the change in attitude toward chiropractic? Major events included: •The 1990 U.S. Supreme Court decision on a lawsuit, known as the Wilks case, that found the AMA and others guilty of illegal conspiracy against the chiropractic profession. •Recognition by the established medical community that most medical therapies for back pain are ineffective. •RAND's 1992 groundbreaking analysis of spinal manipulation that showed this intervention does benefit some people with acute low-back pain. This study directly influenced the Agency for Healthcare Research and Quality to include positive recommendations on spinal manipulation in its 1994 clinical practice guidelines on low-back pain. This federal agency issues such guidelines to help the medical community improve the quality of health care in the United States. Chiropractic: Then and Now Chiropractic, a term used both as a noun and adjective, comes from the Greek and means "done by hand." The practice originated in the late 1890s with Daniel David Palmer, a self-taught healer in Iowa who sought a cure for illness and disease that did not rely on drugs or surgery. Palmer reported curing deafness in a man who had lost his hearing after straining doing heavy work. Palmer attributed the hearing loss to a displaced vertebra and treated it by adjusting the man's spine. Based on this and other cases he treated with spinal manipulation (also called spinal adjustment), Palmer advanced his theory that most disease is caused by misaligned vertebrae that impinge on spinal nerves. Such misalignments are called subluxations. According to Palmer, correcting these misalignments reestablishes normal nerve and brain function and allows the body to heal itself. Today, only a small fraction of chiropractors believe that their treatments can substitute for traditional medicine to care for all illness and disease. Many practitioners focus on musculoskeletal problems of the spine, that is, conditions affecting the backbone and associated muscles. In fact, most people go to chiropractors for low-back pain. Chiropractors most commonly adjust the spine by using their hands to apply forceful pressure, known as a high-velocity thrust, on areas that are out of alignment or that do not have normal range of motion. Sometimes this causes an audible "pop." At times, a chiropractor will do an adjustment with an instrument called an activator. Practitioners also use mobilization (manual therapy that does not involve a high-velocity thrust) as well as physical therapy. Although spinal manipulation is the key component of chiropractic care, most practitioners take a holistic approach and include such things as nutrition counseling and exercise advice in their treatment program. In order to be called a Doctor of Chiropractic Medicine (DC), practitioners must graduate from one of the 16 chiropractic schools currently accredited by the Council on Chiropractic Education. Before chiropractors can practice, they must be licensed by their state. All states require them to pass the National Chiropractic Board examination. Chiropractic services are covered by most health insurance plans, including Medicare. However, conflict between the chiropractic and medical communities continues over such issues as limitations on insurance reimbursements for chiropractic services and allowing health care providers other than chiropractors to do spinal adjustments.

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