Terry A. Rondberg, DC | Wellness for Mind and Body

by Terry A. Rondberg, DC

Based on my previous articles on the subject, it’s clear there is a lot of interest about chiropractic neurology. What’s it all about? I’m posting this blog in frequently asked question (FAQ) format to ensure you can quickly find the answers you need.

Q. What’s chiropractic neurology?

A. According to the American Chiropractic Neurology Board (ACNB), chiropractic neurology is defined as “the field of functional neurology that engages the internal and external environment of the individual in a structured and targeted approach to affect positive changes in the neuraxis and consequent physiology and behavior.”

Q. So what does that mean in plain English?

A. It means that a chiropractic neurologist examines how the nervous system is functioning (or malfunctioning). If the system is out of balance, chiropractic treatment focuses on repairing the imbalance, such as vertigo, Autism, attention deficit disorder (ADD), to restore the patient to health.

Q. What others types of disorders can chiropractic neurology address?

A. Chiropractic neurologists may treat the above conditions, as well as dizziness, disequilibrium and imbalance, dystonia, tremors, chronic pain syndromes, back pain and movement disorders. They may also treat behavioral disorders such as Tourette’s Syndrome, as well as changes in personality or motor, sensory or cognitive impairments resulting from head traumas, accident injuries, traumatic brain injury (TBI) and mild TBI.

Q. So what’s the difference between a chiropractic neurologist and a medical neurologist?

A. According to the ACNB, the chiropractic neurologist provides the same manner of consultation as a medical neurologist, with the major difference being that the therapies and applications are performed without the use of drugs or surgery. So, a medical neurologist or neurosurgeon will prescribe medications, injections or brain surgery to correct a disorder or condition. On the other hand, the chiropractic approach is to therapeutically change brain and nervous-system function.

Q. How is a chiropractic neurologist different than a “traditional” chiropractor?

A. Most chiropractors are trained in the detection and correction of spinal dysfunction. But spinal function is just one of many influences on the nervous system. A neurologist not only has completed the doctor of chiropractic program, but must receive three years of additional training and testing to become a board-certified neurologist in the chiropractic profession. The extra training is specific to the field of neurology and includes the study of neurophysiology and clinical and diagnostic techniques.

Q. What are the benefits of chiropractic neurology?

A. Simply put, many conditions of the brain and nervous system do not respond well to aggressive interventions such as drug therapy or surgery. Both drugs and surgery are often associated with increased risks for serious complications or dangerous side effects. Thus, the approach taken by chiropractic neurologists can be highly beneficial in treating brain and nervous system disorders using safe and effective methods with lasting health benefits.

As most of my readers know, I regularly point out biased claims from organized medicine (often parroted by the mainstream press) that chiropractic is not supported by research. That’s why it’s always welcome news when studies are published that DO point out research proving the effectiveness of chiropractic.

The latest, a report published by Australia’s Cochrane Collaboration, confirms what may seem obviously to chiropractors and their patients — that chiropractic can be effective in helping people overcome low-back pain.

The research, led by Bruce Walker, DC, of the Murdoch University School of Chiropractic and Sports Science in Australia, analyzed a number of different techniques provided by chiropractors. Walker and his colleagues at Murdoch studied 12 randomized controlled trials that included 2,887 participants. Each trial compared combined chiropractic interventions to some other therapeutic approach to low-back pain.

The result: in the short-term (within one month after the study began), pain improved in patients treated both with chiropractic and comparison treatments. Benefits were somewhat greater in the chiropractic group , although the difference was not considered “clinically significant,” the study’s authors wrote.

“If consumers have acute or subacute back pain they can have some confidence that if they go to the chiropractor they’ll see some improvement,” Dr. Walker reported.

References: Walker BF, et al. Combined chiropractic interventions for low-back pain (Review). Cochrane Database of Systematic Reviews. Issue 4, 2010.

About the Author – Terry A. Rondberg, DC
Dr. Terry Rondberg is an outspoken supporter for research on chiropractic care for not just back pain, but total body wellness. He is founder and CEO of the World Chiropractic Alliance, and is a much sought-after speaker worldwide on the issue of drug-free chiropractic.

Tragic news yesterday as a 23-month-old girl died following an overdose of a blood thinner (Heparin) at Nebraska Medical Center. The story says “hospital officials are investigating,” but we already know what they will discover. This tragedy was preventable.

Just ask actor Dennis Quaid. It was announced today that he is starring in a new documentary to help raise awareness about medical errors — three years after his newborn twins were given a drug overdose (also happened to be Heparin) at an L.A. hospital — which almost killed them.

Following is an article I wrote a few years back on medication errors. It’s a sad commentary on our healthcare system that these errors are still so commonplace. Prescription errors are so prevalent in hospitals and long-term care facilities that it has been estimated an average of one mistake per patient per day is made. Of course, most of these errors are not so serious as to lead to serious injury or death, but just ask yourself: are non-lethal errors any more acceptable?

-Dr. Terry Rondberg

Hospital admission = medication errors

By Terry A Rondberg, DC

According to an article appearing in the Archives of Internal Medicine, hospital admissions commonly produce medication errors, some with the potential to be harmful. Background information pointed out that although the admission process routinely includes a medication use history, errors in the history may mean a failure to detect drug-related problems, or lead to interrupted or inappropriate drug therapy during a patient’s stay.

While previous studies had suggested these errors are a potentially serious safety issue, the current study was designed to identify unintended discrepancies between physicians’ admission medication orders and a comprehensive medication use history, and the potential clinical significance of the discrepancy.

Patricia L. Cornish, BScPhm, of the University of Toronto, and colleagues screened medical charts from three months of admissions to the general internal medical clinics at an affiliated hospital. One hundred and fifty-one patients were included in the study who reported use of at least four medications and were either able to communicate or had a caregiver who could communicate for them.

A pharmacist or trained pharmacy or medical student visited patients after allowing 48 hours for clarification of admission medication orders and corrections of problems in the normal course of care. The team member conducted a thorough history of the patient’s regular medication use, relying on a patient or caregiver interview, an inspection of prescription vials, and follow up with a community pharmacy.

Discrepancies between physicians’ admission medication orders and the follow-up history were divided into four types of discrepancies: a drug omission, incorrect dose, incorrect frequency of dose, and an incorrect drug.

These were then further judged to fall into one of three classes of potential severity: Class one – unlikely to cause patient discomfort or clinical deterioration; class two – having the potential to cause moderate discomfort or clinical deterioration; and class three – with the potential to cause severe discomfort or clinical deterioration.

53.6% of patients had at least one unintended discrepancy.

“We identified 140 unintended discrepancies among these 81 patients,” wrote the authors. “The most common error (46.4%) was omission of a regularly used medication. Most (61.4%) of the discrepancies were judged to have no potential to cause serious harm. However, 38.6% of the discrepancies had the potential to cause moderate to severe discomfort or clinical deterioration.”

The authors concluded: “The data presented herein suggest that the processes for recording medication histories on admission to the hospital are inadequate, potentially dangerous, and in need of improvement. To improve patient care and minimize the potential costs of preventable adverse drug events, the health care system should explore ways to improve the accuracy of the hospital admission medication history.”

SOURCE: Patricia L. Cornish; Sandra R. Knowles; Romina Marchesano; Vincent Tam; Steven Shadowitz; David N. Juurlink; Edward E. Etchells: “Unintended Medication Discrepancies at the Time of Hospital Admission,” Archives of Internal Medicine, 165:424-429.

by Terry A. Rondberg, DC

The media constantly communicates to its vast audience the recent medical breakthroughs. Traditional medicine dominates our society. The recent medical mishaps such as dangerous prescription painkillers, are associated with the failures of regulators who ignore the apparent loopholes of allopathic medicine.

However, alternative health care is gaining attention. It is commonly utilized by the general population. A recent study by Hong at Ohio State University found that nearly three out of four adults over age 50 use some type of alternative medicine. Hong noted, “The most commonly used…was chiropractic, which about 43% of respondents had used.” [1]

Unfortunately, the general public is unaware of chiropractic’s potential contribution to overall wellness.

According to the results of the World Federation of Chiropractic (WFC) survey titled, “Identity of the Chiropractic Profession,” only five percent of participating DCs believed the public considers that chiropractors are doctors who correct subluxations, while 81% believe the public defines chiropractic as doctors who help treat back and neck pain.” [2]

Eighty‑five percent of the chiropractors said the nervous system is essential to the practice of chiropractic, and 65% indicated the public should define chiropractic as stress and  subluxation correction.

In 2003, the Institute for Social Research at Ohio Northern University conducted a survey of  North American chiropractors.  The results showed that 89.8% of respondents felt adjustments should not be limited to musculoskeletal conditions and 88.1% felt that the term vertebral subluxation complex should be withheld. [3]

Some chiropractors have expressed that the public perception should identity the profession. Others wish to limit our role to musculoskeletal pain practitioners, justifying their position by claiming that only low back pain has sufficient research evidence and backing. Both sides are incorrect for reasons I have discussed elsewhere. [4,5]

A successful public relations approach should match the public’s interest with our vision of chiropractic. It is necessary for the public to be properly educated on how chiropractic meets their needs.

The success of this strategy came to light when Dr. Madeline Beherendt’s study on infertility was published in the Journal of Vertebral Subluxation Research, (JVSR) which resulted in positive and credible media coverage for chiropractic.

Among the television programs reporting the study’s results were: KBCI Boise, WCBS New York, KING Seattle, KYW Philadelphia, WTNH New Haven, KUTV Salt Lake City, WCPO Cincinnati, WOAI San Antonio, KOLD Tucson, and KPTM Omaha. On one of the specialized health news wire services, the press release was accessed by journalists more than 700 times by the end of March. [6]

Furthermore, Dr. Erin Elster, an upper cervical chiropractor in Boulder, Colo., gathered data from 44 MS patients and 37 PD patients treated during the span of five years. After treating upper neck injuries in 81 patients, 91% of MS patients and 92% of PD patients improved, suggesting that correction of neck injuries may reverse MS and PD.

The Chiropractic Journal reported, “The World Chiropractic Alliance (WCA), publisher of JVSR, distributed a press release on the research results, which was quickly picked up by major news media, including Reuter’s wire service. The news was relayed to newspapers and television stations around the world, and the story showed up in a wide array of media.

“Viewers watching CNN coverage of the Florida hurricanes saw the headline scroll by on the late breaking news crawl … readers saw all the details in The Washington Post … Internet browsers found the story on sites as varied as the National Institutes of Health’s MEDLINE and the Armenian Medical Network. Yahoo News featured the story and it even appeared on the Merck pharmaceutical company’s website.

“Within days, millions of people were exposed to information about chiropractic and how correction of subluxations might result in an improvement or reversal MS and PD. Although the research examined the two specific diseases, the press release emphasized that the role of chiropractic was not to diagnose or treat those diseases directly, but to correct subluxations and, in doing so, affect the progress of the diseases.” [7]

More recently, a collaborative study of chiropractic care, oxidative stress, and DNA repair has peeked the interests of medical news services and alternative health websites. [8, 9]

The public and journalists are not interested in “manipulation” for the treatment of low back pain. However, they are interested in learning about chiropractic as a focal point on wellness and quality‑of‑life issues often neglected by traditional medicine.

The answer is university-based research and not just a few studies focusing on small case histories. Although encouraging, a long‑term solution must be implemented. The university based research, should involve thousands of patients, and published in prestigious, medical journals. The group QOLR has embodied this challenge but your assistance is paramount.

References

1. Hong G‑S: “About 70 percent of older adults use alternative medicine.” News release. Ohio State University . April 9, 2005.
2. “Consultation on Identity: Quantitative Research Findings.” World Federation of Chiropractic, Dec. 7, 2004.
3. McDonald W, Durkin K, Iseman S, et al: “How Chiropractors Think and Practice.” Institute for Social Research. Ohio Northern University. Ada , OH . 2003.
4. Kent C: “A challenge and three myths.” The Chiropractic Journal. September 2004.
5. Kent C: “Where are we going?” The Chiropractic Journal. August 1997.
6. “Infertility research still a top news story in U.S.” The Chiropractic Journal. May 2004.
7. JVSR, WCA hit two more publicity home runs. The Chiropractic Journal. October 2004.
8. “Chiropractic Influence on Oxidative Stress and DNA Repair.” Medical News Today. March 7, 2005.
9. “Doctors crack code on chiropractic care.” Mercola.com. 4/27/05.

About the Author – Dr. Terry Rondberg
Terry A. Rondberg, DC, is a tireless advocate for drug-free chiropractic, chiropractic patients, wellness, and the mind-body connection for physical, mental, emotional and spiritual well-being. As CEO of the World Chiropractic Alliance, he is a global activist for the interests of doctors of chiropractic and their patients.

By Terry A Rondberg, DC

Months following spinal surgery for back pain, patients remember their initial pain as worse than they rated it at the time, reports a recent study in the journal Spine.

A research team, headed by Dr. Ferran Pellisé of Hospital Vall d’Hebron, Barcelona, Spain, concluded that studies relying on such after-the-fact ratings may overestimate the effectiveness of spinal surgery in relieving chronic back pain.

The researchers studied before-and-after ratings made by 58 patients who underwent lumbar fusion surgery for chronic low back pain. Before their operation, all patients completed standard evaluations of back pain and related disability. These prospective (“forward-looking”) ratings were compared with retrospective (“backward-looking”) ratings made an average of three years after surgery.

Patients consistently rated themselves worse than in their original questionnaires, when recalling their preoperative state. For example, on a simple 10-point scale, the patients’ original average pain rating was 7.0. On follow-up ratings, the patients recalled their pain as being significantly worse, with average rating of 8.2.

Based on the original ratings, surgery produced an average pain reduction of 3.3 points on the 10-point scale. Yet, if the recalled ratings were used, the average improvement would have been 4.6 points. Similar patterns were noted for other standard ratings of back pain and related disability.

Whether the time since surgery was shorter or longer, the extent of patient recall bias did not differ significantly. The ratings did not vary in any systematic way, so there was no way to adjust for them statistically.

Retrospective studies – in which patients are asked to remember and rate their state of health before treatment – are widely used in medical research. Few prior studies, however, have looked at how patients’ recollections measure up to actual pretreatment ratings. The use of retrospective studies to assess the results of spinal surgery has increased in recent years.

Relying on such after-the-fact pain ratings may give the impression that surgery for back pain is more effective than it actually is, the new results suggest.

“Our study shows that relying on a patient’s recall of his or her preoperative status a few months or years after surgery is not a valid method for establishing baseline status when treating low back pain,” Dr. Pellisé and colleagues concluded.

SOURCE: “Reliability of Retrospective Clinical Data to Evaluate the Effectiveness of Lumbar Fusion in Chronic Low Back Pain.” Pellise, Ferran MD; Vidal, Xavier MD, PhD; Hernandez, Alejandro MD; Cedraschi, Christine PhD; Bago, Joan MD; Villanueva, Carlos MD. Spine. 30(3):365-368

About the Author – Dr. Terry Rondberg
Terry A Rondberg, DC, is a tireless champion for drug-free chiropractic and mind-body wellness. As publisher of The Chiropractic Journal, on a monthly basis he reaches more than 70,000 chiropractors across the globe.